Written by Christopher Kelly
Sept. 15, 2015
[0:00:00]
Christopher: We are live. Hi, everyone.
Tommy: Hello.
Christopher: This is me, Christopher Kelly, and this is Dr. Tommy Wood.
Tommy: Hi.
Christopher: Hopefully, some people should start coming in soon. I know there's sometimes a bit of a delay for people getting into the room. Oh, yeah, five attendees. So, if you can hear us talking, it would be really helpful -- If you look to the right hand side, you'll see there's a chat box. So you could let us know that you could hear us. That would be really helpful.
Tommy: Yeah.
Christopher: Oh, here we go. Hi, Brad. Hi, Mark. Excellent. I'm always a little bit worried about this technology or any technology actually for that matter that it's somehow going to fail. We'll just wait for a couple of minutes and allow people to get in. Sometimes there's a bit of a delay people getting on. Still waiting for Tawnee as well. [0:01:36] [Indiscernible] It's all I talk about all day long now. It's like I have a Bristol stool chart on my wall here.
Tommy: That's your real area of expertise.
Christopher: It is, yeah. It's all connected though, the blood chemistry and poop. We'll get to that. Tawnee Prazak.
Tawnee: Hey. Sorry about that, guys.
Christopher: No problem. Hi, Tawnee.
Tawnee: Hi. I can't see.
Tommy: Hello.
Christopher: Tawnee, this is Tommy.
Tawnee: I can't see anything yet. Okay, there you are. Hi. Good to meet you.
Tommy: Hi. Good to meet you too. Gary says one of us needs more flattering lighting. Gary, who needs more flattering lighting? Probably Tawnee. He probably wants to see Tawnee. He definitely doesn't want to see us.
Christopher: Yeah, you don't need to see me. I think it's me actually. I'm in the redwood trees here in Santa Cruz and it's kind of dark outside even though it's a very, very sunny day.
Tawnee: I just actually recorded my first ever video podcast with Abel James Fat Burning Man and he was telling me too. He's like, "You need to get lights over there and over here." And I'm like, "Yeah, I don't really do the video thing yet, just the audio."
Christopher: Yeah, the audio is a lot less intimidating.
Tawnee: A little bit. I have to get all dolled up.
Christopher: So why don't we go ahead. Why don't you introduce yourself, Tawnee?
Tawnee: I'm Tawnee Prazak. I'm the host of the Endurance Planet podcast, which focuses on bridging that gap between health and performance for endurance athletes and I got to know Chris through my own journey and my highs and lows in health and as an endurance athlete. I've been doing triathlon for almost a decade of my life and in that time had some really awesome times of great races and great experiences but also when I look too far at times and suffered with health and entered Chris and we've been friends now for over a year and he's helped me a ton of just understanding more about getting things back, maybe longer than a year.
And as a result, sort of being kind of like a journey where I've taken my own example and experiences to really turn this into I feel like something is my calling to help other endurance athletes navigate what sometimes can be complicated. Because it's not just about the training and this health stuff to me whether you're a hardcore athlete or not, it's just of the utmost importance for all of us. In a nutshell, that's kind of it. And I coach too.
Christopher: The podcast is fantastic. I subscribe to a lot of podcasts but yours is the one that I always listen to every time there's a new episode.
Tawnee: Thanks. I appreciate that. We're actually going to have Dr. Tommy on here in a couple of weeks.
Tommy: Yeah. I'm looking forward to that.
Tawnee: Yeah.
Christopher: Excellent. So why do you do the same then, Tommy. Tell us who you are.
Tommy: Sure. I am a fellow Brit. I did a biochemistry degree first a long time ago, then I went to medical school. During both of my degrees, I spent more and more time getting into training. I was particularly a rower. And then more coaching. Then I also, sort of as my rowing career finished and I was doing more coaching, I moved more into endurance sports. I did a lot of marathons, ultra marathons.
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The only triathlon I ever did was a 24-hour off road iron man. And so since then I've gotten into the Paleo side of things and trying to use my biochemistry background and medical background and trying sort of help people. I have a blog. I also have a podcast. My day job, I'm a Ph.D. fellow. I'm currently researching ways to treat babies with brain injury but sort of the ways that nutrition and biochemistry and all that stuff come together.
Actually, a lot of these things sort of we're trying to fit together nicely. And through my blog and my podcast, I've got to know Chris and I've done his podcast a number of times. And he and I continuously throw ideas backwards and forwards about how we can help people particularly in the endurance arena. I try to help Chris boost his performance as well in various ways. So, that's where we get to today.
Christopher: Excellent. Yeah, I can tell you that Tommy is the doctor that you're never going to find. When I first started out as a, I guess I was an amateur cyclist then, really hoping to find a doctor that would help me get that performance boost, I thought I'd fine one and I never did. It was only after I kind of fixed most of my problems and started the podcast and Nourish Balance Thrive and all the rest of it did I meet Tommy and that's when I realized, "Oh, this was the guy that I needed to meet three years ago." It's kind of frustrating.
Tommy is still been an amazing coach and one of the things -- Later on, I will be showing you how you can work with both me and Tommy with blood chemistry to help improve your performance. That's kind of been -- One of the things that's been instrumental to me is understanding that you can get so much faster without doing any more training by understanding the biochemistry. Tommy is the guy you need to listen to if you want to get quicker without doing 30 hours of training per week, I think.
But, yeah, what don't I tell you I get started with this -- I've got a little, a few slides here. I really wanted to show you this because it kind of captures the moment when I realized that I needed to start paying attention to my blood test. And this is the climb, the Downieville Classic Mountain Bike Race. And it's one of the biggest mountain bike events on the west coast here in California. This climb starts at 4,000 feet and it goes up to about 8,000 feet, I believe. Huge climb over eight miles.
I mean, I'm sure everybody listening to this has done an event in altitude and it really, really sucks, right? It's kind of just truly apocalyptically awful, like how hard it is to exercise when you're altitude. And I think that was the moment at which I realized how much difference it could make. I've seen some of my blood chemistry and I saw that I was a tiny bit anemic and that most professional athletes had a much higher level of hemoglobin which is this protein that transports oxygen.
And experiencing this climb made me realize how much of a difference it could make if I could only improve the hemoglobin thing then I could be a much better cyclist. And understanding -- Yeah?
Tommy: Sorry to interrupt. I think I can't see your slides and it looks like a couple of -- There's a couple of people -- I can't see them either.
Tawnee: Yeah, that's what I was trying to figure out. I didn't want to say because this is my first time even doing a Google Hangout. So I was like, "Am I doing something wrong?" Yeah, I see nothing.
Christopher: You see nothing? Can you see it now?
Tawnee: I see black.
Tommy: No, it just looks black.
Tawnee: Now, I see Tommy.
Christopher: Let me try again.
Tawnee: Is there a place where we can click to see how many people are in the room right now?
Tommy: Yeah. On the right hand side, you'll see the webinar jam thing and there's a tab which says "room." So there are 21 people with us at the moment. Sorry guys.
Tawnee: Yeah. Okay, I got this.
Christopher: Let's try this now.
Tommy: Try and click through.
Tawnee: Okay. Something good just happened.
Tommy: Try and click again. So people can only see your avatar. They can't even see your face apparently.
Christopher: Really? Google Hangouts fail.
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Tawnee: Darn it. That's weird. Oh, yeah, there's a picture of [0:10:17] [Indiscernible].
Tommy: Oh, we had it for a second there.
Tawnee: That was it.
Christopher: I mean, when I talk?
Tawnee: Yeah, this is like the presentation that just popped up.
Christopher: Okay. So you can see a picture now?
Tawnee: Yeah.
Tommy: Yeah. Yes, perfect.
Christopher: Excellent. Crisis averted. Okay.
Tommy: And can anybody who's with us, can you just tell us if you can see that slide?
Christopher: There's usually 30 seconds delay.
Tawnee: Okay.
Tommy: Perfect.
Christopher: Okay. Photo now. So that's the climb I was talking about. That's me sucking winds. It's actually not me. This is from this year's Downieville Classics, incredible event if you ever get the chance to do it. So, okay. So, understanding this biochemistry thing, working with Tommy, running lots of blood tests probably more than I need to and getting this thing under control was really what it took for me to upgrade from amateur to pro. And, of course, oxygen deliverability is not just something that you need on the bike or when you're running or when you're swimming.
Your cells need oxygen all the time. So if you can improve your oxygen deliverability, there's a chance that you might benefit in other ways too. So right about the time that I first became interested in blood chemistry and oxygen deliverability, I came across this guy called -- I hope I'm not going to butcher his surname there. I think it's Puchowicz. Dr. Michael Puchowicz. He's a sports medicine physician and he has this fantastic blog called Veloclinic, which is a little bit hard to understand.
But he has some really great information there. I think he's an interesting guy. He's trying to develop models to detect doping. So in particular, these cyclists are putting in all these performances that don't appear to be realistic and he's using that idea as a way to catch people who are cheating. And the reason people are tempted to cheat is because blood doping really works. And this is one of the charts that he presents on his website.
And you can see there on the X-axis, at the bottom. HGB stands for hemoglobin. And on the Y-axis there, you can see the O2 max. So, this is the maximum rate at which you can consume oxygen. So if you're a runner or a biker or swimmer, it's super important. And you can see this hemoglobin is protein inside of red blood cells as it increases. You see a linear increase in the VO2 max. Of course, the increase of VO2 max is surely going to affect your running speed.
And then if you're a cyclist, you can see something similar, a similar relationship between the hemoglobin in grams per deciliter here. It's the units. And the watts per kilo. So if you're a triathlete, you will know watts per kilo. And I'm guessing that none of you listening to this, and certainly not me, has ever seen any of the watts per kilo that's on the Y-axis there. So, 5.8 is kind of -- You'd be a really solid pro if you could do 5.8 for 20 minutes.
And seven is the super human category so that's kind of Michael's area of expertise. He's trying to catch people that are using doping techniques to improve the hemoglobin mass. The reason I'm showing you this is just to help you understand that this hemoglobin thing is so, so important. And through my practice -- I now run a practice with another medical doctor and a pro mountain biker. Her name is Jamie Busch.
We've run hundreds and hundreds of blood chemistries now. And we see this consistent pattern where people are not even, they're not even close to being on this chart. So you see here 15.5 grams per deciliter. You're not even going to be on. I don't know what your watts per kilo is but you're not even going to be on the hemoglobin chart. So you can see these are my numbers. And you see the bottom of that last chart was 15. Well, here's me in 2012 realizing that I probably needed to do something about my low hemoglobin.
The red line is the standard reference range. If you've ever gone and had blood drawn with your doctor and I'm sure you have, then this is the reference range that your doctor is looking at. I think it's important to understand what this reference range is.
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And in most cases, this reference range is just the lab themselves, so maybe LabCorp or Quest. They've taken 7,000 of their results or so. And they just calculated the mean or the average value of hemoglobin and then they've set limits to standard deviations either side of the mean. And so that's going to include 95% of all of the people that have ever done the test. And that's it. They've not looked to any studies and said, "Oh, well, this amount of hemoglobin is healthy optimal for anyone."
Really, it's just a statistical calculation. And the doctor, you really have to understand that -- Maybe this would be a good time to bring you in, Tommy. When you run a blood panel on someone and you see -- Say, it's my hemoglobin there. It was just above 13.3, say. What would you be thinking?
Tommy: So, it would depend on when I saw you. So when I was working in [0:16:05] [Indiscernible], if you came in and we did -- In the UK, we're going to do FBC, a full blood count. In the US, it's a CBC. And so you had a hemoglobin of 13.3. I think, great. There's nothing wrong with that. And just because it's within the normal range. But the job of the average doctor, say as a family physician or somebody working in hospital, is to make sure you're not really sick. So make sure that there's nothing really dangerous, nothing I can't fix quickly or make sure to refer you to a specialist to sort it out.
And having a hemoglobin that's within the normal range, even if it's at the lower end, for me, unless I saw any other signs that you are deficient in iron or losing blood or something, I wouldn't -- As a traditional doctor, you wouldn't really worry about that. But when you go back to those charts you were showing, if you can increase you hemoglobin by one gram per deciliter, that's quite a big jump, say you increased it from 13.3 to 14.3.
For you, Chris, that's somewhere between 0.5 and 0.6 watts per kilo. If you weight 70 kilos, then that's 35 watts the threshold, which is a huge increase for literally, if all we've done is just tinker with your diet a little bit or make sure you got some nutrients that you're missing out on. It's a huge jump for literally doing nothing. But it's important to remember that that's not really -- I know you got frustrated when you went see your doctor and you wanted to perform as well as you could because you're a pro mountain biker and he just said, "Well, you're not really sick, so there's not much I can do for you."
That's not necessarily their job to do that. They have a lot of very sick people that they need to see and work with. So then it's on you to find other ways to fix that. And that's something that we're trying to do is trying to find the people with some basic biochemistry to try and just find out what they can tinker with because there's a difference between you might feel good and you might be healthy. But if you want to perform your best then maybe there's some other things you can do.
Christopher: Yeah. And I think that's a really important point to understand is your doctor just doesn't care. Like you can't -- I mean, you can have this test done with the doctor but your doctor really isn't just not his job to care about whether or not you qualify for the Boston Marathon.
Tawnee: Question really quick.
Tommy: Yeah?
Tawnee: Is there a link between the hemoglobin and everything potentially between chronic inflammation or just even acute inflammation for that matter for athletes?
Tommy: Yeah, absolutely. So something I know come up later in Chris' slides, inflammation is acutely linked to both the way that you absorb and store iron, which you need to make hemoglobin. But also to do with the way that you then break down red blood cells. So chronic, I mean, acute inflammation is probably less of a problem and maybe people have a virus or some kind of infection and they get over it and it's probably not that big of deal.
But chronic inflammation, for whatever reason, can do a couple of things. So it can force your body to store more of its iron rather than use it for something like making the heme, which then goes into hemoglobin and the heme binds the iron. So you can actually make less hemoglobin because your body is storing more of it during chronic inflammation. And on the other end, you can also -- The inflammation can damage red blood cells and can mean that they live for a shorter period of time.
So generally, we say that a red blood cell lives for 120 days, about four months, but if there's a lot of inflammation, then we get damaged to, say, the membrane around the red blood cell and then they start to be eaten up by other cells and the spleen or in the lymph nodes macrophages. They get turned over faster.
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So chronic inflammation can actually affect both the production of red blood cells and the breakdown.
Tawnee: Got you.
Christopher: So we'll get to this.
Tommy: Sorry, I jumped the gun.
Tawnee: I think it's my fault.
Christopher: That's okay. No, it's really -- I think it's good to have -- Sometimes I wonder whether I'm making sense. I'm really glad that there's someone there to stop me. So, understanding the blood chemistry, I think it's really important to keep these three ideas in mind. So this picture is a scanning electron microscope image. It's magnified to about 11,000 times of a red blood cell. And one thing I couldn't figure out. What's all that gunk stuck to it, Tommy? Do you know what that is on the red blood cells?
Tommy: Well, I imagine it's probably some fiber in some clothing. Electron micrograph is a black and white picture so they've artificially colored that.
Christopher: Okay, interesting.
Tommy: That's not a colored photograph.
Christopher: Okay, interesting. So if you keep these three things in mind, it covers almost everything. So the goal is to increase your hemoglobin and run faster. The things to keep in mind when you're looking at your blood chemistry is a production destruction and loss. So production refers to making red blood cells and destruction refers to what Tommy and Tawnee were just talking about, which is the premature demise of a red blood cell. Something has happened to it.
And then loss is like you physically lost it. The blood has gone somewhere as in bleeding. And all things, they really fall into one of these three categories when you're trying to debug a blood chemistry. So why don't we get into the production part first? Tommy, can you talk a bit about how the stimulation and red blood cells are even sort of triggered to be produced in the first place?
Tommy: Yeah. So, it's actually a relatively simple system. You can see from the diagram here. So in the bone marrow, you can see on the right, particularly in some of the long bones like the femur and your thigh bone and your leg, you're making blood cells over time from stem cells. And what happens is sort of the precursors for red blood cells, they're actually being produced a lot of the time, but they need a survival factor. So actually you're making them but then something needs to tell them to stay alive and then be released into the circulation. And that thing is EPO, which people will obviously have heard of from like EPO doping, people taking EPO boost performance because it absolutely does.
And EPO is generally made in the kidneys and has made them response to sensing of how much oxygen is being delivered. So if there's not enough oxygen getting to the kidneys because you don't have enough hemoglobin, there's not enough oxygen getting there, then you get upregulation of some factors in the renal cells and the kidney cells. Something that people might have heard of is hypoxia-inducible factor. So, if that gets unregulated and then that causes you to make more EPO. The EPO gets into the bloodstream and the then it goes and then access the survival factor for the red blood cell, the early red blood cells. And then they mature further and then get released into the bloodstream.
Christopher: Cool. These stages of life cycle development with red blood cells, and that's what this diagram shows. I think one of the really interesting thing about red blood cell is they actually get smaller as they mature. So if you look on the right hand side, well, it's a baby red blood cell but it's fully mature. And you can see it's actually physically smaller than the younger ones. And can you tell me anything more about this process, Tommy?
Tommy: Yeah. So, this is basically what's happening. So you have a stem cell and then those stem cells can go into almost any type of blood cell, white blood cells or the megakaryocytes which then produce platelets later on which is the other major blood cell. And then you sort of go down the red blood cell pathway and then you get to the developmental pathway. And then you can see phase one, ribosome synthesis. That's something that's very important that you need things like B12 and folate in this kind of stage because it has to do with making DNA and making proteins.
And then you start to make hemoglobin. And then between phase two and phase three, the red blood cells are released into the blood as something called a reticulocyte. And then you see that the nucleus is released here and eventually matures into just a normal red blood cell which doesn't have a nucleus. And as you go along this, along this process, you do things like you lose the normal organelles for the sort of the various different structures inside the cell and you lose the nucleus then the cell gets smaller.
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And if you get any arrest in this, say, because of nutritional deficiency, then you get a larger than normal red blood cell and that's something we can use to try and figure out whether there's maybe a certain thing missing from the diet or certain type of deficiency that's then causing your red blood cells to be bigger than normal. And that's just because you've arrested the pathway along the way but those cells are still getting released into the blood.
Christopher: So, I think, that's important to point out at this stage. Let me just go to my slide. There we go. This is a very nutrient dependent process. This just doesn't happen spontaneously without any other nutrients. There are nutrients like Zinc, B6, vitamin B12, folate, which is another B-like vitamin, and iron, nutrients that are required to do this, to produce these red blood cells. And if those nutrients are lacking and, I think, athletes are particularly vulnerable to these nutrient deficiencies, then you're going to just have -- It's not going to be able to produce as many red blood cells and so you have less hemoglobin and you just won't be able to run, bike or swim as fast.
So I'm not sure that many people know this but we've actually got to the point where you can measure the availability or how much the need for, say, vitamin B12. And so that at the bottom of the slide, this is what it's showing you. This is a snippet from my test results actually. It's an organic acids test. And the formiminoglutamate is the name of an organic acid. So this is a urine test that I did. And the formiminoglutamate starts to build up in the urine when there's insufficient folate. So it's not a direct test.
It's not measuring the folate in my blood or anything like that. It's just measuring the need for folate through this surrogate marker formiminoglutamate. And you can see mine is not even -- It's not horrible. I see them worse than this every day when I look at these test results. But it's definitely you can see it's up there. For me, supplementing with folate has been super important and very useful for increasing my hemoglobin.
Tawnee: Can you talk a little bit about -- If you guys, either of you have an opinion on supplementing with folate versus folic acid, this is something I was reading recently in Dr. Phil Maffetone's new book and he goes into a whole section of why we should avoid folic acid.
Tommy: Yeah. So the problem with folic acid is the fact that it needs to be activated in the liver before it's actually useful to the body and can be used as folates or [0:27:46] [Indiscernible]. So, the formiminoglutamate is particularly built up if you don't have any tetrahydrofolate, which is a certain type of folate. And when a certain -- So, the problem is that certain people can't convert folic acid into usable forms of folate. And then it can actually almost act as an inhibitor of folate. So not only does it not give you, increase your folate levels in a useful way, it can actually inhibit the folate that you do have.
And that's not the case for everybody but, obviously, people don't necessarily know what their state is so you can do various things like look at your methylation pathways and with DNA test and stuff. But for the general public, you just don't know whether folate, whether folic acid is the one that you should be taking as useful for you. And the problem is that folic acid is actually added to pretty much everything, any kind of fortified flour, most cheap multivitamin have folic acid instead of a more bioavailable form of folate.
Tawnee: Yeah.
Christopher: The takeaway is just to eat real food and buy expensive supplements that have lots of 5-methyltetrahydrofolate. It's the type of folate that I've been taking.
Tawnee: Is that what's in the EXOS multi?
Christopher: It is, yeah. All of Thorne products have. Yeah, that's the one. That's the nice thing about buying expensive stuff from good brands that you trust. You just don't get stung like that later on when you find out--
Tawnee: Totally.
Christopher: The next poisonous thing was in the last meal that you had. I hate that sensation. But this is, I think, super interesting. I kind of let aggression here that -- Tommy and I, we exchange -- Well, we say exchange. Tommy sends me the papers. I read them and learn from them and he's been an amazing educator. I'm really grateful for him for all that. This is one of the latest ones he sent me. Maybe you can talk a little bit about this, Tommy:
Tommy: Yes, sure. Chris, can you just click back a couple of slides to the list of, that list of nutrients that you had?
Christopher: This one?
Tommy: Yeah, that one.
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So broadly, this list of nutrients that are required to get optimal production hemoglobin in red blood cells which can then deliver oxygen to your muscles when you're exercising, they can kind of be split in two. So, the B12 and folate are very important for production of the red blood cell itself. So as the blood cell matures properly and make yourself a sort of a nice healthy normally shaped red blood cell. And the Zinc, B6 and iron are very important for the production of heme.
Heme is an organic molecule that complexes the iron, what I talked about. And it's a structure known as a porphyrin. It's just the name for the type of chemical structure that it is. And in order to properly produce your porphyrin rings, you need things like Zinc and B6 as co factors for that production. And then, Chris, if you just click back to where you were -- So then the interesting thing is that there are certain people who have genetic defects which are known as hepatic porphyria, which basically means that they get a buildup of certain metabolites along the root of the production of the porphyrin ring, which then produces your heme. And the most common one is something called acute intermittent porphyria.
And basically, what happens is one of those enzymes along the way doesn't work properly, so then you get like a backup, a buildup of all the sort of precursors. And what's really interesting is that if you have acute intermittent porphyria, one of the main treatments for an attack is a glucose infusion. Because what they found out is that if you have a high amount of carbohydrate that actually inhibits the first step of the production of porphyrins and heme, so they've done the study which Chris has put a title.
And what they did is they just gave people with porphyrias, they gave them 500 grams of glucose a day, which actually, if you're an endurance athlete and you're eating loads of maltodextrin gels and bread and stuff to power all your workouts, that's 2,000 calories of carbohydrates is actually not that much. And in those people, the first step of the production of the porphyrin ring is almost completely inhibited. So if you're eating a very, very heavy carbohydrate diet, that could actually prevent you producing heme properly because you're inhibiting the early steps of the synthetic process.
Christopher: That's super awesome. So let me just understand a bit. So if eat too many carbs, that might stop me from producing red or properly healthy red blood cells, right?
Tommy: Yes. So it could. The very high levels of glucose can inhibit the normal production of hemoglobin. And, obviously, everybody will be producing hemoglobin normally but if you're trying to find like that last important step to get that little extra boost, then it's possible that if you are eating a very high carbohydrate diet that you could be sort of holding back part of that synthetic process.
Christopher: That's really amazing. It's kind of like I'm -- All the pieces are starting to fit together. This high fat lowish carb approach obviously works very well for a number of people. I'm starting to wonder whether the reasons are out there. They just haven't been fully -- But this paper is actually from the '80s.
Tommy: Oh, yeah. I mean, nobody has really tested this in athletes. But the people that they tested this in, the part of the pathway that they're inhibiting by giving these high levels of glucose, those function normally in these people. So it's not like we've taken people who have a broken pathway in this part to begin with and then inhibit it more. So technically, this should translate over to somebody with more normal hemoglobin production.
Tawnee: So what should athlete who maybe not totally on board with low carb high fat still believe that they do need some carbs as we're traditionally told to fuel endurance exercise. Like where is that balance? Still get the results you're talking about here in the heme production but still get the energy you need for endurance?
Tommy: I mean, lots of people perform really, really well on a high carb diet. And you can't tell those people that they should switch to a high fat diet. And there's certainly going to be an element of so if you're keeping your levels of oxidative stress low, if your insulin sensitivity remains high because you're still, your metabolism is still very healthy and sort of, people are really starting to overdo it, then even if they're exercising a lot they can still go down the direction of insulin resistance or impaired glucose tolerance.
So in those people who have a very healthy metabolism and they are performing very well and they have low levels of oxidative stress and lots of other things that we can test for, then there's probably no reason really to worry about it. But if it's starting to look like your insulin levels are creeping up, your insulin resistance is getting worse, you have a high level of oxidative stress, then it's definitely possible that cutting back on the carbohydrate and replacing that with some fat could benefit them.
[0:35:13]
Tawnee: Got you.
Christopher: So, okay. That's the production side of things. Let's say that everything is working correctly. We've got our Zinc and our B6 and our B12 and our folate so we have everything we need and the stimulation, we're all producing really nice red blood cells. We've done some testing. We figured out we've got enough of all of these nutrients. And then you have to think about destruction. And red blood cells -- So we already talked about this a little bit. They are quite vulnerable to oxidative stress. So, I don't know, briefly, can you define what oxidative stress is? It's quite a complicated topic but maybe you can define it succinctly, Tommy.
Tommy: Yes. So oxidative stress results as your inability to deal with a number of free radicals or reactive oxygen species, people might have heard these terms, that your body produces. And they can be as a result of exercise itself, of the diet you eat, of maybe poor sleep habits or lots of stress, all those things can increase the oxygen burned in the body and then the stress is created when your body just isn't able to get rid of those. And there's a number of enzymes that people might have heard of, things like superoxide dismutase or catalase and important things like glutathione that a lot of people maybe talked about which is an important antioxidant. And when you have overwhelmed your body's capacity of those things then you end up with a degree of oxidative stress.
Tawnee: Chris, are those your results up there?
Christopher: Yeah. So this is back in 2012, 2013 when I first started testing. I did the organic acid test and this is what I found. These complicated words, they have this fantastic names, these organic acids. The number 28 is p-hydroxyphenylacetate and this is a marker cell turnover. And this is not good, like turning over cells this quickly in a 35-year old guy. Something is going wrong here. And then number 29 is 8-hydroxy-2-deoxyguanosine. That is a breakdown product of DNA. So you know that something has happened to the DNA inside of that cell and the cell is being destroyed.
So again, this is chronic inflammation and it's oxidative stress. And both of those things are capable of destroying a red blood cell. First of all, you've got this problem with production, say you're not really producing red blood cells very well. And then you've got this problem with destruction. The red blood cells are being destroyed by chronic inflammation. And then you got yourself into kind of a nasty situation where there's no wonder you're slightly anemic. I mean, I said at the start, not anemic enough to where the doctor is going to panic and start ordering a whole bunch of tests but anemic enough to where you're going to be significantly slower on the bike.
Tawnee: So really quick. This is something where even as I've improved a lot of hormonal balance and whatnot in my own journey, one area where I'm still seeing results similar to what Chris is pointing out right here in his past results and my even test done earlier this year, I'm trying to still figure out what's the underlying thing considering I feel like I'm the type of athlete who lives super high quality lifestyle pretty doing as much as possible correctly?
Tommy: So, Tawnee, are you saying that you feel that these markers are still high despite the fact that everything else is getting better?
Tawnee: Exactly.
Tommy: That's a good -- I mean, that's a great question. I know that if you look at all your other results, Chris has talked a number of times about how compared to everybody else your results are always so good. And sometimes it's really difficult to track that down. And it could be something that maybe have hidden like toxin exposure in your house or maybe you've rooted out all the toxic mold you might have hiding in the walls and all that kind of stuff.
If you've definitely gone down that road and you don't have any metal fillings that maybe are causing any problems and you've actually removed any of the sort of potential issue. And people can get really crazy about that stuff and I certainly don't recommend that they always do that.
Tawnee: I will say I did go for further recommendation of a doctor where, a functional doctor I went to a couple of years ago to get a couple fillings I had tested and thankfully they are not toxic at this point. They were definitely still recommended to be removed. Although my fiancé may think I'm crazy but sometimes I have a theory that the apartment that we're renting is there's something in here that like I need to get out of here. I don't know. Maybe I should look into it.
[0:40:08]
Tommy: And it could be a high burden of electromagnetic frequencies or mold or the fillings in your mouth. The thing is individually they may not cause problems but these things can all add up potentially.
Tawnee: Yeah. And what about just like stress, like life stress? If I'm still recovering from a chronically stressed out kind of person, does that play a role in it as well?
Tommy: Yeah. Absolutely. It might take a long time for this stuff to come back into line. But as you sort of see your hormonal profile improved, maybe your circadian rhythm, things like cortisol and your other hormones improved, then it definitely look like thing is going down the right road. And, I think, there's definitely -- There's always potential to over interpret everything you see and maybe these markers are just a little bit high for you but if everything else looks really good and you feel really good and you're performing really well, then maybe you don't worry about it so much.
But it's definitely with each of these things, both on the blood chemistry and on the urine test, one individual result doesn't necessarily mean anything. You're looking at the patterns. You're looking at groups of things that might indicate a problem as well as looking the way that somebody eats and the rest of their lifestyle. So you can definitely go crazy just looking at markers and numbers and over interpreting individual results. And it is much more about patterns and putting together the big picture.
Tawnee: I couldn't agree more. Although I will say I think it's cool that when you answered, you didn't really bring up the training itself, all the lifestyle stuff and that's why I really love conversations like this. Because this is another one. My athletes that I coach who have done the urinalysis and everything, this is a common one where you still see levels of oxidative damage and whatnot.
Tommy: And there's definitely a case, looking at a training program and making sure that you're not putting an undue load in because you can definitely absolutely have too much of it, too much of a good thing, and particularly if you're doing a lot of high intensity work which isn't giving you -- There's a real sort of, there's a point where you reach diminishing returns and there's always sort of trying to rule out and remove as much as the excess unnecessary training as possible because that will really feed in as well.
Tawnee: Yeah, cool.
Christopher: This is another snippet from my results. When I first started testing in 2012 or so, this is hs-CRP that stands for high sensitivity C-reactive protein. So this is a blood test. And 1.2 in the red there, that's certainly elevated by my standard. So what this is showing you is that there's acute inflammation. It's a C-reactive protein. It's an acute phase reactant. So you know that there's inflammation going on right at the time that you have the blood test done.
And some of you may have seen numbers even higher than this especially after a recent and heavy workout. But I was quite careful about not doing anything like that before going to have this rather expensive blood drawn done. I had really good PPO health insurance but still I get landed with these massive bills, the deductibles. You never really know how much this blood work is going to cost. And so I was careful not to do that. And still I saw a 1.2 milligrams per liter there. So quite high level of inflammation.
And then over the years, the thing, the difference, the thing that I think make the main difference was sorting out of my gut. So when I did some gut testing, I found several intestinal parasites. I found a worm. I found a weird amoeba. I found all sorts of stuff going on. So it really shouldn't be there. And I took some botanical herbs and then I also took some medicine from a doctor to get rid of some of these bugs.
I think that has made a huge difference in not just the way that I feel like I'm an awful lot less bloated than I was back then. But also into my levels of inflammation which are now really rock bottom low. And I think switching to a high fat ketogenic diet has also -- That was kind of another noticeable decrease in my inflammation. Not really, I don't have the blood markers to show that but just noticed physically that exercise and in particular races, it wasn't taking out of me in the way that it once was.
And when you see inflammation and oxidative stress, you're going to figure out. You've got to do some detective work and figure out what's going on. And doing the blood tracking, I think, is helpful because it tells you whether something is working or not.
Tawnee: I just maybe remember. Chris, we've discovered that I had H. pylori.
Christopher: Yeah, that will do it. That will do it.
Tawnee: Yeah. So going back to that last one with the oxidative stress -- And I haven't talked to you about this yet.
[0:45:01]
But just over a month into your supplement cleanse and, oh my gosh, it's working. It's going to be the same thing as last time. I'm never going to want to get off. I've been feeling awesome.
Christopher: That's great. Tawnee is talking about H. pylori infection and H. pylori is a bacterial infection. One of the things H. pylori does it lowers the acidity of the stomach. It basically messes up all of your digestion, I think. There's two Australian scientists who famously won -- It was Barry Marshall, wasn't it, who won the Nobel Prize for showing that this bacteria caused ulcers and then cancers? Quite an interesting story if you want to look at it from Wikipedia.
It's super common. I run these stool tests on pretty much everybody that I work with and I would say probably 40% of them come back with this H. pylori infection. And this is not some woo-woo thing. You go to a primary care physician and say, "Hey, I have an H. pylori infection." They'll write you a prescription for antibiotics before you even have a chance to say another word. It's definitely something you should get rid of, I think.
Tawnee: Yeah.
Christopher: Let's do it. Let's see what happens to your oxidative stress once you get rid of that.
Tawnee: I know. I can't wait. So in a few months or a couple of months from now, I'll do another urine test.
Christopher: Yeah, that's a good idea.
Tommy: In the context of this, something like an H. pylori infection, which is very common, it affects the acid levels in the stomach. It affects the way you absorb iron, the way you absorb B12.
Christopher: Of course, the nutrients.
Tommy: So, all of it is linked.
Tawnee: It will be fun to do a next round after all this cleansing done.
Christopher: Yes. So I think the final thing, this production, destruction and loss. Loss is a bit different from destruction. With destruction, something has happened to the red blood cell. They died prematurely. With loss, you've actually lost the red blood cell. There's nothing wrong with it. It just went somewhere. You lost it through bleeding. A doctor is always going to be thinking about this, if the loss is bad. It's really hard to pin down the bleeds. It could be a GI bleed. That's very, very difficult to detect. It's either with a scope or any other means of detection.
This picture on the right here you can see, you can buy these home test kits. It's called occult blood test kit. If you're worried that you're losing bloods through your digestive track, you can actually buy one of these kits for yourself. And they're pretty cheap. They're like $6 or something. You could do multiple tests over several days. That might show you. You can't really rule out a bleed but you can rule one in. So it might be worth doing for that reason.
For me personally, I did actually have an occult bleed that went away once I switched to an autoimmune Paleo diet. So I just stopped grains and sugar and stuff like that. And I had the bleed reversed. It seems like athletes in particular are kind of vulnerable to these types of injuries. So maybe do you want to say something about this, Tommy? This was another paper that you sent me and I spent quite a lot of time looking at.
Tommy: Yes. So back in the '90s, there was a lot of research into this, something called athlete's anemia due to the fact that people would do a lot of endurance exercise, the hemoglobin tends to drop. I know you often see it drop. And sort of there was an argument that went backwards and forwards and most of that probably happens because your plasma volume expands. So the plasma is basically the fluid that all your blood cells float around in.
And that is part of the adaptation through exercise that volume expands. And so as the fluid increases then proportionally your concentration of red blood cells will decrease. And that's sort of -- That's a normal adaptation and people just thought that it was just that that was going on. But they'd done some studies more recently which showed that at the very heavy bouts of endurance exercise, you'll actually lose blood into the gut and you lose iron into the gut. And they've done that by giving people labeled iron which then they can see in the feces.
So definitely very, very long periods of endurance exercise because you're diverting blood away from the gut particularly. Then when that blood comes rushing back, we know we see this in a lot of areas that something -- reperfusion injuries, so if something has been starved of blood for a long time, then there's a buildup of a lot of metabolites and as the blood comes rushing back then actually you start to see an injury to the tissue and that appears to happen in the gut and then you lose some blood because of that.
So if you're somebody who is doing a high volume of very, very long sessions, then you might be at risk of losing some blood in the gut. And interestingly, athletes, particularly endurance athletes who sweat a lot can also lose a lot of iron and Zinc through the sweat so that's another place that they can become iron and Zinc deficient particularly which can benefit result process.
Tawnee: There's an interesting story.
[0:50:00]
It was professional triathlete Chris Legh. I'm pretty sure this was back in the '90s. He suffered from ischemic bowel during the Ironman World Championships. I think it was to the point where he was on hands and knees and it kind of ruined his career because you don't just recover from that. It's pretty serious.
Tommy: Absolutely. If you got really bad ischemic bowel, people can lose, have to have sections removed.
Tawnee: Exactly. That's what he had to have happen.
Christopher: Yeah. So be nice to your gut. And think about the timing as well. So the thing that I see in all the bike races is the moment people are finished, some guys, they got a beer in their hand before I finish the race. The guy that won is there with a frickin Coors in his hand. I can't believe it.
Tawnee: Coors, at least still a good beer, come on.
Christopher: I can't believe how much he's beaten me by. So think about that.
Tommy: Maybe it was the beer, Chris.
Christopher: Yeah, it is what it is. It's the beer that's making me slow, and then Mexican food or the type of taco trucks at these events. Maybe then right after your hardest effort is not the right time to dump a load of things which could be quite inflammatory into your gut that's just having its blood supply reconnected. So it's something to think carefully about. Maybe that's the best time to be strict. And if you are going to cheat, do it on a day where it's not -- Maybe a rest day, something I think might be a better idea for that reason.
Tawnee: Maybe it's worth mentioning too. I think more people are getting clued on but the idea of non-steroidal anti-inflammatory drugs, ibuprofen and whatnot, and doing that during exercise as a way to kill pain is the worst thing you could possibly do for yourself.
Tommy: Very bad for the gut, bad for the kidneys particularly if you got a lot of -- The combination of [0:51:45] [Indiscernible] plus ibuprofen, say, or NSAIDs can be really toxic for the kidneys as well. So that was the number of reasons to try and avoid that.
Christopher: And then remember that they kidneys, we needed to be nice to the kidneys because they're the ones producing these EPO hormone that kicks off the whole process of producing the red blood cells in the first place.
Tommy: Everything is connected.
Christopher: Everything is connected. Physiology is horrible like that, isn't it? Nothing looks nice. You can't figure anything out because everything is connected. Getting into some markers you're going to see on your blood test result, I'm pretty sure everybody listening to this has done this test at some point, super duper standard, the most basic blood chemistry. And every single result is going to have -- RBC stands for the red blood cell count. And then hemoglobin, hematocrit, MCV, MCH. Do you think we should briefly go over this, Tommy?
Tommy: Sure. So obviously, the obvious is the total count of red blood cells in the volume of blood that they've taken. The hemoglobin is the concentration or a weight of hemoglobin in that sample. The hematocrit is basically like the proportion of the blood which is a percentage, the percentage of the blood by volume, which is red blood cells. And they use this sort of, they used to measure that and just sort of spin it down and they just sort of like you just use a ruler to just count it.
But now they often will multiply the MCV, the mean corpuscular volume by the red blood cell count to just give you the hematocrit. And so, the MCV is just the average size of your red blood cells. We talked earlier about how the size can change based on various nutrient deficiencies. And the MCH is the mean corpuscular hemoglobin, so the amount of hemoglobin in red blood cells. The MCH is just the concentration in the red blood cells, the hemoglobin concentration.
And the RDW is the red cell distribution width. So it's basically the percentage variability of the size of your red blood cells. So we normally want all our red blood cells to be very similar size. But that can increase again if you got certain problems either because some of them are much smaller or much larger or in fact both is possible and that will increase your RDW.
Christopher: So that's one of the ways. What I'm trying to show you in this table, it's a way for you, like a little crib sheet that you consider when you're trying to debug your blood chemistry. So say you have a B12 and/or folate deficiencies. So this is the pattern that you're going to see. You're going to see low red blood cell count and then the hemoglobin is going to be low. And then the mean corpuscular volume is going to be elevated so that the average size of the red blood cells would be a bit bigger than it normally would.
Because if I go back to this slide, you'll see that you kind of -- If the B12 and folate is not there, then this cell is not going to be able to go through this phase two and eject the nucleus and you're going to end up with a larger than normal red blood cell. And then maybe if you have some of the nutrients on some days but not on others then you're going to end up with all different size. So your day one, I have enough B12 and folate and I ended up with a nice cell that looked like the one on the right.
[0:55:02]
And then the next day I didn't and so I ended up like the normoblast there. So that's why you'd see an elevation in the distribution width. So, yeah, there's definitely pattern here. And we can see the chronic disease, that's the inflammation on oxidative stress. That's the pattern that we see here, it's like the N stands for normal. That means you might have a like a normal MCV. But still everything is low because something has happened to this cell.
Tommy: Yeah. There's a couple. So pernicious anemia, if people saw that on the far right, that is an autoimmune B12 deficiency. So basically your body attacks the cells that produce something called intrinsic factor which is what you need to absorb B12. So then you see a very, very large, very, very high MCV because you can end up with quite severe B12 deficiency. So your red blood cells get very, very big.
Christopher: And then I wanted to show you this. This is a snippet of my results as I try to debug them over the years. And this diagram, this little snippet here comes from the software that I used. Excuse me. And it's kind of cool. It allows you to track changes over time, which is very, very helpful, rather than all your blood test results that are just being scattered about all over the place in different fact scans and all this kind of stuff.
And then also this software, it defines title limits. So there's a functional medicine practitioner who designed this software. He's done some research and he decided what is an optimal level of hemoglobin. And then he color codes the chart for you. You can see double arrows is actually outside of the standard reference range. Single arrow is outside of what he considers to be optimal. And I think getting away from these standard reference ranges is super helpful for allowing you to debug.
And you can see that my, in the beginning, my mean corpuscular volume, the average size of the red blood cell was very big and it got even bigger. The funny thing is I ended up in the hospital having iron infused at one point and it really didn't help that much because I still didn't have the B12 and folate. You've really got to kind of dig deep and figure out what's going on here. I think even my mean corpuscular volume even now is still a little bit elevated. So I might have more to come here. You can see the 14.1 I'm finding inside the optimal range. But I may still have more to come, which is kind of exciting.
Tommy: We got a quick question from David on the side. He's asking about high hemoglobin. He says he has markers of inflammation but his hemoglobin is 16.2. And, I mean, that's a very good question. And what I would particularly think of there is something like either a tendency or actually having something like hemochromatosis, which is -- Or some kind of iron overload. So this can happen even when people who don't.
So hemochromatosis is where you have a genetic mutation, which means that your body sort of accumulates iron or stores lots and lots of iron. And that's going to cause the iron then can get deposited and placed at the liver or the kidney or at the adrenal glands and it can cause various problems. But even in some people, they can just have tendencies or maybe they just have a single mutation or they have a less severe mutation. And it's actually fairly common particularly in men and particularly as they get older. They tend to see an accumulation of iron.
And so if you have a high level of oxidative stress and maybe your CRP is high, your uric acid is high, your ferritin is high -- so ferritin is the marker of iron storage -- and your hemoglobin is high, then it's very possible that might be cause. So you can get a genetic test for that. But also if your ferritin is high and your hemoglobin is high and you have markers of high oxidative stress, then one of the simplest things you can do -- There are various ways to sort of prevent you absorbing all the iron from your diet or you can just donate blood.
Blood donation is actually really, really nice way to improve, to reduce oxidative stress in people particularly if they have a degree of iron overload. So it's obviously -- I don't know any of David's other markers but that's definitely a potential problem particularly for males.
Christopher: Yeah. We've just started adding the iron panels on to everyone because it was just becoming, like sending people back to the lab to figure out whether they have iron overload. That got so tedious. And it's really, really common especially in the older men. If you're not really losing the blood anywhere then iron really doesn't go anywhere else. I mean, you can lose a little bit through sweating but not much. It's super interesting. I've been doing a ton of research with this with the other doctor I work with. It's the most common genetic disorder. One in 200 people in the US are affected by hemochromatosis. And it's really [0:59:53] [Indiscernible] linked to type 2 diabetes and liver damage. It's a very serious condition that really doesn't want to be left undiscovered.
[1:00:03]
Okay. So hemochromatosis, this is the other end of the spectrum. So this is a triathlete, 41 year old iron man triathlete from Australia that I'd been working with recently. And I thought it would be interesting to show some of his results. I do actually have his permission to show his results. And he's also an ultra runner and his main complaint is fatigue. And he has a history of GI bleeds. He's had problems and surgery and bit like the situation you described earlier actually where he ended up having sections of his bowel removed.
And the main complaint now is fatigue and these are his numbers. And you can see that for him his iron is like really, really low. So the percentage transferrin saturation, you can think of this as being the number of seats which are taken on the iron bus. So the iron bus is moving around. And all the seats are empty. There's no iron. This is iron deficiency. This is what it looks like. You see the serum iron is low. Also the ferritin is pretty low. And this percentage transferrin saturation is extremely telling. And then he has other problems too. He has the elevation, and this is super high, the mean corpuscular volume.
Tommy: So what you then see, I imagine, if you look at his blood cell distribution width, so it looks like he's probably got a B12 or folate deficiency as well as an iron deficiency. And then that means that have some really small red blood cells and some really big ones. So then his RDW should, I imagine, would be very, very high.
Christopher: Yes. Of course, it's entirely possible to have multiple problems going on at once. He could have production problems and destruction problems, maybe a bunch of oxidative stress and you could be losing blood too. So then it gets kind of complicated to debug. But still it's possible, I think, or at least it's possible to do good work. Oh, and so the reason I thought this was so interesting to show. So you can see the hemoglobin there is the third row from the bottom, super low, 12.5 is really quite low.
I think this is the point -- Or certainly 11. This is where surely any kind of doctor is going to start worrying about this especially when the person is really tired. So he did a urinary organic acid test with me and this is part of the summary page from the organic acids test. And the thing I thought was most interesting was if you look in the center of this slide here, it says energy production markers.
And these organic acids, citrate, cis-aconitate, isocitrate, these are the steps, the intermediate steps in the citric acid cycle. So if you remember back to your days of studying biology, the citric acid cycle, you can see in the middle of this slide here, this is the traffic circle. And the whole purpose of this cycle is to generate electron donors. And then those electrons are donated to molecular oxygen. And then that process then leads to the production of ATP, which is the energy currency in the cell.
So you can see the problem, super low hemoglobin, 11.1. So he's just not transporting oxygen. So the citric acid cycle here is just backing up. The reason every single one of these steps, you're going to get malate, fumarate, succinate. Like if you look at all these steps, they're all built up very high. And the reason for this is there's nowhere for the electrons to go. There's no molecular oxygen for them to be donated to. And so everything just backs up.
Imagine a traffic circle or roundabout as we call it in the UK, imagine there's been an accident. Everything is backing up. The whole roundabout is just full of stationary traffic. That's what's going on here. And you can see, this guy, why does he feel so tired? It's because he's anemic. This is desperately important to help fix straight away. And then the other thing I thought was interesting, the carbohydrate metabolism is this organic acid L-lactate and people kind of know what lactate is because they do lactate threshold testing.
It's a kind of sign that you switch to an anaerobic metabolism. Anaerobic just means without oxygen. So this guy, when he took the urine sample, he's resorting to this less efficient anaerobic metabolism even though he's not doing any exercise right at that time he did this test. Super important. And then you can see here he had that same formiminoglutamate folate deficiency that showed up in the organic acid test. I'm really confident I'm going to make this -- Because this is someone that just came in last week and I'm super confident that this guy is going to feel more energy once we fix these problems.
Tawnee: I have a question on that. He looks like he's in ketosis. And then also the renal ammonia loading, does that mean that he's overdoing it on protein and it's having to get excreted to the kidneys or am I misinterpreting that?
[1:05:00]
Christopher: Yeah. I think the organic acids, this summary page could be a little bit confusing sometimes. I've made it more confusing by chopping off the header column for this table, the header row rather for this table. And what the test does is it gives you some metabolic associations in this far right hand corner where it says renal ammonia loading. And I'm sure there is a plausible mechanism there somewhere.
The middle column is like kind of intervention options where you can take some more arginine or you can take some more CoQ10. And in some instances, that might be helpful but I'm pretty confident in this instance that the real problem is the anemia. That's what's going on here. Taking arginine as a supplement is not going to help this guy. What are your thoughts on that, Tommy? Do you think that's right?
Tommy: I think that's absolutely right. I think that he's not necessarily in nutritional ketosis but what happens is you produce beta-hydroxybutyrate when you got an excess of citric acid cycle metabolites. So as that whole system is backed up, then ketones are produced as a byproduct of that in the liver. And then they release them into the blood. So I think that's probably almost a byproduct of the fact that he's not adequately cycling his nutrients in there and his mitochondrial function is obviously dropped off because both of nutrient deficiencies and the inability to transport oxygen.
Tawnee: Got you. Interesting.
Christopher: Cool. So, for me now, what I really want to do is help as many people as possible. And that's why I put together this program. Like I say, I'm partnered with a medical doctor and we run this functional medicine practice. And I have this software. And I know I have the ability to help people improve their hemoglobin and help them perform better. And so I've got together with Tommy and we put together a program. You can order a blood test through us and then Tommy and I will spend some time looking at them and then for each test that's run, I will spend 30 minutes with you talking about the results.
If you're interested in doing some debugging with your own blood and urine chemistry, then we can do that for you. And there's a place where you can order some tests. Let's see if I can put in the link where you can order the test. So you should. Now if you look on the right hand side of your screen, there's a link there where you can order some tests. And just for this webinar until the weekend, I'm offering 10% off using this discount code.
So if you go to O2boost.nourishbalancethrive.com, you can see we've got some options for you if you like to run a blood test and have me and Tommy look at it. And the more expansion of option includes the organic acids test. We showed some of the results in the organic acid. I love the organic acids. It really allows me to dig deep and figure out what's really going on for the person. And if that's too much money for you right now, then just do the standard blood test. There's a really, really good blood test for just under $500.
If you already have the blood work, you've done it before, then that's no problem. You can just sign up still and just send me your existing blood work and then I can run it through the software and spend some time with Tommy looking at it and then I can get you on the phone and explain what the results mean and what you might be able to do to improve your health and performance. So the blood chemistry is $500 but it's a big -- Like this is not -- I mean, you can get cheaper blood chemistries but I think it's really worth having all of these markers that you can see on the screen right now.
So in particular, these are the obvious ones that we've already talked about -- hematocrit, hemoglobin, all the complete blood cell count. But I've also added in an iron panel. And then we got blood folate and B12 as well as the organic acid, if you choose to do those. You can figure out what's going on with that. And then hemoglobin A1C and insulin, some thyroid markers, high sensitive C-reactive protein, which I think is really important. Homocysteine can show the need for B12 as well. So it's really quite a comprehensive blood panel. Of course, the real -- Sorry?
Tawnee: I'm sorry. That's just one of the best I've seen. Usually, I have to pull an arm and a leg to get all these things tested and this is great. I love it.
Christopher: Yeah. So I've just realized that -- I mean, that was my experience with the PPO health insurance. But surely my doctor can just order this test? And that's going to be so much cheaper because I have insurance. But, I mean, I just haven't had that experience. The doctor, they need a diagnosis. You'd like have to be presenting with some disease. They're not going to just order a blood panel like this because you're trying to qualify for some bike race next year.
[0:10:05]
In the end, I think it's cheaper just to order it for yourself. Take that initiative and see this is part of your training program. And of course, the real value in this program is not the blood chemistry. It's actually having someone like Tommy look at the results, which is something I've been trying to have happen for the last three years. It's a unique opportunity. And then I'll show you the list of organic acids but I'm not really sure how helpful that is because they have very funny names. They must be difficult to be recognized.
But know that with the organic acids test, it's a ton of information, 46 different markers. And some of these are related to gut function as well. D-arabinitol, for example is a breakdown product of a yeast infection, of candida. I know that a lot of the trouble stem from the gut and the organic acid could be a really nice place to sort of start that investigation. But, yeah.
Tommy: We've got a question from Jennifer and she's asking about the second case study you showed which was this new client of yours. She was just wondering what sort of -- So she says: Does this mean that this guy should take some time off and eat more iron rich foods and de-stress and stuff? Or would you just supplement and keep him in training? Could you give a sort of insight into the structure of the program you put together for him?
Christopher: Yeah. So I spend most of my time and effort in diet and lifestyle coaching. So these tests are really useful for figuring out what's going on for a person. But most of the solution is in the diet and lifestyle coaching. And so people always have non-negotiable factors in their life. Like I work with or have worked with quite a lot of the first responders -- so firemen, policemen and such. They tend to work funny shifts, like swing shifts where they don't get enough sleep and that type of thing.
I see that as kind of -- I can't tell them to give up their job in order to get results. There's always a balance that can be struck. And so for this guy, he's going to be super squeaky clean. He's an Ironman athlete and he's going to do everything in his power except from giving up the sport in order to get better. So he's going to be eating -- In fact, in this instance, he's eating the autoimmune protocol, which is a very strict version of the Paleo diet. And he's concentrating on getting enough sleep so that means at least eight hours every night, maybe even more to help him try to get better sleep because the common complaint for people are not -- It's not like they don't know they need it. It's just that they can't get it.
So I've been helping him with some tips to get better sleep. And then the stress reduction, I think, is really important. In this case, he's actually kind of low stress. He's in his 40s but he's retired already. He's done pretty well in his work, in his life and kind of with his business. So he's retired already. So he has a fairly low stress existence but still humans are pretty good at inventing things to stress about when they don't have any stressor. He's been doing some guided meditation and--
And then the movement part as well. I know a lot of people listening to this will be very, very active but I think the walking is completely essential to be a healthy human being. And so he's been doing a ton of walking. So that's the way I approach this problem. The guy is obviously a bit of a mess at the moment but he's on the path to recovery. He had some gut stuff going on as well. And I don't think he did. I mean, I didn't personally -- When I went through this, I had some gut infections that I mentioned.
I actually was doing the BC Bike Race, which is a seven-day stage race across Canada whist taking oregano oil and a bunch of other botanical herbs in order to kill these parasitic infections in my gut. And I did just fine. I came 15th overall whilst taking all of these supplements. I know it can be done.
Tawnee: I'm a fan of the walking myself after all these years of going hard.
Christopher: It's super difficult. Everybody thinks that, "I know, I run and I cycle and I lift weight." I'm like, "No, you have to walk. You really do have to walk." The lymphatic tissue, it doesn't move any other way. You've got to walk.
Tawnee: Sometimes it's the easy things because you're like, "This is so slow." But then you start to get it. Same with the meditation. You kind of have that aha moment and then all of a sudden it makes sense.
Tommy: I actually have an article on the benefits of more walking on Breaking Muscle coming up tomorrow, I think. I'm all in absolute agreement to this.
Tawnee: Yeah, yeah. And then not only walking but walking in nature. That's going to do wonders for your stress levels. That was really--
Christopher: I'm nowhere near nature. That can be quite -- I find that quite stressful if you live in central London or something. It's like, okay, now this guy is setting me up. I have to travel 200 miles.
[1:15:04]
Tommy: It only needs to be like a green space and you can usually find some trees anywhere. You don't need to go out to the complete wilderness.
Tawnee: But if you have the opportunity though.
Tommy: But if you have the wilderness, absolutely.
Tawnee: Yeah. That was really, really informative, guys. Thank you. I even learned a bunch of good little tidbits there.
Tommy: That's great.
Christopher: Yeah, I know. It's been a real kind of journey for me. I'm really super excited about helping other people with it.
Tawnee: Jennifer has another question about walking in addition to regular training or a place -- I think personally, it just sort of depends. I have incorporated walking in the routine where I'll walk 20 miles a week. But it's non-fatiguing in a way where I'm combining that with more of an aerobic based plan and it compliments each other well. But there are certain days where you don't have to force walking if you just need straight recovery. But I think in addition -- Go ahead.
Tommy: Yeah. I think it really depends on what the training program looks like. I think if I was sort of building a training program from the base up particularly maybe not for a very high performance athlete who obviously has to focus particularly on performance on one's sport but if you're looking particularly for health longevity, then I would start with walking as the base and then build on top of that be that lifting session or high intensity sessions. I think that it kind of can form the foundation.
I know a lot of the aerobic based as well, brisk walking, the effect on both, be it like sympathovagal balance and the anti-inflammatory properties, and you can get an increase in VO2. Just sort of that aerobic based kind of come from walking as well. It would depend on what you're doing but I think it's very important.
Tawnee: Definitely.
Tommy: Okay, guys. You signed off, Chris?
Christopher: Oh, yeah. I was just looking to see if there's any more questions.
Tommy: Somebody has asked for us to convert the units to UK units. I think a lot of the ones you had were similar to the UK units where they've changed some of the hemoglobin measures recently. But we can absolutely. We can find that and post that somewhere.
Christopher: Yeah. If you're in the UK and it's not practical -- So the way this blood chemistry thing works is you place an order online and then I send you a PDF requisition form. So there's no need to go to a doctor to get the blood ordered. You just go straight to LabCorp with the PDF form. And then they take care of the rest, super simple process. You'd be in and out of there in 15 minutes. And obviously, if you're in the UK, then that's not possible. There's no LabCorp in the UK.
But you can go online and order your own blood chemistry and then still sign up for the program. And then just send me your results. And then the blood chemistry software that I have, it handles the different types of units. There's no problem with that. I can give you your report in any units that you want.
Tawnee: Good stuff.
Christopher: Cool.
Tommy: No more questions, looks like it.
Christopher: Yeah. Well, thanks very much. I really appreciate your time, guys. This has been fun.
Tawnee: That was a blast.
Tommy: Yeah.
Tawnee: I'll sign up with you any time. And Tommy, I'll see you on Endurance Planet in a couple of weeks.
Tommy: Yeah. I'm really looking forward to it.
Tawnee: Thanks. I'll send you -- We'll talk. I'll have some questions for you in advance as well.
Tommy: Great.
Tawnee: Bye, guys.
Christopher: Okay. Cheers then, guys. Bye.
[1:18:40] End of Audio
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