Written by Christopher Kelly
Dec. 3, 2015
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Christopher: Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly and today I'm joined by Dr. David Minkoff. Hi, David.
David: Hi, Chris.
Christopher: Dr. Minkoff is another one of those people where I'm kind of getting a little bit nervous when I read his bio aloud. He graduated from the University of Wisconsin Medical School in 1974. He'd been in medical practice over 40 years. The thing I think is most amazing, how many Ironman's have you finished?
David: I have finished 40 and I have 41 coming up in a month.
Christopher: That's pretty amazing. Pretty amazing. How old are you? Do you mind me asking how old you are?
David: 67.
Christopher: That's an incredible career. So you've been in medical practice over 40 years.
David: Yes.
Christopher: That's astonishing. While I was still in diapers or maybe not even born. That's pretty incredible. And I wanted to have you on today to talk about protein and amino acids. And the reason I wanted to do that is there is a product of yours, your formulation of amino acids that I'd been using for a couple of years now and I think those amino acids have been useful for me. Well, I know they've been useful to me in two different ways. And then there's a third way as well in which I'm not quite so sure about and maybe we can get into that later in the podcast.
Recently, someone from Dr. Minkoff's nutritional supplement company approached me and said, "Would you like to put your name on our essential amino acid formula?" And I said, "You know what, I would." And the reason I wanted to do that is because I need to find some ways to try and support my podcasting habit. I've got to a point now where the bill for the bandwidth is non-trivial. I transcribe each and every one of these podcasts.
If you haven't got time to listen to the whole thing, you can read the transcript. There's a speed reader which I'd been using recently in which I think you might find helpful. I'll link to that in the show notes. And I think you'll find that you can quite comfortably read a 10,000-word transcript in probably about 20, 25 minutes with this tool. I'll link to that in the show notes. If you found this podcast useful and you'd like to give back in some way then I would really appreciate it. If you were to buy these essential amino acids that I'd been using with my brand on, that would really help me out.
Dr. Minkoff, where you we start? I think protein, I mean, the word means primary. It's pretty important, isn't it? I mean, why do you think amino acids and protein are important in the first place?
David: Well, our whole body structure is made out of protein. So if you look at hair or skin or liver cells or hormones or neurotransmitters, immune cells, cytokines, immune modulators, they're all protein molecules. If you're going to have a body you have to have -- it has to be able to manufacture and repair proteins. And so the source of those proteins is the diet and what we eat. Unfortunately, many people have challenges with either not knowing what to eat or not being able to digest and absorb what they eat.
From that, they have levels in their body of proteins or of the building blocks of proteins which are amino acids that don't support the body being in an optimum condition. This might reflect as a low thyroid hormone or low testosterone or inability to make muscle or inability to generate energy or someone who like works out a little bit and then they're sore for days and days and days because they can't repair the muscles, ligaments and tendons that got stressed when they worked out.
Or they bite their lip and it takes two weeks for it to heal when three or four days should heal, no problem. These are all reflections of people who have protein deficiency and don't know or haven't figured out how to help themselves with it.
David: Yeah, absolutely. And there's a story, there's a professor of biochemistry named Richard Feinman, who's been on my podcast a couple of times, he always talks about -- Well, he talks about in his book how when he's teaching medical students in New York. He asked them if they can think of a single word that would be synonymous with life. And I would love to be there in that lecture hall and listen to all the different answers. But I certainly wouldn't have come up with the right answer. They all come in from these new medical students. But the right answer that he's looking for is protein. Protein is basically life. Without it, there can be no life. So it doesn't really matter what type of problem you are suffering from, protein comes into it somewhere.
David: Life evolved because enzymes were able to evolve.
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Enzymes are proteins that allow chemical reactions to occur rather than in a random way but in a programmed way. And if you look at evolutionary biology, it's the enzymes that have made the difference. And enzymes are made out of protein. And people who are protein deficient, one of the things that go with them is that they don't have enzymes. And so their life, their quality of life and their amount of life is reduced.
Christopher: Yeah, absolutely. I'd been spending -- It's kind of one of the things I do for fun now is study biochemistry. I am by no means an expert but that's something there's almost a common pattern there when you look at any of these different pathways. It usually starts with some molecule and it has a certain number of carbons and then it's transformed in various different ways. Sometimes the carbons are split in half or sometimes you add some more on but there's always an enzyme and sometimes some energy and some other cofactors. Yeah, without those enzymes, there's nothing. There's no life.
David: Right. And enzymes are proteins.
Christopher: Exactly. Exactly.
David: If you don't have a source of proteins or a source of amino acids then the enzymes in some particular areas may not be adequate. All the detoxification in the body is based on certain set of enzymes. If the poisons coming in can't be detoxified by these enzymes then they further poison other enzymes and so you can't do other things or your body can't do other things.
Christopher: Right, right. Back a couple of years ago, the way in which I thought these essential amino acids were helpful to me the first time was when my gut was a mess. I had a lot of gas, a lot of bloating, frequent diarrhea, a lot of burping, an awful lot of burping, especially when I was exercising. It was clear that something wasn't right. And I was spending a lot of money on really good quality protein at that time, a lot of fish, a lot of red and white meat, a lot of animal protein. But still it appeared that I was deficient in protein and I was suffering from some of the symptoms that you just talked about.
I had muscle soreness that went on for days after I did any type of exercise even endurance exercise. And these amino acids were really helpful for me. The muscle soreness, it went away almost immediately. So I stopped getting completely the muscle soreness after endurance exercise. And, I think, that is an interesting sign.
David: Yeah, because what was happening is that you weren't able to, for whatever reason that was going on in your gut, whether you had a distressed membrane that couldn't absorb it or you didn't have enough digestive enzymes to break down the animal proteins you were eating, but you weren't getting enough free amino acids in your blood so that your muscles could repair. And they just had to repair slowly. And that's why the prolonged soreness occurs.
Christopher: Right. And then so do you think there's a difference between really good -- So most people listening to this podcast, they're not going to be eating bagels for breakfast, Subway sandwich for lunch. They're going to be eating a lot of good quality protein. Do you think that these free form amino acids are still going to be helpful to those people especially if they've got less than stellar digestion?
David: Absolutely. I've worked with a lot of high end professional athletes as well as a lot of sick people. And one of the things that we always do is measure their blood levels of amino acids. And it's a very rare person that is actually getting, is eating and digesting their proteins to the extent that their serum amino acids are normal. And the more busy you are, the more workout you do, the more active you are, the more you need these things. And if your body is a little bit low in some you're going to have trouble.
One of the things that people don't really think about is that a lot of times medications interfere with either the digestion or absorption of basic nutrients. And like you can buy over the counter products like Tagamet or Nexium acid blockers. People get indigestion and they get GIRD, gastrointestinal reflux disease, and they go to the store and they buy medications or their doctor prescribes them medications to help them with their heartburn or their reflux.
Those drugs block acid production in the stomach. And without acid production in the stomach you can't digest proteins. And they become amino acid deficient. It doesn't happen in a week or two but in months it will happen.
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And while these drugs are only supposed to be prescribed for very short periods of time, many people who take them take them for years and years and years. And if you look at their blood levels of amino acids you see they're low. And they can suffer from various things like soreness after exercise or depression or lack of sleep or fatigue because they're unable to make the enzymes and body structures because they don't have the digestion to take the amino acids in from their diet.
Christopher: So I think this is a really crucial point, isn't it? So when you eat protein, you're reliant on the stomach acid, this hydrochloric acid which is going to act on the hydrogen bonds in that protein and the proteins are going to start to unfold and that's going to allow various enzymes like pepsin to start breaking apart these proteins into the individual amino acids. But this process, it doesn't happen in the same way when you take essential amino acid in a tablet form.
David: The other thing about this is there are lots of amino acid products on the market. The genius of this product is that it's -- Here's the analogy that someone can think with in it and it's let's say that we wanted to build cars. And in order to have a basic car, you have to have four wheels, a chassis, a motor, and a steering wheel. Then you'd have a car. And if I shipped you 100 chassis and 400 wheels and 100 motors and one steering wheel, how many cars could you build? You could build one car.
And then what would you have left? You'd have 399 wheels, you'd have 396 wheels and you'd have 99 chassis and you'd have 99 motors because they didn't get used. And that's what happens in the body. If you take in something like whey protein and it's the finest quality whey protein that exists, it's not heat processed and the cow was fed only organic grass and you optimize everything. And then you measure. And you assume that you have hydrochloric acid in your stomach and pepsin and you have another enzyme that comes from the pancreas which is called chymotrypsin and trypsin where the complex protein of the whey is completely broken up into individual amino acids.
And then you also assume that your gut wall is working and the amino acid is going to be absorbed into your blood. If you look at the profile of those amino acids, you have -- It's like not enough steering wheels and too many motors and chassis and wheels. In fact, the way it works out is if you do a balanced study of, okay, I'm going to take in 100 grams of whey protein, how many of it actually once it's broken down into amino acids is my body going to utilize assuming everything else is optimum?
It's only about 16% because so much of it is extra stuff that the body can't use because the balance or ratio of the amino acid to what the body's needs are is off. And so if you look at -- and this is something that can be measured and it's called nitrogen utilization. A fat and carbohydrate doesn't have nitrogen. But a protein does. And so if you eat a protein you can measure how much of that protein is actually assimilated into body proteins, which is what you're eating protein for, by how much nitrogen goes in versus how much comes out.
So if you eat protein like whey, 84% of the nitrogen isn't assimilated into body protein. It's just made into a waste product that has to be gotten rid of and it doesn't do you any good. So one of the beauties of this product is that the balance of amino acids, the ratio of the eight essential amino acids, which make up this product, is that it is idealized for human beings in that 99% of it is utilized to make body protein and less than 1% of it is nitrogen waste.
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And there isn't anything in the world like it. If you look at the hundreds and hundreds of amino acid blends that are on the market and you analyze these, virtually all of them are under 20% utilization. That's what makes it unique. And that's what makes it so effective. About 15 years ago, I was helping George Hincapie. He was one of the cyclists that was on the US Postal team because he had had a medical problem and he needed protein nutrition.
I was called to see if I could help. We gave him this product. He had been sick and he couldn't assimilate food very well. And once we started this product, he recovered very quickly. And he said to me, "I've taken hundreds of different things. And I could basically take anything I want. I'm a professional athlete at most elite level." He said, "Almost nothing seems to make any difference. But when I take this product, man, I see it. I'm stronger. My oxygen utilization is better. My recovery is faster. It really makes a difference." And it makes a difference because someone is able to optimize their own protein metabolism so that their body will function better. And that's the idea of it.
Christopher: Yeah, it's fantastic. I know a little bit about -- So the question, I think, then is why whey protein at all? Why would you sell that product? My wife is a food scientist and her master's degree was in dairy science and she spent a lot of time in the lab. And she knows all about this. It's kind of an interesting story that whey protein is actually a waste product of the cheese making industry. In the beginning, they used to just dump the whey down the drain.
Then they got in trouble for that and they had to start paying someone to take the whey away. And then, of course, some marketing genius came along and said, "You know what, we can put this in smoothies, we can put it in baby formula." And the rest is history. And when you look at the internet right now, there's almost no company on the market that doesn't have a whey protein product. It does taste delicious but as you've just pointed out it doesn't really do that much good like the nitrogen utilization of it is not that good.
David: That's right. And they paid a lot of money to get a lot of scientists to say that, "Oh boy, this is 100% absorbed." Which it is. It is absorbed. But absorption is important but utilization is what's key. And utilization means your body can take those digested amino acids and make it into body protein. And this is another thing that people sort of take for granted but they never think about it. If you look at the calories per gram of different, of the basic three things -- fats, proteins, carbohydrates.
A carbohydrate is four calories per gram. If you eat a banana and it's got 20 grams of carbohydrates in it, it's 80 calories. And if you look at a fat, it's 9.3 calories per gram so you have a tablespoon of butter and it's 15 grams or whatever, 20 grams times 9.3, that's how many calories you get out of that. And protein is four calories per gram. So you look on your thing and you say, okay, there's ten grams of protein in here, that's 40 calories.
And it's only 40 calories if the protein doesn't get assimilated into your body. If it gets assimilated into your body as enzymes, hormones, skin, hair or whatever, it's no calories. It's only what isn't assimilated that's calories. So if you look at whey protein, 84% of it isn't assimilated. So that's 84 times four is the calories that it has. If you take this amino acid product, ten grams of it has less than four calories because 99% of it plus is incorporated into body structure. And there is no calories.
So this can be used not only for recovery for people but it can be used -- If people are looking for weight loss, normally if people are on very calorie restricted diets, they do HCG or they do something else where they're eating 500, 800 calories a day, if you look at for every four pounds of weight that they lose, one pound of it is lean body. It's like a terrible way to lose weight because you're destroying your bones and your muscles and your other tissues while you're trying to lose weight. What you want to lose is fat.
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And what we found is that we give people perfect amino in place of chicken breast and whey protein shakes, you can give them almost no calories. Give them all the amino acids that they need so that they retain their body structure, still keep them on a low calorie diet and they won't waste their lean body tissue but they'll lose a lot of fat. So there's a lot of ways to look at this but it's basically, it's pre-digested. These are pharmaceutical great amino acid. You don't have to go through the whole pepsin hydrochloric acid, chymotrypsin cycle. You take this product on an empty stomach with a glass of water and in 23 minutes these amino acids are in your bloodstream.
Christopher: It does make me wonder how did you do this then? Can you explain to me what these amino acids are made from? And tell me anything about the manufacturing process.
David: Well, most of the amino acids today are manufactured by bacteria. You can program bacteria to manufacture amino acids. And rather than -- it's way cheaper than extracting them. And you can get pharmaceutical grade amino acids this way. So the largest manufacturing in the world of amino acids is a Japanese company called Ajinomoto. It's a multibillion dollar company. And that's how they do it.
They take other products, in this case, these are vegetarian products. These are various kinds of vegetables that then those vegetables are reduced to elemental form, they're fed to the bacteria, the bacteria then produce the amino acids, the amino acids are harvested, purified and then they're mixed so that these ratios are exactly right. And when the ratio is right then you get this amino acid utilization that we're talking about. It's a little bit of a trick to do it but that's basically how it's done.
Christopher: And then how do you -- So where does the centrifuge come into this? I thought that maybe you were separating out the amino acid using a centrifuge.
David: No, no. The amino acids are available. We don't manufacture the amino acids. The amino acids are manufactured by companies and that's all that they do. There are biotech companies that manufacture these things.
Christopher: So we've done some testing on a lot of athletes now and I think a lot of people out there are suffering from the same kind of digestive problems that I did. I see on the blood chemistry various markers but in particular there's urinary indican which is an indication of the putrefaction of protein. So rather than it being broken down and digested and assimilated and the way that we've been talking about is actually the bacteria that's fermenting almost the protein which is a bad sign.
So we're seeing a lot of that on the urinary organic acid test that we do. And so I think these essential aminos are very helpful for that reason. So beyond that though, more recently -- well, I say recently -- in the last couple of years, I'd been taking these aminos during my bike rides. I regularly do two plus hours, sometimes three, four, five or even six hours. And I'm eating a very low carbohydrate high fat ketogenic diet.
And so I'm not ingesting really any carbohydrate at all. But of course, even in ketosis, you don't completely escape the need for glucose. The brain still needs some red blood cells as maybe some other things too. And so I'm wondering where is that glucose coming from? Am I breaking down lean tissue to make that glucose? And so I've continued to take these essential aminos and anecdotally and some other guys that are on my bike team and some of the people that we work with we found that they're saying the same thing, "Now I don't get delayed on certain muscle soreness after riding my bike." This is just anecdote. Is it plausible? Does the biochemistry make sense there?
David: Well, I think what happen -- We found that if you take these pre-exercise or with exercise, it's better than taking them after exercise. But if you're doing long rides, I usually take them before and I take them after. And what you do is the repair starts immediately. When you start exercising, not only are you using those muscles to do something but the repair process starts right away too. So when there are amino acids available, the body will use them and kind of optimize everything.
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I mean, I maybe not as strict as you are but I am in mind ketosis, most of the time I eat a low carb diet.
Christopher: Interesting. So what I'd been doing for the last couple of years is I just throw these tablets into the back pocket of my jersey and then I just take five of them per hour. It is a lot of tablets to swallow. And 2011, I've never taken any nutritional supplements whatsoever. I had never swallowed a pill or a capsule or anything. And so I kind of balked at the idea of having to swallow a lot of pills. But now I'm really good at it. I can swallow five at once easily. Those tablets are really easy for me to swallow now.
That's what I do. I don't like mixing things into my water. People keep saying to me, "You should just mix the aminos in with the water." But, I mean, I don't know if you've ever bitten into one of these tablets especially the branched-chain amino acid, they taste catastrophically awful. And so you have to put something in like Stevia or some sort of artificial sweetener to make them taste palatable. I'm not really a big fan of that. I'd like to drink plain water. So I just put this MAP in my back pocket, the tablets and it has been working really, really well for me.
David: Yeah. That's perfect. That's totally fine to do.
Christopher: So the last thing I wanted to ask you about -- So this was the third way. So just to summarize, if you've got a messed up gut in some way, I think essential amino acid is going to be really helpful for you. And then the second way is anti-catabolic effect. So if you're riding your bike and you're breaking down, you're in the fasted state, your body is trying to mobilize energy and maybe that energy is coming from the amino acid alanine, it's just been liberated from your thigh, then I think it makes sense to take these essential aminos to stop that from happening.
And then the final way which, again, is just anecdote is I've noticed less kind of mental fatigue. Well, someone that's been really helpful for me in understanding this stuff is a guy called Dr. Tommy Wood. He's one of the doctors I work with. He's been sending me some papers. There's something called essential fatigue hypothesis. And so there's this idea that the large neutral amino acid they compete for access across the blood brain barrier. And tryptophan especially that it goes on to make something called serotonin, which is an inhibitory neurotransmitter. And it's been implicated in fatigue.
So it makes sense then. If you could take some other large neutral amino acids that you could maybe compete with a tryptophan, maybe not so much tryptophan we get across the blood brain barrier and then you would feel less fatigue. I'm not a biochemist so I don't know everything about it. What do you think? Is any of this plausible?
David: I think it's totally plausible. When I'm doing endurance events, I always take them. I notice too that mentally I stay sharp. I stay sharp and that fatigue factor, that as soon as the brain gets that, with the research of this that I'm familiar with, when the brain decides that there's sort of too much stress on the muscles, the brain will shut down the muscles before they would shut down. And so while you may still have quite a bit of muscle power left to do whatever you're doing, once the brain shuts it down then the muscle shut down.
And I found that if you use the amino acids during exercise, that the shut down point is very, very much delayed, that the brain then stays nutrified so to speak, and it doesn't shut the muscles down. And you can get sort of the -- you can get the most out of whatever your fitness is at that particular time.
Christopher: And have you played around with tyrosine at all?
David: Well, I take additional tyrosine every morning. I take 1500 milligrams every morning because I find that -- we do a lot of work with neurotransmitters and balancing neurotransmitters aside from just the nutritional aspects of this. Your dopamine and your Epinephrine and your Norepinephrine are basically tyrosine molecules and a lot of people need more. So while I'm taking the perfect amino as the sort of basic building blocks of protein, in addition to food, that sometimes additional amino acids are very helpful. And in that case, you're using it sort of as a pharmaceutical not so much as just a nutrient.
Christopher: Right, right. It has exactly the same effect on me as well. The tyrosine is really quite stimulating. Tommy, Dr. Woods, said the same thing. He used to do -- when he was studying for exams, that he would always take 500 milligrams or maybe a gram of tyrosine before an exam and it would help him concentrate without--
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Caffeine is not the same. It makes you jittery and it's not a good feeling.
David: It helps memory too. The tyrosine definitely helps memory.
Christopher: So why would you think -- It's interesting why do you think you continue to need that? I mean, obviously, your gut is in good shape and you're doing everything right, you eat a nutrient dense diet, why do you think you will continue to need tyrosine?
David: I think just the demands are high. I get up at 5 o'clock every day, I go to bed at 11:00. I'm with patients all day long. I'm training for an Ironman. I teach most nights. So my body is 67 years old. It isn't as good as when I was 40 but it performs like it. I find that if I add these other things in -- and then we're in a toxic environment. The load on the body just in terms of dealing with plastics and petrochemicals and fluorides and all this stuff which you can't escape, the needs of the body are way higher.
If you're going to maintain performance, health, energy performance, then you need to throw a lot of extra stuff in. I think at some point, I think early on you could eat a good diet and you'd be fine. Today I don't think you can just eat a good diet and be fine. I think the supplementation is mandatory because the demands are so high and the body needs the extra stuff to just get along.
Christopher: Yeah. I agree completely. I used to be -- Like I say I'd never taken any supplements before 2011. And I really wasn't doing very good right then. And now I'm doing fantastic. I'm still training just as hard and still being very competitive on the bike. I do take a lot of supplements. I don't think it's a coincidence. I've done a lot of other things too, made a lot of other changes to my diet and lifestyle but I've no doubt. I notice the difference.
When I stop taking tyrosine I notice the difference. And it's interesting to hear you say why you think that is. It's fascinating. But who cares? I take five of these essential amino tablets per hour on the bike. That's worth about a dollar an hour. It's nothing, is it? Just the cost of doing business. I spend more than that on my tires. I run these expensive Schwalbe Racing Ralph tires and they're fantastic. It comes from Germany. There's no way they'll cost as little as a dollar an hour. I think they're good value.
David: [0:32:38] [Indiscernible] per hour, you're spending more than a dollar.
Christopher: Yeah.
David: It's nothing.
Christopher: So, yeah, I think it's fantastic value. And I should probably also say that if you are struggling to make ends meet and these supplements are kind of out of your reach, then you probably shouldn't sacrifice your food budget for them, right?
David: But you know what? Here's what I tell people. A canister of quality whey protein is going to go for a month. It's going to run at least $30 to $40. So don't buy that. That's $30 or $40. Now, if you're going to Starbucks every day and you spend $5 on a coffee, you can make the same coffee for $0.10. So, $5 a day on Starbucks times 30 days, that's $150 there and you got another $40 for your whey protein. You have an extra budget. And if you're drinking a lot of beer and you're trying to maintain your health, well then throw that in there too.
But there is a budget for most people where they can do this and it will really -- It will make their life better. So I think it's a choice thing more than it is affordability for most people.
Christopher: You're right. Yeah, get rid of satellite TV or something.
David: Yeah. Just pollutes your mind anyway.
Christopher: Well, this has been fantastic. Thank you so much. I will link to the product page for these essential amino acids that we've been talking about. I think they're great. I continue to use them and I think it's a really great product. Thanks very much, David, for your time. I really appreciate this. We're recording this on a Saturday, by the way, so I'm super extra grateful to Dr. Minkoff for giving me part of his weekend. I really appreciate that.
David: You're welcome. And it was fun, Chris.
Christopher: Thank you. Is there anything else? Where can people find out about you? I know you do a lot work with the chelation and all kinds of interesting stuff. Where can people go and find out more about you?
David: You could go to drminkoff.com or my clinic is Lifeworkswellnesscenter.com. We're in Clearwater, Florida. We have a large center there where we do integrative oncology and we deal with a lot of sick people with Lyme disease, chronic fatigue.
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Also a fair number of athletes, very high performance triathletes, cyclists, ultra distance athletes because really what we're doing is we're interested in performance. And so we do a lot of measurements on people. We can find out where their body is falling down, provide the right remedies for them so they can either regain their health or improve their gain.
David: Fantastic stuff. Okay. Well, I will link to all of those in the show notes. So if you want to find any of those resources then just look at the show notes for this podcast and you'll find them there.
Christopher: Okay. Well, thanks, David.
David: Okaydoke. All the best.
Christopher: Cheers then. Bye.
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