1 00:00:05,399 --> 00:00:05,859 Hi. 2 00:00:09,600 --> 00:00:10,740 Good morning. 3 00:00:11,500 --> 00:00:13,050 See, there were people there who said 4 00:00:13,059 --> 00:00:15,020 hi, and those people said good morning. 5 00:00:15,360 --> 00:00:17,070 Because in health optimization medicine 6 00:00:17,070 --> 00:00:18,730 and practice, as you heard yesterday, 7 00:00:18,939 --> 00:00:21,059 hi is always a four letter word. 8 00:00:21,579 --> 00:00:23,179 Today we're talking about the 9 00:00:23,189 --> 00:00:24,709 enderic microbiota gut brain 10 00:00:24,729 --> 00:00:26,859 axis in the context of health 11 00:00:26,989 --> 00:00:28,469 optimization medicine and practice. 12 00:00:29,294 --> 00:00:31,304 Now, I'd like to disclose that I'm the 13 00:00:31,304 --> 00:00:33,474 founder of both of these organizations, 14 00:00:33,504 --> 00:00:34,724 Health Optimization Medicine and 15 00:00:34,724 --> 00:00:36,164 Practice, which is a non profit. 16 00:00:36,514 --> 00:00:39,004 We teach physicians health optimization 17 00:00:39,004 --> 00:00:41,394 medicine and non physician healthcare 18 00:00:41,394 --> 00:00:43,034 practitioners health optimization 19 00:00:43,034 --> 00:00:46,034 practice on how to do health optimization. 20 00:00:46,384 --> 00:00:49,614 And The products off descriptions LLC, 21 00:00:49,984 --> 00:00:52,564 which is now held a company held by 22 00:00:52,564 --> 00:00:55,964 smarter, not harder is actually to help 23 00:00:56,184 --> 00:00:59,884 clinicians deal with more acute symptoms. 24 00:00:59,935 --> 00:01:01,425 During a patient or client 25 00:01:01,425 --> 00:01:03,495 care for example, anxiousness 26 00:01:03,845 --> 00:01:05,985 and sleeplessness and pain. 27 00:01:06,365 --> 00:01:08,875 And we are essentially the 28 00:01:08,875 --> 00:01:10,235 main donors to Home Hope. 29 00:01:10,255 --> 00:01:12,575 So that's a disclosure for me. 30 00:01:13,265 --> 00:01:15,015 The general schema of everything 31 00:01:15,015 --> 00:01:16,895 that we talk about is this, 32 00:01:16,945 --> 00:01:19,028 is a enteric microbiota with 33 00:01:19,028 --> 00:01:20,845 a bidirectional communication 34 00:01:20,855 --> 00:01:22,275 with the gut and a bidirectional 35 00:01:22,315 --> 00:01:23,655 communication with the organs. 36 00:01:23,665 --> 00:01:25,285 So it's enteric microbiota 37 00:01:25,325 --> 00:01:26,965 gut organ communication. 38 00:01:27,285 --> 00:01:28,805 I actually created this slide 39 00:01:28,805 --> 00:01:30,415 because I was made to lecture 40 00:01:30,455 --> 00:01:33,295 on enteric microbiota gut lung. 41 00:01:33,620 --> 00:01:35,890 Access during the beginning of 42 00:01:35,890 --> 00:01:38,740 COVID and as you can see here there 43 00:01:38,740 --> 00:01:40,520 is the common theme is that all of 44 00:01:40,520 --> 00:01:43,650 these organs actually have malt. 45 00:01:44,010 --> 00:01:47,170 And I don't mean whiskey because 46 00:01:47,180 --> 00:01:48,960 in health optimization, we 47 00:01:48,960 --> 00:01:50,630 have better drugs and alcohol. 48 00:01:51,315 --> 00:01:53,035 So MALT stands for what? 49 00:01:53,115 --> 00:01:56,155 Mucosa associated lymphoid tissue, right? 50 00:01:56,185 --> 00:01:58,285 So you could see here whereas before 51 00:01:58,405 --> 00:02:00,215 the other systems we should thought were 52 00:02:00,225 --> 00:02:01,935 sterile, like the ureters, et cetera, 53 00:02:01,965 --> 00:02:04,145 and placenta, they actually have a, 54 00:02:04,280 --> 00:02:06,690 Microbiota now, as we have found out. 55 00:02:07,060 --> 00:02:09,540 So after this lecture, you will be 56 00:02:09,540 --> 00:02:11,070 able to discuss knowledgeably about 57 00:02:11,070 --> 00:02:12,670 the fundamental structure functions 58 00:02:12,970 --> 00:02:15,340 and new perspectives of the M. 59 00:02:15,340 --> 00:02:15,540 G. 60 00:02:15,540 --> 00:02:15,710 B. 61 00:02:15,720 --> 00:02:18,080 Axis enumerate the bidirectional 62 00:02:18,080 --> 00:02:19,770 communication pathways of the E. 63 00:02:19,770 --> 00:02:19,890 M. 64 00:02:19,890 --> 00:02:20,040 G. 65 00:02:20,040 --> 00:02:20,210 B. 66 00:02:20,210 --> 00:02:22,354 Axis mentally formed a framework. 67 00:02:22,715 --> 00:02:24,355 Of HomeHope and its fundamental 68 00:02:24,365 --> 00:02:25,915 role in caring for the EMGB 69 00:02:25,915 --> 00:02:27,215 axis as a practitioner. 70 00:02:27,555 --> 00:02:29,105 Be familiar with the technique of 71 00:02:29,105 --> 00:02:30,895 detection and correction of imbalance 72 00:02:31,315 --> 00:02:33,315 of HomeHope versus diagnosis and 73 00:02:33,315 --> 00:02:34,625 treatment of disease of illness 74 00:02:34,625 --> 00:02:37,265 medicine as applied to the EMGB axis. 75 00:02:37,625 --> 00:02:39,035 Discuss knowledgeably about 76 00:02:39,075 --> 00:02:41,125 the enteric microbiota brain 77 00:02:41,125 --> 00:02:43,445 interactions, neuroinflammation, 78 00:02:43,445 --> 00:02:45,145 and identify what's missing in 79 00:02:45,145 --> 00:02:47,915 today's research on the EMGB axis. 80 00:02:49,055 --> 00:02:50,525 And be up to date with the latest 81 00:02:50,525 --> 00:02:52,365 developments in the EMGB axis. 82 00:02:52,795 --> 00:02:54,655 Now, let's take the first part 83 00:02:54,655 --> 00:02:55,775 of this, is the structure, 84 00:02:55,775 --> 00:02:57,325 functions, and new perspectives. 85 00:02:57,765 --> 00:03:00,125 You guys already can always Google 86 00:03:00,125 --> 00:03:02,055 the structure and function, right? 87 00:03:02,135 --> 00:03:03,255 What I'd like you to remember 88 00:03:03,255 --> 00:03:04,615 from this section are really 89 00:03:04,785 --> 00:03:06,115 the perspectives that you should 90 00:03:06,155 --> 00:03:07,885 carry when you are in the clinic. 91 00:03:08,355 --> 00:03:10,145 Let's take a look at a quick structure. 92 00:03:10,145 --> 00:03:11,705 Many of you have more expertise 93 00:03:11,715 --> 00:03:13,375 than I have in this area. 94 00:03:13,585 --> 00:03:14,785 This is distribution of 95 00:03:14,965 --> 00:03:16,595 microbial communities by weight. 96 00:03:16,755 --> 00:03:18,225 As you can see, 78 percent 97 00:03:18,225 --> 00:03:19,245 is in the GI tract. 98 00:03:19,455 --> 00:03:20,795 And here's the distribution. 99 00:03:21,090 --> 00:03:22,970 On the right side of the slide, where you 100 00:03:22,970 --> 00:03:25,510 could see where the colon has 10 to the 101 00:03:25,530 --> 00:03:29,980 11, jejunum 10 squared, and 10 to the 8. 102 00:03:30,040 --> 00:03:31,590 So you could see where the 103 00:03:31,630 --> 00:03:34,580 distributions are of the gut microbiota. 104 00:03:34,930 --> 00:03:36,570 Now the important thing here is 105 00:03:36,610 --> 00:03:38,440 to visualize it in several layers. 106 00:03:38,530 --> 00:03:41,060 The gut microbiota actually 107 00:03:41,260 --> 00:03:43,050 pre process all of your food. 108 00:03:43,050 --> 00:03:45,540 Now, that's a key term here, is it pre 109 00:03:45,540 --> 00:03:48,320 processes everything that you swallow 110 00:03:48,440 --> 00:03:50,620 they try to pre process even non 111 00:03:50,650 --> 00:03:52,490 edible things that you try to swallow. 112 00:03:52,990 --> 00:03:55,130 So here after they pre process it 113 00:03:55,230 --> 00:03:56,410 and it passes through the liver. 114 00:03:56,420 --> 00:03:58,020 That's When you take an oral drug the 115 00:03:58,200 --> 00:04:01,440 liver tries to either activate or detoxify 116 00:04:01,440 --> 00:04:04,250 it however the drug is configured and 117 00:04:04,250 --> 00:04:07,410 then those raw materials are now then fed 118 00:04:07,500 --> 00:04:09,760 to the brain to the heart, the adipose 119 00:04:10,290 --> 00:04:12,600 tissue, the muscle, kidneys, and so on. 120 00:04:12,600 --> 00:04:15,280 All right, so the new perspective is the 121 00:04:15,280 --> 00:04:18,090 enteric microbiota is a post natal organ. 122 00:04:18,220 --> 00:04:20,760 Okay it's an organ that actually 123 00:04:20,800 --> 00:04:23,490 appears and grows after birth, right? 124 00:04:23,550 --> 00:04:26,380 It's seeded usually in spontaneous vaginal 125 00:04:26,380 --> 00:04:28,560 delivery through the vaginal canal. 126 00:04:28,770 --> 00:04:31,479 And as early as 2006, there 127 00:04:31,479 --> 00:04:32,979 were already some publications 128 00:04:32,979 --> 00:04:34,439 that is the forgotten organ. 129 00:04:34,639 --> 00:04:36,329 Now, don't forget microbiota 130 00:04:36,379 --> 00:04:38,589 is not foreign to you, right? 131 00:04:38,629 --> 00:04:40,789 It is part of what grows in 132 00:04:40,789 --> 00:04:42,709 you as an organ, except that it 133 00:04:42,709 --> 00:04:44,529 only grows after you're born. 134 00:04:45,044 --> 00:04:46,754 So here's a more recent, this is 135 00:04:46,754 --> 00:04:49,124 2019 article, a representation 136 00:04:49,154 --> 00:04:52,164 of the gut micro biota in terms 137 00:04:52,164 --> 00:04:54,034 of prenatal, infancy, childhood, 138 00:04:54,034 --> 00:04:56,074 adolescence, adulthood, and aging. 139 00:04:56,314 --> 00:04:58,274 And you could see here on the lower 140 00:04:58,274 --> 00:05:00,604 part what they're actually doing 141 00:05:00,814 --> 00:05:02,524 right in helping to contribute. 142 00:05:02,524 --> 00:05:05,784 Doing now of course the second part 143 00:05:05,784 --> 00:05:07,069 that, that's your enteric microbiota. 144 00:05:07,599 --> 00:05:09,339 Remember in, in old textbooks, 145 00:05:09,339 --> 00:05:10,959 we just say gut-brain axis. 146 00:05:10,959 --> 00:05:12,219 That's already old, right? 147 00:05:12,319 --> 00:05:13,849 You have to specify enteric 148 00:05:13,849 --> 00:05:16,519 microbiota, gut brain axis, right? 149 00:05:16,619 --> 00:05:19,859 In order to be more specific, that the 150 00:05:19,909 --> 00:05:21,979 microbiota itself is an organ in the body. 151 00:05:22,219 --> 00:05:24,059 Now the gut is actually 152 00:05:24,059 --> 00:05:25,739 a brain in itself, right? 153 00:05:25,739 --> 00:05:27,919 It has the lumen, of course the 154 00:05:27,919 --> 00:05:29,239 like the ventricles in the brain. 155 00:05:29,399 --> 00:05:30,779 Myenteric plasters, which 156 00:05:30,779 --> 00:05:31,619 is the main nervous. 157 00:05:32,159 --> 00:05:33,249 system of the brain, which 158 00:05:33,249 --> 00:05:34,729 we call actually the enteric 159 00:05:34,739 --> 00:05:35,799 nervous system, right? 160 00:05:35,829 --> 00:05:36,959 And then there's semicosal 161 00:05:37,019 --> 00:05:38,689 plexus, and then the mesentery. 162 00:05:38,949 --> 00:05:40,179 This is an old book that 163 00:05:40,189 --> 00:05:42,029 actually popularized the idea 164 00:05:42,029 --> 00:05:43,079 that it's the second brain. 165 00:05:43,239 --> 00:05:45,179 For many people, in fact, it is the first 166 00:05:45,189 --> 00:05:47,809 brain because evolutionarily, the brain is 167 00:05:47,859 --> 00:05:50,159 actually a later development in evolution. 168 00:05:50,160 --> 00:05:51,339 You had the gut first. 169 00:05:51,944 --> 00:05:54,024 So the functions would be nutrient 170 00:05:54,034 --> 00:05:56,204 absorption and immune defense, right? 171 00:05:56,234 --> 00:05:58,314 And you could see here underneath 172 00:05:58,324 --> 00:06:00,174 the intestinal lining, there 173 00:06:00,174 --> 00:06:01,704 is the payers patches, right? 174 00:06:01,724 --> 00:06:03,634 And there is the M cell or the micro 175 00:06:03,634 --> 00:06:05,544 fold cell that proceeds it and of 176 00:06:05,544 --> 00:06:06,914 course there's a lymphoid tissue 177 00:06:06,944 --> 00:06:09,614 underneath and this is called the 178 00:06:10,114 --> 00:06:12,154 induction path induction patch, right? 179 00:06:12,154 --> 00:06:14,484 This is where most of the immune 180 00:06:14,484 --> 00:06:17,964 system actually interacts with anything 181 00:06:17,974 --> 00:06:20,494 that's in the gut lumen, right? 182 00:06:21,134 --> 00:06:22,684 Now the new perspective that I'd 183 00:06:22,684 --> 00:06:25,194 like you to take home with you is 184 00:06:25,204 --> 00:06:27,054 that it's the largest immune organ. 185 00:06:27,144 --> 00:06:28,084 When you were in med school, 186 00:06:28,084 --> 00:06:30,014 it was a bone marrow, right? 187 00:06:30,014 --> 00:06:32,344 But we have, in the last 15 years, we now 188 00:06:32,344 --> 00:06:35,044 know it's the largest immune organ, right? 189 00:06:35,074 --> 00:06:36,664 And you could see here the 190 00:06:36,704 --> 00:06:38,914 distribution and with apologies 191 00:06:39,074 --> 00:06:42,074 for those who love Ayn Rand, who is 192 00:06:42,074 --> 00:06:44,394 GALT gut associated lymphoid tissue. 193 00:06:44,614 --> 00:06:46,934 This makes up 70% of 194 00:06:46,934 --> 00:06:49,274 the immune system now. 195 00:06:49,919 --> 00:06:51,649 Let's go to the brain the third part 196 00:06:51,669 --> 00:06:54,699 of the axis the brain we we we should 197 00:06:54,709 --> 00:06:56,399 always take a look that we have two 198 00:06:56,399 --> 00:06:58,209 brains and a single body, right? 199 00:06:58,549 --> 00:06:59,229 Let's take a look at 200 00:06:59,229 --> 00:07:00,249 the second brain first. 201 00:07:00,319 --> 00:07:02,809 It has glial cells, 500 million neurons, 202 00:07:02,810 --> 00:07:05,684 14 neurotransmitters that are identified 203 00:07:05,844 --> 00:07:07,854 and produces 50 percent of all dopamine 204 00:07:07,854 --> 00:07:10,224 and 95 percent of all serotonin. 205 00:07:10,414 --> 00:07:12,094 Now, remember, these are not for the 206 00:07:12,094 --> 00:07:13,634 brain in the central nervous system. 207 00:07:13,644 --> 00:07:15,214 This is for its own use. 208 00:07:15,639 --> 00:07:17,619 As a brain in itself, right? 209 00:07:17,739 --> 00:07:19,929 So it's time for you to forget 210 00:07:19,929 --> 00:07:21,099 the fact that, oh, are these 211 00:07:21,099 --> 00:07:22,299 going to be used by the brain? 212 00:07:22,299 --> 00:07:23,679 No, this is going to be used 213 00:07:23,679 --> 00:07:25,209 by your second brain, right? 214 00:07:25,239 --> 00:07:27,099 It is a brain in itself. 215 00:07:27,099 --> 00:07:28,839 So these are its own neurotransmitters. 216 00:07:28,839 --> 00:07:30,429 These are what it produces for 217 00:07:30,429 --> 00:07:31,929 itself in order to function. 218 00:07:32,479 --> 00:07:33,794 That's why I said it requires a 219 00:07:33,794 --> 00:07:35,264 really, a shift in perspective 220 00:07:35,264 --> 00:07:36,704 to treat it as a brain, right? 221 00:07:36,914 --> 00:07:38,294 The other brain actually has 222 00:07:38,294 --> 00:07:39,794 about 86 billion neurons. 223 00:07:39,794 --> 00:07:41,414 And for those of you who are 224 00:07:41,414 --> 00:07:43,719 curious, really 65 billion of those. 225 00:07:44,164 --> 00:07:45,654 are contained in your cerebellum, 226 00:07:45,664 --> 00:07:47,014 so you have really only very 227 00:07:47,014 --> 00:07:49,064 few that are in your neocortex. 228 00:07:49,624 --> 00:07:52,524 Now the the finding, of course this 229 00:07:52,524 --> 00:07:55,164 was in, I think 2012, is that there's 230 00:07:55,164 --> 00:07:56,614 a glymphatic system in the brain. 231 00:07:56,664 --> 00:07:57,924 We used to think that there was no 232 00:07:57,924 --> 00:07:59,684 lymphatic system in the brain at all, 233 00:07:59,914 --> 00:08:01,874 and it turns out that the glial cells 234 00:08:01,914 --> 00:08:04,744 actually form a perilymphatic space 235 00:08:05,179 --> 00:08:07,769 or a perivascular space around the 236 00:08:08,029 --> 00:08:10,569 blood vessels and actually cleans out 237 00:08:10,569 --> 00:08:12,749 your brain, especially during sleep. 238 00:08:12,869 --> 00:08:15,899 So this is a Nobel worthy development 239 00:08:16,129 --> 00:08:18,139 that they actually saw that there is the 240 00:08:18,149 --> 00:08:20,029 brain has actually a lymphatic system. 241 00:08:21,729 --> 00:08:24,189 Now, the structure of the brain all of 242 00:08:24,189 --> 00:08:26,079 us talk about the blood brain barrier as 243 00:08:26,119 --> 00:08:28,069 if it were the only barrier of the brain. 244 00:08:28,199 --> 00:08:29,359 It is not, right? 245 00:08:29,609 --> 00:08:31,219 There are barriers at the surface of the 246 00:08:31,229 --> 00:08:33,667 brain the arachnoid barrier There's a 247 00:08:33,667 --> 00:08:36,787 blood CSF barrier closer to the cavities 248 00:08:36,797 --> 00:08:38,437 of your brain called the ventricles. 249 00:08:38,757 --> 00:08:39,747 And of course, there's 250 00:08:39,787 --> 00:08:40,957 the blood brain barrier. 251 00:08:40,997 --> 00:08:42,997 So all of these are actually significant 252 00:08:43,007 --> 00:08:44,477 in what we're discussing today. 253 00:08:44,727 --> 00:08:46,157 So when someone says blood brain 254 00:08:46,167 --> 00:08:47,907 barrier, do you mean just the blood 255 00:08:47,907 --> 00:08:49,557 brain barrier or do you mean the blood 256 00:08:49,557 --> 00:08:51,687 cerebrospinal fluid barrier or the 257 00:08:51,717 --> 00:08:53,147 barrier at the surface of the brain? 258 00:08:53,277 --> 00:08:54,327 These are very important 259 00:08:54,337 --> 00:08:55,387 distinctions to make. 260 00:08:57,242 --> 00:09:00,032 Now the function of the brain is for 261 00:09:00,032 --> 00:09:01,902 cognition and emotional regulation. 262 00:09:02,222 --> 00:09:04,692 And is actually interesting. 263 00:09:04,712 --> 00:09:06,132 Psychedelic research find the ego 264 00:09:06,132 --> 00:09:07,732 exists in the default mode network. 265 00:09:07,902 --> 00:09:09,462 This is a network that looks 266 00:09:09,462 --> 00:09:10,712 like a butterfly like this. 267 00:09:10,772 --> 00:09:12,432 It's composed of the posterior 268 00:09:12,492 --> 00:09:14,572 cingulate gyrus, the prefrontal 269 00:09:14,782 --> 00:09:16,412 cortex, angular gyri. 270 00:09:16,412 --> 00:09:18,693 And you can see here that you should 271 00:09:18,743 --> 00:09:19,923 keep in mind, we're talking about, 272 00:09:19,923 --> 00:09:22,163 gut microbiota here, and the thing 273 00:09:22,163 --> 00:09:24,153 that you could think about is your 274 00:09:24,183 --> 00:09:25,823 ego is actually getting controlled 275 00:09:25,843 --> 00:09:27,723 by your gut microbiota sometimes. 276 00:09:28,273 --> 00:09:30,063 The other thing is that the brain circuit 277 00:09:30,073 --> 00:09:32,263 for spirituality has been identified 278 00:09:32,273 --> 00:09:35,183 and it's the periaqueductal gray. 279 00:09:35,253 --> 00:09:37,213 And for those of you who administer 280 00:09:37,213 --> 00:09:38,903 anesthesia at one point or the 281 00:09:38,903 --> 00:09:40,733 other, this is an opiate rich 282 00:09:40,803 --> 00:09:42,543 center that gets you high. 283 00:09:42,613 --> 00:09:45,263 And so there is your brain circuit for 284 00:09:45,453 --> 00:09:48,473 spirituality, and it's also in the brain. 285 00:09:48,503 --> 00:09:50,983 And so this is also being 286 00:09:51,003 --> 00:09:52,793 affected by your microbiota. 287 00:09:53,083 --> 00:09:54,263 I wonder if anyone here would 288 00:09:54,263 --> 00:09:55,773 sequence the gut microbiota of 289 00:09:55,993 --> 00:09:57,673 highly spiritual people and see 290 00:09:57,673 --> 00:09:59,253 what they get in terms of organisms. 291 00:09:59,903 --> 00:10:02,063 Now, then the new perspective that 292 00:10:02,063 --> 00:10:03,732 I'd like you to go home with is that 293 00:10:03,733 --> 00:10:05,663 the brain is not immune privileged. 294 00:10:05,683 --> 00:10:07,723 It has a neuro immune system. 295 00:10:07,803 --> 00:10:09,173 You guys are actually 296 00:10:09,253 --> 00:10:10,533 very familiar with this. 297 00:10:10,633 --> 00:10:12,303 This is the capture, rolling, 298 00:10:12,313 --> 00:10:14,133 activation, adhesion, this is all 299 00:10:14,133 --> 00:10:16,213 white blood cell activity, right? 300 00:10:16,623 --> 00:10:20,373 And it actually can insinuate itself into 301 00:10:20,373 --> 00:10:23,563 the neurons via the perivascular space. 302 00:10:24,103 --> 00:10:25,553 You could see here there's a 303 00:10:25,553 --> 00:10:27,193 neuroimmune crosstalk, right? 304 00:10:27,243 --> 00:10:28,083 There's a healthy brain 305 00:10:28,093 --> 00:10:29,033 and the diseased brain. 306 00:10:29,253 --> 00:10:30,823 You could see in the diseased brain 307 00:10:31,013 --> 00:10:32,533 or the unhealthy brain, right? 308 00:10:32,533 --> 00:10:34,063 There's a reactive astrocyte 309 00:10:34,103 --> 00:10:35,893 and activated microglia. 310 00:10:35,953 --> 00:10:37,833 Remember that astrocytes are just, 311 00:10:38,203 --> 00:10:40,433 what, special types of microglia. 312 00:10:41,118 --> 00:10:42,668 So let's take a look at the 313 00:10:42,668 --> 00:10:44,108 bidirectional communication 314 00:10:44,128 --> 00:10:46,028 in the tripartite axis, right? 315 00:10:46,048 --> 00:10:47,568 So there's neural, endocrine, 316 00:10:47,748 --> 00:10:49,718 immune, metabolite signaling, 317 00:10:49,978 --> 00:10:51,578 and vesicular, right? 318 00:10:51,908 --> 00:10:53,738 Here you have the neural mechanism. 319 00:10:53,788 --> 00:10:55,648 Here's the the neural mainly 320 00:10:55,648 --> 00:10:57,653 mediated as we as is often 321 00:10:57,653 --> 00:10:59,748 referenced as a vagus nerve, right? 322 00:10:59,748 --> 00:11:01,218 And then the endocrine is via the 323 00:11:01,218 --> 00:11:03,978 HPA axis with a cortisol affecting, 324 00:11:04,378 --> 00:11:06,208 gut motility, the immune system with 325 00:11:06,208 --> 00:11:08,158 the cytokines metabolite signaling. 326 00:11:08,518 --> 00:11:10,938 And one more here's the bi 327 00:11:10,938 --> 00:11:12,028 directional communication. 328 00:11:12,038 --> 00:11:13,728 We all know about the vagus nerve 329 00:11:13,778 --> 00:11:15,848 vagus actually slows down intestinal 330 00:11:16,568 --> 00:11:17,778 motility, and that's a signal. 331 00:11:17,878 --> 00:11:19,518 But what you should not forget is they're 332 00:11:19,548 --> 00:11:21,978 communicating with the enteric neurons. 333 00:11:22,038 --> 00:11:22,788 That's important. 334 00:11:22,828 --> 00:11:23,648 We all think it's just 335 00:11:23,668 --> 00:11:24,538 coming from the brain. 336 00:11:24,538 --> 00:11:26,018 Your second brain is actually 337 00:11:26,018 --> 00:11:27,718 communicating with your first brain 338 00:11:27,928 --> 00:11:30,248 in terms of its own enteric neurons. 339 00:11:30,698 --> 00:11:31,028 Okay. 340 00:11:31,598 --> 00:11:33,658 Now there's a bidirectional 341 00:11:33,658 --> 00:11:35,818 communication via the endocrine system. 342 00:11:35,998 --> 00:11:38,338 You have the hypothalamo pit axis, of 343 00:11:38,338 --> 00:11:40,693 course, the cortisol release and so on. 344 00:11:40,903 --> 00:11:44,393 And those actually report basically 345 00:11:44,393 --> 00:11:46,853 affect your microbiota and what your 346 00:11:46,853 --> 00:11:49,563 microbiota do actually produce metabolites 347 00:11:49,563 --> 00:11:51,638 that then are sent back to the brain. 348 00:11:52,328 --> 00:11:54,838 If you take a look here you have 349 00:11:54,838 --> 00:11:57,538 your we only think again this is 350 00:11:57,538 --> 00:11:58,678 what I'm going to emphasize here. 351 00:11:58,678 --> 00:11:59,458 You always think that it's 352 00:11:59,458 --> 00:12:00,348 coming from the brain. 353 00:12:00,778 --> 00:12:02,758 But the gut itself has its 354 00:12:02,768 --> 00:12:04,608 own enteroendocrine cells. 355 00:12:04,618 --> 00:12:07,158 It means it produces its own hormones, 356 00:12:07,168 --> 00:12:10,858 like GLP 1, PYY, CCK, these are all 357 00:12:10,958 --> 00:12:13,568 enteroendocrine hormones that are produced 358 00:12:13,668 --> 00:12:16,508 by the enteroendocrine cells in the gut. 359 00:12:16,868 --> 00:12:18,798 As I said earlier this is 360 00:12:18,798 --> 00:12:20,528 a separate brain in itself. 361 00:12:20,803 --> 00:12:22,913 So it has its own neurohormones, it 362 00:12:23,313 --> 00:12:26,203 has its own hormones that affect it and 363 00:12:26,203 --> 00:12:28,393 that affect the first brain in itself. 364 00:12:28,898 --> 00:12:30,428 The third is bi directional 365 00:12:30,428 --> 00:12:33,388 communication using the immune system. 366 00:12:33,528 --> 00:12:34,468 Of course, here are the 367 00:12:34,668 --> 00:12:35,808 immune cells, right? 368 00:12:35,848 --> 00:12:38,118 They produce the inflammatory cytokines 369 00:12:38,158 --> 00:12:40,798 and they affect the brain if they are 370 00:12:40,848 --> 00:12:42,408 inflammatory cytokines, of course, 371 00:12:42,408 --> 00:12:44,658 then you will begin to have something 372 00:12:44,668 --> 00:12:46,848 like neuro inflammation, right? 373 00:12:47,078 --> 00:12:48,698 It says here that the LPS 374 00:12:48,828 --> 00:12:50,438 activates an inflammatory response. 375 00:12:50,648 --> 00:12:53,478 You all are familiar with LPS. 376 00:12:53,658 --> 00:12:55,698 And one of the things I'd like to say 377 00:12:55,698 --> 00:12:57,948 here is that cardiologists like to 378 00:12:57,998 --> 00:13:00,688 put down to basically bring down your 379 00:13:00,708 --> 00:13:02,648 low density lipoproteins, but your 380 00:13:02,668 --> 00:13:04,888 low density lipoproteins are actually 381 00:13:04,888 --> 00:13:08,478 responsible for mopping up the the LPS. 382 00:13:08,628 --> 00:13:09,538 In your system. 383 00:13:09,548 --> 00:13:11,958 So there is a certain amount. 384 00:13:11,978 --> 00:13:14,348 If you push it way too low, your patient 385 00:13:14,358 --> 00:13:15,748 will actually be in a chronic state 386 00:13:15,748 --> 00:13:18,418 of inflammation because what the LPS 387 00:13:18,438 --> 00:13:20,058 could not be cleared out properly. 388 00:13:21,078 --> 00:13:21,598 Now. 389 00:13:22,198 --> 00:13:24,048 Metabolite signaling, you know that 390 00:13:24,048 --> 00:13:25,318 the colonic bacteria, for example, 391 00:13:25,328 --> 00:13:27,678 produces short chain fatty acids, right? 392 00:13:27,918 --> 00:13:30,338 And and short chain fatty acids, 393 00:13:30,338 --> 00:13:31,848 as you will see in later slides, 394 00:13:31,848 --> 00:13:33,518 actually is responsible for the 395 00:13:33,518 --> 00:13:35,613 behavior of your blood brain barrier. 396 00:13:36,113 --> 00:13:38,003 And among your short chain fatty 397 00:13:38,003 --> 00:13:40,693 acids the most prominent one that 398 00:13:40,723 --> 00:13:42,753 you know about is butyrate, right? 399 00:13:43,003 --> 00:13:45,063 And there, you have seen studies 400 00:13:45,063 --> 00:13:47,593 where low butyrate actually is very 401 00:13:47,593 --> 00:13:49,743 much associated with colon cancer. 402 00:13:49,833 --> 00:13:51,683 When I lecture to my students, I tell 403 00:13:51,683 --> 00:13:53,433 them that if you're looking for a colonic 404 00:13:53,433 --> 00:13:55,773 surgeon, you should ask your colon surgeon 405 00:13:55,773 --> 00:13:58,043 what the primary fuel is of colonocytes. 406 00:13:58,193 --> 00:13:59,603 If he says glucose, you should 407 00:13:59,613 --> 00:14:01,023 ditch him and find another one. 408 00:14:01,023 --> 00:14:02,293 A, these are very simple tests. 409 00:14:02,343 --> 00:14:04,543 Ask what's the primary fuel your GI, 410 00:14:04,553 --> 00:14:06,333 what the primary fuel of your enterocytes 411 00:14:06,343 --> 00:14:08,013 are, if he says glucose, ditch him, 412 00:14:08,353 --> 00:14:09,723 or ask your cardiologist what the 413 00:14:09,723 --> 00:14:11,423 primary fuel of the heart cells are, 414 00:14:11,573 --> 00:14:13,033 and if he says glucose, ditch him. 415 00:14:13,583 --> 00:14:15,153 If you ask your neurologist, 416 00:14:15,183 --> 00:14:16,283 what's the primary fuel of the 417 00:14:16,293 --> 00:14:17,913 brain at rest, if he says glucose. 418 00:14:18,298 --> 00:14:18,808 Fire him. 419 00:14:19,138 --> 00:14:21,328 These are basic or fundamental things 420 00:14:21,328 --> 00:14:23,458 that we all should know, right? 421 00:14:23,458 --> 00:14:24,828 Both doctors and practitioners 422 00:14:24,828 --> 00:14:26,458 should be very aware of what 423 00:14:26,458 --> 00:14:28,308 fuels your fundamental cells. 424 00:14:29,008 --> 00:14:31,198 So it's the neural, it's the vagus 425 00:14:31,238 --> 00:14:32,858 nervous system, endocrine is the 426 00:14:33,238 --> 00:14:36,128 hypothalamic pituitary axis and the entero 427 00:14:36,128 --> 00:14:38,398 endocrine system then there's immune 428 00:14:38,398 --> 00:14:40,608 signaling, metabolite signaling, right? 429 00:14:40,658 --> 00:14:42,258 And then, the last one, 430 00:14:42,288 --> 00:14:47,168 actually Um, is by what's called 431 00:14:47,238 --> 00:14:48,728 bacterial membrane vesicles are 432 00:14:48,728 --> 00:14:50,758 often outer membrane vesicles. 433 00:14:50,788 --> 00:14:53,458 So that the, again, the communication 434 00:14:53,498 --> 00:14:56,658 is bidirectional that the bacteria 435 00:14:56,688 --> 00:14:58,918 actually produce membrane vesicles that 436 00:14:58,948 --> 00:15:01,688 can then fuse with your enterocytes. 437 00:15:02,078 --> 00:15:03,058 And it may contain 438 00:15:03,068 --> 00:15:04,508 anything it can contain. 439 00:15:04,528 --> 00:15:05,938 It may contain RNA. 440 00:15:06,138 --> 00:15:08,498 In fact the Nobel award for this 441 00:15:08,548 --> 00:15:10,438 was showing it containing RNA. 442 00:15:10,818 --> 00:15:12,348 So for those of you who get 443 00:15:12,368 --> 00:15:15,108 questions about COVID vaccine, right? 444 00:15:15,148 --> 00:15:17,828 That it actually has RNA and it's 445 00:15:17,838 --> 00:15:19,608 being incorporated in the system. 446 00:15:19,658 --> 00:15:21,478 Evolution has been doing this for 447 00:15:21,478 --> 00:15:23,318 us thousands of years in our gut. 448 00:15:23,708 --> 00:15:25,018 So that's just something 449 00:15:25,018 --> 00:15:26,598 for you guys to think about. 450 00:15:28,848 --> 00:15:30,768 Now, here's what I was telling 451 00:15:30,768 --> 00:15:32,188 you about, the bidirectional 452 00:15:32,188 --> 00:15:34,818 communication in the EMGB axis, right? 453 00:15:35,178 --> 00:15:38,208 This was in 2013, and he says, 454 00:15:38,258 --> 00:15:40,328 Recently interkingdom crosstalk 455 00:15:40,328 --> 00:15:42,128 was demonstrated between humans and 456 00:15:42,128 --> 00:15:44,588 bacteria through fecal microRNAs. 457 00:15:44,588 --> 00:15:45,968 What, why is that significant? 458 00:15:46,298 --> 00:15:48,208 Because interspecies talk 459 00:15:48,218 --> 00:15:49,888 is not allowed, right? 460 00:15:50,218 --> 00:15:52,078 It's just like reproducing between a 461 00:15:52,078 --> 00:15:54,518 hippopotamus and a swallow, for example. 462 00:15:55,008 --> 00:15:56,178 But now we find that they 463 00:15:56,208 --> 00:15:58,048 actually communicate, right? 464 00:15:58,068 --> 00:15:59,738 And we talk back and forth 465 00:15:59,798 --> 00:16:01,248 with them through RNA. 466 00:16:01,828 --> 00:16:04,128 They alter our epigenome, and 467 00:16:04,128 --> 00:16:05,408 guess what, and therefore they 468 00:16:05,408 --> 00:16:07,618 will alter our behavior as well. 469 00:16:08,308 --> 00:16:09,788 So the way to look at it is 470 00:16:09,818 --> 00:16:11,428 what I term as a holobion. 471 00:16:11,478 --> 00:16:12,828 We are basically an 472 00:16:12,858 --> 00:16:14,438 assemblage of organisms. 473 00:16:14,728 --> 00:16:17,288 We are a network of organisms that 474 00:16:17,288 --> 00:16:19,068 are all communicating with each other. 475 00:16:19,298 --> 00:16:21,398 We cross a species in order 476 00:16:21,398 --> 00:16:23,198 to talk to each other, right? 477 00:16:23,198 --> 00:16:24,878 So human cells, human microbiota 478 00:16:25,348 --> 00:16:27,938 food, fungi, and other viruses, they 479 00:16:27,998 --> 00:16:30,168 are all in a network within our body 480 00:16:30,218 --> 00:16:32,288 as an ecosystem, and they all talk 481 00:16:32,288 --> 00:16:34,408 to each other by different means. 482 00:16:34,618 --> 00:16:36,098 And the last means that was just 483 00:16:36,098 --> 00:16:37,788 shown was actually by membrane 484 00:16:37,788 --> 00:16:39,738 vesicles, which was forbidden. 485 00:16:39,738 --> 00:16:41,168 This form of communication 486 00:16:41,368 --> 00:16:43,478 between species was forbidden by 487 00:16:43,508 --> 00:16:45,758 biology, by dogma a long time ago. 488 00:16:46,348 --> 00:16:49,378 Finally this is 20 19 article. 489 00:16:49,418 --> 00:16:51,998 They're finally using the term holobiont 490 00:16:52,048 --> 00:16:53,948 in the microbiota gut brain axis 491 00:16:53,958 --> 00:16:56,418 articles that you will find out there. 492 00:16:57,698 --> 00:16:59,528 Now, the third part would be an 493 00:16:59,538 --> 00:17:01,058 introduction to home hope for those of 494 00:17:01,058 --> 00:17:03,608 you who weren't here yesterday and then 495 00:17:03,608 --> 00:17:06,298 how to detect and correcting balances in 496 00:17:06,298 --> 00:17:08,598 the enteric microbiota got brain access. 497 00:17:08,968 --> 00:17:09,678 And then the. 498 00:17:09,678 --> 00:17:12,748 Uh, Entire microbiota brain interaction. 499 00:17:12,778 --> 00:17:13,988 The interaction between 500 00:17:14,068 --> 00:17:15,458 the two organs, right? 501 00:17:15,868 --> 00:17:17,518 And then a neural inflammation 502 00:17:17,558 --> 00:17:19,068 and illness medicine versus health 503 00:17:19,068 --> 00:17:20,598 organization, medicine and practice. 504 00:17:21,138 --> 00:17:24,898 This is a very simple way to display what 505 00:17:24,898 --> 00:17:27,038 we do in health optimization medicine. 506 00:17:27,338 --> 00:17:28,688 In illness medicine, essentially 507 00:17:28,698 --> 00:17:29,828 you look for disease markers 508 00:17:29,828 --> 00:17:32,482 like FBS or HBA1C, right? 509 00:17:32,812 --> 00:17:34,792 And then you basically correlate 510 00:17:34,792 --> 00:17:36,002 that with some disease and 511 00:17:36,062 --> 00:17:37,542 you do disease management. 512 00:17:37,552 --> 00:17:38,812 So it's very simple. 513 00:17:39,002 --> 00:17:40,822 Here we do diagnosis and treatment 514 00:17:40,822 --> 00:17:42,092 and that's a clinical practice. 515 00:17:42,502 --> 00:17:43,932 Of illness medicine is to 516 00:17:43,932 --> 00:17:45,282 diagnose and treat diseases. 517 00:17:45,552 --> 00:17:48,042 However with the advent of technology, 518 00:17:48,152 --> 00:17:50,622 we now know how to look inside the cell. 519 00:17:50,812 --> 00:17:52,942 And by looking at it, we see that 520 00:17:53,092 --> 00:17:55,102 actually there are about four drivers 521 00:17:55,312 --> 00:17:57,552 that precede the disease markers, right? 522 00:17:57,712 --> 00:17:59,082 These are genes symbiotic 523 00:17:59,082 --> 00:18:00,832 partners, environment, and time. 524 00:18:01,012 --> 00:18:02,872 For genes, you have the various types 525 00:18:02,892 --> 00:18:05,792 of the nuclear DNA, mitochondrial 526 00:18:05,792 --> 00:18:07,542 DNA, nucleic acids, your symbiotic 527 00:18:07,542 --> 00:18:09,592 partners, your mitochondria, which are 528 00:18:09,622 --> 00:18:11,942 endosymbionts, bacteria that live inside 529 00:18:11,942 --> 00:18:13,852 your cells, your gut microbiota, which 530 00:18:13,852 --> 00:18:15,992 are your exosymbionts, bacteria that live 531 00:18:16,232 --> 00:18:18,412 outside of your cells, your environment, 532 00:18:18,452 --> 00:18:20,812 like the direct and indirect signals from 533 00:18:20,812 --> 00:18:22,892 environment for example light, can be 534 00:18:22,892 --> 00:18:25,882 photo toxic to you and then evolutionary 535 00:18:25,882 --> 00:18:29,202 and circadian time and all of these gears 536 00:18:29,232 --> 00:18:31,652 actually produce metabolites that can 537 00:18:31,662 --> 00:18:34,672 be then detected and corrected, right? 538 00:18:35,012 --> 00:18:36,422 And you can detect and correct 539 00:18:36,452 --> 00:18:38,272 metabolite imbalances, and that's 540 00:18:38,282 --> 00:18:40,342 what we do at Health Optimization 541 00:18:40,342 --> 00:18:42,932 Medicine as a clinical practice is 542 00:18:42,932 --> 00:18:44,652 to detect and correct imbalances. 543 00:18:45,152 --> 00:18:47,012 We really don't do disease, we set 544 00:18:47,012 --> 00:18:48,852 the diseases aside and make sure 545 00:18:48,852 --> 00:18:50,352 we take care of your fundamental 546 00:18:50,362 --> 00:18:51,862 self first in terms of its balance. 547 00:18:52,422 --> 00:18:53,562 If you want to check for the 548 00:18:53,562 --> 00:18:55,632 health markers and adjust the 549 00:18:55,632 --> 00:18:57,672 metabolome itself, then use the 550 00:18:57,672 --> 00:18:59,282 science of clinical metabolomics. 551 00:18:59,732 --> 00:19:02,752 If you want to affect the DNA, we're 552 00:19:02,752 --> 00:19:05,252 too old for CRISPR Cas9 technology. 553 00:19:05,532 --> 00:19:06,032 Trust me. 554 00:19:06,052 --> 00:19:06,642 I tried. 555 00:19:06,702 --> 00:19:09,302 I bought a CRISPR Cas9 lab for 556 00:19:09,302 --> 00:19:11,222 myself and was unsuccessful. 557 00:19:11,252 --> 00:19:13,042 All I was able to do was develop a 558 00:19:13,062 --> 00:19:15,062 glowing Saccharomyces bouillardii. 559 00:19:15,422 --> 00:19:18,352 But anyway if you want to affect the DNA, 560 00:19:18,382 --> 00:19:20,612 then there's the science of epigenetics. 561 00:19:20,962 --> 00:19:22,662 Then if you want to affect the 562 00:19:22,662 --> 00:19:24,812 mitochondria and gut microbiota, you 563 00:19:24,812 --> 00:19:26,992 use the sciences of bioenergetics 564 00:19:27,102 --> 00:19:28,412 and the gut immune system. 565 00:19:28,782 --> 00:19:31,192 And if you want to affect the direct 566 00:19:31,192 --> 00:19:32,812 and indirect signals from environment, 567 00:19:32,872 --> 00:19:34,672 use a science called the exposome. 568 00:19:35,062 --> 00:19:36,862 Exposome, which is the sum total of 569 00:19:36,882 --> 00:19:39,612 your exposure to everything, right? 570 00:19:39,632 --> 00:19:41,602 And my favorite example here is that 571 00:19:41,602 --> 00:19:44,087 if a mother drinks during a pregnancy, 572 00:19:44,087 --> 00:19:46,387 then there's exposure to alcohol, right? 573 00:19:46,417 --> 00:19:48,637 And now you know why we look at this 574 00:19:48,637 --> 00:19:50,527 history when we're trying to figure out 575 00:19:50,537 --> 00:19:52,067 whether or not we have a fetal alcohol 576 00:19:52,087 --> 00:19:54,597 syndrome or an adult that was Exhibited 577 00:19:54,597 --> 00:19:56,527 fetal alcohol syndrome as a child. 578 00:19:56,907 --> 00:19:58,987 If you are looking to change the 579 00:19:58,987 --> 00:20:00,867 evolutionary and circadian time, 580 00:20:01,037 --> 00:20:03,157 you use the sciences of evolutionary 581 00:20:03,157 --> 00:20:05,457 medicine and chronobiology. 582 00:20:05,737 --> 00:20:07,477 Take a look at the Ohms here, right? 583 00:20:07,517 --> 00:20:09,757 Metabolome mitochondrial metabolome, 584 00:20:09,757 --> 00:20:12,617 got microbiome, epigenome so the 585 00:20:12,977 --> 00:20:15,017 cell danger response, a metabolome 586 00:20:15,027 --> 00:20:16,817 for evolutionary medicine and in 587 00:20:16,817 --> 00:20:19,527 chronobiology, we have the chronobiome 588 00:20:19,547 --> 00:20:20,527 and then you have the exposome. 589 00:20:20,527 --> 00:20:22,787 So these are the seven pillars of health 590 00:20:22,787 --> 00:20:24,387 optimization medicine and practice. 591 00:20:24,437 --> 00:20:26,027 Unfortunately, this is not taught to 592 00:20:26,027 --> 00:20:28,817 us in medical schools yet but we hope 593 00:20:28,977 --> 00:20:31,917 that by doing this and educating a 594 00:20:31,927 --> 00:20:35,077 lot more people, we can get to where 595 00:20:35,077 --> 00:20:36,607 we want to be in terms of health 596 00:20:36,697 --> 00:20:37,997 in this country and in the world. 597 00:20:38,387 --> 00:20:39,587 Let's define health. 598 00:20:39,877 --> 00:20:41,727 If you ask any person, especially 599 00:20:41,737 --> 00:20:43,457 a doctor, to define health, they 600 00:20:43,457 --> 00:20:45,387 wouldn't have any definition of health. 601 00:20:45,777 --> 00:20:47,937 I like a more clinically actionable 602 00:20:47,937 --> 00:20:50,157 definition of health, and this is, you 603 00:20:50,157 --> 00:20:52,627 can take this with you, A plus B plus 604 00:20:53,067 --> 00:20:54,887 C is the absence of disease, which is 605 00:20:54,887 --> 00:20:56,867 illness medicine, and the balance between 606 00:20:56,867 --> 00:20:59,057 anabolism and catabolism according 607 00:20:59,057 --> 00:21:01,247 to the cycle of life of the organism. 608 00:21:01,767 --> 00:21:04,207 And we don't do root causes of disease. 609 00:21:04,417 --> 00:21:05,847 There's only one root cause of health, 610 00:21:05,867 --> 00:21:07,247 and it's the maintenance of balance 611 00:21:07,287 --> 00:21:09,827 between anabolism and catabolism, right? 612 00:21:10,057 --> 00:21:12,567 And I hope someone now here knows 613 00:21:12,577 --> 00:21:14,367 the answer to my question yesterday. 614 00:21:14,717 --> 00:21:17,307 Is inflammation anabolic or catabolic? 615 00:21:17,387 --> 00:21:18,807 I'm not going to answer that for you. 616 00:21:19,327 --> 00:21:21,057 So it means that just because you're 617 00:21:21,057 --> 00:21:22,677 not sick doesn't mean you're healthy. 618 00:21:22,787 --> 00:21:25,207 It only means that you're not sick, right? 619 00:21:25,867 --> 00:21:28,717 And optimization Now it's defined as 620 00:21:28,977 --> 00:21:31,737 neotenizing your metabolic subnetworks 621 00:21:31,797 --> 00:21:33,737 to values that it had when you 622 00:21:33,737 --> 00:21:36,477 were between 21 to 30 years old, or 623 00:21:36,477 --> 00:21:38,587 use evolutionarily derived values. 624 00:21:39,522 --> 00:21:41,532 And neotenizing means making young. 625 00:21:41,712 --> 00:21:43,302 When your patient or client comes 626 00:21:43,302 --> 00:21:44,992 to you and says, Oh, but this value 627 00:21:44,992 --> 00:21:47,522 is normal that's normal for the age. 628 00:21:47,542 --> 00:21:50,122 But what we try to do, or what we do, is 629 00:21:50,122 --> 00:21:53,262 actually to move your values to the values 630 00:21:53,262 --> 00:21:55,932 you had between 21 and 30 the golden 631 00:21:55,932 --> 00:22:00,332 age for having children then her dog 632 00:22:00,342 --> 00:22:02,982 actually did this in hormone balancing. 633 00:22:03,122 --> 00:22:05,342 He uses a mean value of 25 plus 634 00:22:05,342 --> 00:22:06,582 minus two standard visions. 635 00:22:06,812 --> 00:22:07,952 United States, by the way, 636 00:22:07,952 --> 00:22:09,922 uses 30 for hormone, right? 637 00:22:10,002 --> 00:22:12,392 Gordon his median value is he takes a 638 00:22:12,392 --> 00:22:15,282 median value between age 20 to 30, and I 639 00:22:15,282 --> 00:22:18,872 use the 50th to 75th percentile at age 21 640 00:22:18,892 --> 00:22:22,062 to 30, or and I use evolutionarily derived 641 00:22:22,062 --> 00:22:23,852 values, for example, for vitamin D. 642 00:22:24,112 --> 00:22:26,382 Vitamin D values, as I see in this country 643 00:22:26,552 --> 00:22:28,762 the range, reference range is way too low. 644 00:22:29,302 --> 00:22:31,222 We do not use illness medicine range of 645 00:22:31,222 --> 00:22:33,932 values, lab values are cut of values 646 00:22:33,982 --> 00:22:35,922 they are survival values and are not 647 00:22:36,327 --> 00:22:39,627 optimal values and normal is not optimal. 648 00:22:41,267 --> 00:22:43,267 Now the practice is very simple. 649 00:22:43,277 --> 00:22:45,217 You measure the levels of metabolites, you 650 00:22:45,217 --> 00:22:47,387 compare them to the optimal ranges, not 651 00:22:47,387 --> 00:22:50,017 the normal ranges, and you balance using 652 00:22:50,167 --> 00:22:51,947 two major techniques, which is network 653 00:22:51,957 --> 00:22:54,687 wide range shifting and ratio correction. 654 00:22:55,077 --> 00:22:56,727 Network wide range shifting 655 00:22:56,787 --> 00:22:58,547 brings the concept of network. 656 00:22:58,557 --> 00:23:00,057 Everything is networked in the body. 657 00:23:00,307 --> 00:23:01,477 If you touch one node, 658 00:23:01,507 --> 00:23:02,897 everything else is moves. 659 00:23:02,967 --> 00:23:04,607 The other one is ratio correction. 660 00:23:04,627 --> 00:23:06,627 For example, if you are looking at 661 00:23:06,667 --> 00:23:09,267 omega 3, omega 6 balance, then you 662 00:23:09,267 --> 00:23:10,817 should correct this by correcting 663 00:23:10,827 --> 00:23:12,727 the ratio and not correcting a 664 00:23:12,727 --> 00:23:16,077 single value in those metabolites. 665 00:23:16,587 --> 00:23:18,577 So this is a visual summary 666 00:23:18,597 --> 00:23:19,987 of home hope balancing. 667 00:23:19,997 --> 00:23:22,677 We all know that oxidative stress 668 00:23:22,697 --> 00:23:25,187 leads to all of these diseases. 669 00:23:25,497 --> 00:23:27,277 It's not only oxidative stress, right? 670 00:23:27,277 --> 00:23:28,857 There's also the nitrogen 671 00:23:28,867 --> 00:23:30,737 stress, the RNS, right? 672 00:23:30,737 --> 00:23:32,297 Which is used by the body really 673 00:23:32,297 --> 00:23:34,097 to kill viruses instantly. 674 00:23:34,697 --> 00:23:36,167 And so here it is, there's a 675 00:23:36,167 --> 00:23:38,067 redox balance and redox signaling. 676 00:23:38,097 --> 00:23:40,417 So we're after balancing, there's can 677 00:23:40,417 --> 00:23:42,647 see here the mitochondrial homeostasis 678 00:23:42,747 --> 00:23:45,057 metabolism inflammation on the other side. 679 00:23:45,147 --> 00:23:47,067 And then if you take a look, this is 680 00:23:47,097 --> 00:23:49,167 the yin yang of inflammation, right? 681 00:23:49,177 --> 00:23:51,777 For if you have , imbalanced redox. 682 00:23:52,027 --> 00:23:54,822 Then your NF kappa B transcription 683 00:23:54,822 --> 00:23:56,452 factor gets activated. 684 00:23:57,052 --> 00:24:00,132 And immediately produces your pro 685 00:24:00,132 --> 00:24:01,772 inflammatory cytokines, right? 686 00:24:02,232 --> 00:24:03,992 There's NF kappa B activation, 687 00:24:03,992 --> 00:24:06,232 your body knows what to do. 688 00:24:06,292 --> 00:24:07,992 Yeah, we're not dumb organisms. 689 00:24:07,992 --> 00:24:09,202 We evolved over time. 690 00:24:09,362 --> 00:24:11,282 We have our own mechanisms of 691 00:24:11,592 --> 00:24:13,542 healing and protecting ourselves. 692 00:24:13,632 --> 00:24:15,412 We should take a look at what we're doing 693 00:24:15,412 --> 00:24:18,762 first before we actually go gung ho and 694 00:24:18,762 --> 00:24:21,232 do different things to the body by shoving 695 00:24:21,242 --> 00:24:23,662 all sorts of things to it, we should know 696 00:24:23,702 --> 00:24:25,852 what the body is doing evolutionarily 697 00:24:25,992 --> 00:24:27,652 before you start changing things. 698 00:24:28,142 --> 00:24:30,802 The NRF2 system produces anti 699 00:24:30,852 --> 00:24:32,692 inflammatory cytokines, and 700 00:24:32,692 --> 00:24:34,652 this is the yin yang balance of 701 00:24:34,732 --> 00:24:37,282 inflammation and anti inflammation. 702 00:24:37,502 --> 00:24:38,962 Many of you like turmeric, is 703 00:24:38,962 --> 00:24:41,112 a very common way to decrease 704 00:24:41,112 --> 00:24:42,232 total body inflammation. 705 00:24:42,282 --> 00:24:43,242 Because it is a direct 706 00:24:43,252 --> 00:24:45,602 activator of the NRF2 system. 707 00:24:45,892 --> 00:24:47,992 Now, here's your pro inflammatory, 708 00:24:47,992 --> 00:24:49,392 anti inflammatory balance. 709 00:24:49,402 --> 00:24:52,122 You you can do a cytokine testing 710 00:24:52,142 --> 00:24:53,832 if you like to, or if your patient 711 00:24:53,842 --> 00:24:56,182 is rich enough to have this done. 712 00:24:56,917 --> 00:24:58,557 Again, you take a look at the 713 00:24:58,557 --> 00:25:00,147 balance of your inflammatory 714 00:25:00,187 --> 00:25:01,557 and anti inflammatory cytokines. 715 00:25:02,247 --> 00:25:03,847 In homo balancing, this is 716 00:25:03,867 --> 00:25:05,637 like the center of what we do. 717 00:25:05,847 --> 00:25:07,557 We optimize the resolution of 718 00:25:07,557 --> 00:25:09,227 the cell danger response, right? 719 00:25:09,567 --> 00:25:11,467 There is cell danger response 720 00:25:11,467 --> 00:25:13,667 consists of four major parts. 721 00:25:13,797 --> 00:25:15,547 Oxidative stress, which you could 722 00:25:15,547 --> 00:25:17,477 see can be the trigger is like 723 00:25:17,607 --> 00:25:19,837 your reactive oxygen species or 724 00:25:19,857 --> 00:25:21,337 reactive nitrogen species, right? 725 00:25:21,637 --> 00:25:23,847 And then your amplifier would be 726 00:25:23,847 --> 00:25:25,907 the inflammation by your cytokines. 727 00:25:26,147 --> 00:25:26,897 And then there's innate 728 00:25:26,897 --> 00:25:28,267 immunity, the activation of, 729 00:25:28,287 --> 00:25:29,787 say, your macrophages, right? 730 00:25:30,137 --> 00:25:32,437 And then there's the endoplasmic 731 00:25:32,437 --> 00:25:33,387 reticular stress response. 732 00:25:33,387 --> 00:25:34,707 As I said yesterday, you guys 733 00:25:35,047 --> 00:25:36,277 must be very familiar with this. 734 00:25:36,277 --> 00:25:38,207 This is unfolded protein response. 735 00:25:38,237 --> 00:25:40,937 This is elucidated over two decades ago. 736 00:25:41,097 --> 00:25:42,157 And you guys should be 737 00:25:42,167 --> 00:25:43,617 experts on this by now. 738 00:25:44,197 --> 00:25:46,597 This acute physical, biological, 739 00:25:46,597 --> 00:25:49,007 and psychological threat induces 740 00:25:49,187 --> 00:25:51,127 the cell danger response, right? 741 00:25:51,397 --> 00:25:53,147 And so does chronic physical 742 00:25:53,247 --> 00:25:54,537 chemical, and biological threat. 743 00:25:54,857 --> 00:25:56,867 Acute threats usually you can resolve 744 00:25:56,867 --> 00:25:58,657 it by ourselves, but the chronic 745 00:25:58,667 --> 00:26:00,117 threats are the ones that produce 746 00:26:00,117 --> 00:26:02,227 chronic diseases like diabetes 747 00:26:02,367 --> 00:26:04,247 or clinical cognitive decline. 748 00:26:04,762 --> 00:26:07,132 So I asked ChatGPT-4, I said, are 749 00:26:07,132 --> 00:26:09,022 there any vitamins, mineral, cofactors 750 00:26:09,022 --> 00:26:10,642 and hormones that dampen and or 751 00:26:10,642 --> 00:26:12,802 quell the cell danger response? 752 00:26:13,012 --> 00:26:16,702 And he says, vitamin DCE, A, mineral, 753 00:26:16,732 --> 00:26:19,132 zinc, magnesium, selenium, cofactor, coq, 754 00:26:19,312 --> 00:26:22,492 10 a LA, and a D plus hormones, melatonin, 755 00:26:22,492 --> 00:26:24,622 cortisol, testosterone, and others. 756 00:26:24,922 --> 00:26:27,262 Omega-3 fats and polyphenols, right? 757 00:26:27,662 --> 00:26:29,692 But should you give everything if 758 00:26:29,692 --> 00:26:31,552 your patient is, or client is in 759 00:26:31,552 --> 00:26:33,142 a cell dangerous response mode? 760 00:26:33,442 --> 00:26:34,022 Of course not. 761 00:26:34,052 --> 00:26:35,542 What we do in health optimization 762 00:26:35,542 --> 00:26:38,552 medicine is actually we measure, right? 763 00:26:38,822 --> 00:26:41,182 So we measure the levels of antioxidants, 764 00:26:41,372 --> 00:26:44,412 vitamins, C, A, alpha lipoic acid. 765 00:26:44,422 --> 00:26:46,952 Those are measurable right now by 766 00:26:47,152 --> 00:26:49,112 clinical metabolomic testing, right? 767 00:26:49,112 --> 00:26:51,272 So before giving any of that stuff. 768 00:26:51,272 --> 00:26:52,942 Just because you have chat GPT 4 769 00:26:52,942 --> 00:26:54,302 doesn't mean you should just inundate 770 00:26:54,302 --> 00:26:55,792 your patient with all the supplements. 771 00:26:55,822 --> 00:26:57,332 Measure and see whether or 772 00:26:57,332 --> 00:26:59,132 not they need them, right? 773 00:26:59,592 --> 00:27:01,612 If your patient is in actual anti 774 00:27:02,046 --> 00:27:03,956 oxidative stress, then they are warranted 775 00:27:04,176 --> 00:27:06,246 to the levels your tests are showing. 776 00:27:06,526 --> 00:27:09,156 Remember that is there is a syndrome 777 00:27:09,156 --> 00:27:11,476 called AIS, anti oxidant induced. 778 00:27:11,691 --> 00:27:12,181 stress. 779 00:27:12,461 --> 00:27:15,121 If you give way too many antioxidants, 780 00:27:15,321 --> 00:27:18,841 your system will go haywire. 781 00:27:18,861 --> 00:27:20,341 It will go the other way, right? 782 00:27:20,391 --> 00:27:21,291 And why is this? 783 00:27:21,321 --> 00:27:22,861 For example, if you enlarge the 784 00:27:22,861 --> 00:27:24,941 pool of your antioxidant vitamin 785 00:27:24,971 --> 00:27:26,511 E, that's a very large pool. 786 00:27:26,511 --> 00:27:27,951 And remember, they're in a cycle. 787 00:27:28,401 --> 00:27:29,631 Whatever is next in the 788 00:27:29,631 --> 00:27:31,511 cycle is still a small pool. 789 00:27:31,741 --> 00:27:33,911 So when you're looking at increasing 790 00:27:33,921 --> 00:27:35,831 your antioxidant pool, for example, 791 00:27:36,031 --> 00:27:37,031 take a look at your antioxidant 792 00:27:37,031 --> 00:27:39,561 regeneration pathway, right? 793 00:27:39,771 --> 00:27:41,241 Because all of those are involved. 794 00:27:41,501 --> 00:27:42,721 What you're going to do is 795 00:27:42,731 --> 00:27:45,541 simply pool the vitamin E and 796 00:27:45,541 --> 00:27:47,311 what it has reduced in its pool. 797 00:27:47,551 --> 00:27:50,541 And then a smaller pool is waiting 798 00:27:50,805 --> 00:27:53,295 to actually do the recycling for it. 799 00:27:53,525 --> 00:27:54,965 And that's the reason why many 800 00:27:54,965 --> 00:27:56,835 studies on, for example, Oh, 801 00:27:56,835 --> 00:27:59,215 selenium and vitamin E failed in 802 00:27:59,245 --> 00:28:02,435 80, 000 cohort for prostate cancer. 803 00:28:02,515 --> 00:28:03,845 If you don't measure this stuff 804 00:28:03,875 --> 00:28:06,105 before giving them it you are 805 00:28:06,115 --> 00:28:08,095 doing a wrong protocol, right? 806 00:28:08,705 --> 00:28:11,405 And then the imbalance of enteric 807 00:28:11,405 --> 00:28:12,375 microbiota It's called dysbiosis, 808 00:28:12,435 --> 00:28:14,175 of course, you know this, and you 809 00:28:14,175 --> 00:28:15,745 can detect and correct, for example, 810 00:28:15,745 --> 00:28:18,692 malabsorption and bacterial dysbiosis 811 00:28:18,792 --> 00:28:20,472 types of metabolites, right? 812 00:28:20,502 --> 00:28:22,682 You know how to do that, and you could 813 00:28:22,692 --> 00:28:25,152 do your recommended supplementation 814 00:28:25,152 --> 00:28:27,172 and dosing with prebiotics, 815 00:28:27,172 --> 00:28:28,612 probiotics, parabiotics, post-biotic, 816 00:28:28,612 --> 00:28:30,522 symbiotics high fiber diets. 817 00:28:30,767 --> 00:28:32,427 As I say in my lectures, the 818 00:28:32,427 --> 00:28:34,847 fastest diminishing macronutrient 819 00:28:34,867 --> 00:28:37,217 in the human diet is fiber, right? 820 00:28:37,817 --> 00:28:40,077 Lifestyle adjustments like meal timing 821 00:28:40,137 --> 00:28:42,327 all of us usually sacrifice our meal 822 00:28:42,327 --> 00:28:47,257 timing in order to do our work or to 823 00:28:47,387 --> 00:28:49,227 have our extracurricular activities. 824 00:28:49,717 --> 00:28:51,247 So let's take a look at the entire 825 00:28:51,277 --> 00:28:52,657 microbiota and the blood-brain 826 00:28:52,657 --> 00:28:54,397 barrier that you can see here. 827 00:28:54,397 --> 00:28:56,787 The role of short chain fatty acids. 828 00:28:56,787 --> 00:28:58,257 As you can see, short chain fatty 829 00:28:58,257 --> 00:29:00,507 acids you have to have the levels 830 00:29:00,507 --> 00:29:03,812 such that they actually promote the 831 00:29:03,822 --> 00:29:05,412 strengthen the blood brain barrier. 832 00:29:05,472 --> 00:29:07,152 It has an anti-inflammatory effect. 833 00:29:07,152 --> 00:29:08,802 It's neuroprotective, it 834 00:29:08,862 --> 00:29:10,272 regulates the microglia. 835 00:29:10,522 --> 00:29:12,952 Some of the SFCAs can actually cross 836 00:29:12,952 --> 00:29:14,532 the blood brain barrier, right? 837 00:29:14,772 --> 00:29:17,212 And it's an area of ongoing research, 838 00:29:17,262 --> 00:29:20,052 and it can serve as an energy source of 839 00:29:20,352 --> 00:29:22,932 in the brain, such as it's the primary 840 00:29:22,972 --> 00:29:25,192 energy source for your colonocytes. 841 00:29:25,692 --> 00:29:27,192 When you're supplementing, for example, 842 00:29:27,192 --> 00:29:29,512 the short chain fatty acids directly and 843 00:29:29,512 --> 00:29:32,387 not via a high fiber diet modification or 844 00:29:32,387 --> 00:29:35,097 prebiotic probiotic modification, then you 845 00:29:35,102 --> 00:29:36,687 make, you should make sure that the short 846 00:29:36,687 --> 00:29:38,397 chain fatty acid actually is s enteric 847 00:29:38,397 --> 00:29:41,477 coated enough to actually get uncoated 848 00:29:41,507 --> 00:29:43,702 or dissolved in your colon, right? 849 00:29:43,917 --> 00:29:46,427 Otherwise it's basically useless. 850 00:29:48,567 --> 00:29:50,527 Now the enteric microbiota and 851 00:29:50,527 --> 00:29:52,207 brain neurotransmitters, as you 852 00:29:52,207 --> 00:29:54,707 can see here essentially the 853 00:29:55,257 --> 00:29:58,207 neurotransmitters SCF FAs and BDNF. 854 00:29:58,217 --> 00:30:00,947 So the neurotransmitters, serotonin, 855 00:30:00,957 --> 00:30:02,487 90 percent of serotonin is produced 856 00:30:02,487 --> 00:30:04,607 in the gut, but remember serotonin 857 00:30:04,627 --> 00:30:07,097 is not produced it's not, doesn't 858 00:30:07,107 --> 00:30:08,307 cross the blood brain barrier. 859 00:30:08,682 --> 00:30:10,022 So the serotonin in the brain 860 00:30:10,052 --> 00:30:11,582 is produced by the brain itself. 861 00:30:11,772 --> 00:30:13,212 You have your tryptophan. 862 00:30:13,422 --> 00:30:15,112 There's a large neutral amino acid 863 00:30:15,112 --> 00:30:17,562 transporter that actually transports 864 00:30:17,562 --> 00:30:18,782 tryptophan and creates its own serotonin. 865 00:30:18,952 --> 00:30:20,942 So this serotonin is actually produced 866 00:30:21,212 --> 00:30:23,772 for the use of the gut itself, right? 867 00:30:24,132 --> 00:30:25,902 And then dopamine Some bacteria 868 00:30:25,932 --> 00:30:27,602 can produce dopamine and they 869 00:30:27,602 --> 00:30:29,432 can have the systemic effects. 870 00:30:29,622 --> 00:30:30,982 We don't know whether or not the 871 00:30:30,982 --> 00:30:32,242 cross is a blood brain barrier. 872 00:30:32,242 --> 00:30:33,192 I suspect it doesn't. 873 00:30:33,412 --> 00:30:35,652 GABA, of course, is a notoriously huge 874 00:30:35,852 --> 00:30:37,957 molecule it does not cross a blood 875 00:30:37,957 --> 00:30:39,757 brain barrier in a classic sense. 876 00:30:40,057 --> 00:30:42,767 And therefore it has to be synthesized 877 00:30:42,917 --> 00:30:46,312 from scratch via the glutamine from your 878 00:30:46,312 --> 00:30:48,262 diet, which becomes glutamate in the 879 00:30:48,262 --> 00:30:51,502 brain and then gets converted into gaba. 880 00:30:51,922 --> 00:30:54,372 Now, certain strains of lactobacilli and 881 00:30:54,372 --> 00:30:56,682 bifidobacteria can actually produce gaba. 882 00:30:57,177 --> 00:30:58,647 And then norepinephrine is 883 00:30:58,657 --> 00:31:00,137 also produced by gut bacteria. 884 00:31:00,157 --> 00:31:02,537 So again, the main perspective here, even 885 00:31:02,537 --> 00:31:04,887 if you don't remember any of this, is 886 00:31:04,897 --> 00:31:07,717 that the gut is itself a second brain. 887 00:31:07,812 --> 00:31:10,492 It has its own neurotransmitters, 888 00:31:10,542 --> 00:31:12,412 it has its own hormones, and 889 00:31:12,442 --> 00:31:14,762 you should respect it as that. 890 00:31:15,262 --> 00:31:18,932 So the enteric microbiota effects on BDNF. 891 00:31:19,407 --> 00:31:22,207 You have BDNF upregulation, stress 892 00:31:22,207 --> 00:31:24,087 response, if you have stress induced 893 00:31:24,087 --> 00:31:25,797 changes in your gut, it will actually 894 00:31:25,797 --> 00:31:28,887 decrease your BDNF and for inflammation, 895 00:31:28,937 --> 00:31:30,387 of course, gut microbiota can 896 00:31:30,387 --> 00:31:32,497 modulate systemic inflammation, which 897 00:31:32,497 --> 00:31:34,957 can in turn influence BDNF levels. 898 00:31:35,037 --> 00:31:35,667 What if you're. 899 00:31:35,917 --> 00:31:37,317 Patient or client complains 900 00:31:37,947 --> 00:31:39,457 that he or she is so poor could 901 00:31:39,457 --> 00:31:41,137 not buy all the prebiotics and 902 00:31:41,137 --> 00:31:42,637 probiotics that you recommend. 903 00:31:43,077 --> 00:31:44,867 One of the biggest things that 904 00:31:44,867 --> 00:31:46,967 you could do is actually exercise. 905 00:31:46,997 --> 00:31:50,287 It can raise your BDNF by about 60 percent 906 00:31:50,337 --> 00:31:53,597 and beats any the results of any SSRI that 907 00:31:53,597 --> 00:31:55,477 you could give out there for depression. 908 00:31:56,487 --> 00:31:57,447 That is if you could 909 00:31:57,497 --> 00:31:58,887 push them to exercise. 910 00:31:59,397 --> 00:32:00,907 Your microbe associated 911 00:32:00,957 --> 00:32:02,277 molecular patterns, right? 912 00:32:02,307 --> 00:32:04,197 And then you have damps damage 913 00:32:04,197 --> 00:32:05,547 associated molecular patterns. 914 00:32:05,547 --> 00:32:07,197 You guys are familiar with those, right? 915 00:32:07,197 --> 00:32:09,567 Those are all terminology pumps and damps. 916 00:32:09,987 --> 00:32:11,667 And you could see here that 917 00:32:11,697 --> 00:32:13,347 microbiota actually modulate 918 00:32:13,347 --> 00:32:15,777 your neuro immune function and. 919 00:32:15,877 --> 00:32:17,797 Implications of the modulation of 920 00:32:17,797 --> 00:32:20,284 neuroimmune function, actually altered gut 921 00:32:20,284 --> 00:32:22,244 microbiota can lead to increased levels 922 00:32:22,244 --> 00:32:24,794 of pro inflammatory cytokines, right? 923 00:32:25,064 --> 00:32:26,544 When you look at immunity, when a 924 00:32:26,544 --> 00:32:28,124 patient presents to you or a client 925 00:32:28,124 --> 00:32:29,374 presents to you, for example, with 926 00:32:29,434 --> 00:32:32,584 lupus or some autoimmune system, don't 927 00:32:32,684 --> 00:32:34,964 look immediately for autoimmune causes. 928 00:32:35,004 --> 00:32:36,928 Look right away at the gut health. 929 00:32:37,249 --> 00:32:38,689 What can you do immediately for 930 00:32:38,689 --> 00:32:40,669 your patient or client is actually 931 00:32:40,669 --> 00:32:42,529 to clean up the gut, seal it up, 932 00:32:42,709 --> 00:32:45,614 and make sure that, the microbiota 933 00:32:45,614 --> 00:32:47,534 are appropriately replenished. 934 00:32:47,874 --> 00:32:50,224 Autoimmunity neuro degeneration. 935 00:32:50,559 --> 00:32:52,779 They're implicated in neuroinflammatory 936 00:32:52,809 --> 00:32:54,809 aspects of Alzheimer's and Parkinson's. 937 00:32:55,189 --> 00:32:57,299 I have a few of these patients and one 938 00:32:57,299 --> 00:32:58,829 of the first things that I do really is 939 00:32:58,829 --> 00:33:00,849 to clean up the gut and decrease total 940 00:33:00,859 --> 00:33:02,799 body inflammation because an inflammation 941 00:33:02,799 --> 00:33:05,259 in the gut will already give you a 942 00:33:05,299 --> 00:33:07,619 clue that the brain is also inflamed. 943 00:33:08,269 --> 00:33:09,909 Question again, how does one 944 00:33:09,939 --> 00:33:11,099 take care of gut dysbiosis? 945 00:33:11,639 --> 00:33:14,139 Dietary changes like prebiotic foods, 946 00:33:14,139 --> 00:33:16,579 probiotic foods, low sugar and low fat 947 00:33:16,619 --> 00:33:19,409 supplements probiotics, digestive enzymes, 948 00:33:19,409 --> 00:33:22,199 glutamine, berberine, caprylic acid, zinc, 949 00:33:22,229 --> 00:33:24,509 carnosine, curcumin, lifestyle changes. 950 00:33:25,079 --> 00:33:27,119 Stress management, physical exercise, 951 00:33:27,159 --> 00:33:29,459 adequate sleep medical treatments, right? 952 00:33:29,489 --> 00:33:31,009 If antibiotics are warranted, I 953 00:33:31,009 --> 00:33:32,799 prefer to use natural antibiotics 954 00:33:33,299 --> 00:33:34,849 and antifungals, right? 955 00:33:34,879 --> 00:33:37,199 And fecal microbiota transplants those 956 00:33:37,199 --> 00:33:39,469 have been in the news over five years ago. 957 00:33:39,769 --> 00:33:40,989 These are the classes of what 958 00:33:40,989 --> 00:33:42,339 actions you can think about for your 959 00:33:42,339 --> 00:33:44,439 patient or client, dietary changes, 960 00:33:44,449 --> 00:33:47,309 supplements, lifestyle changes, and if 961 00:33:47,389 --> 00:33:49,269 if warranted, any medical treatments. 962 00:33:50,019 --> 00:33:51,119 So you know, this is 963 00:33:51,129 --> 00:33:51,869 just a simple diagram. 964 00:33:51,869 --> 00:33:53,869 You already know what this means. 965 00:33:53,869 --> 00:33:55,289 Probiotics are healthful 966 00:33:55,289 --> 00:33:56,349 microbial living cells. 967 00:33:56,569 --> 00:33:57,959 Parabiotics are dead or 968 00:33:57,959 --> 00:33:59,329 inactivated probiotics. 969 00:33:59,669 --> 00:34:01,049 And then prebiotics are chemical 970 00:34:01,069 --> 00:34:02,529 agents that have the ability 971 00:34:02,529 --> 00:34:03,719 to stimulate probiotics. 972 00:34:04,029 --> 00:34:05,329 Postbiotics are beneficial 973 00:34:05,329 --> 00:34:06,529 metabolites of probiotics. 974 00:34:06,779 --> 00:34:09,019 Prebiotics and modulation of 975 00:34:09,019 --> 00:34:11,059 the microbiota gout brain axis. 976 00:34:11,099 --> 00:34:12,929 So that's how this is from this 977 00:34:12,929 --> 00:34:15,329 paper and that's how I'd like you to 978 00:34:15,329 --> 00:34:18,159 remember the gut is, it's not as a gut, 979 00:34:18,179 --> 00:34:21,249 but microbiota gout brain axis, gut 980 00:34:21,289 --> 00:34:23,129 associated lymphoid tissue, because 981 00:34:23,279 --> 00:34:25,709 that's where most of the problems of your 982 00:34:25,739 --> 00:34:27,719 patients or clients will be coming from. 983 00:34:27,899 --> 00:34:30,209 Think of it as really an immune system. 984 00:34:30,449 --> 00:34:32,179 And as I say to my guys in health 985 00:34:32,229 --> 00:34:34,079 optimization medicine, your immune 986 00:34:34,079 --> 00:34:35,739 system is responsible for your defense. 987 00:34:35,949 --> 00:34:37,069 And if you look at the United 988 00:34:37,069 --> 00:34:38,319 States, the Department of 989 00:34:38,319 --> 00:34:40,579 Defense has the biggest budget. 990 00:34:40,709 --> 00:34:42,979 Energy budget of the body is also 991 00:34:42,979 --> 00:34:44,924 the biggest for its immune system. 992 00:34:45,784 --> 00:34:48,794 Alright, so again there's the imbalance 993 00:34:48,854 --> 00:34:51,054 of the gut immune system, you have a leaky 994 00:34:51,054 --> 00:34:52,824 gut you guys are very familiar with this. 995 00:34:53,164 --> 00:34:54,984 As you can see here there are 996 00:34:54,994 --> 00:34:56,684 factors that can cause decreased 997 00:34:56,714 --> 00:34:58,664 permeability, like propionate, 998 00:34:58,884 --> 00:35:01,030 butyrate, oligosaccharides, fiber. 999 00:35:01,340 --> 00:35:03,750 Increased with propionate, 1000 00:35:03,750 --> 00:35:04,690 glucose, fructose. 1001 00:35:04,940 --> 00:35:07,730 So always have that balancing principle 1002 00:35:07,730 --> 00:35:09,550 in mind when you're looking at the gut or 1003 00:35:09,550 --> 00:35:11,430 the brain or any other part of the body, 1004 00:35:11,780 --> 00:35:14,520 and if there is too little permeability, 1005 00:35:14,550 --> 00:35:16,510 then you cannot absorb anything, right? 1006 00:35:16,510 --> 00:35:17,610 It's too much, then you have 1007 00:35:17,610 --> 00:35:18,600 what's called a leaky gut. 1008 00:35:18,960 --> 00:35:21,670 So what you have in here is you 1009 00:35:21,670 --> 00:35:23,380 achieve a balance between an optimal 1010 00:35:23,381 --> 00:35:26,020 type of permeability for your client. 1011 00:35:26,040 --> 00:35:27,480 And this is very individual. 1012 00:35:27,820 --> 00:35:30,370 Because the lifestyle, the diet of your 1013 00:35:30,370 --> 00:35:32,950 clients usually stay in one place and 1014 00:35:32,950 --> 00:35:34,610 then it's usually very steady, it's 1015 00:35:34,610 --> 00:35:37,560 continuously very fatty, and you guys know 1016 00:35:37,560 --> 00:35:39,520 that the most difficult thing to change in 1017 00:35:39,520 --> 00:35:42,010 any client or patient is behavior, right? 1018 00:35:42,440 --> 00:35:44,290 So you have to follow their behavior 1019 00:35:44,290 --> 00:35:46,340 for a while, while adjusting 1020 00:35:46,430 --> 00:35:48,180 the permeability of their gut. 1021 00:35:48,490 --> 00:35:50,620 It's not a one size fits all thing when 1022 00:35:50,620 --> 00:35:52,770 you're looking at the client, right? 1023 00:35:52,830 --> 00:35:54,720 So the, and then you could measure, 1024 00:35:54,720 --> 00:35:56,740 calprotectin, EPX, fecal secretory 1025 00:35:56,780 --> 00:36:00,060 IgA, the butyrate, pionate, acetate 1026 00:36:00,110 --> 00:36:01,870 take a look at those levels and 1027 00:36:01,870 --> 00:36:03,670 determine appropriate supplementation. 1028 00:36:03,980 --> 00:36:05,670 Now you could do your elimination 1029 00:36:05,680 --> 00:36:08,050 diets, your glutamine, probiotics, 1030 00:36:08,050 --> 00:36:09,490 digestive enzymes, et cetera. 1031 00:36:09,800 --> 00:36:11,110 One of the things that induces 1032 00:36:11,150 --> 00:36:12,950 leaky gut actually from stress 1033 00:36:13,000 --> 00:36:14,390 is post operative patients. 1034 00:36:14,555 --> 00:36:16,495 when you're dealing with a post operative 1035 00:36:16,495 --> 00:36:19,355 case, and they usually just dump the 1036 00:36:19,395 --> 00:36:21,735 patients in the recovery room and give 1037 00:36:21,735 --> 00:36:23,935 them nothing by way of any support. 1038 00:36:23,945 --> 00:36:25,695 And when you receive the patient 1039 00:36:25,705 --> 00:36:27,585 is in severe leaky gut and 1040 00:36:27,955 --> 00:36:29,225 complaining of other problems. 1041 00:36:29,295 --> 00:36:30,675 So what you can do there is to 1042 00:36:30,675 --> 00:36:33,305 recommend six grams off of glutamine 1043 00:36:33,315 --> 00:36:35,275 in a liter of water to be sipped by 1044 00:36:35,275 --> 00:36:37,465 the patient in a while in the OR, 1045 00:36:37,465 --> 00:36:40,085 especially if intestinal surgery, right? 1046 00:36:40,115 --> 00:36:42,065 And that actually keeps the patient 1047 00:36:42,065 --> 00:36:44,145 in positive nitrogen balance, right? 1048 00:36:44,445 --> 00:36:46,505 And that will make sure that 1049 00:36:46,505 --> 00:36:48,365 your intestinal permeability 1050 00:36:48,375 --> 00:36:50,135 is not harmed that much. 1051 00:36:50,345 --> 00:36:52,045 It will say any surgery to the 1052 00:36:52,045 --> 00:36:54,665 body is still stressful, right? 1053 00:36:55,305 --> 00:36:56,445 How does one take care of 1054 00:36:56,445 --> 00:36:57,325 the leaky gut syndrome? 1055 00:36:57,375 --> 00:36:58,455 So you don't need me for this 1056 00:36:58,455 --> 00:37:00,235 anymore, you just need to chat GPT 4. 1057 00:37:00,485 --> 00:37:02,405 Dietary changes like the elimination 1058 00:37:02,415 --> 00:37:04,645 diet, high fiber foods, probiotic 1059 00:37:04,705 --> 00:37:06,885 rich foods, supplements, probiotics 1060 00:37:07,045 --> 00:37:09,085 glutamine, digestive enzymes, omega 3s, 1061 00:37:09,405 --> 00:37:11,775 zinc, collagen or bone broth, right? 1062 00:37:11,825 --> 00:37:14,395 Vitamin D, turmeric, lifestyle changes, 1063 00:37:14,405 --> 00:37:15,955 stress management, if they need to 1064 00:37:15,955 --> 00:37:18,715 divorce their husbands or wives, right? 1065 00:37:18,805 --> 00:37:20,345 Adequate sleep, right? 1066 00:37:20,415 --> 00:37:22,415 If the partner is snoring, it's 1067 00:37:22,435 --> 00:37:24,385 been shown that for each snore the 1068 00:37:24,385 --> 00:37:26,179 cortisol level rises in your partner. 1069 00:37:26,252 --> 00:37:28,072 each snore that your partner makes, 1070 00:37:28,072 --> 00:37:29,432 your cortisol actually rises. 1071 00:37:29,942 --> 00:37:30,952 You may be in love, but 1072 00:37:30,952 --> 00:37:32,132 you are sleep divorced. 1073 00:37:32,132 --> 00:37:33,862 And then regular exercise, which is 1074 00:37:33,862 --> 00:37:35,172 one of the most difficult things to 1075 00:37:35,172 --> 00:37:36,592 get your clients to do, unless they're 1076 00:37:36,592 --> 00:37:39,082 actually younger and seeking a mate. 1077 00:37:39,402 --> 00:37:40,932 Now medical treatments, 1078 00:37:40,932 --> 00:37:42,602 as I said, only if needed. 1079 00:37:42,602 --> 00:37:43,962 Antibiotics, antifungals, 1080 00:37:43,962 --> 00:37:45,142 anti inflammatories, right? 1081 00:37:45,242 --> 00:37:46,272 And what I want you to note 1082 00:37:46,292 --> 00:37:48,152 here is simply the classes. 1083 00:37:48,282 --> 00:37:49,812 Dietary changes, supplements, 1084 00:37:49,812 --> 00:37:51,812 lifestyle changes, medical treatments. 1085 00:37:52,007 --> 00:37:54,277 , we're looking at brain balance when you go 1086 00:37:54,327 --> 00:37:56,337 take a look at neuroinflammation, right? 1087 00:37:56,677 --> 00:37:58,459 It's a balance of micro, microglia. 1088 00:37:58,459 --> 00:38:01,517 They're either activated or inactivated. 1089 00:38:01,597 --> 00:38:03,497 Arresting microglia will have 1090 00:38:03,497 --> 00:38:05,157 a regular phagocytic function. 1091 00:38:05,407 --> 00:38:07,227 They will have steady state monitoring. 1092 00:38:07,237 --> 00:38:08,567 Remember, this is an immune system. 1093 00:38:08,567 --> 00:38:09,557 They're soldiers. 1094 00:38:09,672 --> 00:38:10,502 They're sentinels. 1095 00:38:10,532 --> 00:38:12,322 They monitor their environment, even 1096 00:38:12,322 --> 00:38:13,832 if you consider them as brain cells. 1097 00:38:13,832 --> 00:38:15,372 They serve as the immune function. 1098 00:38:15,822 --> 00:38:17,252 And then there's the activated 1099 00:38:17,322 --> 00:38:19,152 microglia, which now produces 1100 00:38:19,152 --> 00:38:20,812 your pro inflammatory cytokines. 1101 00:38:21,522 --> 00:38:23,452 And you can see here there's an 1102 00:38:23,522 --> 00:38:24,902 active function, neural injury. 1103 00:38:25,052 --> 00:38:27,292 I went quickly through a slide earlier 1104 00:38:27,302 --> 00:38:29,272 that showed the cell danger response. 1105 00:38:29,332 --> 00:38:31,152 Now, what I wanted to emphasize 1106 00:38:31,212 --> 00:38:32,742 there is the following. 1107 00:38:32,872 --> 00:38:35,092 There are only eight ways by which 1108 00:38:35,222 --> 00:38:37,442 a cell, a fundamental cell, can 1109 00:38:37,442 --> 00:38:39,482 respond to stress evolutionarily. 1110 00:38:39,737 --> 00:38:41,577 All the other ways that it responds are 1111 00:38:41,587 --> 00:38:43,457 actually due to the specialized functions. 1112 00:38:43,517 --> 00:38:45,067 And that's what we actually 1113 00:38:45,097 --> 00:38:47,147 teach in our online module on 1114 00:38:47,147 --> 00:38:48,897 evolutionary medicine, is the cell 1115 00:38:48,897 --> 00:38:50,397 danger response metabolome, right? 1116 00:38:50,597 --> 00:38:52,707 There are only eight of those, and if 1117 00:38:52,707 --> 00:38:55,087 you could actually resolve those eight 1118 00:38:55,087 --> 00:38:57,517 different steps, you actually have already 1119 00:38:57,517 --> 00:38:59,427 resolved the cell danger response that 1120 00:38:59,437 --> 00:39:01,567 the the stress is putting out, and you 1121 00:39:01,567 --> 00:39:03,902 have quelled it, and you're Patient 1122 00:39:03,902 --> 00:39:05,612 or client would start feeling better. 1123 00:39:06,492 --> 00:39:06,702 All right. 1124 00:39:07,932 --> 00:39:10,122 Now, here's a cell with 1125 00:39:10,122 --> 00:39:11,622 no neuro inflammation. 1126 00:39:11,622 --> 00:39:13,302 There is an oval for inflammasome 1127 00:39:13,332 --> 00:39:15,002 unless you've been living under a rock. 1128 00:39:15,002 --> 00:39:15,072 You. 1129 00:39:15,602 --> 00:39:17,412 All know what an inflammasome ear 1130 00:39:17,712 --> 00:39:19,762 is, the most famous one of course 1131 00:39:19,782 --> 00:39:22,372 is the NLRP3 inflammasome, right? 1132 00:39:22,822 --> 00:39:24,772 This is the staging area 1133 00:39:24,782 --> 00:39:26,132 for your inflammation. 1134 00:39:26,372 --> 00:39:27,402 As you can see, everything 1135 00:39:27,412 --> 00:39:29,072 is nice and neat and clean. 1136 00:39:29,542 --> 00:39:32,852 And when you look at the gut, you should 1137 00:39:32,872 --> 00:39:35,342 always think about the brain, right? 1138 00:39:35,362 --> 00:39:37,062 Because they have the same 1139 00:39:37,282 --> 00:39:38,712 fundamental structures. 1140 00:39:38,802 --> 00:39:41,212 You have your bloodstream, you have your 1141 00:39:41,212 --> 00:39:44,422 endothelium and you could see that The 1142 00:39:44,452 --> 00:39:46,522 lymphoid tissues are underneath the gut, 1143 00:39:46,732 --> 00:39:49,452 whereas in the brain, your glial system 1144 00:39:49,542 --> 00:39:51,702 actually serves as the immune system. 1145 00:39:52,092 --> 00:39:54,642 So always think of these two in 1146 00:39:54,642 --> 00:39:55,992 parallel, especially if you're. 1147 00:39:56,472 --> 00:39:58,022 patients or clients are exhibiting 1148 00:39:58,022 --> 00:39:59,672 brain fog at the same time, right? 1149 00:39:59,672 --> 00:40:01,132 You might think, oh, the thyroid. 1150 00:40:01,132 --> 00:40:02,742 No, it may just be a simple 1151 00:40:02,882 --> 00:40:04,422 neuroinflammation from 1152 00:40:04,452 --> 00:40:05,722 a gut dysbiosis, right? 1153 00:40:05,852 --> 00:40:07,232 Don't jump into conclusions 1154 00:40:07,232 --> 00:40:09,092 immediately that your patients need 1155 00:40:09,292 --> 00:40:11,042 any of these big guns right away. 1156 00:40:12,327 --> 00:40:14,147 Now, see here, take a look at 1157 00:40:14,147 --> 00:40:15,787 neuro inflammation, they will occur 1158 00:40:16,047 --> 00:40:17,807 almost at the same time if you don't 1159 00:40:17,837 --> 00:40:19,337 address the inflammation of the gut. 1160 00:40:19,507 --> 00:40:20,707 inflammation of the gut usually 1161 00:40:20,707 --> 00:40:22,177 occurs first because that is 1162 00:40:22,177 --> 00:40:23,817 what is exposed to food, right? 1163 00:40:23,817 --> 00:40:24,857 External elements. 1164 00:40:24,887 --> 00:40:27,037 So the body has to fight what it doesn't 1165 00:40:27,037 --> 00:40:28,967 want inside and actually allow what 1166 00:40:28,967 --> 00:40:31,057 it wants to get inside, and you could 1167 00:40:31,057 --> 00:40:33,517 see here is a total inflammation. 1168 00:40:33,707 --> 00:40:35,577 And when I say inflammation, not 1169 00:40:35,597 --> 00:40:36,897 the traditional mosquito bite 1170 00:40:36,897 --> 00:40:38,377 inflammation should come to your mind. 1171 00:40:38,617 --> 00:40:40,257 It is, it should be what's 1172 00:40:40,257 --> 00:40:41,777 called molecular inflammation. 1173 00:40:42,127 --> 00:40:44,177 What you should think about is that there 1174 00:40:44,177 --> 00:40:46,467 is heavy reactive oxygen species load. 1175 00:40:46,667 --> 00:40:49,117 Your NF kappa B is activated. 1176 00:40:49,117 --> 00:40:50,637 Your cytokines are being produced. 1177 00:40:51,012 --> 00:40:52,332 That's the kind of inflammation 1178 00:40:52,352 --> 00:40:53,542 that should be in your head. 1179 00:40:53,792 --> 00:40:55,552 We're no longer in the 1940s, 1180 00:40:55,552 --> 00:40:56,162 where you have to look at 1181 00:40:56,202 --> 00:40:57,972 microscopes to do that, right? 1182 00:40:58,142 --> 00:41:00,032 We deal with metabolites now. 1183 00:41:00,722 --> 00:41:02,632 And you could see in the brain itself, 1184 00:41:02,712 --> 00:41:04,832 you could see that the Euglia cells 1185 00:41:05,072 --> 00:41:06,672 are the ones responding as your 1186 00:41:06,672 --> 00:41:08,922 lymphoid tissue in the brain and the 1187 00:41:08,922 --> 00:41:10,912 alter your neurotransmitters, right? 1188 00:41:11,172 --> 00:41:13,352 Chat GPT 4, like what can be done to 1189 00:41:13,362 --> 00:41:15,632 dampen or quell inflammasome activity? 1190 00:41:16,012 --> 00:41:17,122 It says here. 1191 00:41:17,392 --> 00:41:18,842 Natural compounds like curcumin and 1192 00:41:18,842 --> 00:41:22,172 resveratrol lifestyle and diet like 1193 00:41:22,172 --> 00:41:23,732 fasting and caloric restriction and 1194 00:41:23,732 --> 00:41:26,062 anti inflammatory diet, microbiota 1195 00:41:26,062 --> 00:41:28,192 modulation, probiotics and prebiotics 1196 00:41:28,192 --> 00:41:30,152 fecal microbiota transplant, I've had 1197 00:41:30,152 --> 00:41:32,372 cases where I actually had to send or 1198 00:41:32,382 --> 00:41:35,372 accompany clients in Germany for adult 1199 00:41:35,382 --> 00:41:37,422 fecal microbiota transplant for C. 1200 00:41:37,422 --> 00:41:38,292 diff, severe C. 1201 00:41:38,292 --> 00:41:39,512 diff in adulthood. 1202 00:41:40,092 --> 00:41:41,542 And epigenetic modulation 1203 00:41:41,828 --> 00:41:43,838 metabolomic approaches, which is 1204 00:41:43,838 --> 00:41:45,718 what we actually do in HomeHope. 1205 00:41:45,718 --> 00:41:49,138 So not all neuroinflammation is bad. 1206 00:41:49,178 --> 00:41:51,028 Your gut, there's a certain optimal 1207 00:41:51,028 --> 00:41:52,368 form of leakiness in the gut. 1208 00:41:52,398 --> 00:41:54,498 There's also an optimal form of 1209 00:41:54,748 --> 00:41:57,003 inflammation that's optimal to the brain. 1210 00:41:57,183 --> 00:41:58,293 So on low inflammation. 1211 00:41:58,828 --> 00:42:00,838 There is immune to brain communication 1212 00:42:00,848 --> 00:42:01,908 with immune surveillance. 1213 00:42:02,268 --> 00:42:03,648 There is the, it's involved in 1214 00:42:03,648 --> 00:42:05,408 development, memory, and learning. 1215 00:42:05,458 --> 00:42:07,628 Transient inflammation is involved 1216 00:42:07,628 --> 00:42:09,798 with injury and induced remodeling. 1217 00:42:10,118 --> 00:42:12,228 And this is called eustress. 1218 00:42:12,418 --> 00:42:13,758 This is eu inflammation. 1219 00:42:14,413 --> 00:42:15,363 And for those who are 1220 00:42:15,563 --> 00:42:16,853 stoics here, eudaimonia. 1221 00:42:17,423 --> 00:42:19,913 Anyway negative aspects of 1222 00:42:19,913 --> 00:42:20,473 neuroinflammation, as you can see. 1223 00:42:20,493 --> 00:42:22,373 These are high inflammatory states. 1224 00:42:22,673 --> 00:42:23,933 And again, when you think of 1225 00:42:23,933 --> 00:42:25,913 inflammation, think molecular, right? 1226 00:42:26,113 --> 00:42:27,423 Your mitochondria are highly 1227 00:42:27,423 --> 00:42:28,883 stressed out, they will put 1228 00:42:28,888 --> 00:42:30,653 out a lot of reactive species. 1229 00:42:30,893 --> 00:42:33,043 They will induce your cytokine production. 1230 00:42:33,203 --> 00:42:35,363 Those will activate your NF KB. 1231 00:42:35,368 --> 00:42:36,983 They'll induce your cytokine production, 1232 00:42:37,163 --> 00:42:39,353 and then you will have all the downstream 1233 00:42:39,353 --> 00:42:41,853 effects of molecular inflammation alright. 1234 00:42:43,898 --> 00:42:45,408 Now, what's wrong with this picture? 1235 00:42:45,438 --> 00:42:46,518 Can anyone tell me what's 1236 00:42:46,518 --> 00:42:47,428 wrong with this picture? 1237 00:42:47,588 --> 00:42:49,788 Microbiota and gut brain axis. 1238 00:42:49,828 --> 00:42:50,888 Implications for a new 1239 00:42:50,888 --> 00:42:52,218 therapeutic design in CNS. 1240 00:42:52,578 --> 00:42:54,528 This was just published in 2022. 1241 00:42:55,713 --> 00:42:57,353 So this is beautiful, right? 1242 00:42:57,354 --> 00:42:59,254 microbial metabolite entry, 1243 00:42:59,254 --> 00:43:00,774 altered receptor activity, altered 1244 00:43:00,774 --> 00:43:02,704 neurotransmission, the pathways that we 1245 00:43:02,704 --> 00:43:04,954 discussed, immune, neuroendocrine, enteric 1246 00:43:04,954 --> 00:43:06,974 nervous system, circulatory system, 1247 00:43:06,974 --> 00:43:09,534 vagus, secretions, peptides, gut hormones. 1248 00:43:09,884 --> 00:43:11,124 Very nicely done, right? 1249 00:43:11,194 --> 00:43:12,714 And then up there you have your 1250 00:43:12,714 --> 00:43:14,694 neurodegenerative diseases like 1251 00:43:15,174 --> 00:43:17,274 MS Parkinson's, Alzheimer's, brain 1252 00:43:17,314 --> 00:43:19,234 tumors, and then neurodevelopmental 1253 00:43:19,234 --> 00:43:21,554 and neuropsychiatric disorders like 1254 00:43:21,554 --> 00:43:24,134 autism and depression and anxiety 1255 00:43:24,134 --> 00:43:25,274 and stress and schizophrenia. 1256 00:43:25,274 --> 00:43:26,864 They immediately proceed 1257 00:43:26,894 --> 00:43:28,414 to disease, right? 1258 00:43:28,554 --> 00:43:31,154 Many of your clients or patients will not 1259 00:43:31,164 --> 00:43:33,624 be having these things beforehand, right? 1260 00:43:33,954 --> 00:43:36,374 These things come as a consequence 1261 00:43:36,544 --> 00:43:38,164 of what happens beforehand. 1262 00:43:38,514 --> 00:43:40,474 So if you could catch that for 1263 00:43:40,474 --> 00:43:42,414 them beforehand or prevent that 1264 00:43:42,414 --> 00:43:43,904 beforehand, why would you not do 1265 00:43:43,904 --> 00:43:45,264 it if you already have the tools 1266 00:43:45,564 --> 00:43:47,244 and the products to do it, right? 1267 00:43:47,894 --> 00:43:50,414 So it's not always about disease. 1268 00:43:50,514 --> 00:43:51,884 It's time to think of health first. 1269 00:43:52,524 --> 00:43:53,604 So when you see a client, you 1270 00:43:53,604 --> 00:43:55,024 set aside what their diagnoses 1271 00:43:55,024 --> 00:43:56,954 are, and take a look at what the 1272 00:43:56,954 --> 00:43:58,874 fundamental or basic cell is doing. 1273 00:43:58,894 --> 00:44:00,224 Is the mitochondria all right? 1274 00:44:00,544 --> 00:44:02,324 Is the cytoplasm okay? 1275 00:44:02,384 --> 00:44:03,604 Are the cell membranes okay? 1276 00:44:03,654 --> 00:44:05,524 Is there very fast oxidation 1277 00:44:05,534 --> 00:44:06,744 of the cell membranes? 1278 00:44:06,794 --> 00:44:08,494 Is there any indication that the 1279 00:44:08,494 --> 00:44:10,814 DNA, nuclear DNA is oxidizing? 1280 00:44:11,054 --> 00:44:11,824 Very rapidly. 1281 00:44:11,954 --> 00:44:13,674 You could see all of those in a 1282 00:44:13,674 --> 00:44:15,094 fundamental cell and all cells 1283 00:44:15,094 --> 00:44:16,674 of body have that, except, of 1284 00:44:16,674 --> 00:44:18,464 course, for mature red blood cells, 1285 00:44:18,464 --> 00:44:20,054 which don't have mitochondria. 1286 00:44:20,104 --> 00:44:22,834 So you could see here that diet, genetics, 1287 00:44:22,834 --> 00:44:24,524 and epigenetics, mode of delivery, 1288 00:44:24,524 --> 00:44:27,514 environment, drugs, and exercise affect 1289 00:44:27,564 --> 00:44:29,974 the enteric microbiota gut brain axis, 1290 00:44:30,294 --> 00:44:33,254 and it will affect the behavior, food 1291 00:44:33,274 --> 00:44:35,464 intake, cognitive behavior, stress, 1292 00:44:35,764 --> 00:44:38,574 social interaction, fear, and as I said 1293 00:44:38,604 --> 00:44:40,544 earlier, it can affect your enlightenment. 1294 00:44:40,989 --> 00:44:42,019 Because it affects your 1295 00:44:42,019 --> 00:44:43,009 default mode network. 1296 00:44:43,239 --> 00:44:45,139 It can affect your spirituality, because 1297 00:44:45,139 --> 00:44:46,909 it affects your periaqueductal gray. 1298 00:44:47,159 --> 00:44:49,299 Take care of this organ that grows 1299 00:44:49,709 --> 00:44:52,859 after you're born, or after your 1300 00:44:53,129 --> 00:44:54,809 patients or clients are born. 1301 00:44:55,504 --> 00:44:56,844 Let me just show you the difference 1302 00:44:56,864 --> 00:44:58,884 in care between illness medicine and 1303 00:44:58,884 --> 00:45:00,274 health optimization medicine on the 1304 00:45:00,274 --> 00:45:02,544 enteric microbiota gut brain axis, right? 1305 00:45:02,834 --> 00:45:04,714 The first one is a diagnosed disease. 1306 00:45:04,714 --> 00:45:06,094 In illness medicine, you have 1307 00:45:06,174 --> 00:45:08,294 anxiety, depression, multiple 1308 00:45:08,294 --> 00:45:09,724 sclerosis, Parkinson's, Alzheimer's. 1309 00:45:10,474 --> 00:45:12,454 Whereas what we do is we 1310 00:45:12,464 --> 00:45:13,834 just detect imbalances. 1311 00:45:14,104 --> 00:45:16,074 We use metabolomic tests to detect 1312 00:45:16,074 --> 00:45:18,344 imbalances in vitamin, mineral cofactors, 1313 00:45:18,664 --> 00:45:20,294 carbohydrate, protein, fat, hormone, 1314 00:45:20,404 --> 00:45:23,144 metabolism, exposure to toxins, etc. 1315 00:45:23,494 --> 00:45:26,074 And then use the enteric microbiota. 1316 00:45:26,094 --> 00:45:28,564 Your goal there is to achieve eubiosis. 1317 00:45:28,824 --> 00:45:31,334 For us, we want to correct imbalances 1318 00:45:31,544 --> 00:45:33,544 with supplementation, diet, exercise, 1319 00:45:33,584 --> 00:45:36,054 sleep, and other lifestyle advice, right? 1320 00:45:36,304 --> 00:45:37,524 For illness medicine, you 1321 00:45:37,524 --> 00:45:38,934 want to seal the leaky gut. 1322 00:45:39,354 --> 00:45:41,694 And for us, we want to resolve 1323 00:45:41,854 --> 00:45:43,784 the enteric neuroinflammation. 1324 00:45:43,834 --> 00:45:44,674 Neuroinflammation is not 1325 00:45:44,694 --> 00:45:45,744 only in the brain, guys. 1326 00:45:46,054 --> 00:45:47,564 Remember that you have a second 1327 00:45:47,574 --> 00:45:49,184 brain, and therefore, you have 1328 00:45:49,214 --> 00:45:50,959 an enteric neuroinflammation. 1329 00:45:51,419 --> 00:45:51,739 All right? 1330 00:45:51,949 --> 00:45:53,029 Don't forget these things. 1331 00:45:53,079 --> 00:45:55,299 When you remember this become very 1332 00:45:55,299 --> 00:45:57,209 fundamental to your care because you 1333 00:45:57,209 --> 00:45:59,199 will remember immediately what to do 1334 00:45:59,199 --> 00:46:01,099 with your patients or clients, right? 1335 00:46:01,219 --> 00:46:02,209 Oh, I'm not only dealing 1336 00:46:02,209 --> 00:46:04,019 with neuroinflammation here. 1337 00:46:04,019 --> 00:46:05,279 I'm also dealing with 1338 00:46:05,859 --> 00:46:07,199 brain inflammation, right? 1339 00:46:07,199 --> 00:46:08,429 Because they will tend to 1340 00:46:08,429 --> 00:46:09,939 co occur after a while. 1341 00:46:10,309 --> 00:46:11,369 In the brain, you treat the 1342 00:46:11,369 --> 00:46:12,859 disease like with drugs, right? 1343 00:46:12,859 --> 00:46:15,139 So for Parkinson's, for example, and 1344 00:46:15,149 --> 00:46:16,909 in the brain, you resolve the CNS 1345 00:46:16,909 --> 00:46:19,579 neuroinflammation, which includes 1346 00:46:19,739 --> 00:46:22,459 achieving eubiosis and sealing the gut. 1347 00:46:22,749 --> 00:46:24,849 Now for those of you who have 1348 00:46:24,849 --> 00:46:27,199 Parkinson's patients or are Parkinson's 1349 00:46:27,199 --> 00:46:29,509 clients, you already know that the 1350 00:46:29,509 --> 00:46:30,809 Parkinson's is now considered to 1351 00:46:30,829 --> 00:46:33,329 have, a dual etiologic pathways. 1352 00:46:33,589 --> 00:46:35,559 One is actually via the gut. 1353 00:46:36,039 --> 00:46:38,209 And the other one is central. 1354 00:46:38,209 --> 00:46:40,002 you could see now that we are 1355 00:46:40,002 --> 00:46:41,452 seeing the gut brain connection 1356 00:46:41,472 --> 00:46:43,282 even in the diseases themselves. 1357 00:46:43,282 --> 00:46:45,462 HomeHope, take care of the needs of the 1358 00:46:45,462 --> 00:46:47,602 fundamental cell in its network first, 1359 00:46:47,672 --> 00:46:49,732 and the rest will follow, because disease 1360 00:46:49,732 --> 00:46:51,412 is managed, but health is optimized. 1361 00:46:51,672 --> 00:46:53,582 Managing means that, you're only 1362 00:46:53,582 --> 00:46:55,322 there until the disease resolves, 1363 00:46:55,562 --> 00:46:57,702 but health, you're there every day. 1364 00:46:58,042 --> 00:47:00,042 And my favorite question here from 1365 00:47:00,042 --> 00:47:01,752 an audience one time is asking 1366 00:47:01,752 --> 00:47:03,292 me whether or not we could bank. 1367 00:47:03,702 --> 00:47:04,882 We could bank exercise. 1368 00:47:04,932 --> 00:47:06,012 Actually, you can't. 1369 00:47:06,112 --> 00:47:07,492 And just that's just like 1370 00:47:07,492 --> 00:47:08,782 health optimization, right? 1371 00:47:09,832 --> 00:47:11,902 So the order of use of balancing agents, 1372 00:47:11,902 --> 00:47:13,662 the first line will be your bioidenticals 1373 00:47:13,662 --> 00:47:15,282 and bioactives, like bioidentical 1374 00:47:15,422 --> 00:47:16,612 hormones, bioactive nutrients. 1375 00:47:16,752 --> 00:47:18,402 An example here would be using 1376 00:47:18,402 --> 00:47:21,292 methylcobalamin instead of cyanocobalamin. 1377 00:47:21,502 --> 00:47:23,742 Cobalamin is an artifact of manufacture 1378 00:47:23,852 --> 00:47:26,322 cyanide is an artifact of manufacture 1379 00:47:26,322 --> 00:47:28,752 in cyanocobalamin, Second line would 1380 00:47:28,752 --> 00:47:30,582 be phytocyticals, fungicyticals, 1381 00:47:30,612 --> 00:47:32,752 bacteria, like your probiotics phages. 1382 00:47:32,932 --> 00:47:34,692 And the third line would be xenobiotics. 1383 00:47:35,012 --> 00:47:36,982 And why do I put drugs last, even 1384 00:47:36,982 --> 00:47:38,432 if I'm trained in pharmacology? 1385 00:47:38,962 --> 00:47:40,672 is because Almost all the drugs that We 1386 00:47:40,672 --> 00:47:43,082 have out there have never been encountered 1387 00:47:43,082 --> 00:47:44,542 by the body in evolution, and the 1388 00:47:44,542 --> 00:47:46,152 body doesn't know what to do with it. 1389 00:47:46,712 --> 00:47:48,642 But it knows what to do with your 1390 00:47:48,642 --> 00:47:49,962 hormones, nutrients, and other 1391 00:47:49,962 --> 00:47:51,932 things that it actually uses to 1392 00:47:51,952 --> 00:47:53,932 heal itself or to balance itself. 1393 00:47:53,932 --> 00:47:58,192 So use those first, and use the big guns 1394 00:47:58,202 --> 00:47:59,952 later, because you know when you start 1395 00:47:59,952 --> 00:48:01,652 to use a synthetic antibiotic, you're 1396 00:48:01,652 --> 00:48:04,442 going to bomb your gut microbiota organ. 1397 00:48:05,247 --> 00:48:07,697 So this is the balancing very simple, 1398 00:48:07,757 --> 00:48:09,477 you measure the levels of your 1399 00:48:09,477 --> 00:48:12,827 vitamins, minerals, cofactors toxins 1400 00:48:12,877 --> 00:48:15,307 and neurotransmitters and so on, and 1401 00:48:15,307 --> 00:48:17,497 then you give them measured supplements. 1402 00:48:17,507 --> 00:48:20,507 So the era of asking me whether or not 1403 00:48:20,527 --> 00:48:23,707 vitamin E is good for you is over, right? 1404 00:48:23,707 --> 00:48:24,757 You can measure all of 1405 00:48:24,757 --> 00:48:25,757 those things and they can be 1406 00:48:25,757 --> 00:48:27,387 measured at a reasonable price. 1407 00:48:28,437 --> 00:48:29,607 The latest developments we 1408 00:48:29,607 --> 00:48:31,357 have in this particular areas. 1409 00:48:31,727 --> 00:48:33,947 The doudna herself is now in the game. 1410 00:48:33,947 --> 00:48:35,357 She's she's Nobel Laureate 1411 00:48:35,387 --> 00:48:36,777 in the CRISPR Cas9 team. 1412 00:48:36,977 --> 00:48:38,127 Technology, right? 1413 00:48:38,167 --> 00:48:39,797 And watch out guys. 1414 00:48:39,947 --> 00:48:42,297 She's ready to tackle gut microbiota 1415 00:48:42,357 --> 00:48:45,417 on changing the genome according to what 1416 00:48:45,417 --> 00:48:47,737 you want them to produce, whether or not, 1417 00:48:47,867 --> 00:48:50,867 are we going to have non GMO microbiota? 1418 00:48:50,907 --> 00:48:53,177 I have no idea, but, she's already 1419 00:48:53,177 --> 00:48:55,087 expressed her Interest in the game. 1420 00:48:55,247 --> 00:48:56,897 They found that there's a dedicated 1421 00:48:57,167 --> 00:48:59,177 cytoplasmic container that collects exo 1422 00:48:59,177 --> 00:49:02,177 Somal, DNA, away from the melian nucleus. 1423 00:49:02,182 --> 00:49:03,787 And it's a new organelle . It's 1424 00:49:03,787 --> 00:49:05,047 called the Exclusome. 1425 00:49:05,227 --> 00:49:07,597 So you now know that we have 1426 00:49:07,597 --> 00:49:09,247 another organelle in the cell, and 1427 00:49:09,247 --> 00:49:11,057 it's called the Exclusome, right? 1428 00:49:11,782 --> 00:49:13,372 And the latest developments in the 1429 00:49:13,372 --> 00:49:15,502 brain a new kind of cell shakes 1430 00:49:15,502 --> 00:49:18,212 up neuroscience and we continually 1431 00:49:18,212 --> 00:49:19,792 find newer and newer cells, right? 1432 00:49:19,792 --> 00:49:21,692 The specialized astrocytes 1433 00:49:21,992 --> 00:49:24,242 mediate glutamatergic glia 1434 00:49:24,242 --> 00:49:25,472 transmission in the CNS. 1435 00:49:25,882 --> 00:49:27,372 So if the new organelle is called the 1436 00:49:27,372 --> 00:49:28,752 exclusome, this is called the what? 1437 00:49:29,902 --> 00:49:30,612 This is called the 1438 00:49:30,612 --> 00:49:32,432 glutamatergic astrocytes. 1439 00:49:32,732 --> 00:49:34,042 Astrocytes are not supposed to 1440 00:49:34,042 --> 00:49:36,702 produce any neurohormones, but this 1441 00:49:36,702 --> 00:49:39,012 one produces actually glutamate. 1442 00:49:39,427 --> 00:49:39,777 All right. 1443 00:49:40,457 --> 00:49:41,707 So the latest developments in the 1444 00:49:41,707 --> 00:49:43,377 enteric microbiota gut brain axis, 1445 00:49:43,607 --> 00:49:45,677 Kieran yesterday was discussing, how you 1446 00:49:45,677 --> 00:49:48,057 develop drugs and how you do test various 1447 00:49:48,377 --> 00:49:50,437 types of microbiota in the SHIME system. 1448 00:49:50,807 --> 00:49:52,907 Now they're going ahead rather 1449 00:49:52,907 --> 00:49:54,227 than using the SHIME system. 1450 00:49:54,467 --> 00:49:57,237 What I want you to see here is that one. 1451 00:49:57,527 --> 00:49:58,787 And term that I'd like you 1452 00:49:58,787 --> 00:50:00,537 to remember is organoids. 1453 00:50:00,747 --> 00:50:02,857 You're now, they're now using intestinal 1454 00:50:02,877 --> 00:50:05,577 organoids and brain organoids to 1455 00:50:05,627 --> 00:50:08,087 test what particular microbiota 1456 00:50:08,137 --> 00:50:10,707 are producing what particular 1457 00:50:10,707 --> 00:50:12,597 metabolites that will affect the brain. 1458 00:50:12,657 --> 00:50:14,977 And this is big news. 1459 00:50:14,987 --> 00:50:16,307 This is a totally different 1460 00:50:16,317 --> 00:50:17,567 way of doing things now. 1461 00:50:17,737 --> 00:50:18,607 We've been doing things 1462 00:50:18,607 --> 00:50:20,367 forever via the SHIME system. 1463 00:50:20,997 --> 00:50:23,567 So the latest developments in AI I created 1464 00:50:23,567 --> 00:50:26,067 this chatbot for us who actually do not 1465 00:50:26,077 --> 00:50:28,337 like to memorize things and just like to 1466 00:50:28,597 --> 00:50:30,697 seek things out this is what's coming we 1467 00:50:30,697 --> 00:50:32,617 intend to give this to our practitioners 1468 00:50:32,717 --> 00:50:34,107 health optimization medicine. 1469 00:50:34,317 --> 00:50:36,007 And health organization practice 1470 00:50:36,007 --> 00:50:38,097 practitioners initially, right? 1471 00:50:38,147 --> 00:50:41,097 This is what to do if orotic acid is high. 1472 00:50:41,137 --> 00:50:43,457 And I threw in a few books in there 1473 00:50:43,607 --> 00:50:46,027 and KB stands for knowledge base. 1474 00:50:46,247 --> 00:50:48,562 And this is what it came up with 1475 00:50:48,622 --> 00:50:50,072 after looking at the books that 1476 00:50:50,072 --> 00:50:51,572 I put in there, if orotic acid 1477 00:50:51,572 --> 00:50:53,012 is high, it may be indicative of 1478 00:50:53,172 --> 00:50:55,212 abnormalities in our gene in metabolism. 1479 00:50:55,552 --> 00:50:58,042 And then I actually placed in a separate 1480 00:50:58,152 --> 00:51:00,492 window, the chat GPT response itself. 1481 00:51:00,522 --> 00:51:03,202 As you can see, your, if your books are 1482 00:51:03,202 --> 00:51:05,342 in here, the professional books, the 1483 00:51:05,342 --> 00:51:07,262 response is a lot more professional. 1484 00:51:07,332 --> 00:51:09,942 To your liking, ChatGTP is a slightly, 1485 00:51:09,942 --> 00:51:11,772 a little bit more general, but can 1486 00:51:11,772 --> 00:51:13,662 provide you insights as to the other 1487 00:51:13,662 --> 00:51:15,462 things that you may want to investigate. 1488 00:51:15,732 --> 00:51:18,562 So this tool will be available hopefully 1489 00:51:18,562 --> 00:51:20,092 next year to our practitioners. 1490 00:51:20,362 --> 00:51:22,632 And a lot of AI are actually already 1491 00:51:22,632 --> 00:51:25,477 being used now for the gut microbiota and 1492 00:51:25,477 --> 00:51:29,087 development of more of newer probiotics. 1493 00:51:29,117 --> 00:51:29,327 Okay. 1494 00:51:29,927 --> 00:51:31,547 Here's our summary this is my ending 1495 00:51:31,547 --> 00:51:33,307 slide, here is all the things that we 1496 00:51:33,307 --> 00:51:35,137 talked about, the enteric microbiota 1497 00:51:35,367 --> 00:51:38,457 gut brain axis the ways by which 1498 00:51:38,597 --> 00:51:40,967 they communicate what can go wrong 1499 00:51:41,077 --> 00:51:43,357 with the communication is usually 1500 00:51:43,407 --> 00:51:45,767 mediation by inflammation, right? 1501 00:51:46,612 --> 00:51:48,252 And so the ability of 1502 00:51:48,252 --> 00:51:49,512 brain to influence intestinal 1503 00:51:49,692 --> 00:51:51,672 microbiota, that's one way down. 1504 00:51:51,852 --> 00:51:54,712 And the ability of microbiota is to go 1505 00:51:54,842 --> 00:51:57,452 the other way up in a bidirectional way. 1506 00:51:57,612 --> 00:51:59,102 Don't forget that the classic 1507 00:51:59,102 --> 00:52:00,612 things that you learned about have 1508 00:52:00,612 --> 00:52:01,932 their counterparts in the gut, 1509 00:52:01,962 --> 00:52:03,542 like the vagus has the enteric gut. 1510 00:52:03,782 --> 00:52:05,102 Nervous system, right? 1511 00:52:05,202 --> 00:52:07,212 The HPA axis has your 1512 00:52:07,222 --> 00:52:09,032 enteroendocrine system, right? 1513 00:52:09,092 --> 00:52:11,997 So think of it really as another brain 1514 00:52:12,087 --> 00:52:13,977 that actually has its own functions. 1515 00:52:14,077 --> 00:52:15,917 It's what's gives you your butterflies in 1516 00:52:15,917 --> 00:52:18,127 your stomach, right when you're nervous or 1517 00:52:18,127 --> 00:52:20,107 when you're about to divorce your spouse. 1518 00:52:20,287 --> 00:52:22,737 So when homeHope takes care of the 1519 00:52:22,737 --> 00:52:24,637 needs of the fundamental cell and its 1520 00:52:24,637 --> 00:52:27,437 networks first, and the rest will follow. 1521 00:52:27,677 --> 00:52:29,237 Remember, the disease is managed, 1522 00:52:29,347 --> 00:52:31,227 health is optimized, and I encourage 1523 00:52:31,227 --> 00:52:33,437 you to optimize the health of 1524 00:52:33,467 --> 00:52:35,977 your patients or clients rather 1525 00:52:35,977 --> 00:52:37,937 than managing their disease. 1526 00:52:38,467 --> 00:52:39,327 Thank you very much. 1527 00:52:39,637 --> 00:52:42,397 This is my last slide.