 Welcome to the Dr. Gundry podcast. All right, it's Q&A day where I take your questions from social media and Apple review comments and answer them. Let me tell you, I just love hearing from you. And your questions really inspire me. And some of these even spur me to research and include these topics in my next book. And so keep them coming folks, I love it. Here we go. From Instagram at Timothy George asks, can you go over the most important but not so common blood tests that we should be adding to our yearly physicals like the ones you mentioned in the energy paradox? Or perhaps are there others as well? Amazing book by the way, Life Changing. I'm lucky to have a general doctor who is very open to your teachings and will order labs that you say. Thank you. Okay, so that's a great question, Timothy George. I've put a whole list out in the energy paradox for those of you who have not gotten it yet. So there's certain tests that you really should get from your doctor or your healthcare provider that are cheap and easy to obtain. And then we can go into more esoteric ones. First of all, your doctor is almost certainly going to get a fasting blood sugar, a fasting glucose. Quite frankly, that isn't half as important as a fasting insulin level. Now I can tell you, training third year family practice residents like I do in my clinics that most of them haven't even heard of a fasting insulin level. So if your doctor looks at you funny, just say, humor me, please order it, fasting insulin level. It'll cost you about eight dollars, quite frankly. That's number one. If that fasting insulin level is above 10, then you're in trouble. You have insulin resistance. It's useful to get a hemoglobin A1C. You see, I got my A1C down on half the commercials on TV. Hemoglobin A1C looks at how you're handling sugars and proteins for the two months prior to the test looking backwards in time. But what's surprising is, a hemoglobin A1C should be 5.6 or less. The closer you get to 5.0, the better. You wouldn't believe the number of people I see with a normal hemoglobin A1C who have elevated insulin levels. The other test that some doctors can order is a HOMA IR, capital H, capital O, capital M, capital A, dash, capital I, capital R. The IR stands for insulin resistance. A HOMA IR is another really good way to see whether or not you have metabolic flexibility, which of course is one of the major subjects of the energy paradox. About 80% of us in this country have no metabolic flexibility. Our mitochondria don't have the ability to switch on a dime, to burning sugar for fuel, to burning free fatty acids for fuel. And the longer all of us study the various chronic diseases, including dementia, including diabetes, including heart disease, the more and more we're realizing that this is a mitochondrial dysfunction problem. So all of these will actually help you point to mitochondria dysfunction. Now there's some good general purpose inflammation markers. The easiest one to get is HS-CRP. The HS stands for either highly sensitive or heart specific. Either one is just fine. It's the same test. It'll give you a generalized marker of inflammation in your body. Another useful one is fibrinogen. If you're a woman, ferritin is actually a useful marker for inflammation. Now most doctors associate ferritin with iron levels, but I can tell you it correlates very poorly with iron levels. So if you're a woman and you have an elevated ferritin level, that means we need to look further into inflammation markers. So those are some simple markers to get. We can get more esoteric. One thing that I urge everybody to get is to have their apoE4 genotype measured. You've heard me talk about this. You've heard Dr. Dale Bredesen. You've heard Dr. Promiter talk about this. The apoE4 gene determines whether you're going to make a lipoprotein that carries fats around your body. The apoE4 genotype, which about 30% of people carry, is sometimes called the Alzheimer's gene. Now you really want to know whether you carry that because whether you follow me, whether you follow Dr. Promiter, whether you follow Dr. Bredesen. This is not sealing your fate that, oh my gosh, I carry the Alzheimer's gene. I don't want to know I have that. I'd rather not know. You can actively do something to prevent the development of Alzheimer's if you carry this gene. And it's well worth your money to find out about that. The other one I would get in terms of a genetic test is the MTHFR mutation. And if you say that out loud, we would bleep you from network television. We laughingly call it the mother effer gene for obvious reasons. It determines whether or not you carry a mutation that you can't convert vitamin B12 and folic acid into their active forms, which are methyl B12 and methyl folate. And knowing that actually gives you power to get methyl B12 and methyl folate into you as supplements. So if you have, for instance, anxiety, depression, ADHD, bipolar, schizophrenia, alcoholism, drug abuse, and suicide tendencies, you may in fact carry one or more of these MTHFR mutations. And it's a really good idea to figure out if you have that. Now for the real nerds in the audience, ask to get an insulin-like growth factor level, IGF-1. It's one of the best ways of looking at how slow or fast you're aging. And there's some fun tricks to play with influencing IGF-1, just a word of warning. If your IGF-1 is high above about 200 to a 250 and you're over the age of 40 or 50, that increases your risk of developing cancer. On the other hand, if your IGF is very low, it's very unusual to develop cancer. Insulin-like growth factor is simply that. It is a growth factor that stimulates cancer cells to grow. So that's a good start and thanks for asking that question. David Fevella from Instagram asks, do I need amino acids? If I am a vegetarian, where can I get them from? Any specific foods or supplements? Is it true that if I don't eat meat, I need to supplement because they are only found in meat? Well, here's the good news. Gorillas and horses don't ask about where they can get their amino acids and as far as I can tell, gorillas and horses do very well with muscle mass. So amino acids are present in plants and in animals. They are the building blocks of protein. There are essential amino acids that we do not manufacture ourselves and so we have to obtain them from our diet. Now so much emphasis in the vegetarian and vegan community is combining foods so that you don't miss out on certain essential amino acids. And so much wasted time is devoted to grains or devoid of a couple of essential amino acids and beans are devoid of other essential amino acids. But if you combine grains and beans, you'll cover the base for essential amino acids. Believe me, there are plenty of essential amino acids in a vegan or vegetarian plant paradox program. You will get it from the leaves that you eat. You will get it from the roots that you eat. You will get it from the nuts that you eat. There are, for instance, several nuts like sacha enchi and baruka nuts, baru nuts that have all the essential amino acids covered. And so you don't have to go looking anywhere else. One thing that is very interesting about vegans is vegans actually have low levels of creatine, which is a protein. And there are interesting studies that vegans are deficient in creatine. And there are some interesting studies that vegans have smaller brains than non-vegans because they're lacking creatine. So if you're a vegan, I do recommend supplementing with a creatine supplement. And they're not animal derived. You can get vegan creatine and just supplement with creatine as part of your diet. Great question, though. From Lukas Wozak on Instagram, what's the ideal age to begin fasting? Well, so fasting covers a lot of territory, as I talk about in all my books, particularly the energy paradox. So as I've talked about before, if you're a woman of childbearing age and you want to get pregnant or you're planning to get pregnant, then quite frankly, time-restricted eating, water fasting, juice fasting is not for you. I've seen so many patients that fasting or intermittent fasting has actually prevented them from getting pregnant. And when we had them stop that practice, that started things. Also, if you or a family member have a tendency to focus on controlling your eating habits, then this is not for you. This absolutely is not the direction you want to go in your relationship to food. On the other hand, if you look at hunter-gatherer societies, I got news for you. They're not waking their kids up at 8 o'clock in the morning for a bowl of oatmeal to send them off to hunt berries. The kids don't eat until the adults eat and many of them do not eat until 10, 11, or 12 noon with their first meal. And in fact, the idea of eating breakfast, as I've talked about before, is a modern nuance that was actually fostered in great part by the Kellogg's Cornflakes Company in 1906, telling you and convincing you with a massive advertising campaign that breakfast is the most important meal and it simply is not. So if you want to make this a part of normal family activities of skipping breakfast as an example or eating an early dinner and not snacking at night, that's a normal healthy practice. The more you introduce your kids to this style of eating early on, you're going to set them up for a much healthier lifespan to come. Holly Boiko from Instagram asks, what is the best fiber you would suggest to eat weekly daily? Thank you. Holly from Ohio. Well so there's so many great sources of fiber, it's hard to start. Certainly the fiber in vegetables, in leaves, in radicchio, in Belgian endive, in curly endive, I posted on Instagram recently a salad that I had from a chef outside of Missoula Montana for their wellness weekend that was just every last wonderful chicory family of vegetables that was absolutely delicious and I've mentioned before whenever we're visiting southern France and Italy, there are chicory vegetables in every salad on every plate with every meal. So we're beginning to see radicchio, which some people call this Italian red lettuce. It's this bright red and white firm ball that's in many, many, many grocery stores now. Belgian endive is everywhere now, it's in Trader Joe's. Grab yourself ahead of those, pick up some Belgian endives and just mix them in your salads, it's an easy way. On the other hand, ground flax seeds is a great source of fiber, it's a great source of a short chain omega-3 fat called alpha-linolenic acid, but if you're going to buy ground flaxseed, the minute you open the package, put it in the refrigerator because it goes rancid. Preferably buy whole flax seeds, grind them in a coffee grinder, and then sprinkle them on your salads, put them in your coconut yogurt, put them in your goat or sheep yogurt, great way to introduce fiber. Cillium husk, you can get ground cillium husk anywhere. And don't forget that resistant starches, for instance like a purple sweet potato that you cook then cool and reheat, is another great source of fiber. And not to forget hecuma, get yourself some hecuma, many places now have it pre-sliced, use it as a dipping chip for guacamole. And guacamole has a lot of fiber, avocados are a great source, plenty of places to get your fiber. And remember, you're eating the fiber to feed your gut buddies, and the more you feed them, the better your health. All right, from Instagram, at grain free for life, ask, what do you think about Botox? What do you mean, what do I think about Botox? Yeah, if you like to have a frozen forehead that has no expression, please enjoy it all you want. Botox has been shown to be useful for some people for treating migraines, it has been shown to be useful for treating other neurologic conditions. But remember, it's a slippery slope, and there are package warning directions because of the potential and real side effects of using Botox. So buyer beware, Palm Springs quite frankly may be one of the Botox capitals of the world including here in Southern California. And every time my wife Penny talks about maybe I should get Botox like lots of my friends, we hop in the car and we head to Santa Barbara, which may be the anti-Botox capital of the world, and I show her what normal people look like, and that holds her back for a while. So if you want it, just be careful, okay? From Instagram at albinjusj, how do you rid yourself of insomnia? Well, so insomnia has many, many, many contributions. We know that an abnormal gut microbiome is a big source of insomnia. We know that viewing blue light late into the evening, watching TV screens, watching your phone, reading on a computer are great ways to keep you awake. Eating close to bedtime is a great way to keep you awake. Recently in the Energy Paradox wrote about this trick, which is kind of fun to try. Get yourself some glycine capsules. Glycine is an amino acid. Take about three grams of glycine right before you go to bed. Glycine interestingly drops your body temperature. And strange but true, you have to have a drop in body temperature to induce sleep. That's another thing. Get yourself one of these new cooling mattresses. It really works. The other thing for some people is get yourself one of the heavy blankets and wrap yourself like a toddler in it, another trick. In other words, eliminate the causes that are keeping you from falling asleep. And in my books, I've got lots of tricks with other supplements for helping you initiate sleep. From Instagram, Jeff Eden asks, what should we do to restore our microbiome post-COVID vaccine? I use your power blues, vital reds, polyphenol, olive oil, mito-x, told to restore vitamin D and vitamin C. Is this sufficient? First of all, there's no evidence that I can find that I've ever heard about that the COVID vaccines, any of the three that are commercially available, change your microbiome or destroy your microbiome. Now catching COVID changes gut permeability. That much has been well shown. But these vaccines are not going to change your microbiome. Having said that, as I've said over and over and over again, a diverse, healthy microbiome and an intact gut wall is one of your best protections that you have available from preventing viral illnesses, including COVID-19. But you don't have to worry about if you've gotten the vaccine getting your microbiome back in order. That's a great question. Erin O'Kelso on Instagram asks, in relation to Aleve ibuprofen being the equivalent of swallowing a hand grenade for your microbiome, how does prescribed out-of-all or vivant sit? Well, first of all, these compounds like Aleve or ibuprofen don't destroy your microbiome. They actually destroy the wall of your gut. And in my upcoming book, you'll actually find out why that happens. And it's a real eye opener. This is not conjecture. We know why these actually poke large holes in the wall of your gut. So they don't bother your microbiome, but once you got a leaky gut, once you have a hole in your gut, then even friendly bacteria can become enemies. They can become frenemies. And that's what we want to prevent. I look briefly. There does not seem to be an effect of Adderall on vivants on the gut microbiome. But I'll go back to again saying that there is more and more and more and more evidence that anxiety, depression, ADHD, the gut microbiome, the microbiome gut-brain connection is driving a lot of this. And the exciting news is changing your microbiome, giving your microbiome prebiotics that we just talked about a few minutes ago, may be paramount to getting these things under control naturally. And Furuta on Instagram asked, what is the best way to lower triglycerides, especially if it's part of your genetic makeup? Both my husband and I are on the plant paradox. Well, and thank you very much for being on the program. Yes, there is a genetic component of familiar hyper-t triglyceride emium, but it's incredibly rare. And I have a number of patients who have been told they have that, and they run triglycerides of 2,000, 3,000, 4,000, and all of them have come down dramatically by following the plant paradox program. Now I have had the pleasure of having Jim Hector on my program, The Diet Myth from England. And he and I agree that there are some people who are super sensitive to carbohydrates, particularly fructose, fruit sugar, in producing triglycerides, and I've written about this extensively in the energy paradox, and people who are super sensitive to sugars and starches. If you want to keep your triglycerides down, you really can't eat very many sugars and starches. I happen to be one of those people. On the other hand, if you're not super sensitive to it, and you can challenge yourself, I've done this before my blood test, then they are not going to be your major problem. But as a starting point, fructose is instantaneously changed into triglycerides in your liver. So a great place to start is really either eliminating fructose from your diet. And remember, simple table sugar is half fructose. So getting sugar down lowers triglycerides. Uday from Instagram asks, what's your morning routine look like? My morning routine is one of three of my dogs jumping on my head, usually at about 5.30 in the morning and saying, okay, quit ignoring me, let's go. And that involves having some espresso. I have a couple of cups of espresso, black, or I put MCT powder in it. And we'll go into that, we've written about that in all the books. I don't eat breakfast, as you know. And then I take my three dogs for a hike of about two miles through our neighborhoods. And then I come back and head to work. And as you know, I see patients six days a week, including on the weekends. And I'm here at Gundry MD on Fridays. So that's what my morning routine looks like. Oh, and I take a bunch of supplements in the morning and I take a bunch of supplements at night. And as you know, I've listed all the supplements I currently take in the longevity paradox for those of you who are interested. From Apple Reviews at Idaho, Lisa. Love, love, love the podcast. Thank you, Idaho, Lisa. My question is, in my early 20s, I had severe ulcerative colitis. Subsequently, I had to have the large intestine removed completely. And they reconstructed my small intestines so that I don't have to have an ostomy bag. Aha, you had a pouch. Can I get three most important tips on energy and eating in my situation? Well, first of all, I want to make sure that you're taking a methyl B12 and putting it under your tongue every morning. About 1,000 micrograms will do it if you want to be safe and take 5,000 micrograms. So be it. You most likely don't have a lot of what's called terminal ilium left or it's been used to make your pouch. And so you won't absorb B12 very well. You lack intrinsic factor or the absorption of B12 sites. And that's a really easy trick. The good news is, as you know, I take care of a large number of people who had ulcerative colitis, who don't have it anymore thanks to the program. You really don't have to, if you're following the Plant Paradox program, you're on the right track. As you know, we know that some people can get ilitis from these same culprits. So the more you can do to protect your remaining gut, the better. So feed your gut buddies. They're still critically important to you. And keep up the good work. I'm glad you follow the program. At the Healthy School Bus on Instagram, can we use acacia powder as a prebiotic? Absolutely. That's another really great prebiotic. The other thing I think we need to understand that a lot of these gums, like guava gum, like gum arabic, like acacia, which have been villainized in the past as really, really bad for you, the tide is turning. These are phenomenal sources of prebiotics. And the more prebiotic fiber I get into you, the happier gut buddies are. And the more they will make postbiotics, which will make you happier. Anonymous wrote, you say no wheatgrass, but then recommend eating grass-fed meat. What gives? All right, so you and I are not cows. We do not have three stomachs that allow for fermentation of lectins. You and I have not been eating grass ever in our lives. We were not designed to eat grass. There's no evidence of any primate eating grass. And so you were not designed to handle the lectins in grass. On the other hand, a cow or grazing animals have been eating grass for millions and millions and millions and millions of years. They've been designed to detoxify lectins in their three stomachs by fermentation. So if you had a stomach that fermented grasses, you could probably get away with grasses. The problem is cows were never designed to be fed corn and soybeans, which have a totally different set of lectins. And sadly, we know that cows do not react well to the lectins in corn and soybeans because they get horrible heartburn. And half of the world's supply of tums is actually mixed into cattle feed so that they don't get heartburn and they keep eating. So calcium carbonate is in cattle food, so they don't react to those lectins. So the reason you want grass-fed and grass-finished beef is they've got the system to handle those lectins. They've evolved to handle them and you haven't, sadly. Good question. Kim FS on Apple gives the podcast five stars and says, Dr. Gundry, you're the best. I appreciate the way you choose special guests for your show. It's really important to have updated information coming in consistently. The health world seems constantly changing, especially lately. And your quality podcasts help keep me motivated to stay elect and free. Speaking of which, is there any way we can prepare and consume ancient Himalayan buckwheat so it can be on the plant paradox yes list? My second question is, do you venture to share your opinion on the safety or potential benefits of ozone therapy? Would love to hear from you on that topic. Well, way back when, when I was first investigating lectins and whether certain foods had lectins, I was really, really hopeful that buckwheat was going to be lectin-free and I was really disappointed to, unfortunately, find multiple papers showing that buckwheat has lectins. Having said that, you can use a pressure cooker to destroy the lectins in buckwheat. So get your ancient Himalayan buckwheat and cook it in a pressure cooker and you should be perfectly safe. Ozone therapy, that would be quite honestly a major topic and because ozone therapy has such a slippery slope in terms of its harm that, quite frankly, I have never had to use or recommend ozone therapy for any of my patients as part of their therapy. So all I can say is there's a lot safer ways to fix what ails you than ozone therapy. We'll leave it at that. All right, at Brian J. Roth on Instagram. We've fed your daughter your yes foods and she was eating solid. She's now almost three. However, we see that she doesn't digest cooked sorghum like it comes out in her poop the same way it looks on the plate. We cook it really well in a pressure cooker. Why is this happening and should we just avoid feeding her this for now? So we see this happen sometimes with corn, with other people that the corn is completely undigested as it poops out. This may be actually some digestive enzyme insufficiency and even if she's three, I'd suggest taking some digestive enzyme capsules and mixing it in her food. There are multiple digestive enzymes that are very cheap and just see, first of all, if that makes a difference. If that doesn't make a difference, there's no human need for sorghum. So just take it out of her diet. At I am David Fevella on Instagram. When is the best time to eat pistachios? Four hours before bed or 10.30 AM. And if it's in the morning, will they make me feel sleepy? All right, here's a myth that we're going to destroy right now about melatonin. And I speak, talk a lot about melatonin in my upcoming book. Melatonin has been associated with sleep for as long as anybody cares to think about. But spoiler alert, melatonin does not make you sleepy. I know, I know that's what you've been told. Melatonin is produced by your brain for a completely different purpose. And that's to rejuvenate and repair your mitochondria. And that's why if you're going to eat a nut, pistachios have the highest source of melatonin of any food. In fact, quantum levels higher than any other food. And they won't make you go to sleep. So eat your pistachios, eat your other melatonin foods for the benefit for repairing your mitochondria. That great question. That's all the time we have for today. Those are great questions. Keep them coming in. We will do another Q&A very soon, I promise you, because you keep sending it in, I'll keep answering them. Because I'm Dr. Gundry. And I'm always looking out for you and your questions. See you next week. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher, or wherever you get your podcasts. Because I'm Dr. Gundry, and I'm always looking out for you.