The Supplements Episode - Part 2

And we're back. Cell to Systems supplementation episode two. The Craig's List. The list that Craig is bringing to the table from a provider perspective that is going to rock your world. Let's go. Craig, hit them.

Number one, you know, I think red yeast rice is strong. This gets an A in my book. Um, red yeast rice is basically the same molecule, the same compound as the pharmaceutical drug lovastatin. All right. Uh, lovastatin is a statin medication that is designed to inhibit HMG-CoA reductase, which is associated with cholesterol synthesis in the liver.

So, why does it get an A? In my book, it it gets an A because nature gave us here on Earth a statin. Uh red yeast rice. It uh contains monacolin K which inhibits that same enzyme HMG-CoA reductase which is again responsible for cholesterol synthesis through the liver and it is very effective at doing what a statin would do. Um but you know it's a double-edged sword, right? Uh because if you are prone to the same sort of symptomatology of muscle aches and joint discomfort, some people even complain of brain fog. I think that that's, you know, much more anecdotal than hard evidence uh that it can have um an interference on brain function. But if you are prone to those symptoms, then uh there's a good chance that red yeast rice could actually also contribute to those as well.

Just like a statin, I recommend that my patients who are on uh red yeast rice take it at night. Nighttime during sleep is the primary time with which the liver is generating cholesterol. So if you're on a statin, you want to take your statin at night. If you're taking red yeast rice, you want to take it at night. I always uh recommend that they use CoQ10 as well. Um, so 200 milligrams of bioavailable CoQ10 in the form of ubiquinol is something that I recommend.

Another thing with red yeast, rice and statins uh is that there is a select group of patients who will have liver enzyme elevation when they take these medications. So your provider needs to be looking at and monitoring your complete metabolic panel. If you're somebody who is a heavy drinker or you're doing other things, taking a host of supplements that you don't know how those are influencing your liver, then you need to be cautious in that area as well. But um you know, red yeast rice along with certain other supplements uh do have, you know, strong uh lipid modulation qualities to them and so they do get that A in my book. Um

yeah, I think the red yeast rice thing is really cool. I um I have I've used it in the past and I'm not using it now, but I probably um I have some at home. Probably go back and start using it just uh again, but that's something I'll talk to you about exactly how much I should be taking. Uh I've got ubiquinol in the mix. But um you know, I'm on a statin, so um you know, I don't know if it's double duty if we go start going into that, but again, this stresses back to don't try this at home.

You know, you know, don't jump off that roof. This isn't a episode of Jackass, right? Um, you need to be talking to your provider about these things. This is how precision I mean, this is really, if you really want to be in this world, this is where you do it. This is how you do it. You do it with a provider. And if you take a look at the intensive that I did with Craig, uh, where we spent two whole days together, uh, that was incredible.

You know, Craig, as I listen to you, I almost go, you know, I just want to build a store for you um to put onto your website where people can actually buy these products because there's so many times where people go, okay, well, that's great, but where do I get it? And I think you know where to source stuff and can actually, you know, the products that you would put in a store are things that you could actually stand behind. So, that's something that I think we should discuss because there's no money in the supplement business, right? There's no money in actually selling that. It's a pain to actually fulfill it for a practice. Um, you know, some of it may drop ship, but the bottom line is knowing going going to that source and knowing that you're getting the right stuff. Um, and doing that in conjunction with your provider or, you know, maybe if you're in the area, you can see Craig if you're if you can get in the panel, that's your lucky person. All right, keep going, Craig.

Yeah. So, next on my list is another one that does um has been shown to positively influence lipid biomarkers and we know that it has this benefit as well for glycemic signaling. Um this is berberine. Berberine is another hot topic um in health industry right now. It's uh you know overall metabolic wellness. People think of berberine as this supplement that can help to um you know activate AMP related signaling and it can uh alter hepatic glucose production and we have good data that berberine can lower insulin levels. It can lower A1C uh but with as with anything that we put into our bodies there are potential ramifications.

Uh berberine has some u microbiome effects, right? Uh at higher doses berberine can actually act sort of like a broad-spectrum antibiotic uh in a sense, so it is antimicrobial and some people do not tolerate it from a gastrointestinal standpoint. Uh it's usually taken at doses around 500 milligrams to 1500 milligrams a day. I usually recommend about 500 milligrams per meal in my patients that are dealing with insulin resistance issues, dysglycemia, um, and metabolic syndrome. Uh, but, you know, again, it it can promote constipation. Long-term data evaluating its effect on the microbiome is still pending. We we need to see more over the coming years.

Um breastfeeding mothers should probably, you know, really definitely talk about this with your clinician um to see if there are any safety signals there. But absolutely, there's, you know, good hard data for berberine as helping to improve insulin sensitivity in the body, um help with glucose control and improve overall metabolic health. So, I'm a I'm a fan of that. It's not something that I'm utilizing in everybody. If they have GI issues, IBS, leaky gut, this that or the other thing, really got to look at that heavily uh to see how that may influence. So, um you know, positive supplement potential pitfalls. Yes.

And the other side is too there's some talk that uh not everybody responds to it, right? So, maybe a hyper responder or a nonresponder to it. And again, once again, that the way to find out if you are or you aren't um is by working with a provider to make sure if you're going to take that that you're you're doing it the right way. I you know that the reason why I keep saying this is I just feel like people get on to YouTube and they start they hear these things and people are pumping stuff and next thing you know they're ordering a bunch of stuff and they have no idea um what they're kind of getting into in the supplement world is um it is serious. It's serious stuff. It's not to be played with.

Oh yeah. Yeah. Absolutely. I think you know with berberine it may come down to a dosing issue. If people are seeing oh you know my my capsule is 500 milligrams take once daily. Uh they may be underdosing to get the true benefit there. But um again take it up with your clinician and figure out what dose is right for you if you want to give it a try in the first place.

Yep. All right. What's next on the list?

So, next on my list, I would say, you know, these these are a couple of simple things. So, we can probably breeze through them real quick and especially so because we covered one of these uh on a recent um you know, podcast episode, but um vitamin D uh is vitamin D3 or cholecalciferol and iron, right? So, these two things, these two micronutrients are critical in the body for various different things.

Iron we know is responsible for the production of hemoglobin and myoglobin. It's responsible for ATP uh synthesis and and energy in the body. So critical um you know critical micronutrient to make sure is actually replenished in your body. This becomes very important in patients who are experiencing sort of bleeding issues. Um that could be anything and everything from uh somebody who's you know uh menstruating to somebody who has a gastrointestinal ulcer or they've got other issues in the colon or maybe they've had bowel surgery before impacting portions of the bowel that are actually responsible for iron absorption.

Uh so iron when it's low uh the number one concern typically is iron deficiency anemia. Well, you can be iron insufficient and experiencing symptoms of low iron uh even if your red cell indices are not suggestive of a true iron deficiency anemia and your hemoglobin's okay that so on and so forth. So, common symptoms that people experience, well, they may get headaches. They may have brain fog. They may uh have low exertional tolerance and just feel like their energy is dragging throughout the day. They're sluggish. A lot of people also complain of restless legs. And then there's the whole thing that a lot of people have heard about about the craving to eat ice.

So, if you experience any of these things, you know, you may want to talk to your clinician about getting an iron and TIBC as well as a ferritin level. Um, ferritin is a marker for iron storage in the blood. And uh really you know a a level below 80 is often times that point at which you know patients might start to experience symptoms associated with lower iron availability or iron storage. Um and we I often see that their TIBC their total iron binding capacity is climbing.

Uh I talk to my patients about it like a storage unit, right? You have a storage unit that is empty uh and it's got a big capacity for furniture and picture and all the other stuff that you would want to put in there. As you start to move stuff into the storage unit, that capacity goes down. So when you see a total iron binding capacity that's climbing with a low ferritin often times also alongside a lowering iron saturation or a declining iron saturation um then this is a big clue that hey we need to look into this a little bit more. Do we need to look at intestinal absorption issues? Is there any you know thing that could suggest that there's bleeding throughout the gastrointestinal tract? Why is this person potentially deficient in iron?

Iron should not be dosed indiscriminately. Iron overload is a very real thing that can damage the liver. It can damage the heart, can have negative issues on the brain uh and central nervous system. So, you don't want to just take iron willy-nilly. But if you are in fact deficient or insufficient, uh it should be optimized.

The next one is vitamin D. We talked about this recently on your on our podcast. Um and you know deficiency again needs to be correct. Vitamin D deficiency is defined as a level that's less than 20 with vitamin D insufficiency as being a level that's between 20 and 29. We talked about how this is important for um bone density and um you know skeletal system health. We talked about how this has been shown sort of back and forth to be a contributing factor in someone's risk for respiratory disease. Um, and overall, you know, their propensity to develop infections, common cold, flu, that sort of thing.

Uh, there's a lot of back and forth data out there. The most up-to-date research suggests that well, don't go chasing the number. If you're insufficient or you're deficient, that's your key to go ahead and replace vitamin D with a targeted protocol. Uh but if somebody comes into the practice nowadays and they're, you know, vitamin D level is 45, I'm not saying to them, hey, you got to push this up to 80 or 90 or anything like that. Vitamin D also in excess can contribute to problems, can cause hypercalcemia, can leech calcium from the bones, contribute to bone thinning. So again, indiscriminate vitamin D uh use is not something you want to do just because you heard it on the internet.

And you hear a wide range of dosages from people out there all over the internet. Hey, a thousand IUs, 10,000 IUs, you know. So again, that's another one where you really want to be working with your clinician on that. And it is a fat-soluble vitamin. A lot of people will try and take this in the morning before they go to work on an empty stomach. You got to take it with a a fat containing meal. Uh it's lipid soluble. So, uh all of those vitamins, you know, your D, A, E, K, uh they're going to more readily absorb into your body, uh with, you know, meal that contains fat. Um, next on my list, those were my A's. Those all got my A rating. I'm going to go to some of the B's. Um, you know, we've talked a little bit about um amino acids, right, today, right, during last week.

I'm so glad you're bringing this up because I was going to save this one because I almost don't want to hear it, but I really want to get into this because c can I just take a minute just to kind of lead into this a little bit, Craig? Because

Sure.

So, you know, I'm taking a product. There are a lot of people that are touting it, the perfect amino. It's a product that's taken off and they've expanded their line into a variety of areas. What's interesting about this is there's this talk that this particular nine essential amino acids that are in that product uh are what you need and everybody is amino acid deficient. But what they say is that compared to a scoop of whey uh whether that you know depending on the concentration whey protein isolate obviously is what we recommend or chicken breast or steak or fish. Uh that this is something that is absorbed by the body.

Number one, it's predigested and they are in their true amino acid form. So there is this you know equation of uh mass. So it's more bioavailable. So if you take 10 tablets it's equivalent of 52 or 50 grams of protein or something like that. Uh but there's this equation of mass. So you know I've kind of run it both ways. I've looked at it and I'm like, okay, one tablet is one one gram of protein essentially. That's the equivalent value. Um, so 10 tablets would be 10 grams.

Great primer in the morning. Certainly, you know, if you're going to train fasted like I do with, you know, ketones and a little caffeine. Good muscle sparing uh idea to make sure that you're not getting catabolic in the in the midst of I mean obviously you're tearing stuff down but you know and muscles made at night and sleep but but I'm curious what your thoughts are on this. This is one. This is a hot. This is hot.

You know, they get a B in my book, but uh B stands for beneficial. And uh I am a proponent, you know, the area where people get mixed up. And Jock, I know that you are, you know, big on amino acids and and you've got a nicely dialed in regimen. Um, and you know, I think that you can speak on this even better than I can, but you know, the the thing that people get mixed up is that the the BCAAs, the branch chain amino acids, of which there's leucine, isoleucine, and valine, um, are really just the on switch, right? So, you can't expect to just take your BCAAs and then go crush it at the gym.

And this is the muscle that you need. You need the full protein. You need the the all of the essential aminos, you know, the all nine um because that's where the synthesis happens, right? It's you're hitting the on switch with the BCAAs. We talk about that like 2.5 um milligram dose of of leucine or whatever as being the, you know, the muscle on switch, but then you need everything else, the foundation, the rest of the aminos to really synthesize the lean muscle protein. So, um I'm a I'm a big fan. I think that you're doing it right and um you know, you're certainly gaining muscle, not losing any. And uh that's, you know, how people need to think about it.

You just bring up a great point because for years you heard about people just talking about, oh, just get your BCAAs. And uh we know, you know, that's not it because you can hit your leucine threshold, but at the end of the day, that is the trigger, as you mentioned, that then is going to soak up all the other stuff and bring it. You need all of those to be present. And there's some interesting products that have a whole host of other amino acids that are there.

Uh there was some, you know, talk recently and there's one guy that posted something and I think he got a science wrong and I just kind of had to call him out on it and he's talking about, you know, fast twitch, low slow twitch, uh activation, and then the mTOR pathway and all of the things that were happening there. And I'm like, well, actually, you've got a little bit a little bit backwards, but that's cool, man. Check this out. Here's how it really works and that, you know, the idea that once you get into that slow twitch and that's when you need that to happen, you need to have that in that moment to be on board.

So, yeah, amino acids so so important in my opinion. Of course, nothing replaces a solid whole food diet. Um, you know, I think we really have worked on my diet and I've had incredible results, made some real adjustments and so quickly. You know, that's the one thing I would say. I love what Cynthia Keller, Dr. Keller said about the gut microbiome turning over in two days. Uh, it's really true. You can make adjustments in your diet and have dramatic results in a quick period of time. I mean, a short period of time.

Um, so, you know, amino acids, I'm so glad you brought that up, man. It's such a hot topic. We could do an entire show on that and all the mechanisms of action and how they work uh for people in so many different ways from the skin to the brain to you know all the different levels of health. I want to ask you a question. Do you feel that this is true that most people are amino acid deficient?

Um no not if they're consuming an appropriate diet. I would say no. That that is the kicker, right? I mean a lot of people are not consuming adequate protein. A lot of people this day and age are regularly underfueling. So in when you pose it that way, I would say yeah there there may be propensity for people to be deficient in amino acids. If you're eating right, if you know what your protein thresholds should be for the day, your th your protein goals, um, and you're really doing what you can to follow that and and meet those expectations, then you're probably doing okay.

Probably not. Again, I'm going to say this again, go back to, you know, you work with your provider who actually knows about this stuff. Not all of them do. I mean, in your education when you're going through it, there wasn't a lot of nutrition, right? But your post you had a ton and then you continue to study it. You continue to look at it. You know a lot about it. But not everybody does. And for a long time a lot of doctors had no idea.

There are a lot of great nutritionists out there. We're going to have somebody on the show on the Pathway to Peak Performance show coming up. I won't say who it is. It's a she's, you know, like a world famous trains Olympians and all that kind of stuff. And I think chronic under nutrition is so true. So macros may not be the bigger the the only picture. Macros and micros. So for those that have don't know what that means if you're watching the show for the first time, macronutrients being protein, carbohydrates, and fat. And then the micronutrients that sit within them.

So, you know, we always want to have I think from from where I'm looking at it, Craig, I look at my protein based on the way I do it is a little bit more geared towards my anabolic resistance due to age related anabolic resistance. I'm going to take a higher level of protein. So, I'm doing that on a total body weight versus lean mass, which is another way of doing it. Um, and then uh fat is pretty much fixed. And I'm trying to get most of my fat from really high quality olive oil that is not cooked, you know. So, it's, you know, cold-pressed extra virgin, high polyphenol, uh, really good stuff.

Um, and then my carbohydrate profile, you know, is going to go up or down whether I'm in a caloric deficit or I'm in a maintenance or surplus depending on where I'm training. Uh, and I think as I get older, you know, you get to a level where you're just like, okay, now I'm just trying to even this out and kind of keep it at the right maintenance. Body fat percentage is what it is and muscle mass is what it is. We want to hold on to it. Um, certainly not trying to be a bodybuilder, right?

So, amino acids, awesome. So glad you brought that up. I just think that is so hot right now. There's so much of that being sold um and so little of it understood. So, thank you for bringing that up.

Of course. Of course. Yeah. The next one that I was going to mention is actually really in the same vein. Um, and this is just touching on a couple of amino acids in particular. Um, L-arginine versus L-citrulline, right? Um, which are in all of these pro a lot of them are in all of these products that we use for pump in the gym and preworkout. Um you know men's health products uh for supporting erectile function um you know hands down the one you want to go with is L-citrulline.

Okay, L-citrulline is going to actually have better oral bioavailability than uh L-arginine. It is going to associate with less gastrointestinal issues and discomfort and it's going to convert back into that L-arginine in the body which is potently going to activate nitric oxide synthesis. So, you know, the blood flow benefits are real for um erectile health, for blood pressure management, to support cognitive wellness um and overall tissue health, right? Um but I think, you know, for me, hands down, it's an L-citrulline if you're going to go and look for some sort of amino acid to support nitric oxide synthesis.

Yeah. I'm curious. Um there was a lot of talk, uh Dr. Bryan, who's the big nitric oxide guy, um, came up with a product that's those lozenges. I've used them. They definitely give you a pump. It's cool. And then there's the beet product that, you know, that's out there. Uh, but when we get down to just actual supplementation around using L-citrulline, um, you definitely see it. You take it, you take five grams of that, uh, preworkout.

You're, you know, depending on again when I say that take five grams that when I say that's what I've done, it's not what, you know, not saying anybody else should do that. This is just my opinion. I hope you agree with me, Craig. Uh, if you don't, please tell me. But I think you should be looking at supplementation based on your weight. So, you know, like a woman taking five grams of L-citrulline who's 135 lbs versus a 200 plus man uh is a bad idea. So, you know, I I was using a product that was L-citrulline and L-arginine combined and I

I think there are a lot of those. Yeah, it's not uncommon.

Yeah, I think I'm going to ditch it just for the L-citrulline uh and and use that. Uh there was another guy we both know who told me uh many years ago now uh that you should just be on L-arginine. That's the thing that you want to be taking. I guess we both don't feel that way. Um, so that's that's interesting. Man, that is another hot one. Why is your list so much better than mine, Craig? What is the deal?

These are things, you know, that starting with berberine I could touch on. I mean, we could do a whole episode that might be a good idea for an episode to touch on all the uh various supplements that are natural that can make a marked improvement in somebody's lipid and cholesterol panels. Um you know especially now as we're looking at cardiovascular risk in deeper detail right we're looking at apo levels we're looking at Lp(a) uh lipoprotein little a we're looking at um lipo profiles particle size and numbers and evaluating these things alongside other uh factors that contribute to cardiovascular risk high sensitivity C reactive protein myeloperoxidase homocysteine.

So I think we could make a case for making an episode on, you know, a lot of these things that I use regularly in my practice because, uh, let's be real, you know, there's a lot of people in this space that they're they're very statin averse. And I I think you know that's an unfair picture for statins because we know that they're very beneficial for actually helping to calcify soft and moderately soft plaques that are the actual dangerous atherosclerotic plaques that can rupture and occlude distal coronaries and you know travel to the brain and so forth. So when you're talking about a medication that we know saves lives you know statins are they they just have overwhelming evidence. So um but there are a lot of patients that don't like to use statins or they've taken them and they did experience some of those negative benefits. So there are options, you know, there's there's red yeast rice, there's citrus bergamot, there's vitamin E tocotrienol, there's other uh citrus flavones, tangeretin and nobiletin, uh that can work very well to improve uh lipids. So but I do want to touch on one thing, if it's okay for me to just steamroll and keep going, dude.

Yeah. So homocysteine, you know, homocysteine is regularly evaluated on my blood t blood panels. Homocysteine is uh naturally occurring, um you know, it's a byproduct of amino acid metabolism. It is a known independent cardiovascular risk factor. Uh so people have increased risk for heart attack and stroke because of the way that it potentiates vascular inflammation when your levels are elevated. Homocysteine optimal level should always be under 12. It is better to be under 10 and optimally should be less than eight.

Now when we look at homocysteine, there are some things from a dietary standpoint that can drive homocysteine up. Things like cured meats, aged cheeses, uh you know, certain wines, things like that can drive homocysteine levels up. But also a very common genetic trait is associated with hyperhomocysteinemia. This is MTHFR and some of the other variations that are similar that are going to contribute to decreased ability to absorb B12 intestinally and abnormal or impaired folate metabolism. Uh so it's a very common uh single nucleotide polymorphism. You know, it's a what we call a, you know, a SNP uh or a trait in the population.

And uh anywhere from a quarter to a third of Americans have some variation of this uh abnormal gene and they experience those problems. They have issues with absorbing B12. They have impaired folate. Uh and they can develop hyperhomocysteinemia. In pregnancy medicine and OB-GYN, this is a common culprit uh for miscarriage. So, anybody who's listening who's had one or more miscarriages should at least look into their MTHFR status with the genetics test or at least get their B12, folate, and homocysteine levels assessed.

When homocysteine is elevated, there are a couple of things that we can do. Number one, we start thinking about, okay, what is their baseline B12 and folate levels? Do they need methylation support? Are we moving towards methylated B vitamins? Are we looking to implement 5-MTHF or 5-methyltetrahydro uh folate uh into their regimen? Uh if you have some sort of functional deficiency in one of those, and there's other tests like methylmalonic acid and whatnot that you can use to uh see whether it's a true B12 insufficiency or whether it's more in the folate angle, um you know, you there are things that we can do to bring that homocysteine level down.

So we use methylated Bs, we use um some methyl donors. Uh sometimes, you know, we use a supplement called betaine or trimethylglycine, um which is going to, you know, once you've sort of optimized B12 and folate but that homocysteine level is still elevated, it's a good idea to look into, you know, what what's their B6 level. Um and also should we integrate some betaine or trimethylglycine into the regimen, because um it helps with that uh conversion of homocysteine back into methionine, um which is a less, you know, it's it's not harmful to the vascule in the same way homocysteine is. So um you know, that's one that I use commonly, both both of those.

And the interesting thing about TMG or betaine, betaine, um is that you can also do uh patients that have like reflux, um and Dr. Keller talked about this a little bit on the podcast that we did with her, is that these people get, you know, they get reflux, they get put on a proton pump inhibitor, and a lot of times, you know, that creates problems. It's it a low stomach pH is necessary to for good diversity of your commensal and keystone bacteria. It's necessary for opening the pyloric sphincter, so stomach contents can transit from the stomach into the small intestine. Um a higher pH consistently or chronically over time in the stomach can uh perpetuate dysbiosis of things like staph and strep.

Um, so a lot of times these people don't actually need inhibition of their stomach acid. They need to look at the foods that they're consuming, see whether the triggers may be there. Um, and then they can do a betaine uh challenge test where they actually, you know, take um build up to a certain amount of betaine capsules before each meal. Um, and this can help with overall um digestion, and uh you find your dose that you need before the meal and then you back it down by one pill. It's a whole protocol. Um but you know, anybody who's suffering from a gastrointestinal issue like reflux, that sort of thing, they're on a PPI, should come see me because I'll help you out.

Yeah, dude. I mean, like, I remember when I first started to have acid reflux, what I've really come to realize is, you know, taking hydrochloric acid, actually, just really eating a clean diet. Don't drink alcohol, uh, don't drink coffee, eat a clean diet, and I have zero problems. None whatsoever. There's none. I have no I have no reflux. I have no issues at all. And what does that tell you?

I think it's such a area that, you know, we've really gone down the wrong path in just prescriptive authority and, oh, you have reflux, oh, you have GERD, this, that, or the other thing, here's your famotidine, sort of at the, you know, least uh noxious but still not innocuous, and then your um proton pump inhibitors. They are really just sort of operating against our natural physiology in a very similar way to like birth control. And I'm not saying they're not necessary in some people, patients with var uh Barrett's esophagus, patients who have abnormal Z-lines on upper endoscopy and there's a lot of, you know, uh esophagitis present and there's concern about neoplasia, esophageal cancer, sure, okay, I get it.

But your average run-of-the-mill 30, 40, 50-year-old who's dealing with reflux, um are they eating too much, you, are they staying upright after their meals? What is the quality of their meals? A lot of processed foods. Um, you know, do they have some other food sensitivity or intolerance that really we can root out with like a simple IgA food sensitivity test? Um, then, you know, hey, I mean, I just I just think that it's like medicine that's being lazy and not looking to really help people, just prescribe medications.

I just couldn't agree with you more. I mean, I just think that it's like, I don't know what the exact percentage is and, you know, again, far be it for me to say. My guess, my take on it is like 80% of the problems that are out there are really just lifestyle choices. And if you correct those, unless you have some of the things that you discussed, you're going to be good. Let's move on. What's What's next on the list?

Inositol and myo-inositol. Uh I'm I'm a fan of these uh for PCOS, now known as PMOS, uh signaling. Um you know, I think that there is relatively strong evidence there uh to support that these things can help regulate metabolism, um and paired with other things like, you know, taurine and berberine and chromium, we can sort of target multiple areas um in the patient that has PCOS at the same time. Um some of these things can be very beneficial for the nervous system and for for calming as well. Uh so myo-inositol or inositol uh I think is a win in my book.

Another thing that um you know I was looking at, uh just to sort of quickly go into it, I like curcumin, um you know, which is sort of the the active um ingredient in in turmeric, the spice. Um and you know, this has some anti-inflammatory benefits, some heart health benefits. There's talk, right? There's talk and there is some exploration of is there a positive benefit in thwarting off Alzheimer's risk uh with these things that, you know, are supposed to be like nutritionally derived anti-inflammatories. Um so I I am a proponent of that. Um you know, if you listen to Dr. Mark Houston, who is the lead of the Hypertension Institute, um you know, he includes a regimen of curcumin in his uh plaque regression supplement stack. So I think curcumin deserves a spot.

Um and then a couple others that I'm sort of regularly recommending to my patients um that are interesting: phosphatidylcholine and phosphatidylserine. Now these are phospholipids that readily integrate into the cell membrane. Uh as our cells age, our cell membranes decline in their resilience. Well, we want to keep them boosted and and keep them optimally functioning because, number one, they protect the cell. They're they're a support structure, a scaffolding for the cell. Number two, um you know, they are the area, the main area where our receptors are expressed, right?

So we're looking at insulin receptors, glucose receptors, hormone receptors, neurotransmitter receptors, all of these receptors are expressed on the cell membrane. And so we want our cell membranes to have good integrity. Um, and phospholipids can help uh, you know, supply some of the fundamental substrate that we need to readily improve our our cell membrane health.

Phosphatidylcholine, um you know, not without its pitfalls as well. Uh people that have leaky gut often times have uh elevation in what's called trimethylamine N-oxide. Um TMAO, as it's as it's referred to, and by the way, TMAO will contribute to, is is an independent risk factor for stroke and heart attack and things like that. Um, so people that eat a diet that that's rich in, uh, choline-containing foods, notably red meat, beef, uh, and eggs, um, you know, maybe they and they have TMAO elevation, uh, lipopolysaccharide translocation. They're having vascular inflammatory risk factors increase as a result of that. If they're also eating, you know, diet rich in choline, um, you know, they probably don't want to supplement with additional phosphatidylcholine.

Um, and then phosphatidylserine is the one that's more associated with like potential brain preserving benefits. Um, so I think that um, you know, that one is is something that I integrate somewhat regularly into my practice. Uh, there's some interesting research out there. There's a number of studies actually uh on the potential benefit of of serine, phosphatidylserine, for nervous system health. So I do like that one, but you know, it gets like a B minus, C++.

Is this uh neuroanglia?

Yes. Yeah. Yeah. So absolutely a component of those plasmalogens for sure.

Mhm. Yeah. I mean, I think we're into a territory where people really have no idea where to get that kind of stuff. Uh I guess you can get off their website, but you definitely do not want to do that. Uh that is that you now you are really into a territory that is do not travel this road alone. That's not air that you want to breathe. That's rarified air up there, man. You need you need to be on oxygen for that. That oxygen is your provider.

Yep. Yep. It's interesting. Phosphatidylcholine we can give IV. Um, and that's pretty cool, especially when we look at some of the other therapies that we're um integrating at the same time. Things like procaine, things like EBO2, uh, pairs really well with like a phosphatidylcholine infusion, just because those therapies are influencing the cell membrane of various different cell types in the body, and uh, we want to, you know, synergize with that. So the phosphatidylcholine is is something that I I do sometimes for patients. But that's really it.

Yeah, Craig, another incredible episode. Your list was so good. Uh, wow. I would just say that you really went on the deep dive into some really intense supplements. I'm so glad you covered the amino acid piece. For those of you that are listening or watching, please remember to like, share, and please subscribe. You know, it's interesting. YouTube tells us that the majority of the people that actually watch the show don't actually subscribe. And that really helps us to grow the show and bring more and more guests to the table, which is something that we're working on, to increase the number of people that will be on the show moving forward, uh to bring you more and more uh critical information as you heard from Craig today. Just information that is super important. All right, everyone. Thanks so much for watching. We'll catch you on the next episode.