Episode #62 Full Transcript

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Podcast from #62 https://bengreenfieldfitness.com/2009/09/podcast-episode-62-is-ben-greenfield-actually-healthy-the-blood-urine-and-saliva-results-are-in/

Introduction: In this podcast episode: the results are in and you get to find out the hidden health risks inside the body of yours truly.

Ben: Hey podcast listeners, this is Ben Greenfield and today we have quite the episode. You may have noticed that it’s a little bit longer than usual so consider that just your special opportunity to learn a lot more. We’re going to be very brief today with the special announcements and only answer a couple of the crucial questions in the Listener Q and A because the featured topic for this week is out of this world, incredibly interesting and in my opinion one of the most important podcasts that we’ve ever done. Now as you may have already read in the Shownotes, it’d be very useful for you during this podcast to understand it even better if you went back and listened also to podcast number 53 where I speak with Dr. Richard Cohen about the six key internal performance factors that everybody needs to worry about from the elite athlete all the way down to just the recreational sports enthusiast or the person who’s trying to shed a few pounds. So we’re going to move right on, not waste any time in getting the special announcements done – the Listener Q and A and then we’ll go straight into the featured topic.

Ben: I’m going to be answering three questions  in today’s Listener Q and A. These are time sensitive questions and I want to make sure to address your concerns before the crucial time rolls around for you and the first question is from Listener Adrian.

Adrian asks: I’m running in my first marathon this coming Sunday in Portland. I’m not sure if I have a strong stomach or what, but I haven’t paid much attention to what I eat before long runs. The morning of, I usually eat half a whole wheat English muffin with peanut butter and maybe half of a banana and a little coffee or tea. Lately I’ve been eating half of a Lava bar and sometimes I fix myself a Chia fresca. (I’m sorry Adrian, I might be ignorant but I actually don’t know what a Chia fresca is.) I seem to have a great run especially after the Laura bar and wanted to hear your thoughts on those bars. Also I usually eat just an hour before running. As far as the night before goes, I’ve eaten everything from Indian food to Schezuan food to hamburger and gin and tonics. We have reservations at an Italian place the night before my marathon and I’m just looking for some insight on foods I should stay away from. Thanks so much for your thoughts. Maybe if I qualify for Boston I will feel more like a real athlete and I can come see you for nutritional guidance. Thank you very much.

Ben answers: Ok, first of all before I address the meat of your question, let me say for those of you out there who heard the last part of that question about feeling like a “real athlete,” I train everybody from the complete non-athlete who has no interest in sports whatsoever and just wants to lose a little bit of weight or tone a little bit of lean muscle all the way up to the pro-level athlete. So, don’t feel like you have to be some special person to come to me for nutrition consulting or fitness consulting or running coaching, cycling coaching, triathlon coaching. You don’t have to be at a certain level. So to answer the first part of your question, you want some insight on what foods to eat and what foods to stay away from before a marathon – we have talked on the show before about fueling before a long run and just a couple of those key points is that two hours is about the minimum time that your body is going to need for gastric emptying, meaning that your meal – your final pre-race or pre-big run meal should occur two hours prior. Now, you can – if you’re getting hungry right before the race top that off with a quick hit of blood sugar like half a banana or a sports gel. Literally about 5 minutes before you toe the starting line but for the most part you should be getting the majority of your food in two hours prior. Now my opinion for marathon… you’re not eating that much. A Lara bar  I believe is about 200 calories and half of a whole wheat English muffin with peanut butter – again not that many calories. Most of the females that I work with I’m having eat 400 to 500 calories two hours prior to the event and guys – some of the bigger guys up to 700 calories two hours prior to the event. So, that will help your energy levels and it will help decrease your need to eat during the event which can slow you down and be a little bit logistically challenging. Now as far as the content of that meal, we primarily go for a blah complex carbohydrate. Not a lot of fats, not a lot of proteins, not a lot of fiber and that will digest most easily and lead to stabilized energy levels and also keep a lot of blood from being shuttled from your exercising muscles down into your gut. Because proteins and fats take a lot of water, they take a lot more blood to digest. So those aren’t ideal pre-race or pre-workout type of meals when you’re looking at speed and performance and being a goal. Now Lara bars, I have no problem with. That’s a great bar. It uses a fruit sweetener, it doesn’t have a lot of high fructose corn syrup in it. They use primarily organic holistic ingredients. But the number of Lara bars you’d have to eat for 400 calories might be a little bit too much fiber for you. So you could for example have a Lara bar but make a little bit of oatmeal or make a little bit of quinoa on the side – break up that Lara bar and put it in there or have your Lara bar with a little bit of fat free yoghurt. So a few different options. For Italian and for any restaurant really, I recommend a serving of preferably red meat if you’re not a vegetarian or a vegan with a side of carbohydrate and pretty limited fiber. Don’t do the unlimited salad and bread sticks type of option. So a sample meal at an Italian restaurant might be a small steak – like a 6 or 8 ounce piece of meat preferably rather lean or fat trimmed and you have that with a little bit of pasta on the side like a whole grain pasta with a marinara sauce. You don’t necessarily want to go with a pure serving of carbohydrate because that’s not going to provide you with all of the metabolites that your body is going to be trying to draw on during that long effort the next day. I like the meat because you get some of the protein, you get some of the mitochondria, you get some of the amino acids and that’s what I’ve been using lately before my bigger performances and it actually helps out quite a bit. So go for a red meat with a little complex carbohydrate and not a huge salad. I know some people will say well I had a giant salad with a salmon on top and that’s fine but you’re going to be in the port-a-potty line the next morning trying to purge all that fiber from your system and all that water from your large intestine before you take off. So, those are my recommendations Adrian. And great question.

The next couple of questions were quick questions related to the Triathlon Dominator package.

Christy asks: Ben, if you would release a version of this plan for athletes who favor the Olympic Distance, I would buy it. Would you consider it?

Ben answers: Christy, this plan – the Triathlon Dominator plan that you’re referring to could pretty easily be modified for Olympic distances. Because it’s made up of high intensity intervals, because it actually uses pretty minimal amounts of training time – what you would need to do is take all the weekend workouts that are a little bit longer than weekday workouts and reduce their volume by about 50 to 60 %. So automatically take a bike ride and if it recommends that you’re going on a 2 hour bike ride, shave that down to 45 minutes. You’re going to maintain the weekday workouts pretty much as they are. Keep those exactly as they are and then to remove a little bit of the calorie intake from the meal plan, because you’re actually working out less on the weekends, take two of the four snacks of the meal plan out on the weekends and completely remove the snack that you’re supposed to take in during the workout – or the fuel you’re supposed to take in during the workout, and that will ensure that you’re not taking in too many calories in the plan. And then Ryan had a question.

Ryan asks: My first question regarding your Triathlon Dominator program is can I tailor it to half Ironman training and racing? My second question is how is speed work incorporated when most of the training appears to be high intensity interval training? Is one able to trigger the physiological adaptations of both aerobic and anaerobic endurance with high intensity interval training? My third question is how is pacing worked into the training? Are heart rate zones incorporated into the training?

Ben answers: Ryan, you can modify this program for half Ironman training. Pretty similar to my recommendations about the Olympic distance except now you only reduce the volume of those weekend workouts by closer to 40%. So that two hour bike ride is going to be closer to about an hour and 20 minutes. To use the same example. With this reduction in volume you would again reduce the meal plan slightly. You’d retain the meal that you’re taking in during the workout – retain the refueling during the workout but take out two of the weekend snacks. And then finally as far as the pacing and the intensity, I give instructions in the program on how to use power on the bicycle or how to use heart rate. It’s kind of an option that I leave to the person who’s doing the program depending on what they have available to them. Then we use testing on the swim that is based off your 100 meter time. So it’s called the T-pace and there’s instructions on how to actually keep track of your T-pace as well as logs and everything that you need to keep track throughout the entire program. So, as far as the high intensity interval training, I want to make sure there’s not a misunderstanding here but that actually is speed work. Thos are anywhere from 1 up to as long as 5 minute efforts that really actually do make you faster. Those do increase your muscular endurance and actually we’ll talk about that pretty comprehensively in the interview that you’re about to hear. So remember if you have a question you can email me [email protected]. I do have a few questions that I didn’t answer this week just because our interview is so long, but I will be answering those next week. Remember that I will be down at Kona at the Ironman World Championships from Oct. 4 through Oct. 11. I will be bringing you a podcast next week from Hawaii. If you’re down there, whether you’re participating or you’re watching or you’re part of the event in some way, make sure you come and say hello and let’s go ahead and move on to this week’s epic interview with Dr. Richard Cohen and Tim Monaco who are from a company called Bioletics. And what Bioletics does is they allow you to test all the variables that we’ll be discussing via a kit that they send to your home. And I’ll put a link to Bioletics in the kit and everything else in the Shownotes as well. So if you listen and you’re interested in finding out some of the stuff about your own body, you can just go to www.bengreenfieldfitness.com and click on the link in the Shownotes and you will be ready to rumble.

Ben: Hey podcast listeners, this is Ben Greenfield from www.bengreenfieldfitness.com and today is a pretty important episode. You may remember back to podcast episode number 53 where we talked about six key performance factors that every athlete on the face of the planet who’s truly serious about their performance needed to know about. And on that show, I interviewed Dr. Richard Cohen who is himself an avid athlete but also a physician who has about two decades of experience in preventive medicine and human performance. He was training and counseling members of the American Medical Community on nutritional issues for over 15 years and right now he is recognized as one of the leading authorities in the biological analysis of athletic performance factors. And after speaking with Dr. Cohen about some of the factors that athletes really need to take into consideration, factors that athletes need to get tested on and find out about… I went through a process guided by Dr. Cohen of testing my body for the six key performance factors that he recommended and that he talked about in that podcast, namely vitamin D, ferritin, my mineral levels, my hormone system, my amino acid status and then also the specificity to which the foods I was taking in metabolically actually matched up to my unique metabolism. And so after going through all that testing the results have come in. We now know where I stand with all my internal performance factors and today I have on the other line not only Dr. Cohen but also Tim  Monaco. And Tim Monaco works with Dr. Cohen, he is a metabolic typing advisor. In addition, those of you who are exercise professionals out there will recognize when I say he is a Check practitioner. That’s a high level practitioner in fitness, wellness and nutrition. He’s a certified personal trainer. He’s a licensed massage therapist. He is himself an ex-professional triathlete. He was a pro-triathlete for five years. He won numerous national and pro titles in triathlon and duathlon, even in ultra-distance running. Now he is a competitive masters level triathlete but both Dr. Cohen and Tim are going to sit me down here on this call so to speak and talk to me about my results and you’re going to get to listen in and to find out how this system of testing yourself actually works and what you actually get out of it. So Dr. Cohen and Tim, thanks for coming on the show today.

Tim: Thanks very much, it’s good to be here Ben.

Dr. Richard Cohen: Hey, appreciate it Ben, looking forward to giving you the good and not so good news.

Ben: Alright, the good and not so good news. And just so the listener knows, I actually – I know very little about my results. I’ve heard shreds here and there this week leading up to the call but this is really something you guys are going to hear live in terms of me finding out what actually is going on inside my body related to performance factors.

Dr. Richard Cohen: Let me impress this one other thing. It’s all good news because now we have some info. We can tweak some things and they can understand the importance of what we’re trying to help them with.

Ben: Ok, well I’ve never done this before so I’m going to hand the reins over to you guys and let you start talking to me about what’s going on with me.

Dr. Richard Cohen: Sure. Sounds good. Well Tim won the arm wrestling contest and he’s going to go first and he’ll start with the metabolic typing.

Ben: Ok, one thing I guess we should make sure to talk about as we go through this is what I did with each factor so that the audience knows how you guys got the results.

Dr. Richard Cohen: Right. Maybe I’ll just do a quick overview of what we did test and we can sort of proceed from there.

Ben: I think that would be perfect because on my end – and I did mention this to the audience in a podcast a few weeks ago, I got a big box in the mail and it was full of all the papers, all the forms that I needed, all the things I could get tested with at home. There was one test – the ferritin test that I needed to go down the street to my local lab to draw. Everything else was literally just pricking the end of my finger and putting a drop of blood onto one pad and dripping a little bit of saliva into another, peeing in a cup a couple of times but Dr. Cohen could probably give a much more comprehensive overview than that.

Dr. Richard Cohen: Right. Maybe we could do before each test, we could just give a brief overview of what it was and if you want to comment on that, that’s great too.

Ben: I think that’s perfect.

Dr. Richard Cohen: Ok. So this is just the general – so you know what’s coming up is the 6 factors was – one was the metabolic typing which was a computer survey based on particular likes, dislikes of food; how you feel after eating certain types of food, how do you react to foods, how do you feel after caffeine? It also included other physical traits as well so it’s a combination of some ancestral needs as well as your own individual biochemical needs.

Ben: When I was going through that questionnaire I just… I mean the questionnaire was pretty straightforward, I was kind of going with what my gut instinct was when I filled that out. I was kind of going with the first response that came to my mind I guess.

Tim Monaco: Yeah, and that’s ideally what you want to go with because being kind of a general screening tool, the questionnaire can have some questions that in some cases people don’t identify with or they think there might be one or more answers that apply to them. So that’s exactly how I advise people… just go with your gut feeling and we’ll get a really good idea of what’s going on with you and what kind of specific needs your body has.

Dr. Richard Cohen: It’s also redundancy… there are some questions that are repeated to ensure that the responses are more… will explain… it’s a starting point and it’s a guide for you to sort of fine tune how to fuel your body. So then the other factors that we looked at were your hormone recovery status which was testosterone and cortisol; amino acid test – looking at amino acids which is critical for all the fundamental functions in the body. We looked at PH and mineral status which we kind of linked together and that looks at bone health and also your utilization of calcium, the balance there and lastly we looked at vitamin D status which is another critical, critical component to health and wellbeing. We’ll discuss each one of those and I guess without further ado I’ll hand you over to Tim and you can start with the metabolic typing because in essence how you fuel your body defines all these other components. That’s the fundamental block on the pyramid.

Ben: Ok.

Tim Monaco: So the whole idea of metabolic typing is looking at the really individual biochemical and genetic needs for any given person and there are six different metabolic types that you can fall into. And the really interesting thing that I think is revolutionary about this whole system is that I would say every diet that’s ever been sprung out there on the market has elements of this to it and what I… I think the reason why some people have success on one diet and someone else might have success on another diet is that they just happen to fall into that particular slots that… like one diet might be (inaudible) those 6 metabolic types and if you happen to be in that group then it’s great and you’re right on the money but for the other people it’s not going to work so well. So, I think just understanding and acknowledging that we’re all individual – our biochemical needs are different, our genetics are different. Literally we’ve all come from different blood lines and gene pools that have come from all over the world. So there are certain – I would say groups that are more prevalent in North America. Most of us are of European descent and we have a couple of different blood lines in our family. But I would say in most cases when I do testing, the large majority of people fall into what I would call a fast oxidizer or a protein type which leaves us… needing more protein and fats to really optimize their health which goes against most conventional, especially sports nutrition advice where generally it’s like 60 to 70% carbohydrates, maybe 20% protein, 10% fats and the usual dogma out there about limiting saturated fats and limiting animal proteins… it really can be a problem if you happen to be a protein type. So Ben, you are on that side of the equation. You are what’s called a fast oxidizer which I think the easiest way to explain that is that we all have what you would call a metabolic fire and if you metabolize and burn really hot… so if you kind of take that fire analogy, you need a big log on your fire in order to keep that fire burning strong. So if you happen to be on the other side of the spectrum – a slow oxidizer which you aren’t – if you put a big log on a small fire, it’s going to put out the fire. You need kindling. So the analogy sis the carbohydrates is like kindling. Fat and protein is more like a big log. So the person who’s more of a slow oxidizer or a carbohydrate type… those people need carbohydrates and less heavy fat and protein and they do really well on that. If they’re the fast oxidizer or the protein type, on our side of the spectrum – I also happen to be a fast oxidizer – if you eat too many carbohydrates you end up just burning through them really quickly. It’s just like throwing kindling on a fire and it just keeps burning out really fast and you don’t have any long burning fuel. So, the effect of that as you go through your day is that how you feel – really connecting what you’re eating with how you feel – it’s what your energy levels are or what your focus is, how you can concentrate, training wise what your endurance is like, overall how your body is maintaining muscle mass and even body composition like how much fat and lean muscle mass you’re going to have. The usual thing that I see is that people who are fast oxidizers who are eating too many carbohydrates – they generally don’t have good body composition. They usually are carrying a little extra weight, a little extra body fat and once they make the right adjustments which is kind of counterintuitive for most people to be eating more fat and protein… their body starts to shift and their metabolism starts to get in better working order and all of a sudden you start losing fat and you start getting leaner and depending on what sport you’re doing – as an endurance athlete you’re not looking to necessarily build muscle mass but you do want to maintain muscle mass and being an ultra-distance athlete, that’s a big issue because if you’re not getting enough fat and protein and your metabolism isn’t working right then you’re going to start breaking down a lot of your lean muscle mass and getting in a catabolic state. So, you always want to be in a more anabolic state.

Ben: Yeah, it’s interesting because I have this metabolic laboratory here in Spokane and I’ve tested my metabolism and I have a very high metabolism and when I first had that tested I just kind of assumed that because I had a high metabolism that I should be eating a lot of carbohydrates to fuel that metabolism and so I wouldn’t say that I’m on a traditional high carbohydrate diet but I do or at least I did until I heard a rumor that I was a fast oxidizer about two weeks ago – I ate a little bit higher carbohydrate diet to fuel that metabolism and so being a fast oxidizer as you described it or having more of that protein type doesn’t necessarily mean that you don’t have a high metabolism, it just means if you do have a high metabolism, you shouldn’t necessarily be fueling it with a high carbohydrate blend. Am I on the right track here?

Tim Monaco: Yeah I think that’s a good point that we should clarify is that I think the metabolic tendencies are different from your actual metabolism in the sense of how many calories you’re burning a day, so just your base metabolic rate and then all the extra calories you’re burning through all the exercise you’re doing is going to be giving you x amount of calories a day that you need just to maintain health and your body weight and most Ironman athletes who are – you could be burning 5000, 6000 calories a day – probably between 2000 and 3000 just base metabolic rate which is what you’re burning just walking around breathing. But the thing with metabolic typing is definitely that the mix – the calorie mix and what are called the macronutrient ratios. So that being your fat, carbohydrates and your proteins. So dialing in that ratio is really the key that’s going to distinguish which type you are and getting on the money with that.

Ben: Well I have to tell you that this was one of the results that I did actually hear about a couple of weeks ago even though I hadn’t heard officially from you yet. I think Richard mentioned it to me in an email because the questionnaire was one of the first things that I filled out and I just made some small changes. Some very small changes. For example, I usually have a bowl of oatmeal or a bowl of quinoa in the morning and I substituted about half of that bowl with that goat whey protein that I’ve been using from Mt. Capra. I usually will work at a coffee shop in the afternoon, kind of after a workout and I’ll typically have a bran muffin out there. And I started substituting almonds or walnuts that I actually brought. And then probably one of the more significant changes was a lot of times pre-race, like the night before, I’ll have a couple of sweet potatoes or a couple of yams and I actually did have a race a couple of weeks ago or last week actually and I had a prime rib with a baked potato instead of that slightly higher carbohydrate pre-race dinner and felt really good. I actually had a great race and came in second place and barely lost to a fairly top level pro and it actually felt pretty good. So I can see where you’re coming from with some of these changes and the questionnaire that I was answering to come up with this metabolic type seemed pretty straightforward. It was like what are your energy levels like are after this meal and this meal and this meal and it included questions on there on emotions as well I think and I took it about four weeks ago so I’m forgetting some of the questions but it was pretty comprehensive from both an emotional and kind of a logistical fueling perspective. So those were kind of my thoughts on some of the stuff that I felt after I made those adjustments in protein.

Tim Monaco: Yeah, I think that’s a really important part of the process really, that doing the survey, finding out what the information is, we send you out an actual food list which you probably have.

Ben: Yeah, I got that and it was incredibly comprehensive. I actually printed it out and put it on our refrigerator and I’m starting to make some tweaks in my diet based off of the list of foods that you guys sent me. But yeah I pretty much got everything that I would ever need to make the adjustments in the diet. It’s not like I didn’t eat healthy already. It’s just that I’m just shifting the scale so to speak more towards protein.

Tim Monaco: Yeah I think most athletes are pretty knowledgeable. They do the work, they do the reading, they’re on the Internet. They read about stuff because they want to know and they want to learn and this is truly just a matter of making a better choice for your particular needs. So when we sent this package of results – it has the food list, it has your macronutrient ratio, it has some sample diets. There’s a little bit more information about how the system works if you’re interested in reading through it and then there’s what’s called the diet check record which is your tool to find the dieting as you go forward because the way I look at it is when you do the test, it brings you basically from having no clue and you’re eating just anything and everything that comes your way to probably 90% of where you should be and then diet check record is a sheet that you can write in your meals. You can make notes of how much you’re eating, when you’re eating it. When you’re using the diet record after your meal – one to two hours after it – there’s questions about if you feel fat, if you feel full or if you’re hungry or you have cravings or if you don’t have cravings, if your (energy) feels good or doesn’t feel so good. If you have feeling uplifted, feeling mental clarity so it’ s basically giving you the tool to really identify how that food is affecting you and I think it’s a huge kind of jump in consciousness when you can actually link what you’re eating and how it’s affecting your body and unfortunately that’s one of those things that in our day and age most people have been born and raised in a society where food is plentiful and it’s more about entertainment and flavor than it is about energy and sustenance. Most people I think they don’t put two and two together when it comes to what I’m eating becomes how I’m feeling an hour later.

Ben: Right, and you know when I send out food logs to the athletes I coach or when I use Training Peaks to prescribe them their recommended meal plans and things of that nature, I do have a place there where they can tell me their comments about how they felt, about how their energy levels were, etc. but I think kind of the missing piece for me as a coach is to have that comprehensive metabolic questionnaire that I went through that will let me tweak an athlete’s diet even more using some of the tools that you guys provide just because rather than saying well this is healthy so you should eat it, instead I’d be able to say well this is not just healthy, but it’s you. It’s the way that your body is going to respond most optimally and I thought that’s what was really cool and I’m pretty excited frankly to see… I know it takes several weeks of changing your diet to really feel the full effects but I’m excited to see how my body responds. I’m happy especially with my race that occurred just a week and a half after I started to change up my diet.

Tim Monaco: Yeah, it’s good to get some positive feedback happening real fast for you.

Ben: Yeah, and also you know, probably so our podcast doesn’t last hours and hours, one of the things we should do is really encourage people to go listen to episode 53 that goes into great detail about why you would want to get each of these tests done. Also if you subscribe to Triathlete magazine, there’s an article coming out in there where I talked a little bit about some of the importance of these factors. I don’t think that’s coming out until December of this year. But what we’ll do I think going forward into some of these other components that I got tested on is we’ll kind of give you the overview but not to go into tons of detail into each one so you can kind of put podcast episode number 53 and then this episode together if you as a listener really want just the full meal deal to get all the details on why you would want to be doing everything. But yeah, starting things off with the metabolic questionnaire I think was incredibly important for me to just find out the overview in terms of the macronutrients of what I should be putting into my body and then the stuff that you guys provided to me afterwards is going to be enormously helpful rather than me having to play the guessing game so to speak.

Dr. Richard Cohen: Absolutely. I can chime in here with just a couple of other points. It’s a starting point, so the more you can listen to your body and I think – nutrition at all points, as we tend to get away from the realization of how critical what we put our mouth affects how we feel… we can get lost especially from a media research representation of what food is healthy and we talked a lot about this before, but what food is healthy and has nourishment – but we’re taking it to a much deeper level to how to combine foods as fuel and then what specific foods – even though one food may nutritionally packed, it may not be good for you. That’s critical. The more you can… you don’t… I love that you started taking small steps and you’re in a good healthy place to start. Sometimes we’re working with people who’re really having more serious problems. Sometimes it’s almost a little easier to do more dramatic shifts but that in your case might be a little more challenging but start making these shifts, start paying attention. Pay attention to how you feel and it’s just, hey how did it feel after that? Well I felt good. Ok. Then you continue down that path and you may find in three, four months you’re almost 180 from where you were. It’s possible. You may find just a subtle addition. For me I find carbohydrates – I’m a fast oxidizer as well – don’t work well in the morning but I can get away with a little bit more later in the day. More in the evening. I’m fine that way. But if I just eat a bowl of oatmeal in the morning, I would be starving two hours later and not be feeling. It’s that plan, and with the understanding of how do I feel, and why am I feeling this way and what’s my energy – to everyone out there, whatever they’re eating, pay attention to your body and I think that would be my final…

Ben: I think before we go forward into some of the blood test and salivary and urine tests that I did, one thing I should mention is that for me, it’s not like I wasn’t healthy already and didn’t already have good energy levels. For me, one of the things that’s big on my goal is for next year I would like to go race in Kona, in the 2010 Ironman World Championships and even though I’ve made it there every time I’ve tried I know that it’s getting more competitive and I know I’m not getting any younger and it gets tougher the older that you get and so this was one of my big motivations as well, was I want to pull out all the stops and this was a big one for me. And I know that you as a listener, maybe you’re not an elite athlete or maybe World Championships aren’t on your list of goals but if you do have a big goal or you just want to make sure that you’re not wasting your time, that’s kind of a motivation as well but I didn’t really talk to you guys too much about that on my questionnaire that I included along with the test that I did, but for me Kona is a big motivator here to really make sure I’ve got everything dialed in so to speak, using the highly scientific term “dialed in.”

Tim Monaco: I think that’s really a very important point. Obviously everybody has got kind of their own specific place on the journey whether they’re a beginner, someone who is really looking to qualify, someone who is a professional trying to win a race or just getting off the couch for the first time – what is considered normal for any individual is a very relative term, a relative state. So I think in a lot of cases, people get used to feeling bad and negative types of progress just kind of happen slowly in most cases and you don’t really realize that you may be slipping down a little bit. Maybe you’re not recovering from your workouts quite so well, so there’s really subtle things, subtle changes that happen. You just don’t identify with what’s going on. So, going through this process is huge because it’s really going to give you that information and enable you to dial it in, as you said. It could be one little thing – one little change that you make and it could bring you back to life. My story… it was crazy. I consider myself a pretty high level athlete and I train as much as I can given my schedule with my family and my job but I still probably get in 8 to 10 hours a week of training and focus on the quality. I’ve been working my way back and doing triathlons the last few years, and making progress but always feeling a little bit like I didn’t quite recover the way I felt I should. So over the winter I tested – I went through and did all the tests and my vitamin D came back absolutely dismal. I think it was 9 and it should 50 to 80. So, that was actually the lowest test of anyone we’ve tested so far. So I have the championship cup on my desk for worst vitamin D. So I started supplementing and in a couple of months, things started to shift and I’ve been absolutely astounded at how good I feel and how well I’m recovering and this year has just been a benchmark year for me because I’ve gone from just what I would call banging my head against the wall, doing a hard workout and taking a week to recover and feeling like I should be moving along but not really doing it and now I feel like I can do a couple of hard workouts in a row. I can really push hard and I wake up the next day and I don’t feel like I’ve been hit by a truck. So I’m a believer in the process and it just kind of makes it more real for me. Obviously I’m on this side of the desk but when I’m dealing with people and I’m consulting with people but I’m a player to and I’m an athlete and I’m very much in the game. I can appreciate it.

Ben: Alright, well should we move on to the next test?

Dr. Richard Cohen: Yeah absolutely. I think we can, as you said… if any listeners go back to the previous podcast and we discussed each of these factors more in depth. So what I can try and do is just give a brief prelude.

Ben: Absolutely.

Dr. Richard Cohen: Brief prelude to each one and then we can move forward. So let’s go in my mind what the most critical marker that anyone can measure at this point in my viewpoint is your vitamin D level. There’s so much information out there now and you can read about it, but the 30 second blitz is vitamin D is… not essentially a vitamin. It’s an essential hormone like substance in our body that’s activated by the sun and it basically has genetic expression control of multiple cellular functions. So basically it affects anything. That’s the simple term. When your vitamin D is low, it can cause a multitude of problems and with regard to athletes, it’s that hormone substance that affects muscle tissue. When vitamin D is low, endurance, power, performance can suffer significantly and as Tim said he was even living in Bend, Oregon. Sunny, sunny Bend and training outdoors.

Ben: The Palm Springs of the Pacific Northwest.

Dr. Richard Cohen: Right. And he was seriously low on vitamin D. So we like to shoot for, in talking to the latest researchers and what we’ve seen… an ideal performance level of vitamin D if you have that assessed is between 50 and 65. It doesn’t necessarily need to go up much higher than that. How do you know? You really have to test that. So your level Ben came back at 45, which actually in the spectrum of people we assessed is not that bad. You know? It’s very mildly less than optimal. So whatever you’re been doing… I don’t know if you’ve been – you didn’t put it on the survey – if you take any vitamin D.

Ben: Actually I don’t take vitamin D. There’s very, very kind of trace levels in a few of the supplements that I have, but I don’t take vitamin D or vitamin D3 specifically per se.

Dr. Richard Cohen: The question is, is there anything that you can think of if you’re not taking D and other supplements – I’m thinking the mineral whey. That has it, some protein. Other than your… maybe you go out and ride without a shirt.

Ben: I do the majority of my training shirtless.

Dr. Richard Cohen: There you go.

Ben: Whenever I do go outside, because I do spend a lot of time in front of my computer. I do do a lot as an author and writing and on the Internet, whenever I am outside I make it a point to be as naked as possible, to expose as much skin as I can. So maybe that’s how I’m keeping… I think when I sent it in to you guys though, for me to be at 45, I think I sent that in mid to late August in the throes of training for half Ironman and spending several hours outside especially on the weekends and so I would imagine that going forward here, living in Washington in this climate that if I’m at 45 now and the ideal dose for me for athletic performance like you say is 55 to 65, I shouldn’t be seriously consider bumping up my vitamin D levels or actively taking a vitamin D3 supplement.

Dr. Richard Cohen: Exactly. What you showed is you can pretty much also get it done with the sun exposure, even being outside a couple hours. Not quite. So during summer when you do that, maybe add 1000, 1500. 1000 to 2000 to what you’re doing but during the winter I would go up to anywhere between 4 and 6. And then it’s something you can re-check again probably before you start heading out in the spring so recheck again in January, February.

Ben: Sorry, I was going to say one of my offices is located inside a dispensary in a natural health food store and a lot of people there tend to really like the Carlson’s vitamin D and I don’t know if we want to push specific brands and stuff, but when you’re talking about 4000, 6000 IU do you guys prefer a cod liver oil source or do you go with a fish oil vitamin D capsule source? What are your recommendations on something like that?

Dr. Richard Cohen: I use a couple of different brands. I haven’t paid attention necessarily to how that’s affecting as we start adding more athletes, we can do that. The one thing I do know and I have seen and I haven’t broken it down, like I say, specifically – there are people who do not absorb even on gel caps efficiently because they’re fat based and people may have individual absorption issues and you’re requiring it to get into the system. I’ve seen people go up to 10,000. They think wow I’m doing great. Their vitamin D levels haven’t budged. They’ll go up from 20 to 30. So there’s two components. One is always assess because she thinks it might be doing the job and you may not. Two, is you can’t beat the sun. Whenever you have the opportunity to get the D from the sun, do it. And there’s some neat devices actually we’re working on that should be able to assess how much D you’ve received from the sun so I can share that in the coming future. It converts some factors and assesses so you can get a sense of ok this is enough UVB but now I’m sort of reaching a point where I need to be concerned about it. Really the third thing is I had some experiencing using a vitamin D spray. A little bit more expensive, not too much. More consistently reliable. They break the D down to these very small particles that can bypass the gastrointestinal system. So you get a more effective absorption and it’s a more reliable spot… that’s when I tell people, ok this is what you need. We’re pulling up that whole absorption factor.

Ben: So where do you get that?

Dr. Richard Cohen: That’s actually something… and I don’t want to harp ourselves but it’s something Bioletics will be carrying. It’s a nano…

Ben: I don’t care if you harp yourselves, I want to find out the best place to get this stuff.

Dr. Richard Cohen: So that’s something that I’m excited about as well but to back off, if you can get sun when the sun is available… because who knows what else? Let’s say off the point, instinctively we didn’t get D from food or supplements. We got it from the sun. Whatever benefits the sun may provide that we’re not aware of, I’m sure that there’s something that eventually we’ll find out. So, I think you’re pretty good, Ben. You got it with the shirtless riding and hey pull your shirts off when you’re out there riding. So that would be…

Ben: I’ll switch to the padded Speedo.

Dr. Richard Cohen: Yes, we need to start a new trend. Riding shirtless to get D. Ok, so moving on to my next – that’s the most important marker.

Ben: And really quickly, that was… I have to remember back, that was a blood spot. A little prick on the end of my finger onto a few different pads that came along with the test that was literally dried out and sent in the mail, same day type of thing.

Dr. Richard Cohen: Finger stick. Two drops of blood. Cool. Ok. So the next test is – so for me is a – and we’ve talked a lot about this over the podcast so your followers would certainly be understanding magnesium. And unfortunately if there were inexpensive tests for magnesium, it would be in here because it’s truly as important as D is to genetic control, magnesium which was in (chlorophyll and photosynthesis) is involved in so many different enzymatic pathways and so many critical functions in the body. The only real test right now is a scanning electromicroscope test that’s done in the lab. It’s commercially available. It’s $350 and the fact is that 85 to 90% of the people are not getting enough magnesium. So this urinary NTX marker which we talk about is a urine sample and what we look at is mineral metabolism. It actually looks at if you were turning over more bone than would be ideal. It’s not a specific marker for magnesium, I feel really comfortable if those levels are slightly elevated. Magnesium is – you just got to make more of an attempt to get it. So your urinary NTX marker was 50.4 and we’re looking to get a level less than 37 and then we would consider over 60 someone who’s significantly breaking down bone.

Ben: You kind of broke up there for a second. You said under 37 would be ideal but over 67… is that what you said?

Dr. Richard Cohen: Over 67 is a severe… you’re getting into accelerated breakdown significantly. I’ve seen 100, 150. To mention, we did the Tee cross country girls and they were at 150. They weren’t (inaudible) their diets and so forth and weren’t anywhere near what you were doing, but having said that, hey, you’re turning over some bone and as we go on, you’re sure to see there are many factors that could be playing a role. Certainly the vitamin D, possibly it may be that some D is critical for healthy bone and mineral metabolism. It may be that your D was just starting to rise through the summer and if we checked you in spring, your levels might have been 30. So that’s a component. Generally for the markers, these markers will slowly shift bone’s dynamic. So that can be approved with a high level D, but as we go on and look at some other factors here… I throw in magnesium, is critical. You’re already starting to take some magnesium.

Ben: Yeah, I noticed on my survey I’m taking a transdermal.

Dr. Richard Cohen: What else are you taking?

Ben: Well I’ve been stepping up my transdermal magnesium to… I was just a few sprays on the arms before a workout, now I’m putting it on kind of on the upper head and neck, kind of rubbing it on before bed, 10 to 15 sprays on both the upper body and the lower body before a workout or after a workout. And then orally, there’s a few different supplements that I take that contain small amounts of magnesium. 25 mgs here, 10 mgs there. An example would be Millennium Sports, they have a product called Somnidren which is kind of a GABA sleep aid and I take that a couple of times a week and I think that has 25, 50 mgs in it. But nothing on a regular basis, but I have really been kind of starting to set up the magnesium.

Dr. Richard Cohen: Got it. Ok, that’s probably 30 to 50 sprays. If we start getting to… about 50 sprays gives you about 500 mgs. And that topical was unusual… topical does get in there. There are data that have shown that using that scanning electromicroscope data that shows it does recover magnesium levels and it seems to be the best way to do that other than intravenous magnesium. I would say keep that up. It’s critical.

Ben: And would you say, for somebody like me to be at 50.4 wanting to be around that ideal level of 37 or below in terms of milligrams of magnesium per day that would safely… obviously I want to back off if I got the loose stool but you said… did I hear you say 500 mgs?

Dr. Richard Cohen: 500 of the topical should be fine at this point. From what I’m seeing, you don’t have a lot of symptoms. You’re not going to get the GI excess magnesium problems that you will with an oral and it’s so hard to take anything oral other than there some new novel liquid magnesium we’re looking into and I’m curious to see the responses. It’s something I learned from Caroline Dean but there’s no risk to it. It’s relatively inexpensive to use the spray so I wouldn’t worry about it too much. And like you say, you can do it once a day or you can put it on your arm a couple of times a day, put it on your legs. Some people like to take a magnesium bath periodically and just put those salts especially after a hard race. So just incorporate that. It’s inexpensive and…

Ben: I did forget to mention I do have the magnetic clay magnesium flakes as well and I bought it on a once a week basis after a tough workout, I’ve been doing a soak in those.

Dr. Richard Cohen: Cool. I think that’s right. So we’ll come to that NTX again here.

Ben: That was a urination, wasn’t it?

Dr. Richard Cohen: That was a urine spot, right. So then let’s look at another key factor that we looked at. Each of these interrelating with another, was we looked at amino acids. And what’s the amino acid test again? It’s another finger stick. This one involved four blood spots. And in just 10 seconds amino acids are critical for enzymes, for neurotransmitters, for protein, for bone, for muscle, tissue recovery. In essence if your body is your house, your amino acids are your foundation and the studs in the walls and everything that builds you. What happens with athletes specifically, especially in endurance athletes is they start – if they’re not utilizing protein well, if they’re not getting enough protein in their diet which we learned in the metabolic typing may be the case for you or if they’re just not digesting well which also you have some GI bloating, some minor… maybe extra calories. It may be that too many carbohydrates. But what we’ve found for a number of people is since amino acids control enzyme production, pancreatic digestive enzymes – if they become deficient then it’s sort of this spiraling situation where you don’t get enough enzymes. You don’t digest your protein. So when we looked at your pattern, we saw three that were… we actually have five… three that are under the 20% and considered low. Valine, isoleucine and then we had… icoleucine is one of the branch chain amino acids which controls muscle. And right below that at the 21st percentile was leucine and lycine. So the three key branch chain amino acids: isoleucine, leucine and lycine are not where you want them to be. And then we have two other amino acids: valine, which is also controlled with muscle metabolism. That’s low. And then the other one is tyranine which is also associated with some catabolic states. So it looks like the five key essential amino acids that are associated with metabolism or the breaking down of tissue are not where they want to be.

Ben: Just for me thinking about this, this is prior to me actually launching into a little higher protein intake. And I don’t know if I mentioned this on my survey. I take Recoverease which is kind of a glutamine branch chain amino acid blend but I typically only take four. Dosage requirements on that tell you when you’re in periods of training you take 6 up to 8 so I don’t know if I can bump those up, what are your recommendation?

Dr. Richard Cohen: What we found in the research is that while branch chain amino acids are useful, if you really truly want to get a recovery you need to restore all 8 essential amino acids. Basically you’re trying to throw pieces to the puzzle, because proteins are digested into amino acids and they almost become these multi – these puzzle pieces for the body that the body can take and break and put together in all these different ways. It’s just thinking of a little game where you take the Lego blocks and you make shapes of all the different pieces. That’s what in essence the body is in – if you’re trying to build a structure and one of those pieces are missing, well guess what? It’s not going to function as well. So generally, what I recommend especially for a high level endurance athlete and someone wanting to recover is to use an essential amino acid blend and it’s multi… like all the 8 essential amino acids. The neat thing about the essential amino acids are they’re highly effective and almost all go to muscle tissue recovery where if you eat proteins – I’m not saying we shouldn’t eat real protein but the more, if you cook proteins you break down the absorbability. If your digestion as you’re getting older, under stress – you’re not digesting those as well and protein powder… here’s the paradigm shift that I’ve had. We think I’m getting my protein, I’m getting my protein powder. I must be fine. Well, it’s really am I getting my amino acids? It’s not the protein that we want. It’s the amino acids we get. And if the protein is not highly useful or highly utilized, you may not be getting what you need in regard of how it’s being broken down. Even with high quality whey protein – and there is a place for that, absolutely in our diet as other benefits – it’s only about 20 to 25% utilized for that anabolic tissue recovery where the rest is broken down and you get nitrogen waste. That’s just really utilized for calories. So we can be much more efficient, so the paradigm shift is eat whole foods and to be able to digest them, but use essential amino acid blends to support recovery. Actually there may be and it’s something we’re studying and there’s been some good research – if you take someone as they age and you support their amino acids, you see tissue hormone recovery – actually testosterone levels change, cortisol levels are reduced. So maybe… amino acid utilization is part of the whole aging process and that’s what they’re suggesting. So critical essential amino acid blend and you know what’s nice is you can take about 20 grams of essential amino acid blend in a powder is the easiest way. 10 grams twice a day. You can go up to 30 for someone your weight on a real heavy training day. We tend to like people to take it in the morning and then either before or after a ride, if it’s just a normal ride and if it’s a heavy, heavy ride you could do it before. Some people put it in their drinks and if it’s going to be a three, four hour event, they’ll sort of continuing the fueling process. That’s something that we’ve tried to put together a nice formula based on some research and Bioletics has an essential amino acids blend. There are a couple of similar ones out there. We’re real pleased with what we’ve seen with this one. The one other point is what’s nice is 20 grams of an essential amino acid blend is equivalent to about 75 grams of whey protein.

Ben: That’s a lot of protein.

Dr. Richard Cohen: So you can truly flood the tissue levels and what we’ve seen – Tim, I don’t know if you mentioned his heart rate recovery? I don’t think he mentioned that but what he noticed and we’ve sensed from other people are his max heart rate… Tim, how old are you? 43. He looks younger. Tim’s 43 and I guess as you get older, your heart rate that you can max goes down. He’s noticed since he started this, he’s up about 10 beats. He pushes out, his heart rate is… his engine is firing, the muscles of the heart are able to function at a better level. So critical. And amino acids flowing back to the NTX to see how they’re all related, load tissue amino acids can also play a role with bone. They’re structural. So that turnover may also be part of the bone metabolism issue. So, let’s move on. So we have vitamin D pretty good. You got that one. NTX, not bad. Could be related to the D and very likely related to the amino acids. Ok. And the one other thing that we wanted to look at with the minerals – NTX which I neglected – was your PH and PH was done by every morning for 10 days, you just took your morning sample and put a little dipstick of PH. And generally what we want to look for is a PH level around 7, 7.2 and your average for those 10 days was 7 which was good. That says to me a lot of what you’re doing, you’re eating healthily. You’re able to seemingly tolerate the grains from an acid alkaline basis and that may be one of the reasons why you’re feeling reasonably well. (inaudible) eating carbohydrates, a lot of times, very acidic and that causes problems in itself and causes bone issues. So from the acid alkaline issue I’m not seeing that as a significant cause to any bone issues. It could be the mineral whey you’re using is alkalizing you or any number of things that you’re doing. So that’s good. I’m happy about that.

Ben: I also take one of those greens supplements which I know has a strong alkalizing effect. I take something called EnerPrime which is spirulina and blue-green algae and all these highly alkaline foods.

Dr. Richard Cohen: That’s getting the job done. So those are the two things that I recommend people… well three things, is find your metabolic type and adjust for that and then realistically in the world, how often do you sit down to a huge salad? So having a mineral whey which is rich in nutrients and using a greens formula, it’s not only physiologically beneficial but you feel better when you have it and I think I psychologically feel better. I say ok, I got nutrients.

Ben: Exactly. And I mean again, for me it comes down to not the fact that I’m not healthy. I haven’t been sick in three and a half years at all since I’ve been taking care of myself and my diet but I’m ready to bring it to the next level.

Dr. Richard Cohen: Got it. Ok. So we have two more markers to talk about. The next one, which… it’s funny, I do some other… before we started Bioletics, I focused all my energy on these which are hormones of recovery or male hormones regarding to aging and testosterone. Certainly testosterone is what makes a man a man and testosterone controls tissue and muscle growth and recovery and sexual desires and so forth. As we age, testosterone levels decline. The use of anabolic steroids to raise testosterone and so forth obviously have particular benefits as well. That’s a whole other topic of conversation. What this test you did… and it was a saliva sample. It measures the active bio-available amount of testosterone and then the stress hormone cortisol.

Ben: I think that’s important that you mentioned that about bio-available because I had looked into this before testing and getting a blood version of testosterone is subpar compared to the salivatory…

Dr. Richard Cohen: It doesn’t always… right. Testosterone is a hormone that’s produced predominantly down in the serum bound to protein. It’s called serum hormone binding globulin and it basically carries it around and the majority of that found in the blood is inactive. And while having a high testosterone – total testosterone in the blood is certainly a positive result – very frequently I find men with lower fractions or higher levels of the protein bound and therefore the amount that’s left over which is generally 1 to 3% of free… tends to be too low. So unless you test free testosterone, even if your total is high, you still may be deficient or deficient in the active amount that’s doing the job. The nice thing about saliva is it sort of filters out all the protein so whatever makes it into saliva is free and available so it gives you a much more clinically relevant result. Unfortunately there’s only by blood so if you’re going to check testosterone by blood, I’d also request a free testosterone… and most docs don’t do that. And then even most labs actually calculate – they do a calculated free testosterone. They don’t actually measure it. There’s only a few labs that actually have the equipment and go through the expense of truly measuring free testosterone (unintelligible). That’s an important measure and one other measure — not directly sports related but when I look at men and aging I always look at estrogen and estradiol as well, measure that with you. But with obesity and medications and all the environmental pollutants such as BPA in plastic water bottles – please throw away your plastic water bottle. That would be my – if any one drinks from a plastic water bottle and uses it in heat… go read it. It’s one of the craziest things you can do. You’re basically flooding yourself with estrogen. I like to see that being the next move in racing, all the plastic bottles in the heat… it’s not a good thing. At all. You might as well just take birth control pills basically. Anyway your testosterone cortisol – we like to see for your age 28, I gave it away Ben, and you want to see testosterone levels around…

Ben: I’m actually 27.

Dr. Richard Cohen: About 100.

Ben: I’m actually 27. Does that give me any room?

Dr. Richard Cohen: Yeah, you should be higher.

Ben: Ok so I should be at 100 for what my goals are?

Dr. Richard Cohen: The range in the saliva with the lab that we use. Ok, so the ranges are different. So anyone hearing these numbers, just remember we’re not talking total testosterone and we’re not talking free testosterone that’s found in the blood. We’re talking the specific lab range based on their measurements. Lab set measurements. So even total testosterone, each lab’s measurement is a little bit different. They set their particular standard. So the lab that we measure, based on their data and the studies – optimal levels should be anywhere from 90 to 120. Ok? And you’re coming in around 46.

Ben: Are you kidding me?

Dr. Richard Cohen: I do hundreds of these. As I say, we’ve been doing salivary testosterone and hormone support for years…

Ben: Holy moley…

Dr. Richard Cohen: And 46 is not where it needs to be. Why is that? We also looked at the stress hormone cortisol and excess training and stress and lack of sleep and so forth can sometimes elevate that and ultimately we want to see a good ratio. High amounts of the anabolic testosterone and normal or optimal ranges of the cortisol. Not too high, not too low. So your cortisol is 13 in the morning. The screen is not bad. Cortisol is a hormone that cycles through the day. A comprehensive picture of cortisol would be you actually do four samples through the day and we’d see the curve or you can do a 24 hour urine. So with the 13 and signs of stress related issues, it’s not something that’s necessary… no sleep problems and no major recovery problems. But certainly the testosterone at 46. Something’s up with that. And what is it? It could be you’re overtraining at the point…

Ben: I can tell you exactly when that test was given. I believe it was on a Thursday that I took that salivary sample and I had a half Ironman on Sunday. So I had been tapering for a good 7 days when I gave that. I wasn’t… overtraining or training excessively by any means at that point.

Dr. Richard Cohen: Right, but you did have a half Ironman?

Ben: I had one coming up. I was resting and recovering for one.

Dr. Richard Cohen: Got it. So that’s lower than you would expect to see it. Overtraining? Possibly. Would you… that’s a question back to Tim, being a fast oxidizer and I don’t know Tim how you brought this in, you may benefit from more high intensity interval training than longer endurance. That’s a sort of subtle (inaudible) it might do you better.

Ben: Well you know…

Dr. Richard Cohen: The longer slow endurance, it tends to be more draining on our anabolic levels. If you look back to all the paleo type realizations, we did a lot of power… so that’s another thought to consider. I’ll let Tim come back and just talk about that. Let me just spin around to some other things that could play a role. The aminos could make a difference, as we talked about earlier. Getting those amino acids could be one of the drains. Obviously having it at this level over time is not going to be optimal for your health. We don’t know where your baseline per se is, typically I see guys in the 40s coming in, or their 50s having this level. I don’t know what was your peak level when you were 18 or 20. Some guys tend to be much higher. They may have been 120 normally and if you were 120 dropping to 46, that would be a significant decline. If you’re naturally 85 it’s still a decline and testosterone is something – hey what type of a guy are you? You tend to see the higher testosterone guys are… it’s like football, the orthopedic surgeon, it’s that very bravissimo over the top type guy. So you may be a little bit lower or not, I don’t know. But that’s something to consider. We don’t have that…

Ben: Well you know, just to ask you as a physician, I know I’m being recorded on podcast right now and it could be something embarrassing for me to bring up but when we’re talking about performance in the bedroom, we’re talking about male potency and things like that – would a drop in testosterone like this actually cause issues in that department?

Dr. Richard Cohen: Totally. Yeah, so that’s not where we want it to be. It could be one of the reasons.

Ben: I don’t really struggle with that per se, however I know my virility now at age 27 is not exactly what it was when I was 18, not doing triathlon, body building, single and had higher levels of hormone levels I’m sure. I can definitely notice changes in terms of bedroom performance and things of that nature.

Dr. Richard Cohen: It’s funny, I don’t know how many times they tease this out but definitely marriage… there are studies that say when they get married, their testosterone levels. It’s probably a mating thing. If we kept our testosterone levels high… there wouldn’t be many marriages that lasted.

Ben: This is true. It’s a natural way to keep us with our mates.

Dr. Richard Cohen: Search and conquer, it’s like “Thank you,” right? But having said that, it’s not only that type of issue. It does play a role in lots of factors. Now what I was alluding to before, for a guy involved in this… it was like gosh, testosterone is his master key and it is, but what we’re starting to find is maximizing D, maximizing amino acids, switching or playing around with the type of training someone does – those three play a role in what I see with a younger guy with hormones that are not where they need to be. So those are the things I would recommend. Definitely this is something you want to do again and probably throw in an estradiol just to make sure that there’s not some spurious exposure that. For whatever reason, I’ve seen that. You’re a thin guy so it tends to be higher estrogens in guys who drink more or have a little extra body fat or might be over the counter medications, less active, eating non-healthy… but I’ve seen guys, like I said, water bottles and just exposure to who knows? Something you wouldn’t want to miss. It’s an easy fix. And then after that, if we can see where it is, there are some herbal nutrients that can…

Ben: That’s what I was about to ask. Just because some of the things that I’m familiar with or heard about just for myself as a sports nutritionist, things I’ve come across in magazines and literature that I want to ask your opinion on after seeing how low I am… DHEA, is that something you’ve had experience with?

Dr. Richard Cohen: I wouldn’t do that. It doesn’t convert readily to testosterone. It’s probably worth looking at a follow up because DHEA cortisol is also a stress component and that issue is important. I struggled with putting this together, if I should put the DHEA in there but at the end I decided that testosterone cortisol as a screen was probably a more primary marker. DHA has some anabolic but not much…

Ben: Now what about boron?

Dr. Richard Cohen: Boron… some. But I’d go… the whole idea is to not worry so much about the micro minerals initially. I think if you – one thing I like people to do is use some of the Himalayan salts, some of the micro multiminerals that has… I think it’s 80 or 90 different minerals in some of that. And you can make a salt solution.

Ben: Really? For actual testosterone increases?

Dr. Richard Cohen: Well just for overall micronutrient recovery as opposed to start playing guesswork and saying do I need boron? Do I need zinc? You can start guessing and wind up on nutrients… that’s something you can assess, but generally it’s functional… the big step first. Get the amino acids. Make sure the bones are in good shape, your amino acids are recovering…

Ben: And vitamin D is (Cross talk).

Dr. Richard Cohen: Get your (inaudible) to where it needs to go. Tweak some of those. See if there’s a way you can tweak your training a little bit and use some of these essential minerals in this healthy salt which you can actually take – you mix it up, it’s called Soleil and you just take the crystals and you put it in a jar and add some water to it and it becomes like salt water in the ocean. Just take a teaspoon of ocean in the water and there’s some good research with the effects of that. So that’s just basic healthy eating. And at that point, I’m really… I’ve been doing this longer and longer, getting away from so many synthetic nutrient replacements – yeah, it has its place but not as a first step. In your case, if you don’t notice an improvement and you can use some of the issues you’re concerned about, where I’d rather go with you would be once we had a better sense of where the estrogen is and the DHEA… just go into herbal support. We can use maca which is a nourishing food and supports the pituitary gland. Nettles, which helps detoxify and also frees up testosterone from the protein. Tribulus, a good form of tribulus also helps nourish the pituitary gland. So there are other things. Magnesium helps testicular production along with zinc. So there are ways to support that and nourish that if we feel we need to. I’d say 9 out of 10 times, and another key I have people do is take enough essential fats. You’re just doing flax, you may need more Omega 3 directly and while we could test that and it’s another test, but it’s not part of that. I’d generally say try adding some good Omega 3 type oils. Cod liver, fish as opposed to the flax oil. You might see some benefit there. you can certainly see how they all tie in together.

Ben: Oh absolutely.

Dr. Richard Cohen: The amino acids, the vitamin D, the NTX are sort of markers which have now flowed down into your testosterone and it’s not necessarily testosterone first.

Ben: Now a quick question for me because it wasn’t quite clear so I know it wouldn’t be to listeners. You’re talking about the salt, the microminerals – and that is an actual salt that you can…

Dr. Richard Cohen: Yeah, there’s Himalayan salts. You should be able to search on line. I could give you some readings too. Himalayan salt. Also Chris Lieto has a company. It’s called Base Performance and  they have a salt, electrolyte and that is basically this Himalayan salt and it’s a nice product. It’s actually… it’s an electrolyte you can throw in. It’s magnese and it’s potassium and they use microminerals as well. That’s what we need. That’s what humans have consumed for hundreds and thousands of years. This base prime salt that used to be minerals in our earth in the ground, in the soil that got into foods and our soil is not what it used to be. So that’s a nice basic healthful thing to add in to our… we’re not talking salt – table salt, sodium chloride – I’m not quite sure where that ever got into our particular diet but that’s not a healthy thing to consume. But these whole mineral based salts, you can use to flavor foods and you can take directly and if anything this salt hypertension is directly related to this almost synthetic based salt that we add to foods to preserve it as opposed to a mineral base so we’ve seen people actually drop blood pressure by adding these mineral based salts. Let me have Tim sort of add to the exercise component.

Ben: Did Tim fall asleep over there?

Tim Monaco: No, I’m just hanging out and observing. So, I think just when you are looking at the – I would say primal effect of different types of training and I think a lot of people that are listening might already have some familiarity with this but in general doing more weight bearing exercise, strength training, more interval, short burst exercise is generally more anabolic. So it’s going to break you down but it has more of a hormonal drive that’s going to be creating a bigger push in hormones, kind of like a surge so that it actually is going to be creating more recovery, more muscle rebuilding where endurance exercise tends to be more catabolic in an evolutionary way so that’s why a lot of endurance athletes struggle with their body composition. That’s a little counter intuitive because you think that people are out there training 4, 5, 6 hours that they’d be skinny as can be and have no body fat but that’s not the case in a lot of people and what’s happening is you’re actually breaking down muscle mass and your body is put into more of a stress response so the cortisol which is your body’s main stress hormone is elevated. It’s kind of like a survival mechanism and that breaks down muscle mass and it also cues the body to go into a protective mode and store fat more readily so over time even if you’re getting on the scale everyday and monitoring your body weight, often times your body composition will change. Especially as you age you’ll lose muscle mass and you’ll be slowly gaining fat and you might step on the scale and see the same number year to year. Your body composition is actually shifting. So I think as far as the metabolic typing goes, the people who are more towards the protein and fat type probably need to be a little bit more careful about doing excessive amounts of endurance work and low, slow exercise. You have to be a little more discerning because the fact that you are more higher metabolic drive, you need more protein and fat. You basically are more of a power animal. You’re built for speed.

Ben: That’s interesting because I come from tennis and bodybuilding. Those were my sports before.

Tim Monaco: Exactly. I think that’s not uncommon to see people coming from explosive team sports and stuff like that and then shifting into this kind of training. I have to say that everybody needs to do distance work in order to gain endurance but you just have to be a little careful about not overdoing it and really just monitoring how the training is affecting you and obviously doing the testing is going to give you some real hard information as far as your hormone levels.

Dr. Richard Cohen: This is something that obviously people haven’t broken down with regard to body type. My sense is you would, just from my experience – I don’t know how much you’ve played with it, Tim, yourself, other than awareness – you might be do better and there’s certainly been research about the high intensity training for endurance athletes. Not that you cut out all endurance training but if there are options, say ok I’m going to substitute this for two minute high powered intervals with the rest and four to eight of those and that’s going to be equivalent to doing a long two hour ride. You may find the equivalent – it may even be, I would suggest, the optimal for you. More research is certainly suggesting that as people are aging, forgetting the metabolic type, obviously they have some core base that they can get away with that and you recover quicker.

Ben: Yeah I guess I have two thoughts on that and I suppose since this is going to turn into the most epic long podcast we’ve ever done…

Dr. Richard Cohen: We have one more to cover too.

Ben: Do we? Do we still have one more? Okay, well just real quick. You guys are preaching to the choir on this one. Two thoughts – I have experienced in the past four years of coaching more of the Ironman triathlete, especially my female athletes that I’m working with will come to me and have gained 5, 10, 15 sometimes 20 lbs while training for Ironman triathlon and what I discovered when we first started into this was that when I started giving them intervals and I started giving them the weightlifting and we switched the routine they’d done to prep for one Ironman triathlon to this new routine that I designed for them that they didn’t experience that problem with fat gain and weight gain ironically while training for Ironman. And I’m going to call these people out, I know they’re probably listening to the show – a few of my clients who in the past couple of months I’ve talked to… female marathoners, same thing, displaying signs of a lot of cortisol load, coming to me having gained weight and I’ve switched up their programs and started them into weightlifting but kind of audited their weightlifting program and they’re just weak lifting 5 lbs, 2.5 lbs, maybe 8 lbs and really not getting that hormonal release that’s conducive to weight loss that they need. And then my second thought was both the programs – kind of the major program I have out there for triathletes – the top 12 resistance training routines for triathletes and then my new Ironman Triathlon Dominator package are both designed around the concept or intervals, intervals, intervals; high intensity weight lifting, power and not doing a lot of the junk miles – the long slow endurance training. So I’m on the same page as you guys as far as that’s concerned. If you’re a pro triathlete and you have tons of time to train, maybe the Mark Allan philosophy of pure aerobic training might work but especially for us age groupers it seems to work better to do the interval and the weightlifting. Ok. Ferritin.

Dr. Richard Cohen: Right, who knows what his metabolic type is, do you know Tim?

Tim Monaco: Well it’s kind of ironic that Mark Allan was one of the first guys to buy into the Phil Maffetone program back in the 90s and then that kind of morphed into the 40, 30, 30 zone diet. I think actually Dr. Cohen has worked with them and then as I started in the beginning, it’s like if it works for you – if that happens to be your metabolic type then you’re golden. But if you’re not, you’re in big trouble but I think the case so far, it’s what you just said that if you’re a pro-triathlete and you’ve got nothing to do but train you’re going to get stronger by doing more base work. But for the most part, the run of the mill person who has a job and a family and a life and can only train a limited number of hours, you’re going to get the most bang for your buck by doing more interval work and then cycling through different phases of training.

Ben: Right, and knowing I’m going to sound like I’m talking myself up here – just from personal experience you can do the style of interval training and high intensity training and power and weightlifting and as an age grouper still breathe down the necks of a lot of the pros and even beat many of them. It’s something that works when you have limited training time.

Dr. Richard Cohen: Absolutely. And you know what? For some types it may actually be the best thing for them. So that’s again an awareness, sort of like the diet. No surprise you came from tennis and some bodybuilding. Not saying that you can’t do triathlon, but keep in mind who you are. And that’s the most important point. So lastly is ferritin. Ferritin is an iron storage marker and it’s something that could be not… it releases these other factors – iron stores and bone and proteins do play a role. In men it’s definitely less of an issue. Men just don’t regularly bleed out and they tend to eat a little more. They have more calories so they tend to get enough iron into their system. Also, on the flip side is you don’t want to miss all iron. That’s why it’s part of the package especially for women. If your iron is low there’s just no way you’re going to perform. Iron is the key component in hemoglobin which carries oxygen. Obviously if you’re not getting oxygen to your tissues effectively, that’s a problem. Ferritin levels that are low don’t necessarily mean anemia which is a total lack of red cells when your iron stores are extraordinarily low but we’re looking for at least to be in an ideal range. Similar to D, it seems to be between 50 and 80. Anytime you start slipping below 40 and into the 30s, it’s very possibly and likely affecting your performance and other things that you do.

Ben: Now just a quick question. I don’t know what my levels are yet but quick question, if you’re above 80, because I know that iron toxicity can be a problem for some people – is it the same deal with ferritin? Can you get that too high?

Dr. Richard Cohen: Absolutely, yeah. So your level is 90 which is fine. Not too low, not too high and actually I’m glad you premised that. Too high… while it’s useful for an endurance athlete… and iron deficiency is the number one worldwide deficiency per se. But in popular world, especially for men there is conditions where if you start taking iron and you are genetically proposed to absorb iron, you can wind up with high levels of iron which would be seen in these high ferritin levels getting up to 200, 300, 400, 500. Iron is an oxidant. It causes rust on metal. It oxidizes your tissue and it’s a potential risk for illness. You don’t want to have more iron than you need so before anyone starts taking iron, even a low dose regularly, especially men you want to check your levels. We’ve seen a couple guys in their low 30s that are running 200 plus. It’s like you definitely don’t want to be having iron and I said to him you probably want to check this. If you start to run up, you probably want to donate some blood periodically and that would bring it down and reduce any risk. It’s a healthy thing to do.

Ben: So with the high levels of the ferritin, in my case being a 90, I would just want to be careful that I wasn’t supplementing with iron and that would be the first thing for me to consider if I had low energy levels.

Dr. Richard Cohen: Right. At some point, probably 5 years, 10 years down the road check it again at some point. But at this point 29 and 90, I don’t see that you’re at any risk for… it’s called hemochromatosis of ferritin levels, you go up to 1000 and it could blow out your liver and cause severe problems. But we’re looking at again, everything we’re focusing on – we’re not looking at disease, we’re looking at functional imbalances. For women, we tested the local high school team as we talked about here in Bend, and of the 20 girls we tested, everyone except for two that were just coming off of flus and their ferritins were artificially elevated had levels under 35. We saw girls 25, 20… none had anemia but a good percentage of those were not recovering the way they wanted to and they had heavy legs. It’s just one of the things you shouldn’t miss and absolutely any woman endurance athlete should have an idea of where they are as a baseline and if they’re tending to run in 30s and 40s a little bit of iron everyday would not be a bad thing for them. They’re not going to run into any problems. You were good there. Nothing really to be concerned about. You know, you did ok Ben.

Ben: Thanks doctor.

Dr. Richard Cohen: You did ok. We got some meat here, I’m glad for the talk. I wanted hopefully…

Ben: Probably would have been boring if I was perfect.

Dr. Richard Cohen: Right, I was hoping we could find a few things that would highlight – and honestly it’s the rare person that we don’t find imbalances, which is why this is really fun to work with you and people who are really interested about their health. Because we don’t need to convince you to do this. You already get it. We’re just going to take this information and say ok here’s how we fine tune, here’s how you fine tune your protein intake. Change this, add a little more amino acid – more effective than protein powder, relying on that as a sole source, sure. Throw some protein into some cereal, throw it in a blender but know that that may not get the job fully done for you.

Ben: Yeah, one of the biggest surprises for me was what you said about my testosterone levels being almost half of what they should be for the level I really want to be at. And I like that you guys have really highlighted the fact that a lot of this stuff depends on the interconnection between the vitamin D and the essential amino acids and the magnesium and the testosterone and that if I were to try to start to get all the building blocks in place that it’s likely that I’m going to feel pretty profoundly the effects.

Dr. Richard Cohen: Exactly. So you know you’re on the right track then, absolutely. That’s the goal that we’re trying to achieve here.

Ben: Ok, well I know that for the listeners this has probably been an epic journey. I know a lot of people listen to this while they’re out running or cycling or working out so we just made your workout that much longer. You can thank us for that. But it’s likely and you’ll know this when you listen to this podcast that I will release this particular interview probably as a special interview all on its own without our special announcements and our Listener Q and A just to make this a little more palatable for you in terms of length and the last thing I want to touch on – even though it’s in podcast number 53 is the fact that you can get a hold of Bioletics and they can test you the same way that they did me. And what I’m going to do is put a link in the Shownotes to this podcast and you can follow that link to actually go find out more about getting tested by Dr. Cohen and going through this process that I went through and I’ll also invite anyone who’s interested to email me, [email protected] and I could put you in touch with Richard and put you in touch with Tim. Did you guys have any final thoughts that you wanted to express before we end the show?

Dr. Richard Cohen: I think we’ve done a nice job of covering it all and sort of showing how critical even in someone who’s doing things really well, and that was our findings too with someone who very consciously part of their life trying to make a difference in their health and certainly doing so, but not dialed in. And that’s the key, and when you can dial in, little tweaks here can make a major difference and that’s the fun part of what we’re doing here.

Ben: Richard, Tim. I want to thank you guys for coming on the show. I know that during the interview today it was a one headset interview on your guys’ end which is probably why I know we didn’t hear as much from Tim as we probably could have. I know you’re a wealth of knowledge Tim but you guys were kind of having the headset back and forth I know when you were talking. But to both of you I want to say thank you for coming on the show.

Tim Monaco: Thanks a lot Ben, we appreciate it. And I guess that’s about it.

Ben: Alright, this is Ben Greenfield signing out from www.bengreenfieldfitness.com. Have a healthy week.

For personal nutrition, fitness  or triathlon consulting, supplements, books or DVD’s from Ben Greenfield, please visit Pacific Elite Fitness at http://www.pacificfit.net

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