April 27, 2019
[00:00:52] About this Podcast
[00:02:06] Podcast Sponsor
[00:04:25] Start of Talk at Kentucky Castle
[00:08:36] My Quick Background
[00:15:12] Guidelines When Examining Your Lab Results
[00:22:39] Podcast Sponsors
[00:26:00] RBC Magnesium
[00:39:59] High Sensitivity C-Reactive Protein (hsCRP)
[00:43:03] Triglyceride HGL Ratio
[00:47:50] Full lipid panel, and an Omega 3 index
[00:51:47] Insulin-Like Growth Factor (IGF-1)
[00:55:53] CBC with Differential
[01:02:17] Food Allergies and Sensitivities: Cyrex
[01:07:12] Microbiome Testing
[01:10:25] Mold Toxicity
[01:21:27] Blood Glucose
[01:25:16] HRV & Readiness
[01:31:00] Keeping Track of It All
[01:33:36] End of Podcast
Ben: I have a master's degree in physiology, biomechanics, and human nutrition. I've spent the past two decades competing in some of the most masochistic events on the planet from SEALFit Kokoro, Spartan Agoge, and the world's toughest mudder, the 13 Ironman triathlons, brutal bow hunts, adventure races, spearfishing, plant foraging, free diving, bodybuilding and beyond. I combine this intense time in the trenches with a blend of ancestral wisdom and modern science, search the globe for the world's top experts in performance, fat loss, recovery, hormones, brain, beauty, and brawn to deliver you this podcast. Everything you need to know to live an adventurous, joyful, and fulfilling life. My name is Ben Greenfield. Enjoy the ride.
Hey, the super ultra-special podcast episode you're about to hear is the first of a two-part series that I recorded when I was in Lexington, Kentucky, lecturing at a wonderful precision medicine conference down there. Not only did I get a chance to get on stage and talk about all the different blood and biomarker tests you should get, how to interpret them, how to line up your reference ranges, what tests are worth your time, what tests aren't worth your time. I gave that lecture which I'm going to give to you today. I also gave a follow-up Q&A, a 90-minute Q&A on all this stuff with about four other physicians on a panel with me. We're going to get deep dive in a precision medicine in the next couple of episodes. Cool stuff.
The shownotes for this episode are going to be at bengreenfieldfitness.com/kentucky. Then, what I'll do is I'll put the shownotes for the follow-up episode that comes after this over at bengreenfieldfitness.com/kentucky2. That's bengreenfieldfitness.com/kentucky and bengreenfieldfitness.com/kentucky2. Maybe, I drank too much bourbon before this show.
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Matt: What I realized and what impresses is me is [00:04:54] ______ just actually a really good person. Seeing how mindful and intentional he is.
Ben: [00:04:58] _______
Matt: Seeing how intentional he is with his kids and his wife. We were going to a horseback one morning and they have had time do their [00:05:09] _______ generously in the car on the way there. Every meal, they take a deep breath in and they talk about what they're grateful for. To see how these kids, he enjoys his kids and let them have a good time. He's looking for all these teachable moments and truly did an inspiring. I felt like I should tell you that because you all know the other stuff, but you may not realize that. How does that help you right now? It does. Luckily, he's also very smart, he's going to give you some great knowledge right now.
Ben: I've learned a lot from that Mike too about the genetic snip stuff they do. You can actually learn more from 23andMe and your risk for having a unibrow or preferring sweet vs. salty things. They do a lot with genetics. I'll touch on that during my presentation as well. When these guys told me they wanted me to talk a little bit about self-quantification, really my [00:06:00] ______ was going beyond just like with Fitbit or even something a lot like an Oura Ring or some of these things we can use to track sleep and steps, and really delve into taking some of your health into your own hands. Looking at things like the type of tests that you can order online nowadays, stuff you pay $10,000 for a decade ago at the Princeton Longevity Institute or things that the execs are doing at the places like the Health Nucleus in California. There so much that we can now learn just from our own computer browser, an email inbox, with our PDF results from some home blood test or that stool you've been keeping the refrigerator for a couple days before you [00:07:05] ______. “Be careful. Don't eat the stew in our refrigerator until you ask first.”
There's a lot that you can learn now and that you can find out yourself by ordering a lot of different labs online and paying attention to certain parameters. In [00:07:29] ______, there's thousands of different things that you can track. I know that a lot of you, just from the few conversations that I've already had this morning, seem to be pretty keen on health and pretty self-educated. When it comes to digging through these thousands of different biomarkers that you can track, what I wanted to do today was just identify some of the things that I think are the best parameters to track, especially if you're interested in that ideal combination of health span and lifestyle. Then, I also want to get into some of the stuff like ketone monitoring and blood glucose monitoring and tell me your analysis and a few of these things that go beyond what you might test for on a standard blood panel.
Basically, the goal here is to allow you guys to walk away with a pretty good working idea of some of the lowest hanging fruit in terms of quantifying was really going to move the dial for you in terms of health span or lifespan. You've already learned a little bit of that from Mike's presentation. Now, you all know why we didn't get out almonds for breakfast that [00:08:26] ______. You drop dead with heart attacks right and left here. We just ate bacon and avocados instead because there's [00:08:28] ______.
A quick background. I know that a lot of you listen to my podcast and know my background where I'm coming from, but, specifically, when it comes to quantification and where I'm coming from when we're talking about testing things like your blood and your biomarkers, I started off back in college when I was studying physiology and biomechanics. I really got hardcore in a body build, which is what I'm showing you a photograph of me right now. That's me more than a decade ago. I guess that's about 92%. The thing is that bodybuilding is like this old-school original biohacking sport where people are constantly tweaking and testing different macronutrient ratios, gaining weight, losing weight rapidly, gaining muscle, losing fat at a pretty rapid pace. That, initially, got me interested early on that day. What can you do to really bring the body from good to great, not necessarily from a health standpoint in this case, which is drawn from a pure physique standpoint?
Then, after that, I got into Ironman Triathlon. I raced Ironman Triathlon for about 10 years. It was about six years into that, which would have been six, seven years ago that I actually started to dig into and order tests from some of these companies that were popping up, a few of the physicians that I interviewed on my podcast offer the blood panels score for me. I started to dig into some of these early services that were online where you could order some of your own lab work like DirectLabs, for example, or Genova Diagnostics. I started to tweak and test on my parameters. I thought I was freaking fit. I have [00:10:21] ______ engine that could go for days and look really good in spandex. I could ride a bike quickly.
When I started to get my lab results back, I was pretty shocked at what I saw. I had a hypercortisolemia or, at least, it appeared that I did. I probably. I'll explain in a while when I talk to you, guys, about hormones later on. I had rampant amounts of inflammation and CRP value that I'll talk to you about as well today. I had pre-type 2 diabetes based on my fasting blood glucose levels. I have a lot of shit going south in my body, despite me being healthy on the outside. I was that stereotypical athlete who was healthy on the outside, but dying on the inside, or, at least, far from optimized on the inside. Actually, that initial testing when I was fit, but really truly unfit, was what inspired me to write that first book I wrote, “Beyond Training,” where I start to figure out what can an athlete do to find that ideal balance between performance and health and longevity? That's what really got me interested in this stuff was realizing, “Geez, we can look good, we can feel good, but we can be dying a slow death on the inside and not know about it.”
Now, I do a lot of also racing and I still race for Spartan. I still dabble around the mud and barbed wire. I don't profess some of these masochistic sports to be healthy, but I still try to keep a pretty good idea of what's going on inside my body using a lot of the tactics that I'm about to show you. I don't think that this is something that you need to do just because you want to be, say, a professional athlete or do an Ironman or do a Spartan Race. I sometimes get pain in this for somebody who only works with pro athletes and, frankly, [00:12:14] ______ 80% of the people I work with, they're just like CEO's, execs, people who want to live a long time, people who want to feel good, people who want to sleep better, people who have got issues that they want to fix. I'm not even working with pro athletes anymore. I'm primarily with the people you just want to feel good and live a long time. Don't think that a lot of these things that I'm going to talk to you about, or just a few, if you want to, say, race in Ironman Triathlon. We're talking about things I think are important for the general population.
Harping on what I was talking a little bit about earlier, what I want to go through today are some of the best blood biomarker evaluations that you could do on yourself initially. I'm going to give you, guys, specifically, 12 of the best biomarkers that you can test, some stuff that flies under the radar, some stuff that you might already have a decent work or knowledge of. I'm not saying that what I'm about to show you is all you ever want to test for. Well, when I sat down and thought about what I wanted to talk to you about today, I was trying to identify some of the things that you might find interesting. They go beyond, let's say, vitamin D or total cholesterol, or some of the things that you get done to just an average every day, bloody valve and some of the stuff that I use to dial a little bit more.
As we go through, you've got Matt's cell phone number. You can drunk-dial him later on, or send him obscene photographs of himself. That's writing this number down on the board there. If you have question, you can text that over to Matt. That way, I'll roll through and then, I would say we can either save all of our questions for the end, or Matt sees a question and it's just super-duper relevant we don't want to skip over it, he'll just interrupt me and ask the question right then and there. We basically got how long do we have here Matt for folks?
Matt: [00:14:36] _______
Ben: [00:14:38] ______ help when we get through this stuff. I did work in the opportunity for a pee break. You're welcome.
Matt: First question.
Ben: We already have. I didn't even start yet.
Matt: The first questions is, “What product do you use for your hair? It looks amazing.”
Ben: The trick is you just don't wash your hair. You just let it get super oily [00:15:00] _______.
Matt: [00:15:02] _______
Ben: Yes. Call me.
Matt: Call me.
Ben: I'll tell you exactly what's in my hair right now, Badger Balm Pomade. That's right. It's got to be clean enough to be able to eat it. That's the final rule for what goes in my hair [00:15:11] ______ be in there.
Before we get into what parameters you want to look for in your blood biomarkers, it's probably important for you to understand that when you get the results back from an average, let's say, a comprehensive metabolic panel and a complete blood count from your doc and you're looking through all these reference ranges and they're going over with you, or you're looking at it yourself, and you're just, “This is what a lot of people do. They look for ‘let's mark high, let's mark low.” They'll just skip over everything else and pay attention to what seems to be leaping out from the left that's a lot of time when you get your results. It'll be like a big bowl of number that says too high or too low, or something like WellnessFX or something will pop up red and everything else is green, you just pay attention to the red part.
The problem is [00:15:56] _______ when it comes to interpreting this data and taking caution with the reference ranges that they give you, “What you're looking at right here is basic parabolic curve with a statistical analysis. The way that these curves work is you've got about 95% of the population fits into the middle of the curve and then you've got 2.5% or so on either side of that reference range that's relatively unaccounted for on this lab test.” Part of that is due to the biochemical individuality that I think you could read about in a book by the same name. That's a full book called, “Biochemical Individuality” by Roger Williams. You come through that book and it shows how there are 12 different sizes of the stomach and all these different shapes of the liver, and certain people excrete vitamin D and extremely rapid rate and some people hold on to vitamin D, so, well, they get vitamin D toxicity from the average multivitamin. It's a fantastic book written in the 60s. It just goes into all the different ways that we operate biochemically. Then, you combine that with what Mike was talking to us about when it comes to genetic individuality and a lot of these snips, and you get a pretty good idea that you might fall into that 5% of the population, or I think more that these reference ranges don't account for.
If you're looking at, say, your alanine aminotransferase or aspartate aminotransferase liver enzymes and it's telling you that your liver is just fine because your enzymes are at a certain level, that does not necessarily mean that that certain level is what's healthy for you. That's what's healthy for the general population. You'd say the same thing about thyroid, you'd say the same thing about vitamin D. It's a great deal of biochemical genetic individuality that needs to be taken into account. You could see here at number one that I've already written down explained you 5% people fall outside the curve.
Another thing is that ranges tend to widely vary from lab to lab, meaning that, typically, when you get into tests, the reference ranges that that lab is using, those are supplied to them by the tests manufacturer, whether that be Genova Diagnostics, or MetaMetrics, or any of these other companies that are producing these tests. What labs are supposed to do is they're supposed to go out and get a third party eval to see if those reference ranges actually are correct and fall in the value of that test manufacturer's recommended. In fact, most labs don't do that. You might test with one lab that will tell you your vitamin D levels are perfectly normal and you might test with another lab that will tell you your vitamin D levels aren't and will give you different reference ranges. That's what you will learn about when I talk about safe food allergy testing. Different labs, in many cases, are using different tests that are using different forms of evaluation. You need to understand that your value is going to vary widely from lab to lab or even from physician to physician. That's another problem reference range.
Number three that I've written here, and this is a big one. A lot of reference ranges don't reflect the absence of disease. The absence of disease, not necessarily the ability for you to go from good to great, or for you to say, “I'll live until you're more than 100.” It's just, A, is this person going to get drop dead in the next few months or not? You can use some examples such as your thyroid. Typically, what a laboratory or reference range will reveal is that if your TSH, thyroid stimulating hormone, is below 4, you're pretty good, your thyroid is doing okay. When you look at thyroid dysregulation, a lot of people, whether it's autoimmune thyroid issues, whether it's inadequate conversion of T4 to T3 due to high cortisol or low blood sugar or whatever the case may be, they actually do better with the TSH that's below 2. I'm looking over at client's labs or the blood and the biomarkers, I'm looking for a TSH that fall between 0.5 to 2. If I'm scrolling through let's say a WellnessFX lab report and I get to the thyroid section, I get to TSH, and it shows, “Hey, green, you're doing just fine. Your TSH is at 3.82.” Well, to me, that's actually not a great TSH. Sure, that's going to indicate that I might not have full-blown hypothyroidism. But it's not an indication of really great thyroid function. You want to take into account the fact that maybe these reference ranges do not reflect good to great. The same can be said for inflammation or magnesium or any of these other parameters I'm about to show you. You need to realize that many of the lab reference ranges are absence of disease, and not necessarily your potential for longevity or for health span.
Then, the final thing is that in these shops, [00:20:59] ______ lab reference ranges. They should vary widely based on whether you're male or whether you're female. I'm going to show you some of the reference ranges that you should be looking for when you get results from a lab test that you've done or maybe your doctor goes through your results with you but you want to go through them yourself using some of the information that I'm about to provide to you. A lot of times, male versus female is accounted for. A perfect example that would be iron is something that, as you'll learn later on, can be an element that can essentially rust you from the inside out. Men, technically, should have a lower iron value than women have. Another one would be your liver enzymes that I talked about earlier, your ALT and your AST. Those are supposed to be a lot lower with females than they are for males, but most of our reference ranges just spit out numbers and don't say, “Hey, this is what your numbers should be if you're female. This is what your numbers should be of your male.” There are all sorts of problems when you're going through your results that you need to be aware of. Take some notes as I show you some of the things that you should be looking at today. By the way, I should have told you this at the beginning, if I go back here in my introductory slide, I will make these slides available to you so you don't have to memorize all these values. Not that you guys don't have minds like steel traps and eight cups of coffee in your systems right now. You can memorize all this. If you go to bengreenfieldfitness.com/kentuckycastle19, you can download the slides and also articles, podcasts, scientific papers, and references for a lot of things that I talked to you about, if you want to take an even deeper dive or just read a lot of stuff related to some of the other–
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Let's dive in, just jumping in the good stuff here. Some of the lab drivers, specifically, if you go through 12 different things that I think you should look at and test for if you're really going to take some of your health into your hands.
The first is RBC magnesium. RBC stands for red blood cell, red blood cell magnesium. Now, this is an important one to look for based on the fact that as you can see here, it's going to indicate things like insulin sensitivity, physical performance, can affect sleep and sleep architecture, potential for sarcopenia, which is the loss of muscle as you age. Whenever I reference here what type of physical or biological degradation could occur as a result of one of these parameters being out of whack, most of this is based off the actual research that shows this is the biggest things to worry about if this number is not optimized.
In case of RBC magnesium, we get insulin sensitivity, visual performance and sarcopenia potential, the problem is that when you get a blood test, a lot of times just looking at intracellular magnesium which is not bioavailable magnesium. What you need to instead look at –I'm sorry, extracellular magnesium. This is not bioavailable magnesium used by the cells. Either one for intracellular magnesium. That's what an RBC magnesium test looks for. When you're getting your blood analyzed, you get your magnesium values back, if it says it's low, it says it's high, the first thing you need to look into is whether or not that's an RBC magnesium. You need to ask your doctor; is this is an RBC magnesium or is this an extracellular magnesium? Those two differences are very important.
Now, what do you need to be looking for ideal ranges, when you look at the result it's about 6.0 to 6.5. There are a few cases that I'm going to show you today where it's going to be different between men versus women, but for RBC magnesium, generally, 6.0 to 6.5 is where we're getting that ideal combination of health span, performance and lifespan. That's what you want to look for on a magnesium evaluation. Also, there's a company called Intracellular Diagnostics. Intracellular Diagnostics will also evaluate magnesium via [00:27:58] ______. That's also very accurate evaluation too when you're looking at your magnesium levels.
Magnesium is number one. Anybody have questions about magnesium, by the way? You can text Matt if you do. Or, if there's super relevant stuff that pops up, you can go ahead and raise your hand, whether it's like, “How do I [00:28:14] ______ this, how do I get more of this, [00:28:18] ______, et cetera. In most cases, what I'm recommending right now, most of my clients who are low in red blood cell magnesium is just using magnesium in the evening. There are different forms. I like to get different forms of magnesium. Like magnesium threonate, magnesium glycinate, magnesium citrate. There's a company called Jigsaw Health that I personally use. They make a triplicate form of magnesium called MagSRT. In most cases, I'm using anywhere from 400 to 600 milligrams or the mix of magnesium and [00:28:51] ______ RBC magnesium levels. Pretty valuable, especially if you're eating a lot of mineral-rich fruit growing from a mineral-rich soil and organic produce that have them.
The next one is estradiol. A lot of people think, especially men, that paying attention to estrogen level is only something that women needed. But, estrogen is actually something, I think, lies under the radar as far as something you need to pay attention to. You can see here what I've listed all the different things that low estrogen levels or optimized estrogen levels will affect. Bone mass, oxidative stress or antioxidant potential, your nitric oxide production, glutathione, one of the main antioxidants in your body, muscle repair, muscle strength. Non-optimized estradiol levels are going to affect all of those things. It's an important number to look at. For men, I've got the ideal ranges written right here, 10 to 82 picograms per milliliter. That's what you need to look for on your results. Women, it's going to fluctuate based on where you're at in your cycle. You can see some of the different values here for women, less than 50 picograms per milliliter on menstrual periods of 200 during follicular development, up to 400 just before ovulation.
Now, when it comes to measuring hormones, the problem is that blood measurements will often just give you a snapshot of what's going on with those hormones. They also will show you the upstream and downstream metabolites of those hormones. I'm a bigger fan of a salivary or, even better, a urine test to evaluate your hormones. A salivary test can at least give you, via four to five different salivary measurements in a 24-hour cycle, what's occurring during the entire day. Your hormones are supposed to fluctuate during the entire day. If you're just driving to a lab in the morning, or your doctor does your labs at 8:00 a.m. in the morning, gives you that one-time blood snapshot of a hormone, you're not getting the full picture. An adrenal stress index, salivary index could give you a little bit more data. What I'm going to show you a couple of minutes here are the results of something called the Dutch Test, which is a dry urine test with hormones. This one's great because it not only gives you with the adrenal stress index, it gives you as far as how your hormones are fluctuating during the day because, basically, what you're doing is you're peeing on a strip at five different points during a 24-hour cycle. It can also give you the upstream and the downstream metabolites of those hormones. You can see, I'll give you an example of cortisol for example and why this is important, why you might get a blood test that says you're super-duper high in cortisol and you need to meditate and do yoga and listen to Anya while you do your enemas, and all this stuff for lower cortisol. In many cases, it's actually not the fact that your cortisol is high. The issue is that the cortisol is not being broken down accurately. We'll get into the Dutch panel a little bit. Estradiol is the second one in addition to RBC magnesium that we need to look at track.
Kind of opposite of estrogen or estradiol would be testosterone. Man think that only women need to try estradiol. Women think that only men need to track testosterone. In fact, it's both sexes should be paying attention to both of these hormones. In the case of testosterone, we're looking at libido, sexual performance, energy, strength, bone density, muscle mass, cardiovascular disease, and overall mortality if testosterone levels are not optimum. I'm not necessarily saying that everybody needs to be on bioidentical hormone replacement therapy. You know that that's a very good strategy, I think, as you age, assuming that it's overseen by doctor and you're testing to make sure the levels are optimized. You should, at least, be paying attention to different things you can do to optimize hormones.
Now, the biggie with hormones is that they can be bound up by proteins. You will get testosterone for example. Testosterone, your total testosterone, can be bound up by two different things, albumin proteins or sex hormone-binding globulin. Now, if you're total testosterone is bound up by albumin proteins, it's still relatively bioavailable. More importantly, if your total testosterone is bound up by sex hormone-binding globulin, it's not bioavailable. You'll often at times find that if your cortisol is truly very high, your sex hormone-binding globulin is also high because it's almost that message that nature sends your body that it doesn't want you to make babies in times of stress. Whereas, if you got a lot of cortisol going on, you produce more sex hormone-binding globulin that bind up that total testosterone keeping you to free and active, and keeping your libido elevated, or keeping you to be exceptionally active.
The idea is that you want about 2% of your testosterone to be free. If you look, let's say you're guy, your total testosterone measured, you free testosterone is where it's supposed to be. 2% of it should be free. Your T-level should be at least 1 to free 49 free-T-to-bound-T. Bound T being what's bound to sex hormone-binding globulin and what's bound to albumin. If your total testosterone is 500 nanograms per deciliter, then you're free T levels would need to be right around 10 nanograms per deciliter. I'm a bigger fan of paying attention to the free T versus just total T. Some guys will have what might be considered to be low total T. Let's say, you're at 350 or something like that, but they've actually got free T levels that are pretty good or higher than 2% of that total value. On the flip side, you'll see guys walking around with 1,000/1,100 of total T. In some cases, even guys buy that hormone replacement therapy, large amounts of total T but because they're so stressed out or there are other things going on that are causing the total T to be bound, a lot of that testosterone is just bioavailable. It's important to pay attention to your total testosterone and also to your free testosterone.
I've got a few values here for you. For free T, you're usually looking at ideal levels being about 4.6 up to 22.4, and your bioavailable T, which is your albumin-bound testosterone, because remember that albumin as bound testosterone is still bioavailable. Sex hormone-binding globulin as bound testosterone is less available. You want that to range from 110 to 575 nanograms per deciliter. For women, it's a lot lower, obviously. They range from .02, .5 nanograms per deciliter with ideal levels of bioavailable T from 0.5 to 8.5.
The other thing that I always like to take a quick glance at, if I'm measuring hormones like estradiol and testosterone, is DHEA because DHEA is such an androgenic hormone, a precursor to estradiol, to cortisol, to testosterone. DHEA levels should ideally be optimized as well. That's why I like for example the Dutch Test because it looks at testosterones, it looks at estrogen, it looks for the melatonin, it looks for cortisol, DHEA. DHEA is another very, very good one to look at.
It's going to range quite a bit based on age. I'm going to show you here what DHEA levels tend to fluctuate. What are you looking at right here is the reference range of DHEA for males? You can see that as you go from 0 to 100 on this scale, it ranges anywhere from 5 all the way up to 30 in terms of nanograms per milliliter. It's going to change as you age. This is another issue with reference ranges. You don't just pay attention to whether you're male versus female, but it's also, in some cases, especially hormones, it's going to vary widely in terms of ideal levels as you age. You can use a chart like this, for example. It should be ideal levels of DHEA as you age. You look at your results and say, “Okay, I am 40 years old. Therefore, based on that, my ideal levels are going to be somewhere between approximately, if you look at this chart like 8 up to 25.” I've got references in these slides, if you want to go and look at an actual reference more on this game, if you want to match up the numbers more precisely. There's another graph that shows you reference ranges for females.
When it comes to hormones, like I mentioned, I wanted to briefly touch on this Dutch Test. This is what you're looking at right now is a screenshot of the Dutch Test results. It's cool because it's almost got this plot-like graph that goes from a low range up to a high range to show you if your numbers fall within the right parameters. This is the urine test, a dry urine test. You can order this to your own house, you can do it yourself. But, for example, with the Dutch Test, you can see here what I've written, the free cortisol. The majority of cortisol of your body circulates found a corticosteroid-binding globulin and albumin. About less than 5% of that circulating cortisol is free, but it's only the free cortisol that's able to be active within the body. It can access the enzyme transporters in orbits. Now, free cortisone is also measured by the Dutch Test, which is a corticosteroid-related cortisol. Creatinine, which is a breakdown by-product creatine. Then, a few different other metabolites cortisol breakdown. Why is all this important? I can see your eyes start to glaze over with all the different forms of cortisol. Well, like I mentioned, I tested. I got test after test, blood test after blood test, and said I have high cortisol, hyper cortisol. I need to take my phosphatidylserine and do my transcendental meditation and do yoga and not train so much. Well, it turns out, that what I actually found when I did my Dutch panel was that it wasn't that my adrenal glands were just producing cortisol 24/7 because they were so stressed out. It's not possibly because it didn't feel I was that stress out. Instead of that, cortisol just wasn't being broken down into its metabolites. Or, cortisol metabolites were very high. What did this indicate? Something was going on in my body that was keeping that cortisol from being broken down. Upon further investigation, it turns out that a couple of things that can limit your ability to be able to break down cortisol would be inadequate amounts of storage of glycogen. I was on a very strict ketogenic diet at that time while training. Another thing that can affect it is your thyroid activity. And, lo and behold, my TSH was somewhere between 4 and 5 where I had very low amounts of bioavailable T3. I wasn't getting adequate T4 to T3 conversion, also, probably because I was following a very strict ketogenic diet and being very active. It turns out that for me, it's not about meditation, and sleep, and destressing. It could be for some people. For me, it was about eating more carbohydrates, paying attention to my training a little bit more carefully, and optimizing my thyroid with the adequate iodine, getting adequate selenium, eating some organ meats, and taking that approach versus just lowering cortisol. As you can see, if you want some very practical things from a Dutch panel and give you deeper insight into what's going on with your hormones. I also test DHEA. Like I mentioned, progesterone and progesterone metabolites, all of your different forms of testosterone, and even melatonin as well. It can be even inadequate tests to dig into sleep architecture a little bit. That's why I like the Dutch Test.
Number six. Number six out of 12. Although, I think, this might be number 5 out of 12 because that's an issue up slide there and you guys didn't notice that. Testosterones had both three and four. In fact, that's 11, not 12. Like Matt said, I graduated when I was 15 so I didn't get through [00:40:10] _______. My counting is a little off. Once I run out of fingers, I'm screwed.
High sensitivity C-reactive protein. This is that hsCRP I was talking about. Remember how I said that when I was racing, I felt really good. I look good in spandex. I have an aerobic engine that could go for days, but I had rampant amounts of information. Now, this is important because it will lead to inflammations, and, specifically, heart attack works.
Now, a lot of people will go in and they'll get their information tested. Their hsCRP will be 0.8, 1.0, 2.0, 3.0. When you get above 10.0, that's going to be a really big sign that probably, you've had a heart attack, you're right on the verge of a heart attack. With CRP, it is important to realize that if you're looking at it, you worked out the day prior, especially if you did some form of eccentric exercise the day prior. When I say eccentric exercise, I mean something that will cause the muscles to have to decelerate, usually the top two are running or weight lifting, your CRP levels are going to be artificially elevated. You don't have to worry as much about this number if you worked out hard the day prior. Typically, if I'm going to go in for a lab test, I still like to work out every day. I just sit around eat green peas before I go in for a lab test, but I'll just do swimming, yoga, sauna, a little bit of cycling, like things aren't tearing out the muscles quite as much so my CRP levels aren't artificially elevated.
Now, when it comes to CRP, the other important reason that you need to pay attention to this is because if you have ramped up levels of inflammation and you're also following some of the [00:41:46] _____ advice we're seeing a lot in health industry right now which is, “Pay attention to really good forms of cholesterol, eat your eggs, eat your avocados, have fatty cuts of fish, make sure that you're getting enough fatty acids into your body.” The problem is that high amounts of inflammation can cause oxidation of that cholesterol. In many cases, when I'm looking at someone's lipid panel, which I'll get into here in a second, I go straight and I look at the inflammation, I look at blood glucose, because those are two factors that can cause cholesterol [00:42:24] _______ up. I personally try to keep my total cholesterol above 200, based on the fact that's great for hormones. It's been shown in research to be wonderful for your intellectual development, especially as you age. I would be screwed if I had high total cholesterol and my CRP was elevated and my blood glucose was elevated. I'll get into the cholesterol particles here in a second. But, CRP is another one. It's very important to pay attention to. Sure, there are a lot of other inflammatory markers like fibrinogen and cytokines, all these other things we test for inflammation. CRP is such low-hanging fruit, such an easy blood test to get, but I recommend that you look at that one as well.
Next is your triglyceride to HDL ratio. I just mentioned that if I'm looking at a lipid panel on someone, I pay a lot of attention to CRP and the blood glucose, but one of the other biggie's that I pay attention to is the triglyceride to HDL ratio. This is actually called your [00:43:37] ______ score out of index, because it has been shown to be far more important in terms of determining your risk for cardiovascular disease and your true cardiovascular health, far more important than total cholesterol or LDL cholesterol. You don't even have to get a fancy cholesterol particle lab test called an NMR profile to look at this number. You can get this number just off a basic plain lipid profile that you get from the average doctor.
Let me show you what you want to be looking for when it comes to your triglyceride HDL ratio which indicates what I've written here, all-cause mortality, heart disease, and insulin resistance. Three biggie's that take out a lot of people in it, for it's both health span and lifespan are influenced by this trig to HDL number. Ideally, if you're looking at trends as you change your diet, you can come out, triglyceride should generally go down over time, HDL should generally go up over time. What you want to look for for your ratios your trig to HDL ratio, lower is better. You want to be below 1. This is a problem of reference ranges. A lot of times, reference ranges will look at whether or not you're below, or, I think, the best bad news bears if your triglycerides are at, say, 150 and your HDL is at 40. In many cases, a lab result will tell you, “You're doing just fine through this index of atherosclerosis.” That's simply not the case. I think I called an index of atherosclerosis, I believe, that I should call them atherogenic index. Don't quote me on that.
Anyway, your trig to HDL ratio is very important. It should be lower. I like to see it below 1. What would below 1 mean? It could mean low triglycerides, high HDL. Low triglycerides, high HDL. For example, how do you get your triglycerides low? How to get your HDL high? HDL responds very fairly with things like omega-3 fatty acid sources, such as fish oil for example. Fish oil supplementation has been shown to be wonderful to increase in HDL. If you ask the people who designed the food pyramid, they'll tell you whole grains increase HDL. They do, like eating a diet of quinoa, amaranth, and millet, and oats, and wheat bread. That will increase your HDL. The problem is that many of those foods have the same glycemic index as a Snickers bar. So, yes, you're increasing your HDL, but you're also keeping blood glucose relatively elevated simultaneously. Instead, from a dietary standpoint, plant intake, dark leafy greens, adequate fiber intake, a lot of EC2 positively favor HDL.
Some people will say, “What if I'm on carbo diet? What if I'm doing low vegetable, low [00:46:16] _____?” Well, you get lots of fatty acids from your grass-fed, grass-finished ribeye steak, and your sardines, your anchovies, your mackerel, and your salmon. There's more than one way to skin the cat when it comes to HDL, but, ultimately, no matter what you do, keep it elevated. When it comes to triglycerides, well, exercise and implore control is one of the best ways to decrease triglycerides that your body isn't having to have to shovel these fatty acids to the storage tissue. Two things that really elevate triglycerides are your intake of processed sugars and starches, and your intake of vegetable oils. If you can just do those two things, you will see your triglycerides start to go down. It's almost like eat more plant/fiber/slightly limited amounts of whole grains, or just fatty acids overall while decreasing vegetable oils and starches, and you tap in this index pretty thoroughly.
The other one to pay attention to–it's interesting a lot of people don't look at, is your HDL to total cholesterol ratio. Lower is better. Again, even if you don't get a particle count, NMR profile particle count, which I'll talk about in a second, this can still give you a decent idea because it's correlated with particle count. If you look at your HDL to total cholesterol, let's say your HDL is at 70 and your total cholesterol is a 190, great, because you want that ratio to be 0.24 or higher, 0.24 or higher for you, HDL to total cholesterol. You can very easily, if your doctor sends you a PDF or print out of your lab results, just go look at HDL, go look at total cholesterol, go look at triglycerides, and you can calculate all of these numbers yourself, and see if you're really truly falling into the range that you want to be at.
Number eight. I'm going to keep harping on lipid here. A full lipid panel, along with an omega-3 index. If someone really truly wants to look at everything that's going on, specifically from a bad to the fantastic standpoint, this is what you want to ask your doctor and functional medicine doctor, your integrative medical practitioner. These guys used the stupid term “precision medicine.” I think [00:48:03] _____ part. I'm just kidding. Precision medicine, functional medicine, integrated medicine, you name it. You want to ask for a full lipid panel. It should be like an NMR panel with the omega-3 index.
This can indicate cardiovascular risk and inflammation. Here is what you want to look for. When it comes to this NMR profile, what it's actually telling you is the size of your cholesterol particles. You've probably heard this before. Guys like Dr. Peter Attia. He has a wonderful six-part interview series with Dr. Thomas Dayspring where they take a deep dive into cholesterol and cholesterol particles. The general idea summed up in 10 seconds as you want your particles to be large, fluffy particles and not small atherogenic, particles. You generally want your particle count to be low. That's the amount you're looking for.
LDL particles should be less than 1,000 nanomoles per liter. That's a big important one. Total small LDL particles, less than 600. I also have some sizes here. LDL size can be greater than 21 nanomoles or nanometers, HDL size should be greater than 9 millimole per liter. VLDL should be less than 0.1 nanomole per liter. This is what you want to look for if you get a full NMR panel. It's actually telling you your particle health.
Now, the other thing is an omega-3 index to go hand-in-hand with this, which actually measures the EPA and the DHA in your red blood cell membrane. It's an index. You can see the example here. If you have 64 fatty acids in the cell membrane and three of those fatty acids are comprised of EPA and DHA, you would have omega index of 4.6. That's how that calculation would go. Now, an index of 8% or higher is ideal. You want your index to be higher when it comes to your omega-3 index, the amount of EPA and DHA in your cells. Most people are testing, especially in America, somewhere between about 4 and 6%, indicating in many cases they would be from a dietary standpoint consuming too many omega-6 fatty acids from vegetable oil seeds, nuts, nut butters, essential oils, et cetera. Too little omega 3 is from a more Mediterranean, olive oil, avocado, olives, fatty fish, small fish like mackerel, anchovies, sardines. It's generally what you see. Vegetable oils are also a big, big issue when it comes to lowering your omega-3 index. The highest risk zone, being a 4% or below, has actually correlated to a 90% risk of sudden cardiac death. There's a reason I'm recommending these specific lab parameters that I'm recommending to you, because these are the things that are very important when it comes to health span and life span.
Omega 3 index, you can also look at what's called your stearic acid to oleic acid ratio. That's the ratio of saturated to unsaturated fats in your cells. This is also very important. It's indicated for non-alcoholic fatty liver. It's huge issue nowadays, prostate, gall, and gallbladder cancer, you want that to be about 0.97 to 1.02. The nice part is if you have a test like this done, you can see a few ways to get it. Omegaquant has one, Great Plains has one, Quest has one, WellnessFX has one. If you get this test done, typically the PDF results that you'll get with it, you'll get a pretty decent idea of your percentages and their reference ranges on those charts are good. Big picture is you want to look at 8% or higher for your omega-3 index.
All right. We're already at number nine, IGF-1. Do you guys know which one this is, IGF-1? Dr. Rhonda Patrick talks about this a lot, insulin-like growth factor-1. A lot of people who are in the fasting and on top of this sector talk about keeping IGF-1 low. Not eating too much dairy, not eating too much protein in red meat, especially being careful to not be in a constant state of growth activation, not on a constant state of anabolism but using things like feast fast cycling, certain times of the year or certain times of the week when you're moderating or restricting your protein intake, not having red meat every day, not consuming dairy every day, unless you're trying to grow up into a big high school football player, you're trying to take a little kid and get them up to get them fat and big. These are things that work for anabolism but that directly conflict with any method that you want to use to increase longevity. You want a sweet spot of IGF-1, in my opinion.
Many people in our industry say keep IGF-1 low. Well, I don't know about you, but if I'm not weightlifting and I'm not eating red meat, and all I'm doing are cold showers and sauna and walking and eating vegetables, yeah, I might live to up 125. I'm going to be like old and libido less, [00:53:13] ______, I don't want to live a long time if that's what I'm going to feel the whole time. In my opinion, you should instead look at life as a series of press-pull cycle where I have certain days where you lift heavy weights and exercise hard, and you have your big ribeye steak for dinner. Then, you have certain days that are recovery day where you might say, “Okay, Sunday I'm doing meditation, prayer, maybe spending an hour in the sauna reading a spiritual book. Now, I'm going to fast from Saturday dinner to Sunday at dinner.” You've got that day where IGF levels are very low, but then Monday, you might be lifted weights and have a nice cut of salmon instead. That's the idea with IGF-1.
Now, in terms of the actual values, the approximate sweet spot, the longevity and performance, if you look at IGF-1 values on a lab test, it's between 80 and 150. That's the range that you want to look at for IGF-1 if you want to limit your risk for dying early or for getting cancer from very elevated insulin or IGF-1 levels but still feel good and be able to maintain muscle, and be able to maintain libido, body temperature, et cetera.
Number 10 is very, very similar. I could say just about the same things about insulin as I could about IGF-1. For the same reasons I just named, you want to pay attention to insulin in addition to IGF-1. Insulin is, of course, also important to pay attention to, because it is what's going to help partition nutrients that you eat or specifically things like glucose that you consume into fat or liver or into muscle, or allow those things to be stored constantly elevated in some levels. You've no doubt heard this analogy before. If you have constantly insulin circulating through bloodstream, your receptors eventually become insensitive so then it creates insulin resistance or insulin insensitivity. You want to pay attention to your insulin levels. A lot of times, a normal blood test isn't showing you insulin, but you want to make sure you get that tested in addition to your blood glucose. I'll talk to you about blood glucose testing later. You can't constantly measure blood glucose like you can constantly measure insulin. This weird thing on the back of my arm here, this is tracking my blood glucose 24/7. It's called the Dexcom G6. At any given point, I pick up my phone, I look at my phone, I'm getting my blood glucose values. I can see what a cup of coffee does to it. I can see what speaking on stage and in front of a bunch of groups from people who didn't get to the eggs for breakfast does do it. I can always know how blood glucose is. They don't make that for insulin, so you actually get a blood insulin evaluation.
Ideally, you want it to be below 3. Some reference range will tell you below 5. I'm a bigger fan of being below 5, international units per deciliter of insulin. Pay attention to your insulin levels as well.
I got two more I want to get into with you here. Number one is called the complete blood count. This is a pretty standard panel in the doctor row. It's called a CBC with differential. CBC with differential is basically, in a nutshell, white blood cells and your red blood cells. Why is this important? Well, your white blood cell is your immune cells, red blood cells your information carriers for things like oxygen and hemoglobin. Now, white blood cells, a consistently high white blood cell count, it's actually shocking how much of a risk there is from a high white blood cell count, and increased death at an early age, particularly from cardiovascular disease. If we're looking at things like neutrophils, eosinophils, basophils, all these things that get spat out when you get a complete blood count, if these things are constantly elevated, not only can it indicate that you've got awesome inflammation, that you have some type of infection, sometimes you'll see these things elevated with one whole mycotoxins closure, et cetera. Basically, the research shows that you will die at an earlier age if you consistently have high white blood cell counts. That's why that's an important one to pay attention to.
When it comes to very, very low white blood cell counts, a lot of times, you'll see psychological depression or depressed immune system or poor immune system being associated with that. There are records ranges for these. Like I mentioned, increased risk of mortality associated with high white blood cell counts is maintained over 40 years following from these tests. This is a pretty powerful thing to pay attention to. I've got some percentages out here before you because, typically, your white blood cell counts are recorded in terms of percentages. Neutrophils, you wanted 40 to 60%. Higher than that indicates viruses, autoimmune disease or detox issues. Lymphocytes, you want at 25 to 40%. Higher would be increased risk of illness or chronic infection. Monocytes, 0 to 7%, higher would be liver dysfunction, sometimes Epstein-Barr, or recovering from it or prostate issues. Eosinophils between 0 to 3%, higher than that sometimes indicates food sensitivities, environmental allergies or parasites. Basophils, 0 to 1%, higher than that, a lot of times, indicates histamine intolerance.
Here's an example of how you use this. Let's say your tests constantly showing high white blood cell counts, and in particular, you're noticing eosinophils are high. You haven't yet decided that you want to shovel out, say, $500 to $1,000 for something like Cyrex food allergy panel, but you've seen this on the past two blood tests that you've done. You see the eosinophils being elevated. Finally, you decide, “Okay, my white blood cell counts are showing, I probably have a pretty high risk of something that are causing the food allergy or I'm intolerant to something I'm eating. I should go out and get a food allergy test.” You could sometimes use some of these cheaper tests, like a CBC, to give you a pretty good idea of whether or not you should order a more expensive test, like food allergy evaluation. I'll get into food allergy testing today as well, by the way.
Red blood cells. You're going to see a lot of different values. Your mean corpuscular volume, your mean corpuscular hemoglobin, your mean corpuscular hemoglobin concentration, your red blood cell distribution width, your mean platelet volume, and your platelet distribution with. I don't have time today to get into every single reference range for each of those values, but what I can tell you is that some of the biggest things you want to pay attention to are your red blood cell count, low being anemia, high being a risk factor for essentially like increased blood clotting or thick blood, erythrocytosis is typically the most common. For women, 4.2 to 5.4 is the sweet spot for red blood cells. For men, 4.7 to 6.1, for children, 4.1 to around 5.5. Those are the main things you want to look at for red blood cells. Make sure–similar to CRP, you haven't done heavy exercise going into CRP test. You want to make sure going into a red blood cell evaluation or complete blood count that you're well-hydrated, because a lot of times if you're dehydrated, that can throw off values, particularly your red blood cells. It's just something to pay attention to. The complete blood count can tell you a lot as you can see.
Then, finally, this item. Iron, a lot of times, is heralded, I think, probably because of the sporting industry and the athletic industry and the prevalence of anemia and a lot of hard-charging athletes, particularly endurance athletes who have a very high red blood cell turnover. The problem is that in the production of ATP by your mitochondria, you produce what are called lipid peroxides. In many cases, this can result when they interact with iron in the production of hydrogen peroxide, which can essentially happen to rust inside your body. This is a bigger issue with men, in particular, who don't weight every month, or a man who aren't endurance athletes who aren't going through a lot of iron. It's fixable if your iron levels are constantly elevated or, in particular, some people ferritin is constantly elevated, or GGT, that's gamma-glutamyl transferase. This is an enzyme that can indicate that you have low iron turnover. If those two numbers, GGT and ferritin, are constantly elevated and iron is constantly elevated, a lot of times guys just need to give blood a couple times a year, quarterly and that fixes the issue. You do not want your iron constantly elevated, especially if you're a man. Increased risk of cancer, heart disease, diabetes, Alzheimer's, Parkinson's. The problem is that typical reference range is used by both laboratories for ferritin are 200 to 300 nanograms per milliliter for women and men. Not only is this an issue because they're giving you the same values for two different sexes, but it's also an issue because for lowering your risk of rusting your body from the inside out, you want your ideal levels for adult men and non-menstruating women to be between 30 and 60. Ideally, you don't want ferritin to be below 20 or above 80. There's a sweet spot for IGF-1 of 80 to 150, there's a sweet spot for ferritin between 20 and 80. Like I mentioned, GGT, which is also an enzyme that you can have measured on a blood panel, that can indicate excess free iron levels as well. You're a man, you want that below 16 units per liter, if you're a woman, you want that below nine units per liter. This is a big issue when it comes to heart disease. This is an issue with iron. It's becoming more and more–the awareness of the issue with it is becoming more and more, probably, I think, more doctors are going to really start paying attention to ferritin, the GGT and total iron. It's something that you need to be aware of and then you need to be looking at, especially if you're a man and you're not a menstruating woman.
Now, appropriately enough before lunch, so you can be [01:02:38] ______ with your mouth. We're going to talk about food allergies and food sensitivities and testing for these. This is another question that I get in the realm of self-quantification, how do I know if I'm allergic to something? Let's say my white blood cell counts were constantly elevated and I decided I'm going to get a food allergy test. Do I get the ELISA? Do I get the ALCAT? Well, I don't recommend any food allergy test because most of them give you a laundry list of false positives, like the 10 14.5 x 11 sheets of paper, which are all the things you're allergic to that you'll hang in your refrigerator and [01:02:57] ______ refrigerator. They're just like a lonely forlorn, like chicken breast and some broccoli because that's all you can eat now, I think. [01:03:01] ______.
The problem is that a lot of this food allergy test are not accurate. They're neglecting the test for variety of things, nor are they doing a double test for each protein to make sure it's not a false positive result. What I use is Cyrex. Some of the reasons I use Cyrex, and I'm not financially affiliated with this lab at all, it's just what I use for myself and all my clients. It's the gold standard for food allergy testing. They've got 22 different arrays of Cyrex. For example, the gold standard I use is their Array 10C. All of the arrays are given different numbers. Array 10C tests for gluten cross-reactivity and crude reaction to about 180 different antigens. They test to certain things. For example, they use the technology that tests for specific protein concentrations for each antigen. They validate each antigen individually rather than using a reference range to an entire group of different foods. They run, like I mentioned, side-by-side duplicates. They're doing two different tests of each protein.
In many cases, what you'll find is that if you eat food that's cooked above a certain temperature, the antigenicity or the allergic reaction to that protein absolutely decreases. A lot of these labs using ELISA, ALCAT, they're testing your white blood cell reaction to the uncooked version of that protein. If your results show that you're allergic to eggs, all it means is maybe you produce an immune system response to raw eggs or raw chicken, not the cooked version of that. It's very common people just do fine with cooked version, but not the raw version. They test for cross-reactivity. They'll look at certain things that cross-react with other things in human tissue, called pan antigens, like a shrimp tropomyosin or aquaporin or a lot of things you'll find in these additives to destroy sauces, condiments, dressings, et cetera. They look at reactivity to common food combinations. They'll tell you, “Well, you don't have an issue with gluten and you don't have an issue with coffee, but if you can suit coffee with the brewed, you get this cross-reactivity issue that actually does through this food allergy reaction.
They will get binding isolates, like lectins, which you probably heard about before, agglutinins. They work at some of these plant defense proteins that other companies don't look at. They look at artificial food colors. That's how your certain type of processed foods that you may or may not want to be careful with. That's why you have dishes of red, blue, yellow. With a lot of these food colorings, you probably shouldn't be eating a lot of anyways, but You might have a really great multivitamin, but they have color in their capsule, blue, and you're allergic to that, you don't even know.
Few other things. They test for oils called oleosins. They're not just testing proteins. They're testing some oils that have hidden protein in them. They're looking at transglutaminase which is actually used to break down [01:05:53] ______. Then, they're also looking at combining IgA and IgG on the same test. Essentially, these are all the reasons why I go with Cyrex for food allergy testing. I also use it for some of the bold and microtoxin testing, I'll tell you about shortly. It's a really great way to test for food allergies. If you don't know where to go for food allergy test, I recommend this one.
My only complaint about Cyrex is that you can't yet order this as a test to your elements of blood evaluation. That must be ordered by a doctor. If you have a good doctor, like a functional or integrated medical practitioner, and you tell them, “Hey, I want to get, let's say, Cyrex Array 10C, is a gold standard food allergy test,” in many cases, they'll order that test for you.
They're also lab, there's one that I work with called TrueHealthLabs, Dr. Brady Walsh or Dr. Bryan Walsh and Dr. Brady Hurst. If you call them up on the phone, they can order this test for you. Speaking of Dr. Bryan Walsh, by the way, who in here is a practitioner or medical practitioner, or has the desires of being a medical practitioner? He has a course of blood marker and lab interpretation course that is fabulous. Some of the stuff I'm teaching you right now, but I mean like a full-on deep dive in the blood measurements and evaluation of labs. This course is really great too. If you guys dig this out, you want to take a deeper dive.
Now, the cool thing is you can also use microbiome testing for food allergies. For example, some of you, you've probably done a Viome test or Onegevity. I know that these guys have a well-known podcast. They just did a podcast with the guys from Onegevity. Both of these are examples of full microbiome evaluations of the gut. The cool thing is that certain metabolites produced by the bacteria in your gut can also reflect your propensity to certain food allergies. I'll give you some example. If you have decreased lactobacilli and increase Staphylococcus aureus, that's associated with egg and milk allergies. If you have a full microbiome analysis–how many of you in here have biome results or Onegevity results back home or on your computer? Mike, you've done a full microbiome yet? You can learn a lot of cool things. Sometimes, they'll test your microbiome and say, “Well, you're deficient in such and such, a probiotic. Therefore, you ought to take this probiotic to maintain health.” There's not a lot of research behind that stuff, but what you can look at are some of the things I'm showing you right now. You can get some interesting data about inflammation, food allergies, food sensitivity, decreased levels of L. rhamnosus, L. casei, L. paracasei, and Bifidobacterium, those are all accompanied by allergies from cows' milk and egg whites. You can have reduced Bacteroides, proteobacteria, and actinobacteria, those are associated with general food allergies and sensitivities. In many cases, you don't have autoimmune reaction like IgA, IgE reaction to a food. There are many cases, it can be your biome, like a bacterial imbalance that's affecting your propensity to produce certain histamines and have certain issues in response to certain foods.
A lack of microbiome diversity results [01:08:57] ______ it just says you have a low amount of bacterial diversity, that can increase your propensity to gluten with all that and histamine production. There are certain species of bacteria that actually can help you with your production of polypeptides that break down gluten. If you are deficient in those bacteria, sometimes you're not gluten tolerant, you're bacterial deficient. By replacing or paying attention to these elements of your microbiome, you can fix these issues. You can get back to eating bread, for example, or things with glutenin. Bacteria will grow from the small intestine. That's when there's an overall deficit of good bacteria in your gut. That's another thing that you pay attention to, your risk for something called small intestine bacterial overgrowth, or SIBO. Then, histamine intolerance. Let's say you get a headache if you have a glass of red wine or some kombucha or some fermented food, this can also be aggravated by an overgrowth of histamine producing bacteria.
When you look at the results from a microbiome test like Viome or Onegevity, these are home tests. It's just a very small swab of your stool. Don't be proud of yourself. I have some clients who are so proud that they have managed to shovel a whole heaping teaspoon of stool into the tube, and that messes up the results. Pay attention to the instructions when you hover over the toilet doing your microbiome analysis. Get some very, very good data from your stool that doesn't just indicate a three-day stool panel. I'll talk about three-day stool panel in just a second here. We'll come back to that because that will test for different things like yeast or fungus, the microbiome tests you we're looking at the absence or presence of certain bacteria, the bacterial diversity in some amount of inflammatory markers. That's another one that I recommend that you get.
Mold toxicity. Anybody, if you're familiar with the growing prevalence of mold issue in homes, mold and mycotoxins exposure in food, fungus, et cetera? A lot of these can cause issues with food allergies. They're brought up by mold and microtoxin exposure. You essentially develop a hyperactive immune system in things that you weren't allergic to or sensitive to prior to that exposure. You become allergic or insensitive to. Companies like Quest Diagnostics or LabCorp, they can measure the following c4a, TGF-beta-1, MSH, VIP, VEGF, and MMP9. Now, I realize there's a lot of acronyms and I practically get into all them long weapons. All of these can actually indicate that your body has been exposed to mold or microtoxins that you might have some amount of molds present. It's a huge issue. One of the best books that I can recommend to you that I think you could probably get through, even if you're not medical practitioner, it's a relatively new book by Dr. Neil Nathan called, “Toxic.” It's a great walkthrough of the issue with mold or microtoxins. The multi-modal approach that's necessary to get rid of bio fill and to fix the issue for good. It comes down to a lot more than just say take an oil or oregano and a full speck of probiotic or something like that. These are serious issues that I think some [01:11:43]. ______.
Anyways, though, Cyrex, like I mentioned, they can do a mold and a microtoxin panel as well. They're Array 11 and Array 12. If you just want to get mold-microtoxins and food allergies all done, I want you to get Array 10C, which is all your cross-reactivity, your antigen production to over 100 many different foods. Then, you can get Array 11 and Array 12 to look at all these different things, like MSA, GPIP, and BGF, and you get a really good picture or whether or not you have mold or microtoxin issues. I'm not flabbergasted or surprised, rather, by the number of people like test who have some amount of mold and microtoxin issues that can, and should be, addressed.
Micronutrients. Most blood panels are going to tell you things like vitamin D or, say, in many cases, RBC magnesium. Vitamin E, vitamin A, sometimes, vitamin B, you'll usually get B12 and some of these other major vitamins covered. In many cases, if you have low energy levels or sleep, chronic fatigue, gas, bloating, or nutrient absorption, you need what's called a micronutrient evaluation. This is also known more popularly as organic amino acids evaluation. It tells you a lot about your body.
When I have a client run this, I'm getting a 20-page report of all the different amino acids, all the different fatty acids, all the different markers of fungus of yeast. You can find out a lot about mitochondrial function, gut function, and overall physiology function with a micronutrient analysis. Just think of this as taking an even deeper dive. I don't have everybody do this test, but for people who I coach, who just want to hear the best of the best about everything about their bodies, or for people who I've seen issues with but I just can't figure out, a lot of times I advise them that they should look into getting a micronutrient panel. You can see some things and look at a full vitamin B complex, all your folic acid, vitamin A, E, and D, beta-carotene, coenzyme Q10, big one for the mitochondria, or your amino acids, all your fatty acids, all your organic acids, elements for inflammation oxidation like lipid peroxides and homocysteine, these are markers that go above and beyond just the hsCRP that I talked about, and then, compounds with yeast and fungal origins. You can find out a lot from one of these analyses.
The one that I use is called the Metametrix ION panel with 40 amino acids. I know that's a mouthful. I'll put a link to that one in the resources page for this presentation if you go to, let's say, bengreenfieldfitness.com/KentuckyCastle19. That's a good test to get. They're more expensive. These tests sometimes go in excess of $1,000. Because they're so niched, a lot of times are covered by insurance, but you can learn a ton about your body. Even if you just do something like this once every few years just to make sure there are no lacking micronutrients issues. There's a lot that you can start with these micronutrient evals.
Gut. I talked about microbiome. What a microbiome test will not look for is the presence of things like yeast, fungus, bacteria, parasites. There's a lot of people who have gut issues who literally have unwanted parasitic critters living in their gut. I'm not necessarily a fan of the idea that all parasites are bad. Many of them are not opportunistic. I mean, I've done intake therapy with the tapeworms and whipworms and use some of those to modulate my immune system, particularly when I travel. In many cases, if you want to look at stuff like C. difficile or H. pylori or some of these other things that can really affect your gut function and mood and sleep. You need to get a stool panel that's not one of these full microbiome analyses, but that's one of these panels where you're literally whooping into the equivalent of a hot dog tray for three days in a row, collecting your stool, and sending it off to a lab. You've got a couple of weeks; you get a PDF into your email inbox that tells you that your shit stinks. I'm kidding. That you have issues going on in your gut. In many cases, this can tell you everything from inflammation, undigested food particles, presence of metabolites associated with leaky gut. There's a lot of stuff that this test can tell you. The one that you can see here at the top of this is called a GI Effects Comprehensive Stool Panel. I'm a bigger fan, even though it's more expensive of the three-day versus the one-day because your stool will change from day to day. This is what I'll ask you to think about, but a parasite is shedding. A lot of times, if you're just getting one glance on one day, it's not even just full picture versus if you spread out eval for three days. That's what I like for the gut.
Then, we have the genes. Like I mentioned, Mike did a pretty good job giving you guys a very good overview of the genes. Did you guys record that, by the way, Matt? That'll be available if someone is listening and are not in the room. That's also something that's probably going to be available in Wild Health podcast if you listen in to.
As far as genes go, a few of the things that I think are the cool lower hanging fruit, even though there's tons of stuff you can dig into. For example, carbohydrate fat sensitivity, detoxification ability, antioxidant capacity, muscle fiber composition is a very interesting one. The idea that certain people have higher amounts of fast-twitch muscle fiber, certain amounts people have higher amounts of slow-twitch muscle fiber, some people are power responders versus endurance responders. Dr. Andy Galpin, I forget which university he's at, but he's doing a lot of things with muscle biopsies and figuring out your slow-twitch, fast-twitch muscle fiber capacity. He works with pro athletes and then completely changing their set breath, loading, velocity, speeds, just based on their muscle fiber composition. If you don't want to go into a painful needle biopsy, you can at least get a decent glimpse into this with a basic genetic analysis. You could see whether or not your neurotransmitter production, or COMT genes, are affecting your dopamine, your serotonin metabolism, whether you're a warrior versus a warrior-type of gene. How you look at your ancestor. There are wonderful books out there like “100 Million Years of Food” by Dr. Stephen Le, or “The Jungle Effect” by Dr. Daphne Miller, or “Returning to an Ancestral Diet” by Dr. Michael Smith. These books help you look at, okay, that I come from South Saharan ancestry, Southeast Asian ancestry, Northern European ancestry, what my ancestors eat and how can I structure my diet accordingly, based on my epigenetic expression what foods I'm actually able to digest and do best with because this is what my ancestors ate. There's a lot to be said for just looking at ancestry, just so you can look at the food and the activity and the lifestyle habits of your ancestors.
We could spend, as Mike and Matt know, hours and hours talking about genes. They have done that. Few of the companies that are using, and my apologies that I just had a tour of the [01:18:54] ______ Wild Health, folks this one if you can look at your genes, but you get tested DNAfit is a very basic analysis that just gives you a general nutrition and fitness overview of your genetics. Most of you are salivary now, I suggest you do a salivary swab, you send it in to these folks. 23andMe, of course, can test for a limited number of single nucleotide polymorphisms, or what are called snips. They can still give you a basic idea. You can also go to the website 23andYou.com. 23andYou.com has a whole list of different websites you can upload your raw genetic data results to take an even deeper dive. Just this morning, I had some 23andMe raw results coming from one of my clients. I just want to do a quick eval for him. I uploaded those results to a software called Promethease, which lets me take a deeper dive into the health data that 23andMe won't release. Yes, I'm working with a limited number of snips, but it still gives me a decent idea of some things like potential for diabetes, celiac disease, et cetera.
StrateGene. Dr. Ben Lynch, the author of the excellent book, “Dirty Genes.” He looks at nine different genetic pathways that are like the lowest hanging fruit, nitric oxide, synthase pathways, and myosin and glutathione pathways, sulfuration pathways, and gives you a pretty good report that you can read through on your own that indicates the biggest dirty genes that your raw genetic data is indicating that you have more or less of a susceptibility to. Genetic Genie is a great website. Another couple of companies I've worked with before is Dr. Bob Miller. He's got Tree of Life. They do a certain type of analyses as well. Probably, similar to what these guys at Wild Health are using. Then, The DNA Company up in Canada. They also do a pretty good analysis as well.
When I say a pretty good analysis, what I'm saying is they're taking your raw genetic data and they're developing a very specific list of exercise, diet, supplementation and lifestyle recommendations based on your genetics. I mean, things as simple as, My son's back there, [01:20:44] ______ the table. He has lower levels of superoxide dismutase and glutathione production capability based on his genetics before school in the morning. It takes a little bit of good glutathione. Both of them have the genes responsible for lower levels of brain-derived neurotropic factor, BDNF. They do things like they go to sauna sometimes; they take lion's bean extract before school. I had firstly the same gene. I spent a lot of times doing aerobic walking in the sunshine. There are specific lifestyle parameters you can change, based on what your genes are telling you. Those are just two examples. There are many more that I can get into. Of course, the most important is you've already learned earlier today, is coffee. [01:21:16] ______. I'm lucky. I'm the best at caffeine oxidizer, so I can pretty much have coffee when I want.
Couple of others I want to go through. Blood glucose. I mentioned that I wear this Dexcom G6 on the back of my arm. Main thing. Number one thing I look at with blood glucose is that fasted values to generally be below 90. Some people are eating a low carb, very low carb diet. They tend to have slightly lower amounts of insulin sensitivity, just because they're not producing as much and they don't need as much. I don't get as worried if I see someone on a low carb diet with values between about 90 and 100 for their fasting values. General population, I like to see it between about 80 and 90, but more importantly what you want to pay attention to is your postprandial blood glucose. The number that I look for is if it's two hours after a meal, my levels are less than 120. A lot of doctors will tell you 140. I think that's too high. After a meal, whether you're testing your blood glucose with a finger prick, or whether you're wearing a continuous blood glucose monitor, which if you approach your doctor and you tell them you're concerned about your risk of type-2 diabetes, a lot of times you can get a prescription for, a lot of times you can get that covered by insurance and just send your blood glucose constantly to your phone to check in on it anytime. Healthy fasting blood sugar, like I mentioned, 70 to 99. Dexcom G6 is the one that I'm aware of. I was having a conversation with somebody about this a few minutes ago during the break, the nice thing I like about the Dexcom is it's also low EMF, for those of you concerned about that I constantly having a Bluetooth signal or a Wi-Fi signal on your body. It's tests low for EMF and it gives you a constant data. The number one thing you look for is 70 to 99 through fasting glucose. Especially, within two hours after meal, as my blood glucose dropped below 120.
Ketones are another thing I get a lot of questions about. This is something that I measure. I have a breath ketone monitor in my office. There are also companies now like Keto-Mojo that are coming out with very cheap, less than a dollar versus $4 a strip. Cheap ways to test your blood ketones. A lot of times, people will test via urine. The problem is if you're following a low carbohydrate diet, or if you're trying to get in ketosis, the more and more efficient that you do at utilizing ketones, the less and less of this thing called acetoacetate is going to wind up in your urine. You'll see less ketones even though your ketones are just fine. Urine isn't a good measurement. Breath, that's pretty good. They've done a lot of correlative studies that have found that the levels of ketones in your breath, the levels of acetate in your breath, correlate pretty well with the levels of beta-hydroxybutyrate in your bloodstream. Doing a simple breath measurement allows you to not have to test your blood on a frequent basis. It also allows you to get a decent idea whether or not you're in ketosis. There are companies like Ketonix, Keyto (that's K-E-Y-T-O), and also LEVL. Actually, I have all three of those. I just get random sheets at my house all the time. They can all give you a decent idea of your breath acetone levels and tell you whether or not in a red light, green light, yellow light, if you're in here or out of ketosis.
Gold standard, like I mentioned is blood. If you really truly want to maintain the state of ketosis, which would indicate that your brain, your liver, your heart, your diaphragm, hitting a very stable slow burning fuel available to them that's also very good for anti-inflammation stimulates a lot of what we're getting in a fasted state, increased cellular autophagy. There's a lot of reasons that having a high amount of ketone to being good. Utilizing ketones is a good idea. Blood is the gold standard for that. You can simply do a blood measurement when you get up in the morning and before you go to bed at night, get a decent idea of your ketones. Ideally, for true metabolic efficiency, ketones between 0.5 and 3, blood glucose between 70 and 99. You can measure those two values. You're in on a lot.
HRV and readiness. This is what you want to pay attention to if you have some type of device that can quantify your blood. I use an Oura Ring. A lot of people use a wristband called WHOOP. The problem with the average–Fitbit, for example, or Jawbone, is they don't actually dig into your nervous system. They don't tell you what it's for, your heart rate variability. What this allows me to do is know any given point throughout the day how stressed my body is, how prepared my body is to train, how good of a job my sympathetic and my parasympathetic nervous system are doing, being coordinated, how tone my vagus nerve is, and how well that's [01:26:09] ______ the sinoatrial nerve of my heart, meeting cardiovascular function. There's a lot that you can learn from HRV and readiness. These are all the different values that something like an Oura Ring uses to calculate my readiness score. How good was my sleep the night before? How balanced has my sleep been over the past week? How much activity did I do the day prior? What was the activity balance of that activity based off my activity on other days? What's my body temperature, which is very important. A lot of times your readiness would be low when you wake up in the morning because you've had meat sweats all night and the room was too cold. Resting heart rate, and especially your recovery index, which is how good a job your heart rate is doing recovering and dropping low after exercise. Then, finally, heart rate variability, which is a measurement of the difference in time between each beat of your heart, which indicates a good interplay between your sympathetic and your parasympathetic nervous system.
These are all eight factors that go in calculating a morning HRV or readiness score. You could look at all these individually. One of the reasons I wear the Oura Ring is because you just wake up in the morning and I can dig in each of these numbers individually if I want to, but it can also just say your readiness score. My readiness score today was at about 80. Not super high, but my sleep score was really high. I got a great sleep last night, but it was so high because I took 26,000 steps yesterday. It looked at my step count and said, “Okay, you have a very high. This proportion in high amount of activity yesterday. You had good sleep but you should be careful about exercising too much, which is why I'm not wearing my weighted vest right now and my backpack with the kettlebells in it. It's the only reason. You should wear that on stage. You get a really good idea of how your body's doing each day.
The other thing is sleep. Sleep can also be measured. These are the parameters that I look at with sleep. Again, I use the Oura Ring to do this. Total sleep, sleep efficiency, meaning a lot of times you could be lying in bed for nine hours but it you get six and a half hours of sleep. That's poor sleep deficiency. Sleep disturbances, how many times you wake up during the night. REM sleep, which is where a lot of our memory consolidation and learning is going to occur. Then, deep sleep which is where a lot of nervous system muscular repair recovery's going to occur. We want accurate levels of both. Sleep latency, which is how long it takes you to fall asleep. If your head hit the pillow and your sleeping 3 minutes, your sleep latency score is going to be great. If you lay awake with racing thoughts and it takes 37 minutes, your sleep latencies going to be poor. Then, sleep timing. How's your sleep architecture base in your circadian rhythm? Are you going to bed at 9:30 and getting up at, say, 5:30 on a regular basis? Or, you're 11:00 one night, 9:00 another night, 1:00 am another night. That would indicate poor sleep balance and poor sleep timing. There's a lot of things to pay attention to that go beyond just, “was I in bed for eight hours tonight? Do I wake up and I'm not sore tonight?” These are all ways that we can quantify our body. It's easier and easier to do now in this day and age. I really don't think there's any reason that you shouldn't be quantifying things like sleep and HRV.
All right. I've got two more slides to show you here. We're on the home stretch. The first is telomeres. A lot of people want to know if we can actually measure the telomeres, the end caps on your DNA to figure out whether or not your telomeres are shortening at too rapid pace. Generally, you have adequate levels of telomerase enzyme in your body that regulates telomere length. Your telomeres are shortening at not too rapid of a pace. This would indicate that attempts you're making to increase your health span or, more specifically, your life span, your longevity, are actually paying off.
Now, telomere testing is a little bit of the wild wild west right now. A lot of times, they're just testing, for example, the telomeres on your white blood cells on single drop of blood. You tend to get results from different labs that come back tell you of different telomere lengths. For a long time, I was pretty odd at using TeloYears, but I recently interviewed Dr. Billy Andrews, excellent podcasts on all the different things that can help keep your telomeres long. Go listen to my podcast with Dr. Billy Andrews if you haven't yet. He likes repeat diagnostics and life length as the top two ways to measure your telomeres. You should be doing on a yearly basis to find out what your biological age is, compared to your chronological age. Maybe you're chronologically 60, but biologically you're telling your telomere tells you're 49. Or you should be chronologically 30 and your biological age and I see this 60, 70, because you have rampant inflammation, glucose, all these elements that are increasing the rate of with your telomere short. You can actually test this.
Then, finally, there's a company called the Cyber Screen. They're not testing your telomere length. What they actually look at is, on a frequent basis, you send in a test of that and it looks at epigenetic changes of your DNA expression over time. That's also a cool metric that you can use. It's very similar to telomere analysis, to track your age and how fast you're aging, or [01:30:59] _______.
Then, finally, how the heck do you keep track of all this stuff? Do you just have a folder on your computer where you're storing all your lab results, or are there websites where you can upload all these results to one single platform to be able to look at them? Well, there are a few different ways to go about doing this. The company HeadsUpHealth is pretty good. That's an online software. I believe they have an app too. You can upload all your lab results, keep track of things like your Apple Health app, et cetera. Just put it all onto something like HeadsUpHealth, it'll keep track of a lot of that for you.
HumanOS, they are a company that do a lot of good health education. They're in the process of building out metric tracking, lab tracking, self-quantification tracking into their system as well. Maybe, if you can just subscribe to their newsletter and how to find out when that stuff becomes available on their site. WellnessFX, that's the platform that I've used for a very long time to upload all my lab data or to get tested. They have it all here in one single spot, all my blood biomarkers, et cetera.
Onegevity is like the up and coming new replacement for WellnessFX. You can go listen to the podcast with Onegevity or my podcast on Onegevity. You can basically learn how they're allowing you to take your gut microbiome, your salivary information, your blood information, et cetera and have that all exist on one platform, rather than have you having all this disparate info spread all over the place.
Training Peaks is another one. That's what I use to track a lot of the exercise and a lot of the recovery metrics for the clients that I coach. Then, finally, Dropbox. You can literally have just a single Dropbox folder. The cool thing is, and I'll tell you exactly what I use. All my lab results from any company go directly into a Dropbox folder. I can then upload those to a Onegevity platform or a WellnessFX platform. Then, my Oura Ring data, my sleep in my HRV and my food data, that just goes straight into my phone on an app. When I'm coaching client, it's very simple. I have access to their Training Peaks. All their work out and their exercise information. I have access to their Oura Ring, so I've got access to all their sleeping nature and information. They take out, they have a private Instagram account. They share their food logs would me every single day. Then, I keep all of their lab information on Dropbox. That allows me to just have everything. There are a few different spots. I keep track of blood biomarkers on Dropbox, HRV and sleep on the Oura Ring data, food on Instagram, and exercise on Training Peaks. I can juggle four different things. I juggle to the same approach that I use it myself.
Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.
I recently had the pleasure to speak at the fabulous and intriguing “Kentucky Castle,” a unique destination hotspot with a full biohacking facility, sauna, farm-to-table restaurant, precision medicine arm, hemp farm, horse facilities, and much more. The castle is owned by one of the physicians who hosts the “Wild Health” podcast, on which I was recently a guest.
This is part one of a two-part series that addresses the oft-confusing world of “taking your health into your own hands” via genetic testing, blood and biomarker tracking, sleep measurements and other forms of self-quantification. In part two, you'll get to sit in on a very interesting post-talk Q&A with myself and several of the physicians in attendance at the conference. Enjoy!
**Editor's Note: Forgive the extraneous background noises. All effort was made to ensure the clearest possible sound in spite of it :)
In this episode, you'll discover…
-My history as a bodybuilder, triathlete and his transition to his current message…9:00
- Bodybuilding is a bit of a biohacking sport
- I began to take lab tests and was shocked at the results
- Pre-type 2 diabetes; inflammation
- Healthy on the outside but dying on the inside
- Inspired his first book Beyond Training
- Doesn't work primarily with athletes anymore; mainly people who want to feel good and live a long time
-Some guidelines when examining your lab results…16:15
- Lab results indicate an absence of disease, not necessarily one's potential for health and longevity
The 11 Blood Biomarkers
-RBC (red blood cell) Magnesium…26:10
- Insulin sensitivity, physical performance
- Different from extracellular magnesium
- Intracellular Diagnostics
- Jigsaw Health
- Men need to be concerned with estrogen, not just women
- Dutch Test
- Women should be concerned, not just men
- Hormones can be bound up by proteins
- You want 2% of your testosterone to be free
-High Sensitivity C-Reactive Protein (hsCRP)…40:22
- Link between inflammation and heart attack risk
- Numbers will vary depending on your workout regimen
-Triglyceride HGL Ratio…43:25
- Is more important in determining your risk for C/V disease than total cholesterol or LDL cholesterol
- HGL to total cholesterol level: lower is better
-Full lipid panel, and an Omega 3 index…48:15
- Tells you the size of your cholesterol particles
- You want the particles to be “large and fluffy”; count should be low
- You want the Omega 3 index to be higher
- Highest risk zone (4% and below) = 90% chance of C/V disease
-Insulin-like growth factor (IGF-1)…52:10
- Good for getting bulked up; not so much for longevity
- View life as a set of press/pull cycles
- You want to live long and live an enjoyable life too
- Work hard, eat red meat one day; fast and yoga the next
- Sweet spot: 80-150
- Lipid peroxides result when interacting with iron in the production of hydrogen peroxide (rust effect in the body)
- High iron levels contribute to a number of diseases and conditions
-Food allergies and sensitivities…1:02:41
- My big beef with food allergy tests; you get a bunch of false positives
- No double tests for each protein
- Cyrex Array 10 C: My gold standard food allergy test
- Must be ordered by a doctor
- Mold toxins
- See Cyrex Array 10 C above
- Micronutrient analysis
- Microbiome test won't track parasites
- GI Effects comprehensive stool panel
-And much more…
Resources from this episode:
-Book: Biochemical Individuality by Roger Williams
-Book: Beyond Training
–Cyrex Array 10 C
–GI Effects comprehensive stool panel
-Book: 100 Million Years of Food by Dr. Stephen Le
-Book: Dirty Genes by Dr. Ben Lynch
–Kion: My personal playground for new supplement formulations. Ben Greenfield Fitness listeners receive a 10% discount off your entire order when you use discount code: BGF10.
–Organifi Gold: A new take on an ancient secret: Pain-soothing herbs, incredible antioxidants, and phytonutrients all in one delicious, soothing “Golden Milk” nighttime tea! Receive a 20% discount on your entire order when you use discount code: BENG20.
–WHOOP: The performance tool that is changing the way people track their fitness and optimize their training. Save $30 off your order when you use discount code: GREENFIELD