October 6, 2018
IMPORTANT: Please scroll to the bottom of this episode for an important addendum to this podcast.
[0:06:00] Meeting Dr. Karim Dhanani
[0:10:16] Hearing About Biological Medicine from Dr. Karim
[0:12:03] Bioregulatory Medicine and Biological Medicine
[0:15:00] Dr. Fritz-Albert Popp’s Biophotons
[0:21:00] Paracelsus Clinic in Switzerland
[0:22:47] MORA machine
[0:26:28] Dr. Karim's Favorite: Weber Laser Device
[0:29:53] Personalized Genomics and the 23andMe Test
[0:34:30] Copy-number Variance
[0:38:44] Executive Function Genes
[0:41:06] SNP Testing + CNVs + Indels
[0:45:00] Customized Supplementation from Test Results
[0:49:00] Getting into My Results: Vitamin D Issues
[0:53:44] Getting into My Results: About Low-level Gluthathione
[1:07:46] Getting into My Results: Endothelial Function and Blood Sugar
[1:23:08] Getting into My Results: Vascular Health Monitoring
[1:26:08] Getting into My Results: Neural Function and the Brain
[1:47:12] If I Were Your Patient
[1:57:48] Discounted Consultation with Dr. Karim Dhanani
[2:00:42] End of Podcast
Ben: Hey folks, it's Ben Greenfield here. I guess it was about three months ago that I hunched over my kitchen table along with my twin 10-year-old boys. I dripped a bunch of saliva into a tube, which I've done before for genetic testing, but this was for something different, some newfangled genetic test that a doc who I met down in Miami convinced me to take. So, I decided to take him up on the offer, dripped the saliva into my tube, taught my boys how to get the saliva flowing by–our trick is sniffing a jar of peanut butter. That seemed to do the trick. And we got the saliva dripping, we sent off our saliva to this lab in Canada for more advanced form of genetic testing. Then what you have probably been exposed to or read about or ever heard about, and frankly, I was blown away by what I learned from my report and also what I learned from the physician who oversaw that entire procedure for me and my boys. And in today's podcast, we're going to take a deep dive into genetic testing, the real truth about genetic testing, why tests such as 23andMe might not be enough and how you can actually personalize your diet, your supplement regimen, your lifestyle, your exercise, everything based on your unique genetic profile.
My guest is Dr. Karim Dhanani, who I had the pleasure of meeting. Well, Karim, do you remember where we met, actually? It’s kind of funny story.
Karim: Yeah, it was great. We met in Miami at the Carillon, at a wonderful retreat health and fitness spot. Yeah, I loved it there. And I tried to make sure I get out there at least once a year for about a month, partially to run away from the winter here in Toronto but mostly to get into some sunshine and to be with very, very much like-minded individuals.
Ben: Yeah, the Carillon Resort in Miami. It's kind of like the Canyon Ranch on the East Coast, and you and I had a personal trainer there and wound up doing like this crazy mash of–what was it? Was it like a mash up of rock climbing and rowing and these kinesis machines.
Karim: And lifting, yes.
Ben: Yeah. Our friend–
Karim: Most of the time, I ended up on the ground. You killed it though. You did pass the job.
Ben: It was right up my alley. It was hybrid strength and endurance training overseen by our friend. Shout out to our friend, Adam, personal trainer down there at the Carillon Resort in Miami. But anyways, as we were training in between during our rest periods, we had a chance to catch up a little bit and I learned that you are really big in the world of what's called biological medicine, which really was not part of my vernacular at that point. But, based on some books that I've read recently, that I’ll tell folks about as we go through the show today, is something that I find extremely interesting.
You're the chief medical director at Toronto's Center for Biological Medicine. And for those of you who are not familiar with biological medicine, you're going to be by the end of this show. And his clinic, Dr. Dhanani’s clinic, which I haven't been to yet is supposed to be pretty cool like this ecologically sound specially designed facility set up in some pristine Canadian woodland somewhere, but it's this global Mecca for a lot of people who really want to optimize their health. They actually travel to see Dr. Dhanani, from all over the world to get their lives and their health set straight.
So, we're going to talk a little bit more about biological medicine and Dr. Dhanani's history and then during today's show, also, we will be covering DNA testing results. I will link to my results should you like to view them or download them for yourself to follow along or to look at after today's show. And I'm going to put everything over at bengreenfieldfitness.com/genetictesting. That's bengreenfieldfitness.com/genetictesting. That's where you can find the shownotes and access pretty much every book, every website, anything that we talk about today.
So, Dr. Dhanani, first of all, welcome to the show.
Karim: Thank you.
Ben: And second, I want to hear a little bit more about biological medicine, all these trips that you take to Germany to take a deep dive into what they're doing over in Europe specifically when it comes to biological medicine and how you came to do what you do now in the realm of genomics.
Karim: Well, thank you so much for the opportunity, of course, Ben. I appreciate it. I got to say that I'm fairly lucky, I’m fairly fortunate. I had the ability and the capacity. Once I graduated Naturopathic medicine, I had to spend some time with some brilliant people in the world of biological medicine, and essentially, biological medicine is as a framework that encompasses utilizing natural supplementation, but also, the most cutting-edge technology to be able to differentiate with patients what is truly at the root cause. And we always, for the most part, a lot of people tend to say that the root cause is because of a pain syndrome or because of a lack of a biochemical reaction but we really truly want to get at the deepest, deepest, deepest layer of this. In order for us to be able to do that, we have to use wonderful diagnostic tools coupled with innovative thought processes. It's not just looking for what is within the box. It's always looking at what's outside the box that's influencing what's within the box.
Ben: Now, is biological medicine similar to what's called bioregulatory medicine? Because I just read this book and I’ll link too in the shownotes. I even talked about it on the recent weekly round-up. It's called “Bioregulatory Medicine, An Innovative Holistic Approach To Self-Healing.” And that book, I don't know if you've heard of it, it goes into the neurological system, in the respiratory system and the endocrine system and kind of does the same thing. It talks about discovering the root cause of disease and then delivers all these different non-toxic diagnostics and treatments from around the world that people can use to detox and to improve their oral health, which apparently has a pretty significant role in biological medicine, mind-body medicine. Amazing book! But is that the same thing, bioregulatory medicine and biological medicine?
Karim: Yeah. It's extremely similar. It's just using different vernacular. It is again looking at the body's resonance, the body's capacity to be able to want to heal. I often use this very simple example. If I walk up to you and I punch you really hard, my expectation is that you're supposed to do something in response to me. You either punch me back or you run away. Well, if you don't do anything, then the body has some kind of a dysregulation. There's a lack of communication with what's happening within the body. What if I go and I punched you a second time and again, you don't do anything. Then there's something that is rigid within your system. Something is not only broken with regards to the communication but your response to that punch is also challenged. Well, if I then do something a third time, then your body is completely blocked. Meaning, no matter what I do to your system, there is a lack of communication, there's a lack of regulation and there's a lack of function happening within your system.
So, in order for us to determine what stage, what level you are at, we need to do these noninvasive energy type testing, genetic type testing and looking at your blood under a microscope, checking your saliva, checking your blood, checking your urine to be able to determine what stage you are at. So, if I throw a supplement at you and you are blocked, your body is not going to accept the supplement. If I provide your body with a mechanism that is in line with how your system will receive that information, then we are now speaking the same language. It's really interesting when we talk about how cells communicate with each other. We had believed and we often still do believe that we speak via biochemistry. That a white blood cell chases after bacteria because there is a chemical that is released by that bacteria.
Ben: Right, either an antigen or like–we talked about exosomes now as these little vesicles that get released or even free radicals now are considered to be signaling molecules.
Karim: Yes, absolutely. And so now when we look at this sort of conceptual framework, we say, well there is something called a chemotaxins. A chemical is released by these bacteria and the white blood cell then recognizes it and chases after it. What we have seen with Dr. Fritz-Albert Popp’s work who is an absolute genius in this field, he coined the term biophotons in 1976, how cells communicate. There actually is a different resonance. There's a different frequency that is released by that bacterium that is recognized by the white blood cell. So, if that bacterium turns the corner and makes a left-hand turn, the white blood cell doesn't follow behind it. It actually cuts the corner to wall off that bacteria faster than if we were chasing behind it, because bacteria are much, much faster than white blood cells. So, it’s actually quite interesting that the bacteria will send off the chemical. We used to believe that this was how the system works but it's actually not true. It is now an energetic field that is released or mitigates from that bacterium. That's what signals the white blood cells to go after it.
Ben: And when it comes to the biophotonics signaling of cells, what was the name of the guy you just mentioned?
Karim: Dr. Fritz-Albert Popp, P-O-P-P. Absolutely genius when it comes to the world of biological medicine and how cells communicate with each other. It was amazing. I've been going to Germany at least once, sometimes twice a year for the last, oh gosh, 18, 19 years. And it was about 10 maybe, 11 years ago where we had the opportunity for Dr. Popp to lecture to us. It's a group of English-speaking docs from around the world and we travel up to Germany once year for the oldest, largest, most prestigious medical congress in the world. It's called Biological Medicine Week and it’s held in Baden-Baden in Germany the last week in October, the first week in November. And it's my Mecca. It's where I go every year.
Ben: What's it called again?
Karim: It's called Biological Medicine Week.
Karim: And it’s held in Baden-Baden in Germany.
Ben: Okay. I'll hunt it down and link into the shownotes. It sounds fascinating.
Karim: It's absolutely outstanding. Brilliant people from around the world, they get together and they talk about outside the box approaches of healing patients and because truthfully, if I see patients for pain syndromes, they’re in my office because Tylenol did not work for them. If Tylenol worked for them, I wouldn't have any pain patients, but because it doesn't work for them, because there is a biological byproduct that causes inflammation in their system or it just doesn't have the analgesic effect that we wanted to have, that's the reason why they come into my office. So, my job is to figure out a different way of mitigating symptoms for my patients, and I learned the vast amount of information at this Biological Medicine Week.
And so of course Fritz-Albert Popps, he walks into this auditorium, there’s about 20 of us English speaking doctors and we're sitting there and I've got two pens, I've got 19 pages all ready to start scribbling every single word that he says and he walks in a half an hour late with a cup of tea and a cookie. His shirt is hanging out. He’s got a sports jacket on and jeans and he writes–he begins his conversation with us, it's a two-hour lecture, by writing Planck's constant on the board. It's a complicated physics equation and he begins his lecture. I would say it took me about six years and several emails back and forth to his associate to get an understanding of what he was talking about. He was so physics-related and so physics-oriented. It took me by surprise. And of course, I had a prepared question for Dr. Fritz-Albert Popp. And so, my prepared question I asked him and he simply looked at me, he said, “Well, that's easy.” And he writes down a physics equation on the board, throws a chalk against the board and then walks away. He responds in physics. He is absolutely brilliant.
Karim: About three or four years ago, I was walking down outside Biological Medicine Week, outside the main auditorium and myself and a friend from Spain, we were walking down the street and we noticed Fritz-Albert Popp at about noon in a pub, in a bar right beside the Congress Hall. And so, we kind of peered in. “Is that Dr. Popp?’” We’re like a kid, schoolchildren.
Ben: He has coffee and his cookie.
Karim: Right. And so, we walked in, we thanked him for the work that he was doing and was about to leave and he said, “No. Sit with me. Let's have a chat.” His English is good. It's not outstanding but it's very good and it’s better than my German, that's for sure. And so, we sit there, we have a two-hour conversation about physics and how cells communicate with each other and how we got into the role of biophysics, how we got nominated for the Nobel Prize for looking at biophysics and how cells communicate with each other. And so, he tells myself and my friend, “Well, you guys kind of know what you're talking about. You must come to my next Congress.” And it was an Invitation Only Congress for physicists and mathematicians. He calls it “Summer School” and literally it is. A school bus picks us up, takes us–this was up in [00:19:18] ______, takes us to this auditorium where he then has the brilliant minds from around the world again come and speak to the small group of 100 people that were invited only to this lecture. People that were nominated for the Nobel Prize in physics were present. The fellow that was nominated for–oh goodness, for the theory of non-locality when you think of your best friend and the phone rings, well he proved it physics, that this occurs not by chance, not by random but strictly by physics. You put it out of there and it will take time but it will come back. It was absolutely brilliant showing that energy medicine has a larger, bigger role to play than what we call “physical medicine.”
Ben: Yeah. I mean that, in very simplistic terms, is when you look at the ability of cells to produce biophotons and to literally almost like communicate using optical light or ultraviolet light. It's one of the reasons people feel so freaking good when they get out in the sunlight and they have adequate water and minerals on-board when they do so to support that biophotonic communication. I mean it's a fascinating realm you talking about getting invited to that Congress, in this event that you go to, this conference you go to, the Baden-Baden. These are the few times that I kind of wish I was a doctor or at least a fly on the wall in some of these places because I find this stuff absolutely fascinating. I want to hear about how this eventually lead you into your foray into genomics and the type of personalized genomics we're going to talk about today, but I also wanted to ask you I am bringing a whole group of people to Europe next, next year at that time this podcast gets released next year, in June to July of 2019 to this place called the Paracelsus Clinic in Switzerland which is like this 50-year-old clinic where we're going to be undergoing a lot of these cutting-edge technologies in biological medicine. Have you heard of this place before Paracelsus?
Karim: Absolutely. Again, I’m very, very fortunate to have studied with some of the best people in the world in biological medicine. One of those people who is a grandmaster is a fellow by the name of Dr. Thomas Rao. Dr. Rao studied under, again, one of my other mentors. Dr. Conrad Vertman, who is a–I believe he practiced up until the age of 89 or 91 in Austria as a pediatrician, just brilliant and he taught Thomas Rao, and they ran this beautiful clinic called Paracelsus Clinic and he is just, like I said, a grandmaster when it comes to biological medicine. He has a variety of courses that he teaches as well both in personal and online, but he is a wonderful, wonderful kind, caring, compassionate man that has spent his lifetime teaching biological medicine and he has a very, very successful practice out there in Switzerland. I'm gone to visit him a number of times, absolutely a wonderful man.
Ben: Awesome. Alright. That makes me feel good about this conference or this clinic. What are some of the coolest technologies that haven't hit the US yet that are big in biological medicine in Europe right now?
Karim: Wow. I would say there's a device out there called the MORA machine by Dr. Morell and Dr. Rasche. Absolutely brilliant when it comes to how cells communicate with each other. Now, as we are using words to speak with each other, certain bodies require lights to speak with each other, certain sounds, certain is electronics. This device uses electronics and sound to drive specific frequencies into the system. So, if I wanted to measure and increase the amount of–for example, iron in your body if you are very poor absorber of iron and we've done this before on patients where if you take orally iron, the body still can't absorb. Their ferritin levels or transferrin levels are still very, very low in their system. If I drive the frequency, the resonance of iron into their body using either sound or electronics because like we said, every molecule has a resonance or a frequency that it vibrates at. Iron vibrates at a very specific frequency. We know this, we've measured this. We can drive that frequency into the system then give them oral iron and the body will accept it better, their numbers go right back up.
Karim: We have seen this on a variety of cases where we can increase the amount of glutathione in your body just by giving the frequency of glutathione without you taking any substrates or actual glutathione orally.
Ben: When you say the frequency of glutathione, you mean that glutathione or GSH actually oscillates or vibrates the molecules doing a specific frequency, you match that frequency prior to administration of the actual substance itself and you see enhanced absorption or utilization?
Karim: Absolutely, because what you're doing is you're priming the body, you're setting the body not by driving it inconsequential into the system where the body has no choice, but now you're providing a mechanism to carry that molecule energetically into the patient.
Ben: Is that the type of thing that the MORA machine that would be overseen by a medical practitioner or these are the type of things people would purchase for home use?
Karim: These types of devices are fairly expensive and so, if you can afford it, you can use it for home use but it does require a fair amount of training and we do have a lot of medically trained practitioners —
Ben: I’ve been pretty surprised at what my listeners will buy. There’s people out there who are going out and buy, and you have talked about like GAINSWave, acoustic sound wave therapy for your crotch to enhance your directions or your orgasms and I've had people go off to Germany and like buy $30,000, $40,000 units to give themselves their own gonadal treatments at home. So, I'm always surprised at what people will purchase. So, MORA therapy, that’s fascinating.
Karim: It’s pretty impressive, you know. There's the next innervation of the MORA machine and that is the ones that we have in the office here. We've got four of them. We have what's called the Universal Detox Program as an example. There's a variety of programs preprogrammed sets that we can run patients on, but the MORA machine, the Universal Detox Program, what it does is we can actually take a urine sample from [00:25:45] ______. We can derive the frequencies into your system to allow your body to unhinge and pull out things like heavy metals, plastics, herbicides, pesticides. We can then–it's a 24-minute program, we can then take another urine sample from you after. Send both samples over to a lab. The lab will tell us there are more toxicants in the second sample than there is in the first sample. So, we've actually proven that it does pull talks against out of the system. The variety of machines, variety of programs on that machine can do this. One of my other favorite devices is a laser device. Dr. Weber has this fascinating machine where we can use this topically and, if some choose, can also do it intravenously putting light into the system. It's picked up by the red blood cells and white blood cells and traverse to the entire body, thereby enhancing the quality of the red blood cells. You can also do it topically. As we spoke about earlier, you can use red light. You can use green light to blue light, you can use infrared light that has a deeper penetration and all that does is it allows the cells to communicate with each other better. It's not using LED. So, LED is these light–
Ben: That’s what I was going to ask you about because right now, even here in my office, I have these Joovv Lights that are–they’re red and near-infrared LED lights, but this is different?
Karim: Yes. And so, the depth of penetration of LED lights are not as wonderful as some people would lead you to believe. LED lights, they have a wide dispersion field but they don't–the depth of penetration isn't outstanding. When you look at it from the German perspective, they are very precise and very poignant and it is pointing a finger directly at one specific frequency and driving that frequency into the system using lasers. So, it's like dropping a pebble in a still pond. You got a point of impact but then you get a ripple effect. That's the way that they so choose to do it as opposed to the dispersion field with a poor penetration, they would rather have a deeper penetration and get a ripple effect from there.
Ben: And what’s happening when you do that? What effect are you going after?
Karim: The depth of penetration to heal tissue from an inflammatory perspective, it is drastic.
Ben: So, this would be for like a soft tissue injury?
Karim: Yes. But they've also done these studies on stroke cases, post-stroke cases. And the research on this is actually quite astounding where they've taken two groups of people that have had similar like strokes. The first group, they put a crown of 12 fiber optic lids into the skull topically, on top of the skull in various positions. The second group, they do not to do these treatments for. The first group responded walking faster, talking faster and responding so much quicker than group two. The only difference was doing this treatment.
Karim: And so, because the depth of penetration of these infrared lights penetrates through the thickness of the skull, you actually get it moving into the brain and helping the brain to regenerate just as we were speaking to when we're talking about how cells communicate with each other, it's done through light. That light is a beautiful carrier of information. If we can drive that information, that carrier of information and we can put healing frequencies into that carrier, then with that result and impact that we're going to have to that cell that we're touching is so much more drastic. It is so much more healthy than we otherwise would have.
Ben: What's that form of laser called?
Karim: Weber, W-E-B-E-R, Weber laser.
Ben: Weber. So, it's spelled Weber but you pronounce it /veber/ because you have your cool German accent, I get it. Okay, cool. I’ll find links for more information to all these treatments and even a couple of things you’ve already mentioned so far like the book on bioregulatory medicine, Dr. Fritz-Albert Popps’ website, this conference I’m leading in July, et cetera. I’ll put all this stuff over at bengreenfieldfitness.com/genetictesting.
Speaking of which, let's jump into personalized genomics. So, basically, long story short, you told me that 23andMe was giving me essentially a fraction of what I actually really needed to know about my body and my genes, and you had me do a different test instead. So, walk me through what this test is that you had me and my boys do, and why it's different than something like 23andMe?
Karim: Sure. Well again, I’m very, very fortunate to have studied and lectured from around the world. I got a pretty diverse group of patients everything from sports athletes to chronic diseases such as cancer and autoimmune. Having access to the best technology and diagnostic equipment including the ones that I have from Germany allows me to perform and get the absolute best results for my patients. But, I’m only as good as the technology that is present in front of me, the success that I have is solely relevant upon the accurate quantification and the quality of the testing mechanism that I have. I need to make sure that any test that I use has to be accurate, has to be reproducible and has to be very, very functionally relevant.
So, when we look at things like 23andMe which are these direct to consumer tests and I'm looking at this strictly aside from 23andMe being what was called initially Google genetics and those conspiracy theories about who owned 23andMe and who they were married to, and the fact that it is pretty much a public record when you do your genetic testing, stepping aside from that, I know that deep information that they use for 23andMe is strictly using SNPs and what they look for which are single nucleotide polymorphisms and what they're looking, they're just looking for small variations and base pairs and most of the SNPs have absolutely no functional relevance whatsoever. They're basically good for data collection and for Ancestry perhaps, but they have no actual function in the body.
For example, the MTHFR, the one that we always keep hearing about, there are a lot of variations of MTHFR but looking at MTHFR by itself is similar to looking at a tree in a forest and if that tree is unwell, you're making an assumption of the entire forest based on that one tree. It's not the way we should be looking at things. We have to look at associations of SNPs. We have to look at the way the SNPs work together in congruency with each other. The MTHFR is one of several SNPs involved in methylation. If you look at one in isolation, you are not getting the big picture. And so, what we want to do is we want to be able to look at all of this information in context with other SNPs. So, we need to know what your COMT gene is which is your methylation, your catechol-O-methyltransferase genes. We have to look at your serotonin receptor genes if we're looking at just methylation itself.
So, for example, with 23andMe, they’re looking at hundreds of different SNPs, they're putting it into one large PCR plate and they're running a bunch of tests on it, those individual SNPs. And they send out what's called a primer, and that primer is looking for a specific set of base pairs and they're looking for the base pair that is looking identical to the primer. Now, with a lot of SNPs especially with, for example, methylation SNPs. These SNPs look very, very similar to each other and because you're looking at a hundred SNPs plus a hundred SNPs at the same time, the primer can make a mistake. They can pick the similar but not exactly identical SNP. This is why some of the research is stating 15% error rate, other research is stating 40% error rate with these direct to consumer tests.
Karim: That’s my biggest problem, the error rate with these. The second concern I have is these CNVs. We really need to study things like copy-number variance. We also have to look at things like insertions —
Ben: Copy-number variance?
Karim: Yes, CNVs.
Karim: As an example, when we're looking at a primer, if we're doing a typical 23andMe or these direct to consumer testing, they're looking for whether or not these base pairs are similar to the glutathione base pair. And if it is present or if it is not present, you’ll get the result. If it is not present, they will suggest that it is present. They don't tell you whether or not you have one copy of this gene or two copies of this gene.
Karim: So, with glutathione, if you have one copy of glutathione, you detoxify at about a 50% rate. Now, they're just going to assume that you have that copy. So, you are going to walk away thinking I am detoxifying at a 100% rate but they don't know if you have one copy of that gene or two copies of that gene. Now, with CNVs, we look at three different types of CNVs. We look at the GST, we look at its backup to the GST which is the GSTM1. And we also look at something called the UGT2B17 gene. So, we're looking at the glutathione gene, it's a backup and then another gene altogether.
So, let's, for example, look at glutathione. Glutathione if we have one copy of the GSTT1 and one copy of the GSTM1, we're actually looking at a 50% and then a backup to that is 50%. Well, if we have two copies of it, we could be worth two copies of each. We could be functioning at 100% in terms of detoxification. There is a huge difference between. It’s a massive difference that that difference plays one of the biggest roles with regards to our health in terms of detoxification. If we look at the UGTB217 gene, I'm going to look at this example in terms of hypotheticals. If, for example, you are a Slavic Russian, Slavic Russians don't carry the UGTB217. That gene is particularly responsible for eliminating testosterone and DHT, dihydrotestosterone out of the body. If you do not have this gene and you take testosterone for whatever reason, for whatever Olympic result you want to get and the Olympic committee goes in and tests your–
Ben: There's no Russian taking testosterone by the way.
Karim: No, no. And they keep getting test in their urine over and over and over again but because they don't have that gene present, their body does not pull the testosterone out of the system. So, it cannot be measured. So, their results keep coming back negative all of the time. Interesting. When they flipped over and they test the blood, that's when they found a material that they should not be using
Ben: So, this has implications even for things like doping control whether you’re going to test urine versus blood.
Karim: And interestingly enough, those individuals that don't have that gene and also produce another type of estrogen called 2-hydroxyestrogen, I'm sorry, 4-hydroxyestrogen, those are the ones that are more responsible for things like prostate cancer, breast cancer, ovarian, uterine cervical cancers. Knowing this information if you'd genetically have a tendency of not getting rid of your testosterone, converting that testosterone to the bad testosterone, the DHT and not eliminating the 4-hydroxyestrogen, we stand a higher chance of having bad cancer start to develop. So, prostate cancer for men, ovarian and uterine, cervical and breast cancer for women. This information is vital to know whether or not you are a 14-year-old or whether you're not, you're a 60-year-old, having that information is good to know. This way you can treat prophylactically, preventatively before you run into a problem down the future.
Ben: And 23andMe doesn't test for any of these stuff, these multiple SNPs, these are the things you call them CNPs?
Karim: Yeah. Copy-number variance, yes.
Karim: They also don't test for what's called indels or insertions or deletions. These are specific for executive function genes. So, what's called the other two BGene or the serotonin gene known as the 5-HTTLPR gene. These ones are responsible for things like stress, post-traumatic stress disorder. The serotonin ones are mood anxiety, response to SSRIs. They don't measure these types of changes. They measure to see whether it's present or not present, but if they have then been subsequently deleted and they're not present in the body, wow, we need to know this information.
Ben: Wow. Interesting. Okay. So, with 23andMe, can you take your raw results and just export those somewhere else to get this type of information or are you saying like the actual results itself in terms of the raw data, even those you can’t harvest to get this type of variables that you're talking about right now?
Karim: Right, and because the basis is incorrect because the raw data is wrong. Any further evaluations that are utilizing this pool of data, they also become flawed.
Ben: Okay. Is there like a name because for example, I've interviewed Naveen Jain from Viome, they do microbiome testing and they have a special form of biome testing that they do that's a genome sequencing analysis that's different than I think what's called the metatranscriptome analysis that other companies do so they get better results or more complete results. Is there a similar type of differentiation in terms of what you would call the genomic evaluation that you favor versus something like 23andMe?
Karim: Well, the concern at sometimes and although I love those other tests, I think they do a wonderful job. It turns out to be a very, very slippery slope. We have 10 times more bacteria in our system than we have active human cells. They say that we are 99% non-human when they look at DNA. We actually have 10 times more viral DNA than we have bacterial DNA. That is an incredible amount of DNA and RNA to be able to assess. It becomes extremely, extremely difficult thing. What we tend to focus on is the human being, the human body we tend to focus on, its impact, functional impact on the variety of genes that we look at looking at one gene or one SNP by itself is absolutely erroneous. You are–and by that same token looking at certain viral genes or bacterial genes and now they interplay with the human that is absolutely important, but we haven't seen any functional relevance to this as yet.
Ben: Right. So, what do you call the type of sequencing that you do?
Karim: It is still also considered SNP testing so we do SNP testings but in addition to that, we add on the CNVs and we add on the indels. So, it's still considered genomic testing from the human and it provides us with the largest database. We have the largest database for CNVs and indels in the world.
Ben: Okay. Got it. I think it would be really interesting for people to be able to see what you have gleaned from the results of my genetic testing because just from the brief discussion that we had, I was intrigued and it was honestly just in a few minutes that we were able to talk, I got more health information out of you than I have gotten from almost any doc I've ever worked with. So, what I would love to do, if you're game, is to jump into some of the things that you specifically noted from my results because some of the things we found, I think people should really know about because these were issues I was completely unaware of.
Karim: Yeah, sure. I think one of the things that I love about this type of testing is that it's not done in some backdoor lab somewhere. It's done at what we would consider to be an Ivy League university out here in Canada called McGill University.
Ben: Yeah. I’ve heard McGill.
Karim: It is the best. It is the only one that’s certified by Genomics Canada to do all the genetic testings. So, they do all the genetic testing for [00:42:47] ______ Hospital and all of the major hospitals here in Toronto but also provide the same facilities for us to do our testing. And it is a sealed envelope so to speak, so it's not for public record. This information is strictly yours and other practitioner that you so choose to have part of the system. And I would suggest to be one of the most important aspects of this. It's not just huge genetic information. Congratulations! Now you have to get a mini degree in genetics to figure it out, but we also can sit down with you and go over us during consultation. Watch those results mean by linking all of these different components together to be able to provide a fullsome discussion about what your genetics are.
Once we figure out what that is, is this a part of that lifecycle of that patient? Once we figure out what that is, we then take that next step and we say, “ here are the supplements that I think would be exceptionally helpful for you to be able to utilize on a daily basis to plug some holes that might be present in your genes. That in addition to the epigenetics, lifestyle change that we would recommend provide a really wonderful full diagnostic mechanism for you moving forward to become exceptional when it comes to your health.” So, we have something like 75 different ingredients that we can then customize and blends together specifically for that patient. So, it's not just, “Here are 19 or 20 different supplements, go off to the retail health food store and buy whichever ones you see fit.” We actually can take those individual ingredients and we can blend them together and we ship one bottle or sorry several bottles of all of those ingredients, mix together of where you take some in the morning and you take some in the evening.
Ben: I’ve had a lot of companies–here in the States, a lot of companies are talking about doing this. They’ve even had me like send over my 23andMe results. Other companies doing it with my poop like–I forgot the name of this one company. It's like Thriver, some along those lines. They’re trying to customize probiotics. There are other companies doing–I have some up in my pantry from a company who looked at my 23andMe results and sent me customized vitamins. But, what you're saying is that if the actual data itself is flawed that I'm not going to get what I need. Is there something different about the way you're creating these vitamins or supplements?
Karim: Right. And so, one of the best parts is that we'd say a perfectly sort of a GNP facility that Health Canada takes a look at and make sure that we're running it all correctly and properly, the quality of the ingredients that we have. As an example, the Malaysian government invited us out to look at their facility of how they are manufacturing a specific form of tocotrienols. This type of tocotrienols is the only type in the world that you can get in a powdered form that shows a better absorption rate than any oil version of tocopherols or tocotrienols you can possibly get. This is a government funded facility out in Malaysia. The quality of supplementation that we have is by far without a doubt absolutely outstanding. It becomes then customized for that patient and we look at things that are very, very relevant in terms of the genetics. It's not, “Here, you have an MTHFR problem, take a methyldone group,” because we find that people over methylate and people that over methylate, they tend to get more anxious, they tend to get more reactions than if we were to provide folinic acid instead as an example. And so, we become very, very specific to a lifestyle of the patient and that's why we do anthropometric tests before when you do a screener. But then we also make sure that we've got the proper genetic information and then we can customize it specifically for the patient.
Ben: Got you.
Karim: And I will say that when you're looking at something like genetics for stool analysis, I've got to tell you–and as well as for blood. There are a lot of companies, even Canada, that do an analysis on your blood and then provide you with a customized supplementation. If I follow a specific diet, my entire microbiome will change. And then, there's my supplementation change. If I change my diet, my blood chemistry will change, then do I have to change my supplementation? And so, it becomes–again, I keep using the term, “slippery slope.” If we can focus on the tendency of the human being, if all things left equal, will you be producing more 4-hydroxyestrogen and if that's the case, your tendency for hormonally dominant cancers has increased. All things being equal, if you are that producer, you need to take deep–
Ben: Right, because your genes are really going to change unless you say you’re going to get a new crisper or something.
Karim: Absolutely, and that's just it. We only do this test once because your genes, they will not change.
Ben: Yeah. By the way, you mentioned total rabbit hole but you mentioned tocotrienols. I recently did a podcast that I think will be released by the time folks are listening into this one about this GDF11. I don't know if you're familiar with it, but apparently GDF11, mRNA has these really robust DNA repair mechanisms particularly in things like senescence stem cells and two of the best ways to naturally increase your levels of GDF11 are supplementing with quercetin and also tocotrienols.
Karim: Yeah. The impact of tocotrienols on hair follicle growth, on non-alcoholic fatty liver disease, on the what's called a 9P21 gene which we’ll speak about with regards to your genetics and the boys. It's imperative to have something in your system as a protective mechanism. This is notwithstanding. It is an absolute importance to know that if I have inflammation if I have vascular endothelial inflammation, I need to be able to do things to help to protect myself against that.
Ben: Interesting. Okay, cool. So, a little rabbit hole there, but I will link it to the podcast episode with Tom Ingoglia where we talked about this GDF11 stuff. That was my podcast I did with the guys who run the NAD Injection Clinic down in San Diego. So, okay, Dr. Dhanani, let's jump into some of the things that you've gleaned from the results that you saw from me. I think one of the first things you talked to me about that just blew my mind was Vitamin D, [00:49:20] ______ Vitamin D. Can you get into that?
Karim: Yeah, sure. So, one of the things that we look at when we look at Vitamin D is we think it's either the sunshine vitamin or it's something that we have to take orally. Now, with vitamin D, it is not even considered to be truly a vitamin. It's actually considered to be a pro-hormone. It's one of those things that are absolutely important when it comes to the health of our brain function but also to our immune system. And do we measure not just–so when you go for a blood test, they're looking at do you have an adequate vitamin D in your system. When we do the genetic test, we're not looking at blood markers, we're looking at your body's tendency for vitamin D. We measure two different components when it comes to vitamin D. We measure to see whether or not you convert to vitamin D from sunshine directly into what's called the 125-hydroxyvitamin D, the actual component of vitamin D. So, we have to convert it from sunshine to vitamin D. And then once it's converted to vitamin D because Vitamin D is fat-soluble and our blood is water-soluble, we need to have a carrier molecule that carries vitamin D throughout the system. Well, genetically, we also measure that as well. And so, with regards to yourself, you could walk around completely naked in bed in the sunshine and you cannot absorb a very well vitamin D. From the sunshine to the 125- hydroxyvitamin D in your system, you just can't do it.
Ben: That's crazy and that also, by the way, you and I have talked just very briefly about things like my wellness effects results. I spent a lot of time in the sunshine like a lot of people know me as the guy who doesn't put on a shirt and honestly doesn't probably put on pants enough either and spends a lot of time outdoors, and my vitamin D is like–it's 40, 45, something like that. So, it's not through the roof. It’s not what you would expect from someone who is as exposed to sunlight as I am.
Karim: Right. Now, part of that concern is the absorption of vitamin D. Thankfully, you transported very well. So, people that don't transport it very well and errors had been made in the past where people say, “Go ahead. Take 10,000 IUs of vitamin D.” If you have a cold or a flu, “Go ahead, take 50,000 IUs of vitamin D.” If you don't transport your vitamin D very well, you're only going to be absorbing 2,000 maybe 3,000 IUs of that vitamin D. And so, that becomes one of the concerns is. You could be not converting it or you could not be transporting vitamin D very well and we need to know that genetically. If we don't know that that we may not be supplementing very well–so as an example if you have a poor transporter with vitamin D, it would behove you to take vitamin D two times in a day and not just once in a day. Because if you take it once in a day, you will fill your transporters and the rest will pass right through you and get store in fat tissue.
Ben: And a lot of people who are just using the sun and maybe not using vitamin D or only using vitamin D in the fall or winter as I've been prone to do, they would still not be getting enough vitamin D if they happen to have the same genetic issue that I do.
Ben: But if they supplement with it, they can transport it just fine.
Karim: And they will get enough in through their system and passed out to the cells that require it.
Ben: Yeah. By the way, I've been using the Thorne liquid vitamin D, vitamin K blend since we talked. But, I take 2,000 international units a day now. Interestingly and I realized that we're putting health information out there on the internet but this is just, this is what I do to help people out. So, I don't mind even if my health insurance premiums are going to go up should my insurance adjuster listen to the show. Both of my children happen to have the same issues. So, my kids are now supplemented with vitamin D too along with a few other things based on our discussions. So, this was very valuable for me and my wife too to be able to look at our boys and hopefully stave off health issues with them in the future or even just let them optimize things like their bone development or their muscular development or even their neural development, which we know are all associated with vitamin D availability. So, that was really interesting for me to know and influenced my decision to start supplementing vitamin D. What else did you learn? I think another thing was glutathione was a big one.
Karim: Right. This is a bit of a pause for question here. I totally agree if there's a concern with for example glutathione at both with yourself and your wife, for example, what about the kids? Are we trying to play God? Are we trying to play a role that we're not supposed to be playing here or are we just trying to maximize and make the system as efficiently as humanely possible? If for example, 100 years ago, you had a glutathione system that was working at 50%, 100 years ago there was a tremendous amount of talks against present and so you could probably survive and, dare I say, thrive, in that case. If you had a 50% functioning glutathione system now, in today's day and age, oh, I would suggest that chronic disease would pass into your system fairly, fairly easily just because of that.
Ben: Especially–and I take pretty good care of my personal environment. You and I have talked about this, how I live out in the forest and I optimize my air and my water and my light and my electricity and then basically I go F-stuff up every time I step onto an airplane and fly to L.A. or fly to Tokyo or walk through the jet fuel infused runway down to get onto the airplane, or step out and go for a run when I'm in a big city along the roads where all the brake dust and the exhaust is. So, yeah, I mean even if I'm tweaking my own personal environment, there's a lot going on living in this post-industrial era that I think amplifies at least my own glutathione needs pretty highly.
Karim: Absolutely, which is a great segue. When we look at things like glutathione, it's not just the one gene that we look at with a lesser glutathione and I just want to be clear when we're talking to glutathione, we're not talking about the actual production of glutathione and we're talking about the utilization and the recycling of glutathione. So, there’s a variety of genes that are responsible for being able to recycle glutathione. The first is the GSTT1, the second is the GSTM1 and the third is the GSTP1. And so, when we look at the GSTT1, the examples that I use is on Wednesdays in my neighborhood, it's where the trash day is. And so Wednesday in the morning, there's a big lumbering trash truck that comes through, two big men they come out and they grab our trash bins, they throw it into their trucks and off they go. Well, a couple of hours later, the recycle guys, they come by. Smaller bins, smaller guys, smaller truck. They also take the trash, they toss it and off they go. And a couple hours later, there's a guy that cycles through my neighborhood on a bicycle and he's looking around for things that might have been thrown out that are of value. There are some of that throw out a sofa, there's some that throw out a washer-dryer. He calls up his buddy who has a van, they swing by and they grab the sofa, they grab one and off they go. A couple of hours later, the neighborhood–
Ben: You must live in a pretty clean neighborhood.
Karim: I’m telling you. This happens only once a week though. The grade 4s, they have a class project to beautify the neighborhood. And so, they let out early and a bunch of kids go running around the neighborhood and they pick up little pieces of trash off the lawn. So, in my neighborhood, there are four ways to clean that neighborhood up once a week. Imagine that happening thousands of times in every single cell in your body every single hour that is incredible how much we utilize glutathione to make toxicants water soluble to pull it out of the system. When we look at the first two main genes, the largest two main genes to be able to recycle glutathione that is the GSTT1 and that is the GSTM1. Those are the two that are responsible for pulling out the majority of the toxicants out of the system and for fun, you can doctor Google this and you can type in any type of disease process and link that to low glutathione and you will see a very strong correlation between whatever cancer, whatever autoimmune disease that you type in, too low levels of glutathione. Now, I’m not suggesting that low levels of glutathione cause that disease. What I am saying there's a very interesting correlation that perhaps your body is trying to desperately detoxify. It becomes unsuccessful for whatever reason, that might have been the causative agent, that for whatever reason becomes unsuccessful and hence, you end up with a chronic disease. With glutathione the first two that we measure, we look at this as CNVs, copy-number variance, which means we are looking at to see if one gene had been passed over from mom and one gene had been passed over from dad. And in your case, Ben, you’ve got one copy of that gene. So, one of your two parents did not have a copy to pass over to you, so you were working that's considered to be a somewhat average meaning that 15% of the population has at least one of these two genes deleted. The backup to that gene is called a GSTM1 and of that, you don't have any copies. Now, it does not mean that that gene is less efficient, it means that that gene does not exist. There is no blueprint, there's no backup for where your body could go back to and say how do I recycle glutathione again? What can I draw upon to recycle glutathione if there is no blueprint for your body to be able to manufacture the mechanism to recycle glutathione in your system. It is completely missing that paragraph on the 23-page book that we have that is our genome. That paragraph is actually missing.
Ben: Yeah. I’m looking on page 37 right now of my results and it says it has 0 copies of GSTM1 and apparently, that is putting me at risk for poor estrogen metabolism, the elimination of potentially harmful estrogen byproducts which you’d get from plastics and shampoos and soaps and things like that. And it is interesting because if you look at my WellnessFX blood results, which I don't know if I'll have released them by the time this podcast comes up but pretty close to the time this podcast comes out, I'll be putting my blood results out there for people to look at. My estrogens tend to be a little bit high, almost as though my body is building up some of these estrogens that I get exposed to from my environment.
Karim: And that becomes one of the sorts of secondary concerns is not just from the hormonal perspective. It is the backup of the main detoxifiers. So, if you walk into an environment where you are breathing in a chemical, you will run through your GSTT1 fairly quickly because you only have one of those two copies and then the reliance falls to the GSTM1, its backup, to be able to pick up the slack that the first main gene is not able to acclimatize to. And that's why you don't run into the copies.
Ben: Sorry to interrupt you but like underneath this, it says, “ingredients that enhance GST function are,” and then it lists an acetylcysteine and alpha-lipoic acid, selenium and milk thistle. So, when I'm reading through my report like this or for example when you or the folks in your lab are reading through it, does this then come down to that personalized genomics that you talked about regarding supplementation like you would put together a compounded formula for me that includes things like that?
Karim: Based on anthropometrical results, based on your height, your weight, your sex, yes, we would customize a formula that would include not just limited to lipoic acid, selenium milk thistle.
Ben: So, I don’t have to go to Amazon and buy bottles of all those, you just basically create me the formula.
Karim: Specifically, for you, yes. Absolutely.
Ben: Okay, got you. So, in terms of glutathione, the bottom line here is that I fall into the category of somebody who needs to be supplementing with some form of glutathione.
Karim: And that's because if you had one copy, you could probably get by but because that second GSTM1 is not even present it's what's considered absent or deleted, you don't have a blueprint to be able to recycle glutathione. And so, one person that can receive glutathione your body can manufacture it, one person may recycle it several times, you will recycle it much, much less than that before you “blow out” of your glutathione and need another source of glutathione.
Ben: I've got my boys now taking glutathione every day. They're doing like a sublingual glutathione called–right now they're using one called Almsbio. It's like this liposomal glutathione in an oral syringe that has some mitochondrial support. It’s like CoQ10 in it and PQQ, which are really good mitochondrial antioxidants. But, based off the fact that they also have that same missing SNP as I do. They have supplement of glutathione as I am. But one of the things you told me because I was already supplemented with glutathione when you and chatted briefly about my results and I told you that one of the things that I do is I actually get an injection of it about once a week, and you mentioned that that might not be a good idea depending on the source of the injection and I think you are talking about like a liquid versus a powder in the stability of glutathione. I know some people are doing injections or injectable glutathione or other substances that come to them in a powder form. What's the issue with that in terms of stability?
Karim: Yeah, because glutathione is extremely ubiquitous. Anytime you utilize it, it is something that is so active in our body and it is such a–I would use the word complete system of detoxification that any type of toxicant that is present there, it can react to. And I'll preface this by giving an example. So, there I am in Germany in a clinic that deals with Parkinson's cases and so of course Parkinson's patient walks in with a typical pill-rolling tremor with a shuffled gait, sits down in the IV chair and we take a powdered version of glutathione, we reconstituted in the office and we inject that glutathione into the patient. The patient then gets up and walks away. No pill-rolling tremor, no shuffled gait. It’s perfectly stable.
Ben: You mean like in an instant?
Karim: Within 10 seconds. That patient needs to come back every three weeks to get that IV. And it's a very fast but yet a very competent way of manufacturing and reconstituting the glutathione. So, now I'm back in Canada and I'm all excited because I'm about to get my first Parkinson's case. This is, oh goodness, 12 or 13 years ago and I get my glutathione in a bottle, in a liquid. I draw it into the syringe, I inject it into the patient, I get nothing. I apologized to the patient and I said, “Well, this is this is awkward because I was expecting this to work really well.” I have them come back the next week. I redid my formulation. I get an approval from the guys out in Germany. I do the exact same thing and I get the exact same response, which is nothing. The way that we manufactured glutathione here in Canada, and dare I say, in North America, is in a liquid form. It's manufactured in the facility, in the lab. It's already reconstituted in the lab.
Ben: Yeah. That’s how mine comes. It’s in liquid form, stuff they shipped to my house.
Karim: Right, then in DHL or FedEx. Puts it in a box and sends it over to you and it gets moved around, it gets shifted, it gets opened, it gets exposed to sunlight, it gets shaken and then it's put in a refrigerator, for example, and we pull it out again and then we inject it. It has already reacted by that time. It is already in “oxidized form.” So, what you're injecting, and what I have been injecting into patients, way back when, was expensive saline. So, what we're doing now, what the ideal is to be able to do now is to be able to get a powdered version of glutathione that you can get from Germany and some labs can manufacture it here. I'm sure you can get some labs in the States to be able to do that. I've got a couple of contacts that I can provide over to you. They can give you an inert powdered form of glutathione which then, you can reconstitute at home by adding some saline in the syringe with this powdered glutathione, and that will be the active component of glutathione that you will then inject into your system. It's a vastly different system.
Ben: Well, okay, that’s really good to know. So, it looks like maybe this liquid injectable glutathione that I know a lot of other people use like a liquid injectable, it's not really doing much good at all.
Karim: And I think that the best way to be able to get glutathione in your system is have your body manufactured on itself. Should you be able to leave it in then change then you have to look at it an extra source–
Ben: And that's why I recommend things like N-Acetylcysteine, alpha lipoic acid, milk thistle and selenium.
Karim: Absolutely, because then, what you're doing is you're training your body to be able to recycle it on its own. Tertiary to that, you could get an oral source or an IV source. The oral source, I would recommend, if you are going to pick an oral source, is to pick something that's liposomal. It’s more stable than any other mechanism out there. It's not clearly as good as the IV nor the components that are utilized to recycle glutathione like the N-Acetylcysteine, the alpha lipoic acid, the selenium, the milk thistle but nonetheless, a very decent mechanism.
Ben: Yes, stuff I use tastes an orange cream sickle so there's that to tasty.
Ben: Okay, I want to talk about endothelial function and blood sugar. You brought up some genetic markers that are specifically related to that. We took a pretty deep dive into that and even how that might influence things like exercise choices, cardiovascular health. And, when we discussed some of the endothelial issues, you talked about something called EndoPAT as a good self-[01:08:15] ______ method, HRV as well. Go ahead walk us through this whole idea of genetic testing in endothelial function.
Karim: Well, there are a couple of things that I found very intriguing about your test results. One of them is the what's called the 9p21 gene and the second one is called the TCF7L2 gene. The 9p21 gene is looking at endothelial for vascular inflammation. This is independent. I just want to be clear about this. This is independent of lifestyle. This is what your parents had gifted you. If you are eating foods that are causing inflammation to your system that can be easily measured on blood tests. However, what this 9p21 gene suggests is that your mom and your dad, either or both of them, have provided you with the genetics to have a preordained inflammatory dysfunction or inflammatory level that's present already within your vasculature system at the start. So, you're already starting with high levels of inflammation in your vasculature. That's present without even eating anything, without even altering diet, without even having looking at epigenetics. This is a genetic predisposition. You could obviously make it much, much worse by doing specific things, but from an initial, you're first out of the gate, you start off with a tremendous amount of vascular inflammation. So, when we measure this, we look at this is the 9p21 from 0 to 4. 0 being very little, if any vascular inflammation. 4 is the highest that we measure and you set at a 4.
Karim: This is also one of the best indicators for cardiovascular, suppose cerebrovascular and cardiovascular issues. So, things like heart attacks and strokes are fairly prevalent in people that have the 9p21 gene. I do not have a crystal ball. I do not have a magic wand. I do not know this will develop for you but I do know that the predisposition is there.
Ben: Wow. Thanks, mom, thanks, dad. Okay, so, I carry naturally high level of risk for vascular inflammation is what you're saying?
Karim: Yes, right.
Ben: Okay, what can I do about that?
Karim: And because that’s there, if you are to do other things that could increase that vascular inflammation, well, you're setting yourself up for bad things to happen, I would say.
Ben: And people who carry this issue, what kind of things would cause that?
Karim: So, very, very, high intensive exercise.
Ben: Yes, I do any of that.
Karim: If you think about, if you do the quick HITT, if you do a really high intense exercise, let's say, 4 minutes, and then, you stop for 2 minutes, and you go again hard for two minutes, what you're doing is you're creating a massive amount of blood flow that runs through the system and then, all of a sudden stop. And then, you're creating another massive flow of blood flow that happens through the system and then again, it stops. What that does is that flow of blood can create more inflammation, more nicking, and more breaking of that vascular tube.
Ben: Really? See, I was thought that high-intensity exercise or high-intensity interval training was good for cardiovascular health.
Karim: You're right in the sense that it does help to increase the size of muscle, it does increase the cardiovascular tone, however, if you're a 9p21 gene, those are the ones that, you know, those guys that run a marathon and have a heart attack the next day?
Karim: Those are the 9p21 genes. You know, those guys that end up-
Ben: Are you just saying that or these folks have been tested?
Karim: They’ve actually been tested.
Karim: Well, those people that die of chemotherapy than because of cancer? Those are the 9p21s because when you introduce something into the system that is toxic like chemotherapy, now, I understand the reason for the chemotherapy, I'm not going to debate that because that's a whole conversation for another time, but that toxic elements that are put into your system is creating more inflammation. So, those people that already have a preordained amount of inflammation, and you add more inflammation to the system, you’re running into a really big disservice. Those people that walk into an environment where there's a bunch of smells and they react to those smells, more often than not those are the 9p21 individuals because they already walk into the area with a bit of vascular inflammation, to begin with then, they smell in a toxin, and that toxin goes to their vascular system and irritates it further. They already start off at a level with irritated and now it becomes exponentially so. Remember, that the largest organ in the body is not the skin but it is the endothelium. So, you can have vascular inflammation just by breathing something in, just by over exercising a certain way, and by exposing yourself to some toxins, via food, via aerosolized. Those are the people that we need to be a little bit more concerned of when it comes to things like cardiovascular risk and cerebral vascular risk.
Ben: So, you're saying that for me, personally, being for example, a pro-athlete right now, racing in a sport that involves a very large amount of high-intensity interval training, if I were looking at things from pure longevity or vascular health standpoint, that's a poor choice for me?
Ben: Okay, what can I do to mitigate the damage? You're saying watch toxins. I know the blood sugar can be an issue when it comes to endothelial function and I do a pretty good job watching my fluctuations and blood sugar but I mean, are there other things that I can do, or other tests, or tracking methods that I could use to see whether or not I'm okay in that department?
Karim: Well, yes, you mention a really good point with the rest of blood sugar. This TCF7L2 gene which is the best independent marker for type 2 diabetes. It's looking at whether or not your pancreas, the islets of Langerhans, if they are producing the right amount of insulin in response to the starch that you are consuming. If you are producing the right amount of insulin in response to that starch then, your level, your chances of having type 2 diabetes is lowered. You actually have a what's called dysregulation in the amount of insulin that you are producing. So, if you were consuming carbs or starches in high quantities, you are going to create more vascular inflammation. So, I know that you are a star when it comes to the amount or keeping an eye on the quality, the quantity of the amount of carbs that you're putting in your system.
Ben: Yes, I wear a continuous blood glucose monitor.
Karim: Truthfully, had you been anybody else that is not tracking to the level that you are tracking it, that person, given the same activity would have probably run into some kind of a cardiovascular event or a concern.
Ben: Geez. Oh, back when I was racing Ironman, like that's what got me into a lot of this like, biohacking and blood and biomarker testing was when I thought I was super healthy racing Ironman and some of the first basic blood panels that I got, showed rampant insulin and fasted blood glucose above a hundred. So, I had some pretty serious–and I was exercising a lot. You know, it all had to do with diet and diet timing, and carbohydrate timing but yes, I mean, I witness this on my own blood and biomarkers even when I was, what you could argue, more fit and even irrevocably than I am now.
Karim: And going that one step further, yes, it was the genomic predispositions that we have that led us to those kinds of blood results that then, told us to say, “We need to be a little bit more cautious as to how we are exercising to the degree, the intensity that we are exercising,” because of those blood markers which again, is because of these genetics.
Ben: Well, I use, oh, go ahead.
Karim: There’s a certain supplementation that you can use to help to mitigate or protect this endothelial lining. The first thing that I've seen clinically and some of these are the tocotrienols, essential fatty acids et cetera. But what I have seen in my office clinically is I have not met a 9p21 4g person, that does not have high levels of heavy metals. Because what happens is the body says, “I have not a Teflon coat on the inner lining of my blood vessels. I have a cheap knockoff,” sorry, Ben. “I have a cheap knock-off of endothelial protection. I need to strengthen this lining. I need to get some kind of a material that is more Teflon-like.” So, what it does is it will draw upon any type of heavy metal that you might have consumed, you might have breathed into the system, it will sequester that, and you will use that as a protector, if you will, on the inner lining of the blood vessels. So, if you do some form of heavy metal challenge, I will bet you a good free dairy free healthy meal, that you will have high levels of heavy metals if you're not already trying to pull them out of your system now,
Ben: Well, I've already fixed that, because I did. I mean you're spot on. I had high levels of mercury, high levels of lead, even my iron was kind of high. I think copper, and I want to say cadmium was another one. So, I've done some of these tests. What do you call the urine tests? It's like a 24-hour provocation.
Karim: Yes, there are a couple of them and the one that is mostly recommended is what's called a DMPS DTH Challenge.
Ben: Yes, I did that challenge test and I've since done follow up tests that have shown my metals to be under control or even pretty low and what I started doing for the past– well, it's been three years now, I'm doing a detox program from this guy, Dr. Dan Pompa. It's like this full metal detoxification program. I do it every year. It takes three months but because of all the travel that I do and all the metals I get exposed to, and I'm guessing it's this genetic issue that influences the fact that I need to keep doing it, I go back and I do this three-month process where he you know, he's got these different supplements that help to take metals out of the body and it's a whole, you know, I told you this, I use the infrared sauna almost every day, and I do a coffee enema once a week. I do a lot of things to try and cleanse my body of metals but I would imagine if I weren't doing that, I would be a candidate for being in a pretty serious trouble.
Karim: I would agree. I would agree with absolute intensity, yes.
Ben: Interesting. Go ahead.
Karim: It's lovely to know to know what your glutathione levels are. It's lovely to know what your 9p21 gene is. It's also fantastic to know what your blood sugar tendencies are. All of those things are all sort of independent standalone genes but if we take them all in context, meaning, they can be a single tree of those forests but if we take them in context and we wrap it together and say, “These are what we really need to be cautious of.” And so, there are outside objective measures, not just genetic tests, but outside objective measures that you could utilize on a regular basis so you just keep an eye on what your levels are. I still suggest doing every so often a DMPS EDTA chelation challenge. As a side note, what you might want to look for is you might want to look for a spike in your aluminum. We tend to store, we have what's called, superficial middle and deep storage sites. Superficial is considered to be the blood. It's actually not even to stores that, it's more of a transport medium. The middle store side is considered to be more fats, maybe organs, some muscle we store heavy metals in there. The deepest store site is more brain, spinal cord. And so, how we know we are in the deepest storage site? It’s because aluminum tends to be stored in the brain. For some interesting reason, it tends to have an affinity towards the brain. When you get a spike in your aluminum, when you do a DMPS EDTA challenge, that tells the practitioner that you are at the deepest storage sites. In order to get to the deeper storage sites, you have to clear out the superficial, you have to clear out the middle to get to the deepest storage site. So, if you see a spike in aluminum, then we know we're at the deepest storage site, and we know that we've cleared things out from the middle and superficial and we have a few more sort of cleanses to do, and then, we should be clean, meaning that everything is out of your system. Then you just have to consistently do a coffee enema every so often. Dr. Pompa’s work which is fantastic, it's sensational, follow that mechanism as a, “let's keep them out of your body.”
Ben: Got you. By the way for just home testing, for something like toxic metals and this provocation test we're talking about is this pretty much very similar to like a Doctor's Data kit that you could order and oversee yourself at home? Because I know there’s like 24-hour urine collection kits you can order from companies like Direct Labs, for example?
Karim: Yes, I think those are decent mechanisms. However, you need something to provoke the heavy metals to come out of your body. There used to be an oral DMSA challenge that they did out there Germany. They don't do this anymore and the reason for that is that the absorptive capacity of the DMSA is not fantastic. I would suggest, the last that I read, was around 30%-40%. And so, and DMSA doesn't pull out lead, does not pull out cadmium very well out of the system. I would suggest go and visit a practitioner that has the capacity of doing that test where you get, based on your height, based on your weight, you get injected with DMPS and EDTA and then, you sit in a chair and you pee into a cup and you take that over some time and you sent over to Doctors Data. Doctor’s Data is an excellent, that's the one that is used by most practitioners in North America. They do a fantastic job. However, the in-home kits of the DMSA oral doesn't do justice as an IV of DMPS and EDTA.
Ben: Okay, good to know. The other thing that you had mentioned for monitoring your vascular health in addition to HRV, I think it was called EndoPAT. What is that?
Karim: Yes, so, there are a variety of different testing mechanisms that you can utilize as an objective measure to see what your vascular system is doing. There is the Pulse Wave Velocity device, there is an EndoPAT, there's also a coronary artery scan. So, the EndoPAT and the Pulse Wave Velocity, what they do is they actually measure the endothelial lining to see the level of inflammation that is present in that area. The concern sometimes that I have with those systems, although, they are wonderful rapid tests that you can perform, they can also change just like doing a blood test for supplement status they can change over time. So, as you are improving, those numbers should get better as they will but if you eat a meal or two meals that are more inflammatory in nature, that can alter your Pulse Wave Velocity score. So, just keeping in mind that you need to compare apples to apples.
Ben: Okay, so you need to basically be in the same state from a diet and activity standpoint any time that you go on to do something like an EndoPAT test.
Ben: And can most doctors run it? It's called E-N-D-O-P-A-T. That’s how you would describe this?
Karim: That’s correct.
Ben: Any doctor can do that?
Karim: Absolutely, yes.
Ben: Okay. PAT stands for Peripheral Arterial Tone?
Karim: Tone, exactly.
Ben: Okay. That's a pretty quick test that I could just go in and get what would you say, like once a year to evaluate vascular function?
Karim: I think so. I think once the genetics are put into place and you're on a supplement program that really keeps things mitigated and you are following the correct diet and supplementation, obviously, and lifestyle to the epigenetic components are put into place and then, I think once a year is just fine.
Ben: Is there anything to this idea that phosphatidylcholine, it's like something you can get as an IV or as an injection, the phospholipid in that can somehow cause the vascular lining to become more slippery or to effect change that would decrease inflammation? Is that something that could be added to an IV and use regularly?
Karim: I think that is a wonderful mechanism for approach. My only pause for concern on something like this, Ben, is that if you have heavy metals already laden within the endothelial vasculature and you're using phosphatidylcholine or phosphatidylserine, or even the precursor to that the phosphatidylethanolamine as an IV, you end up patting that heavy metal deeper into the vasculature. What you should do first is remove, use the drain, clean out the pipes first, then, do the phosphatidylcholine, ethanolamine and the serine into the system.
Ben: Okay, got you. So, I want to talk about a couple of other things, specifically related to neural function and the brain. You briefly had mentioned neurotransmitters earlier when you're talking about serotonin and I know another one that you're able to test for somebody’s analysis is BDNF, brain-derived neurotrophic factor. Can you get into some of the brain and neural issues that you were able to elucidate from this stuff?
Karim: Yes, I’m really quite happy with what they consider to be executive function as part of this testing. They're looking at, not only just the COX gene, the catecholamine, methyltransferase gene, but they're also looking at dopamine, serotonin, noradrenaline, and the impact of BDNF on the serotonin. So, BDNF is considered to be brain-derived neurotrophic factor and that is something that we tend to think of with sports athletes, with people that have had some kind of a trauma or a head injury, if you will. It's the way the brain can rewire itself. If there is a trauma that happened in a certain area of the brain, the brain has to rejig itself. They have to repurpose new different neural imports to offset that one pattern that has been damaged. And so, the brain-derived neurotrophic factor that allows the brain to be able to produce the chemicals necessary to rewire the brain. If you are 9p21 gene is on the lower end, there are certain things that you can utilize to increase that. One is known as intermittent fasting, far infrared saunas is a second, and low-intensity exercise. So, again, not the high-intensity interval training. Those three things generally tend to increase in BDNF. But, remember, that with yourself, Ben, when you have the 9p21 gene and also as a second note, you have the low SOD, so super oxide dismutase is not being produced in large quantity so your tendency of having high levels of pro-oxidants in your system especially after workout is higher. So, the higher level of pro-oxidants, the 9p21 4g that you have, that can lead to a lot more endothelial inflammation. So, you just have to be cautious with the amount of, again, the extreme activity that you used to do and now are no longer doing so it as a good move, I suppose.
Ben: You mean, doving away from like the extremely long, voluminous and difficult like Ironman Triathlons and marathons and things like that?
Karim: Absolutely, yes.
Ben: Okay, got you. Now, when it comes to BDNF, what you're saying is that I don't naturally produce as much as I could or should?
Karim: Correct, yes. So, what this BDNF is supposed to do is when we have a presynaptic A connection to postsynaptic B, there is supposed to be a memory file. So, it's kind of like that E.T. go home neural synaptic discussion that's supposed to happen that creates a memory file. When you have that memory file and there's a trauma or damage that happens with there, you need to create a new file. You have to become elastic. You have to have more plasticity in your brain to find an alternate pathway. Now, if you have a low BDNF and a low serotonin, you run into a sort of a different concern. If we divide track and look at your executive function, your dopamine is fantastic. I have no qualms about dopamine. With regards to dopamine, this is something that allows us to be able to find not only just pleasure but also joy. These are people that tend to get healthy, get up and go. They want to be able to find a mechanism to be able to have happiness in their life, to have drive, to have determination. Your BDNF is without question, fantastic. I have no qualms at all with this one. When we look at your noradrenaline, also fantastic, no qualms at all you are you have what's called a shortened reduced sensitivity when it comes to noradrenaline.
Ben: Noradrenaline, and by the way just a second ago, you said no issues of BDNF, I think you meant dopamine, right?
Karim: I'm sorry with dopamine. However, when we look at serotonin, serotonin is what we call reduced reabsorption so that means that you don't produce enough of the presynaptic serotonin in your system. There isn't enough serotonin floating around in your body. Now, when we look at serotonin, serotonin is considered to be the seat and executive function. This is not speaking to intelligence at all, this is speaking to how does your body find a way of eliminating all the peripheral nagging that's going on in your system. When we think of serotonin, for example, we think of it as a neurotransmitter that is responsible for allowing us to feel calm, to feel relaxed, to feel sort of chill, if you will. The reason as to how and why that happens is because it allows us to mitigate and push away all of the components that are irritating to us, that are nagging at us from the side, that are all those other thoughts. You know, I’ll give an example, at nighttime, if I'm working on an email that is quite intense, it's quite important and I'm there, it’s 11 o'clock at night and I'm just I'm typing away and my wife comes up to me and she says, “You know what? I give up on you. I'm going to bed but don't forget that you have to turn on the dishwasher. Don't forget you have to throw out the trash, and, oh by the way, remember to make sure that the garage door is closed when you throw out the trash.” Great. If I have low levels of serotonin, I will have to stop my email because these other extraneous things that my wife asked me to do, now, are no longer extraneous. They are now at the forefront of my thinking.
Ben: They're like things that you would ruminate on.
Karim: You won't be able to let it go.
Ben: I have that problem.
Karim: And although, clearly, the most important thing for you at this moment is finishing that email because it's drastically important. These other things that your wife asked you to do are now nagging at you. Now, I don't have a nagging wife, so let me just be clear. I love her to pieces but those thought processes are now…
Ben: I wonder if Mrs. Dhanani is listening in.
Karim: Those thought processes are now at the forefront of my thinking. I will not be able to let it go. So, what I then have to do is one of two things, I either write down on a sheet of paper, “do not forget to turn on the dishwasher, do not forget to throw out the trash, and do not forget to close the garage door.” That's one option. The second option is just to the do those darn things. So, there I go, I get up and I do them. I throw out the trash, I turn on the dishwasher, and I shut the garage door. I make sure it's closed. Now, I'm sitting there and I'm typing away and I finish that email. Now, I can go upstairs to bed. There is something also with low levels of serotonin that's called a mental echo. When you get up to the top of the stairs, one might think, “Wait, whoa, hold on a second, did I actually close that garage door? Hmm, I probably didn’t. Let me just double check.” And there you go, bounding down the stairs again, checking to make sure that that garage door is closed. If you don't do that and sometimes for people that have that mental echo or what they call a ripple, they can actually be in bed ruminating about those things.
Ben: Yes, I totally have this issue. I've found that for me to be able to function day to day with a clear head, and it was my friend, it was Ari Meisel, who first kind of introduced me to this concept in his book, “Less Doing, More Living.” Creating some kind of an external dreamcatcher or some way that I could actually keep a clear head by writing down, or getting on to paper, or digitally what it was that was ruminating in my head and now I do that. I constantly have an Evernote document open on my computer, on my Kindle, and on my phone. It syncs across all three devices and anytime anything flips across my head that I need to remember, I jot it down in that Evernote document so that I can come back to it later and revisit it because otherwise, I spend nearly in the entire day ruminating on little things I'm supposed to remember.
Karim: And that is exactly my point. When you have a low level of BDNF and you have low levels of serotonin, you create that exact situation that you're describing, where you will ruminate over something and you will not let it go. Now, again I'm not speaking to intelligence. In fact, I would go one step further that those people with lower levels of BDNF and low levels of serotonin, they actually can connect and link things better than people that don't have that genetic variance. As an example, if you had had a conversation with somebody today, sorry, three weeks ago, and then today, we’re having another conversation, because you haven’t truthfully let go of that conversation that you had three weeks ago about some extraneous piece of material, and then today, you have a conversation with me and we then talk about some other piece of extraneous material, you can actually remember that older one, three weeks ago remember the current one and link them together and say, “Wow, oh, wait hold on. I never thought about that. Let me see if this works.” Because of those low levels of serotonin that you [1:36:16] ______ of the extraneous things actually dissipate and you can sometimes have been playing, maybe not in the forefront but in the background, when something to the forefront is exposed to you, you will then bring that background out and you will say, “Wow, I'm going to connect on that. I'm going to make sure that these two people that don't know each other make sure that they connect and I'm the one that will connect the two of them because they're both talking about interesting things that are separately unrelated but can be connected together.” So, in fact, people in your stance actually end up doing better because you don't let anything go. You hold on to it. Now, it can give you trouble with sleep, of course, because you will ruminate over things like if you have 20 things to do in a day and you've done 10, you will not sleep.
Ben: Drives my team nuts, too, because I will–not only are you correct, I do lay awake at night unless I have that clear head and, by the way, the–so the one thing that I don't do is open up the Kindle or the iPhone or the computer while I'm in bed. What I have in bed is one of these Pilot penlights and a blank piece of paper. So, if I wake up during the night, I flip on that Pilot penlight and the pen produces a very, very small amount of light much less than the actual screen and it doesn't distract me or put me into work mode versus when I take out my actual device. But, yeah, I have to do the same thing. I have to write things down. It's called the Night Writer. I'll link to it in the shownotes. So, I think it was Tim Ferriss who first alerted me to the existence of this LED Pilot's pen that you can use for writing at night. But the other thing that will happen is, I annoy my team sometimes. For example, at KION or my assistants or my virtual assistants because I remember things incessantly, like I'll remember a task that I assigned to them six months ago or eight months ago or a year ago and follow up on it out of the blue just because I constantly how these little things coming across my mind like my mind never shuts down.
Karim: And it also allows logic thinking, deep thinking and connectedness to different parts which is pretty outstanding when it comes to memory. So, it's clearly not an intelligible thing. It is a focus concentration and ability to multitask thing of which you do a really, really good job with. The second thing that BDNF is also responsible for is circadian rhythm. So, sleep is also really important. So, if there is an issue with lowered amount of BDNF, one may have difficulty with falling and maintaining the sleep. So, it will have some trouble–you will have some trouble in telling your body, “It's now time to fall asleep,” because with low levels of BDNF, your brain will consistently be on. And some might even call it the hamster wheel, right, where your brain just keeps repeating things over and over again, until either you write it down or you get it taken care of.
Ben: Yeah. The mind on a hamster wheel. My boys, also, apparently from what you informed me about have the same BDNF and serotonin issue. And so, one of the things that we've really started to go out of our way to do, and I just have a few boxes of this on the kitchen counter now, is Lion's Mane Mushroom Extract because, apparently– and it's very interesting. If you look at it in nature, it looks like a whole bunch of axons and dendrites perhaps sprouting from some kind of a brain. But this Lion's Mane Mushroom is apparently very good for BDNF support.
Karim: It is. It's excellent. Along with–as part of the supplementation, it would be things like ashwagandha, GABA, Rhodiola, 5-HTP, all of these things that tend to increase your natural serotonin production, along with things that will increase BNDF. So, that is the infrared saunas that we spoke to, low-intensity interval training. Sorry, low-intensity exercise and intermittent fasting. But, this is where we run to a little bit of a concern when we have to take all of these different components with regards to your genetics and put into one happy bow for Ben Greenfield, and that is very simply one gene is saying something, which is intermittent fasting for your BDNF. However, your blood sugar, the TCF7L2 gene is saying, “You need to be having small frequent meals because your blood sugar levels are off.” So, when we look at– that's why we also look at other metabolism genes like the FTO gene. So, clearly in your case, the type of diet that you should be–so from an epigenetic perspective, the type of diet that you should be following is small quality meals with low levels of saturated fat. And I don't like to give–I don't like to name diets because we tend to be very specific to the patient, but I will name a specific type of a diet for you. It'll be similar to the Paleo/Mediterranean diet with fibrous vegetables. You can use avocado, but no bullet proof-type phenomenon. No coffee and butter. You can't do the saturated fat. This is–
Ben: Now, just backing up for a second. When you're talking about the saturated fat thing, that has to do with more than just the serotonin and BDNF we’re talking about, doesn't have to do with the APo genes?
Karim: Yes. The APoA gene. Absolutely.
Ben: Can you get into that?
Karim: So, there's like a genetic profile. Yeah, sure. There's a genetic profile that we've got with your system that measures whether or not you should be consuming saturated fat. And I sit in the same stead for you. What I did was, I did a DEXA scan and I didn't like my percentage body. So, there I did intermittent fasting and I would have the cup of coffee, just like all of us used to do, buttered coffee in the morning, and then not eating till 2 o'clock in the afternoon. My first meal would be at 2 o'clock in the afternoon. My last meal would be at 8 o'clock also in the evening. And I would feel fantastic.
Ben: That's a very popular protocol.
Karim: Yeah. And I felt lovely. I felt fantastic about it. I did after 16 months. Eighteen months later after I initiated this program, I decided to do another DEXA scan. And I did, I lost 11 pounds. I felt great. I lost 17 pounds of muscle. My percentage body fat actually went up. When I did my genetic test, I'm the same as yourself, Ben, I cannot have saturated fat. So, when I have saturated fat–
Ben: Unless you have to have very low percentage of it.
Karim: Yes. It gets stored for me as fat. So, we recommend around 7 to 10% if you fall in the same categories, both you and I, the APOA2, 7 to 10% of fat of our diet should be of that saturated-type fat. So, you can have avocados, but you cannot have things like coconut oil or MCT oil. Those fats actually get stored as fat and can create inflammation in your system.
Ben: When you say those fats get stored as fat, you mean that rather than getting shuttled through the liver for the production of ketones…
Ben: …they would more easily be converted to potentially inflammatory triglycerides and also shuttled into also potentially inflammatory storage adipose tissue?
Karim: Absolutely. And so, it would get stored as a–adipose tissue tends to be an organ. It produces quite a bit of inflammation and also is can be hormonally dominant. So, when you consume saturated fat, it does not get utilized as a source of fuel for us. It gets stored and then can become inflammatory in nature.
Ben: And the gene that is responsible for that is what again?
Karim: It's called the APOA2 gene.
Ben: The APOA2. And I possess the variant of the APOA2 gene that dictates I would do better on Mediterranean-style monounsaturated fats with an intake of saturated fats as a portion of my total dietary intake being less than about 7 or 8%.
Karim: Absolutely. Yeah.
Ben: Interesting. How many other people tend to have an issue like that because the ketosis and high-fat diets are extremely popular?
Karim: It's interesting though. I see quite a few patients like that and they range from people, like myself who are Southeast Asian to people that are just Asian to Caucasians to–goodness, everybody. I see across all walks of life. I can't look at–you know, as we were saying with the Slavic Russians, they don't have the UGTB217 gene. I can't say the same for APOA2. So, I can't look at an archetype of an individual and say, “You have an APOA2 variant.” I can't say that. I see that across the board. I see probably about 30% of my patient base that have this.
Ben: Interesting. Okay. So, you got into that as you're talking about serotonin. Are you saying that this particular gene has an impact on neurotransmitters as well?
Karim: I think what ends up happening is, with this particular gene, it can create more inflammation. The more inflammation that you have in your system, it has a tendency of going to your vasculature. And with vasculature, it can cross the blood-brain barrier and have an impact on focus, concentration, not directly on serotonin, but inflammation into the brain.
Ben: Okay. Regarding serotonin, would there be any other things that you recommend when it comes to serotonin measurement for myself or other people who tend to have this rumination issue?
Karim: I think, with regards to serotonin, you also have to make sure that BDNF is also a factor. If you have an issue with both serotonin and BDNF, that's when you run into the hamster wheel phenomenon. If it's serotonin itself, then certain nutrients like GABA, Ashwagandha, Rhodiola, 5HTP, these are all wonderful serotonin precursors. They help you increase the amount of serotonin in your system. Meditation, I found to be exemplary for increasing serotonin in your system.
Ben: Interesting. So, it's not just supplements. A lot of this stuff comes on the lifestyle like longer aerobic or easier aerobic sessions versus lots of high intensity, crush yourself with the workout sessions or meditation, intermittent fasting, use of a sauna. It's interesting how many things from a lifestyle standpoint can be used to optimize your body or your brain based on your genetics.
Karim: It's incredible how much my practice has shifted and changed just because I received this information for patients. I can almost dictate how their body's going to respond given a situation based on their genetics. The information is profound.
Ben: Yeah. It relates to something you told me. I think the way that you phrased it, was you said, “Epigenetics can disqualify genetics.” And you said that as you were saying that if we–well, tell me what you told me regarding if for one of your patients.
Karim: I was actually quite impressed when I was looking at your genetics. And it was interesting though because when we had first spoken, you'd indicated to me, “Well, let's just–we can go over the genetics and we can record this as the podcast night. And I suggested to you, “So Ben, that might not be a great idea.” Your response was, “Well, why is that?” I said, “Because your genetics, goodness, I wasn't expecting your genetics to have so many–” I'm going to use the word flaws, if I may. And that's when we decided to have a conversation about it first before we decided to record this podcast. And you so graciously still allowed to this process to occur, and I was challenging you I think to live and say, “Ben, you may not want the world to know about your genetics because your genetics are not awesome.”
Ben: Yeah. You said, basically, I'm more F’d than most of the patients that you see from a genetic standpoint.
Karim: Yeah. That's what the impressive part was is that you are–you've got this triangulation of three things that I would put in the regard of being concerning. The first is your glutathione levels. Your glutathione levels, your capacity to be able to detoxify to put toxicants out of your system is fairly low. And so, those toxicants can stay in your system and they can cause inflammation. This is the first part. The second part is, if your inflammation, your capacity to handle inflammation is very, very good, I'm not concerned. However, with your 9p21 and your TCF7L2, which is your blood sugar one, if those are out challenged, which they are for you, your inability to detoxify and your inability to reduce the inflammation in your vasculature, that sets us up for some cardiovascular risk. Those two are ones that were concerning for me. Then we tacked on this third concern of the serotonin phenomenon. And, I look at all of these and I say, “Wow, Ben has low levels of glutathione. He has a very, very active lifestyle, so he's producing a lot of pro-oxidants that will then get thrown into his vasculature that's going to cause a massive amount of inflammation, and he has his BDNF and serotonin concerned where he's going to be nervous and anxious about not getting his things done and he's going to probably be flying around the world even more, doing more, creating, again, more information, and it becomes a cascading cycle. And I thought, “Wow, Ben, you know, I really need to have a chat with him and talk to him about this.” And as we spoke, I was extremely impressed by the amount of things that you were doing epigenetically–having a 24-hour blood glucose monitor on use, not something that people do on a regular basis. All of the things that you were doing epigenetically has proved to anyone who should be listening that genetics are only trumped by the epigenetics. Your lifestyle that you were following, the clean eating, the exercising, the recognizing of what exercising you should and should not be doing, and the overall functionality of how succinct you are with finding ways to exhale, to be calm, to yet still be very, very efficient, and with the activity levels. I mean, it's astounding how well you are doing given your genetics. So, I'm duly, duly impressed because when I first saw your genetic report – that's why I reached out to you and said, “Hey, Ben, your report is in. We need to have a conversation about this.”
Karim: I think you had thought that I wanted to have a conversation with you because of a podcast, but I actually wanted to have a conversation with you because I was concerned about your genetics. I mean, simply I was concerned about your genetics.
Ben: One could argue that I'm mildly obsessive over enhancing health, and I think that being in the position I am and constantly getting exposed to folks like you were just streaming a lot of this cutting-edge knowledge, it allows me to probably fix a lot of potential genetic issues that I would have experienced and I don't want to shove any of my family members under the bus, but I look around me and my brothers and my sister and–you know. Again, I want to be careful because I know, you know, my family listens to this podcast, but they're not doing as well as they probably could from a health standpoint. And I question what parts of my genetic profile they share and how much better they could be doing if they were doing a lot of things that I'm personally doing, you know, from a biohacking and then nutrition and lifestyle standpoint. At the same time, there are probably things that I've done that haven't done me any favors like a lot of the high-intensity interval training and the hard-charging stuff. And you even encouraged me. And I've thought pretty intensively about this since our discussion about whether or not it is prudent for me to continue to compete at the level that I'm competing in the sports I've chosen to compete in versus say, maybe thinking a little bit more about golf and hiking and a lower intensity, constant steady state sports such as say, open-water swimming or solo cycling or something that allows me to not have those frequent blood and vascular, almost like waterfalls or fire hose type of experiences that you said would not do my vascular function any favors. So, it's certainly got my brain ticking a lot of my brain despite its potentially low levels of BDNF. Think a lot about some of the things that I can change, so this has been incredibly eye-opening for me. I know we're getting pretty long in the tooth, but I wanted to make sure that we equip people with the knowledge they need if they want to get a test like I did or to work with you. I know that you are going to be putting together some packages for folks who are listening in. But the basics from what I understand is that folks can get tested. They have the option when they get tested to get a consult with you. And they also have the option they get tested to get some of these like customized supplement packages that fix some of the issues that are highlighted on their genetics. Is that correct?
Karim: Yeah. I've always found that that information is key. And, when you're equipped with this information, you can make the conscientious decisions as to what your next steps in life should be. But we're not able to make that decision if we don't have the accurate information. So, yes, I would love to provide the testing mechanism to your large fan base. I think that would be an opportunity for them to learn more intricately about their genetics and the functionality of their genetics. I don't really care if I blink four times. If I have chocolate, there's a gene out there that I think that does that, makes no difference in my life. But if I know that I don't have or I'm missing completely a glutathione gene, that makes a massive difference in my life. And so, knowing that information, I think is huge. But because there is a lot of information there, you do need sometimes on occasion to have someone to help you guide through all of that information, of which, I'm very, very happy to do. And then, of course, the last bit being it's not just that information. And looking at things from an epigenetic perspective, what can I do on a supplement's perspective to see if we can mitigate some of these concerns and rather than go off to the health food store and buy 30 different pills. Because I was on 17, on average, 17 different supplements on a regular basis, and I would cycle between them. Now that I'm on these nutrient supplements, what I've done is all of those ingredients and then some. So, now I think I have twenty-three different ingredients all blended into one formula. So, I don't have to run out and buy different things. It's just specifically that compliance is so much easier. I don't have a wrist pain from opening up all these different bottles, it's all into one. And so, the connection between genetics, lifestyle, and then solutions with supplementation gives us a perfect opportunity to have that process contended with.
Ben: Literally, like when you get your supplements because you're going to be more– we're talking about kind of getting to go some packages for me and I'll try and get photos of what this looks like for people on my Instagram channel, et cetera. But in the meantime, you're saying you can take a lot of the stuff and encapsulate it or somehow get it into one serving or one bottle?
Karim: Yeah, we have a–there's a manufacturing process here. JMP is certified facility in Toronto, just outside Toronto in Mississauga. They take all these individual ingredients and they customize it. They blend exactly the quantity in milligrams in international units of exactly what is required per individual patient. It takes about four days to make for one patient. So, it does take a little bit of time, but it's customized blended just specifically for that patient. And it is truly the next generation of medicine.
Karim: And I think the aspect of walking to a health food store and picking this or that for whatever you feel is necessary or whatever the health food store owner deems necessary, I think those days are numbered. Like we look at, can your body take beta-carotene and convert that to vitamin A? Can your body absorb and transport vitamin D? What about vitamin C, can you absorb that in your system? If you can absorb it, why are you taking higher doses of vitamin C? Unless it's required, unless it's the winter months, unless it's the cold and flu season unless you're trying to ward off something. But on a regular basis, you may not need vitamin C if your body can absorb different food.
Karim: And so those kinds of things we look at to determine what's necessary for you.
Ben: Very cool. All right. So, what I’m going to do is I'll–if folks go to bengreenfieldfitness.com/genetictesting, so far, what you can get there, what we've put together is you can get $50 off a consult with Dr. Dhanani. if you want to have a consult with him to go over your results or even talk about testing, you can basically hire him – automatically, get $50 off for being a listener. Normally, the tests that we just discussed would cost $920. Right now, at the time that you're listening to this, we’re bringing that down to $400 for the test. Normally, if you're to get the customized supplements, you'd be paying about $229 a month. I'll bring that down to $199 a month for all the customized supplementation protocols based on your genetic results. So, I will put all of those savings along with a special link for you over in the shownotes at bengreenfieldfitness.com/genetictesting. I can tell you right now. for me, personally, this was one of the most eye-opening and insightful medical tests that I've ever done for myself and perhaps just as important or more importantly for me, for my boys, because now River and Terran are growing up knowing, okay, vitamin D blended with something like vitamin K is crucial for me in my development. Glutathione is something that's going to allow them to fight an uphill battle against the post-industrial era that they're growing up in. They know now about BDNF support. They're doing the sauna. They're doing glutathione. They're doing aerobics exercises. They're doing a lot of things just like dad. And so, I think this is really important too, for you to be able to see what it is that your kids or your loved ones should be up to from a health standpoint. And, of course, all they really care that much about, ultimately, was the fact that they're so genetically related. I think there was only like one SNP or one variation, which they were different. I think Terran had one variation–one of his testosterone genes. But ultimately, they thought that was pretty cool too, how similar they actually are. So, this is fascinating. I think we only scratched the surface of biological medicine and all the other things we could have talked about Dr. Dhanani, but what I'll do is, again, in the shownotes at bengreenfieldfitness.com/genetictesting, I will link to everything from the medical week conference in Germany that we talked about, to this bioregulatory medicine book that I read, the Corona Resort in Miami, supplements, the DNA testing results that we've just gotten done discussing, should you want to just view them in PDF format. Everything that you need along with a link Dr. Dhanani's website where you can get all the discounts on your own consultation, your own testing, your own supplementation protocol, that's all customized for you. Everything's going to be over at ben.greenfiedlfitness.com/genetictesting. Dr. Dhanani, we might have to do a round two based off of all the different things that we could probably geek out on.
Karim: Yeah, it'll be my pleasure. That was fun.
Ben: Awesome. Alright, folks, well, I’m Ben Greenfield along with the great Dr. Karim Dhanani from Toronto's Center for Biological Medicine, signing out from bengreenfieldfitness.com. Have an amazing week.
Since recording this podcast, I have added the company “YouNutrients” as an alternative to Dr. Dhanani for the type of test discussed in the show. They offer their complete functional genomics test package for $399 USD (that’s a savings of $50 from retail price), and your test package includes both Hormone and Genome Pulse panel tests as well as a clinical report for each panel, along with full access to their webinar series, which introduces the science and interpretation of your genomic results with regards to key biological systems and processes. Click here for that special offer from YouTrients for Ben Greenfield listeners.