December 12, 2015
[0:00] Introduction/ For Sigma Foods
[3:08] Dr. David Minkoff
[8:59] How Dr. Minkoff Got Into His Current Field
[15:11] Testing For Mercury
[17:27] How Dr. Minkoff Came Upon Amino Acids
[36:17] The Use of BCAAs
[41:52] Ketosis and Amino Acids
[47:05] Amino Acids and Nitrogenous Waste Build-Up
[50:32] Amino Acids for Appetite Suppression and The Like
[56:43] End of Podcast
Ben: Hey, folks. It's the holiday season, and so today I want to tell you about a little holiday treat that happens to be the sponsor of today's episode. It's hot chocolate, but it's not just any old hot chocolate. It's actually a mushroom hot chocolate shot combined with cordyceps. Now I've talked about Four Sigma Foods on the podcast before, and you can check them out at foursigmafoods.com/greenfield. What Four Sigma Foods has done is they've created a hot chocolate that isn't full of sugar and many marshmallows. Oh no, no, no. It's actually boosted with natural guarana and cayenne chili. It's got the cordyceps mushroom extract we've talked so much about on the podcast before, and it has this really strong dark chocolate flavor that leaves you with a blissful and guilt-free feeling. So you can check this stuff out if you go to foursigmafoods.com/greenfield and, yes, and, you'll get a 15% discount on this hot chocolate if you use 15% discount code bengreenfield. The stuff you're going to want to look for on that site is called Xoco. That's X-O-C-O. Xoco hot chocolate mixed with mushroom extracts. How do you like them apples? Alright, now on to today's episode on amino acids with the great Ironman triathlete and physician, Dr. David Minkoff.
In this episode of The Ben Greenfield Fitness Show:
“There's an epidemic now, chronic illness, MS, autoimmune disease, rheumatoid arthritis, Lyme disease, chronic fatigue, and fibromyalgia, Parkinson's, ALS, these degenerative chronic diseases. I saw that within a few months of treating her with the methods that I learned, her symptoms completely went away.” “Especially if they're trying to do like a detox fast, it's way safer and way better. Your liver needs these things to detoxify. And if you're not putting it in, it's going to catabolize your muscles and your body.”
Ben: Hey, folks. It's Ben Greenfield, and my guest today is actually standing at Ironman Florida talking to me on his cell phone. So you may hear things like the Ironman announcer in the background and potentially the hubbub of folks going back and forth, but this guy is such a wealth of knowledge and I am so excited to have him on the show today that I really don't mind interviewing him straight from the Ironman Expo down at Ironman Florida. But I just thought I'd let you know that this is a cell phone interview. Anyways though, my guest's name is Dr. David Minkoff. And Dr. Minkoff and I go way back.
So I first met him, and he's a 41-timer, a 40-time, 41-time hopefully, within a couple of days, Ironman triathlon finisher, and I met him at the Half Ironman World Championships in Florida about six years ago where I interviewed him a few weeks later for a podcast episode called “A Peek Into The Life of An Ironman Physician”. And then he actually helped me with a personal metal detoxification that I needed to go through, and I did that using a metal chelating spray that Dr. Minkoff designed, and I interviewed him about that in a podcast about how hidden sources of heavy metals are destroying our health and what we can do about it, and I'm going to put a link to all of these interviews that I'm talking about in the show notes in case you want to go and listen to the other goodies that we've had with Dr. Minkoff. And you can listen to the show notes over it bengreenfieldfitness.com/amino, that's bengreenfieldfitness.com/amino.
Now Dr. Minkoff also helped me with my son's exercise-induced asthma. We talked about that in the podcast about why kids are getting exercise-induced asthma. He helped me figure out why River was getting asthma during his soccer games, and we fixed it. It's completely gone, thanks to Dr. Minkoff and the advice that he dished out in that episode. Well, now he's back, again, straight from Ironman Florida, and Dr. Minkoff is back to fill us in on amino acids, branched chain amino acids, essential amino acids, ketosis and all the things that go into amino acids, because they can be a little bit confusing in terms of how to use them, how many calories they have, how quickly they're absorbed, how you would combine them with things like low carbohydrate intake, whether or not they're able to be used to stave off bonking or central nervous system fatigue, a lot of things going into amino's. They're one of my go-to supplements that I use for sports performance, but I want to give you a chance to be able to kind of wrap your head around how these things actually work.
Now Dr. Minkoff actually graduated from the University of Wisconsin Medical School. He's an MD, and he worked in infectious disease, in the neo-natal intensive care and emergency medicine, and then eventually branched out into alternative and complementary medicine, and opened the LifeWorks Wellness Center, which is known as one of the foremost alternative medical clinics in the US. And like I mention, he spends time in the trenches practicing what he preaches. He's done 40 Ironman triathlons, he's about to do his 41st and he knows quite a bit, not only about swimming, and biking, and running, but also about medicine and nutrition. So Dr. Minkoff, thanks for coming on the show today.
Dr. Minkoff: Whoa. Thanks, Ben. Good to talk to you again. [0:06:37] ______.
Ben: Yeah. So how are things down at the Ironman Expo in Florida?
Dr. Minkoff: Well, I just got here. It's a six and a half hour drive for me, so I literally just got out of the car. It looks busy. I think they have a full race. Last year it was 45 degrees or 50 degrees, which means that we couldn't swim. This year, it looks like it's going to be nice, hot. It's clear and I think it's going to be just a perfect day to race.
Ben: You Floridians are so soft. 45 to 50 degrees keeps you from swimming?
Dr. Minkoff: They didn't let anybody in the water. They brought everybody down to the beach at 6:30. From midnight on, I'm sure that there was no chance anybody was getting in the water, but we all got wetsuits and we went down to the beach, we we're looking at it and said there's no way. And then they canceled it, and then they had us go on the bike by number, five guys every 10 seconds, and I was number 3,400 and something, so I sat around the cold from 7 until, I think, 9:30 or quarter to 10. And by then, I was toast.
Dr. Minkoff: I did the bike and half the run, but I was just never warmed up. It was a freezing day. It was a tough day.
Ben: The last time I raced in Florida, they did something similar. They cancelled the entire swim mass start because of an impending hurricane that was blowing in enormous waves into the beach there at Clearwater and they moved us all inland to swim in this nasty stagnant pond, basically, leaving like they had you do when you raced Ironman, one by one, one after the next, and you just sat there in this long queue of athletes waiting to take off for the swim. So kind of an anti-climactic way to start and Ironman triathlon. But ultimately, I'm looking forward to hearing if number 41 winds up going into the notch on your belt. So you'll have to keep me posted on that. In the meantime though, LifeWorks Wellness Center, where you practice, I've been there, I've visit the clinic down there in Clearwater, and it's pretty well-known in the US as one of the top anti-aging and alternative medical clinics. But before that, I mean you're all over the map. You worked in infectious disease, in neo-natal intensive care and emergency medicine. What got you into the woo-woo health side of things, as many would call it these days?
Dr. Minkoff: Well my wife, who is also a very good triathlete, she's just a very good triathlete, she usually is podium in almost anything she enters. In 1996, decided to have fillings removed from her teeth, I was an emergency room doctor at the time, I didn't know anything about toxicology, or heavy metals, or anything like it. About few weeks after she had the mercury removed from her teeth by dentist who wasn't really trained to do it and didn't have the right equipment, she got an episode of thyroiditis, and then she got what looked like MS. She couldn't lift one arm, she couldn't move one leg. I took her to the best neurologist I knew and they said, “It looks like she's got MS”. We need to start her on steroids, and interferon, and some other things.
Ben: It looks like she's got MS? Like multiple sclerosis?
Dr. Minkoff: Like multiple sclerosis. Like acute multiple sclerosis. She's a nurse, she always ate well, she always took care of herself, she's always a great athlete. And it didn't make any sense to me, and one day by accident, she has a home help nursing business and I went to pick her up, and a dentist had just moved in and the sign said “Natural Dentistry”. So I saw him coming out to his car and I went to talk to him, introduced myself, and I said, as I go, “My wife has just been diagnosed with MS and the only thing I can think of that might be related is that she had the mercury fillings in her teeth removed some weeks ago. But I don't know anything about this, or if it's even possible.” And he said, “Oh, yeah. It can be, and you better get educated because way back then, nobody knew anything about this.”
Ben: So at that point, you were already a doctor, right?
Dr. Minkoff: Oh, yeah. I was and this was 1996, so I had already been practicing medicine since 1974, so…
Ben: This was just stuff that you guys hadn't covered in medical school, the idea behind like mercury and metals?
Dr. Minkoff: (laughs) No, no. Then, everybody was getting mercury fillings, there was no warnings about mercury in fish, there was no consciousness about giving pregnant women vaccines with mercury. There was nothing. There was nothing. There was a few dentists who knew about mercury-free dentistry and how the proper way to remove it was, but basically nobody knew anything. So he said, “There is a doctor in Seattle who knows about this stuff, and he teaches courses to doctors, and you'd better go up there and learn it,” because the guys I had referred her to, the endocrinologists for her thyroid and the neurologists for her MS, it wasn't even on their list, the possibilities of what could be wrong with her. And so I went out to Seattle and I trained with this doctor, and I learned it, and I came back home, and I did the testing on her, and lo and behold, her mercury levels were very high. And I got very interested in this whole subject of, there's an epidemic now, chronic illness, MS, autoimmune disease, rheumatoid arthritis, Lyme disease, and chronic fatigue, and fibromyalgia, there's Parkinson's, ALS, these degenerative chronic diseases. And I saw that within a few months of treating her with the methods that I learned, her symptoms completely went away.
And I had no idea at that time to go into practice, but I was so inspired by it. Boy, there was a lot of stuff I don't know. I knew neonatology and infectious disease, and I'm board certified in pediatrics, and I had been in emergency rooms for about 20 years, and I was really good at that stuff. But this other stuff, I didn't know anything about. So she got interested too, and probably two weekends a month, we flew somewhere to do a weekend seminar to learn, and we opened up a little clinic on a part-time basis, 'cause the emergency room is shift work. So I had a couple afternoons a week that I could sort of get my hands wet in it, and we just started to see people with all kinds of things that nobody knew how to handle. And as we learned, we got better at it, and the clinic grew, and grew, and grew, and I left emergency medicine. I've been doing this full-time for a long time now, and it's amazing how a lot of people who have lost hope, I think the average person I see has seen 9 or 10 doctors, but you can make these people better, you can help them to get better if you figure out what are they toxic with, and their bodies are deficient, their guts don't work.
And we can repair them, and they will recover their health, in our hands, about 85% of people that come, they actually get better, and then they can go on and live their normal life. This isn't a genetic defect. A lot of these people get to pinholed as, “Oh, you're depressed.” “This is menopausal depression,” “this is clinical depression,” they're given psych-type drugs. But really, nobody's looking very carefully at basic things, like, “Your mercury's high,” “your arsenic's high,” “you have chemical phthalates, and plastics, and petrochemicals, and mold toxins and, oh, by the way, your body magnesium level, and selenium level, and essential amino acids, and essential fat levels are low, you have no CoQ10, and you have no zinc. And oh yes, you have parasites in your intestine, and your urine's showing high levels of mold toxins.” And that's your typical patient.
Ben: Yeah, it's crazy. So you're testing a lot of things when someone goes into the clinic. And I know we've talked in some of the previous episodes that we've done about some of things that you test for, like metal, for example, and how you chelate that, and that's a full hour-long discussion you and I have had, and for people listening in, I'll link to that over at bengreenfieldfitness.com/amino, but just one question for you regarding that, Dr. Minkoff, before we turn our attention to amino acids, and that is as far as testing for mercury. What is your preferred method of testing for something like mercury?
Dr. Minkoff: Well it depends what you're looking for. A lot of times what happens is that the urine levels, if you don't challenge the body, you won't get any. Because once you have a metal exposure, unless you have a big exposure or you have ongoing exposure, it clears from the blood and then clears from the urine within a couple weeks to a month or two. So if someone's eating a lot of big fish, like tuna, shark, mahi where the levels of mercury are high, and let's say they're having sushi a couple of times a week, their blood levels of mercury will be elevated, and we can pick 'em up on blood. So I look at blood. The lab we use, we'll look at aluminum, cadmium, arsenic, mercury, and lead, and many people have high levels. We also do a challenge on people where we'll give 'em a chelator, whether an oral chelator, like Metal-Free, or an IV chelator, and then measure either their urine or stool levels to get to see what comes out. And if you give the chelator and they have high levels stored in their tissues, then the body will shed the mercury and you can pick it up in the urine or the stool.
Ben: Okay, got it.
Dr. Minkoff: I don't really like care levels because a lot of people who are sick, or if they're mineral deficient, or if they're amino acid deficient, mobilize the heavy metals to the hair, and the hair looks okay, but really they're not okay. It's just that they can't move it because they're missing things.
Ben: Got it. So that metal chelating spray that you reference, that's the same one that you recommended to me when I was doing a metal detoxification, the Metal-Free Spray. It's like a sublingual spray, right?
Dr. Minkoff: Correct, correct.
Ben: Okay, cool. And I'll link to all this stuff in the show notes for those of you listening in because there's a lot of stuff here, I know. But amino acids is what I wanted to actually ask you about, Dr. Minkoff, 'cause I get so many questions about those, and I know that you study them quite a bit and use them quite a bit with yourself, and your patients, and the athletes that you work with. So my first question for you regarding amino acids is when did you begin to use amino acids and why. How did you kind of discover amino acids?
Dr. Minkoff: Well, it was about 10 years ago, I had another health care practitioner come to my office as a patient, and she was an expert in a program for cancer that was developed by Dr. William Donald Kelly. He was a dentist who worked out a way that you could, he cured himself of pancreatic cancer, and he had about 10,000 documented cases that he worked with that were cured with cancer using some very high dose concentrated pancreatic enzymes, and then a few other things. She came to me because she was ill and had heard about me, and she had apprenticed to Dr. Kelly before he died for a couple of years, and she was an expert in his method. And she brought me his book when she came, and I read the book, and it said in there that you could test to see if you had smoldering cancer by taking a dose of these enzymes for a couple of days to see if you turned on symptoms, aches, and pains, other things, that you should keep taking these enzymes because it would kill the brewing cancer cells in you.
And up to that time I had been mostly a vegetarian for about, since age about fourteen. I did eat some dairy products, I would eat occasional fish, but mostly it was brown rice, and perogies, and a lot of vegetables. And I had, at the same time, been suffering from a hamstring for about a year and half that I could not get to heal. Every time I tried to work out how hard, it would hurt again and I was afraid to do anything. And I tried really everything, from chiropractic, to massage, acupuncture, frequency specific microcurrents, I had it injected with propane. I had everything, it didn't make a difference. So we started two things were going out at the same time, so I said to her, “Well, I want to try this program, but I don't think I have cancer, but let me try these enzymes and see what happens.” And she gave a couple days worth of the enzymes and I started taking them.
Ben: What kind of enzymes were these?
Dr. Minkoff: These are pancreatic enzymes.
Ben: Okay, pancreatic enzymes.
Dr. Minkoff: But it's mostly chymotrypsin.
Dr. Minkoff: But this isn't like a digestive enzyme that you buy in the health foods store or get from a healthcare practitioner, or even like Wobenzyme, which is a stronger version. These are just like massively strong. I mean they're like 10 or 20 times the strength of anything you could get. And Kelly was manufacturing these, and when he died, his son took it over. So these are very strong, and the idea is that when you take them, they absorb through your body without them being digested. They go into your blood stream, and if you have a brewing cancer, the cancer protects itself from being seen by the immune system by putting a coat of protein on the surface, like a decoy coat, to make the body think that these are friendly cells. And these high dose enzymes, when we take 'em, digest off that protein, they expose the cancer tissues, and then the immune system can attack it.
So when I took these enzymes, within two hours, I had the worst burning stomach I'd ever had in my life. It felt like I drunk hydrochloric acid. And I had to take bicarbonate and drink a lot of water, and I'd went to her and I said, “I don't think I have cancer, but I sure can't handle these enzymes. So about six months after that it always bothered me why can't I handle these things. But then I'd met a guy who had been in Europe and he had picked up a blend of amino acids, and he said, “These are really something. They're very unique.” And, “You should try these, and maybe they'll heal up your leg, and maybe you could use 'em in the clinic. So I tried them, and within about six or seven weeks, my hamstring was fine, this was like late spring when I tried it, and I went to Ironman Canada that year and I had my best time that I ever had. I also noticed that my maximum heart rate had always been about 172, and that on the amino acids after I was acclimated to 'em, my new maximum heart rate had gone up to 184. So I had a real physiologic change that I could not only perceive, but I could measure. So I started using these amino acids in the clinic, and a lot of people started to, like, “Wow! I'm better. My energy's better. I feel better.”
Ben: And just to interrupt you briefly, how many, or how many grams, or how many tablets of amino acids were you using at that time to do something like heal an injury?
Dr. Minkoff: I was taking 10 every morning. And they're a gram, the amino acids are a gram each.
Ben: So 10 grams?
Dr. Minkoff: So 10 grams. He said experiment with more. If you do a long ride day, a long run day, take another dose when you're done because you'll recover faster. So that's the program that I went on. And then this patient of mine came back about six months later, and I thought, “I'm going to try these enzymes again just to see if there's any difference.” And I took the enzymes for four days, real high dose. My stomach was completely fine. And then I realized that because I'd been a vegetarian, I was probably inadequate in amino acids. That's why my muscle didn't heal, my stomach lining wasn't normal, and that once that I was taking these amino acids, my body actually went back to the way it was supposed to be. That was a huge, sort of, revelation for me. Like, “Holy smokes, maybe it's not just me.”
So then I started to measure every patient, their blood levels of amino acids, which is 22 amino acids. I would measure their blood levels of amino acids, fasting in the morning. And I found that all chronically ill people, almost all athletes, in fact, almost everybody had deficiencies in their serum level of amino acids, especially the essential amino acids which are the, there's eight of them and they include the branch chain, but then there's five more. And these eight amino acids make up over 50% of every protein in the body. And if they're, if any one of them is in a low state, then the protein that that's needed for may not be made when it needs to be made. And that could be anything from a digestive enzyme, to muscle, to tendon, to bone, to a neurotransmitter, the growth hormones, the insulin, these are all made out of protein. In fact, there's about 50,000 proteins in the body, paired or made newly every day.
Ben: Did you test your body, or do you now test to find out if people are amino acid deficient? Like is there a good test to actually see if you need amino acids?
Dr. Minkoff: The one I like the best is, Genova does it. It's called the ION Panel.
Ben: Okay, yeah. I'm familiar with that one.
Dr. Minkoff: I like it 'cause it's not just amino acids, it's minerals, and vitamins, and essential fats. It's not cheap, but if you're interested in health and fitness, send the money and get the test because you will be amazed at what you find. There's almost nobody who has a normal panel. And when you know what's wrong, you can fix it.
Ben: Yeah. I've had that panel done before. I ordered it through, there's an online company called Direct Labs where you can actually order one of these panels. And yeah, you get a ton of information. And I definitely found out I was deficient in several amino acids when I took it. I would imagine a lot of athletes especially are due to protein turnover and the increased calorie requirements. But ultimately, when, so you started using amino acids, and then you began to implement these into your clinic and use them with patients and athletes?
Dr. Minkoff: Yes. I give them to every patient I see. And they all keep taking it because they feel it and it corrects their blood levels, usually within about three months, and in some of them who are like wasted, like they're a cancer patient and they've been through tough therapies, chemotherapy radiation and they're really sort of emaciated, then I'll give them 30 a day. I was giving 10 three times a day. And generally within three or four months, they'll add 14 to 16 pounds of lean body weight if we add the Perfect Amino to their regimen.
Ben: Yeah. I personally was catabolizing my body with Ironman triathlon, and that's how I went from being 210 pounds in bodybuilding down to 175 pounds in competing in Ironman was just long, fasted bike rides and runs. And eventually, the way that I stopped my body from losing muscle, once I began to get too light, was I kept on doing these runs and these rides, but I would simply take about 10 to 20 grams of amino acids per day, either during the workout or after, to basically keep muscle catabolism from continuing to occur. So, yeah. I know a lot of people do use them for muscle building and maintenance of muscle mass as well.
Dr. Minkoff: Yeah. And I think, like in the bodybuilding arena, there's a very well- known trainer down in South Florida, in Miami, who's having his guys take a hundred grams of whey protein two or three times a day to try to get the maximal protein, but almost nobody can take that much because they get gas, and bloating, and they just can't take all the whey protein. And I said, “Why don't you try using this amino acid blend that we have and give 'em 10 or 20 a day. It won't affect their gut at all and it's way more anabolic. Your body can use these to make muscle about five times better, almost six times better, than whey protein without all the GI distress.” And he went on to these things, or he started putting his guys on these things, and he called me, he said, “I can't believe the difference.”
Ben: How is it different than whey protein, or rice protein, or pea protein? Like how is an amino acid actually different? I mean is it void of calories? Like how would you compare it to something like a protein powder?
Dr. Minkoff: Well, here's the thing, when we eat a protein, it doesn't matter if it's rice protein, or fish protein, or beef protein. There are two possible pathways that once, so when you eat the proteins, your body breaks it down into amino acids. If you think of it like proteins are words and amino acids are letters. So in the English alphabet, there's 26 letters, and if you put those letter together in different combinations, you get different words. So with amino acids, there's 22 amino acids and you put 'em together in different combinations, and you get different proteins. Like insulin, I think, has 69 amino acids in a very specific order. And when you put 'em in that order, that's insulin. If you do, say, the muscle protein, the skeletal muscle protein, I think there's like 455 amino acids in one of those chains. So that's much bigger, but basically it's the same thing. So your body has to take, say, a steak, break the steak by digestion into individual amino acids, 'cause you can't absorb the protein by itself, it's too big. Those amino acids go into the body, they go into the bloodstream, they go to the cell.
And once those amino acids go to the cell, the cell then will do one of two things with the amino acid. It will either use them to make protein, or it will break, amino in Greek or Latin, stands for nitrogen. So an amino acid is a carbon chain with nitrogen on it. Carbohydrates, in fact, don't have nitrogen. They're made out of the same stuff, except they don't have nitrogen. So if the body can use the amino acids to make a protein, then the nitrogen stays in your body 'cause now it's a piece of hair, or it's muscle, or it's an enzyme, and it stays in. If the amino acid comes in and the body can't use it, it will break off the amino. And what you're left with is basically a carbohydrate. And the body will use it as a carbohydrate to burn or to store as fat, or glycogen. So if there's an amino acid that is used, then it gets made into protein. And if it's not used, that amino acid goes to the liver, it gets packaged as ammonia, and then we urinate it out. Urine is basically amino acids that have to be gotten rid of in the form of ammonia.
So what it turns out is that if you do studies on different proteins, let's say you take whey protein, and you measure, you feed somebody only whey protein for three days, and you can measure how many grams of nitrogen that get in when they took the whey protein. And then you measure their urine during those three days, you collect all their urine, and you measure how much of the nitrogen came out. That will give you an idea of how much was actually retained, 'cause the ones that get made into proteins don't come out, the ones that can't be used come out. So with whey protein, if you, let's say, ate a hundred grams of whey protein per day for three days, only 84% of the nitrogen that you took in will be peed out, which means only 16% percent of it is retained. And the reason for that is the mixtures of amino acids in whey aren't very close to what the human body needs to make our protein. And so a lot of them get wasted.
Another quick analogy. Let's say you're in the business of making cars, and the basic parts to a car are 4 wheels, one chassis, one motor, one steering wheel. Like simple as four. And I sent you 400 wheels, 400 steering wheels, 400 motors, and 400 chasses. How many cars could you make? And you could only make 25 cars because the wheels would get used up. And they you'll have all these steering wheels, all these motors, all these chassis left over, and they're going to sit in your junk yard. And that's what happens with the human body is when the stuff's left over, there isn't a storage pool for amino acids or for proteins. They have to be gotten rid of.
Ben: In this case, your body would create 25 cars, and then it would dump all the chassis and everything else that got shipped, the extra 375 leftover pieces it's not going to be able to use that just gets dumped out via your urine. It has to be processed by your body as nitrogenous waste.
Dr. Minkoff: Exactly. So then we could then do a balance study on, “Okay, let's do whey protein and see what happens.” “Let's do brown rice protein, let's see what happens.” “Let's do soy.” “Let's do beef.” “Let's do fish.” And this number is actually how well is the nitrogen in that thing utilized, how well is it made into body protein. And the numbers come out like this: whey and soy are about 16%, beef and lamb and fish are about 32 to 33% utilized. So they're about twice as good as the vegetable protein. The best protein for diet is whole chicken eggs. Egg plus yoke is about 48% utilized. Breast milk's the only thing that's better. It's about 49% utilized. And this formulation of amino acids is tailored to be the most utilized thing that's ever existed, and it's 99% utilized. So when you take this mixture of eight amino acids, the Perfect Amino, the utilization of the amino acids is 99 plus percent. There's virtually no nitrogen waste. And virtually no calories because there's nothing burned. It gets made into body protein by your body. So that's why it works so well, because it's exactly what the body needs to manufacture protein.
Ben: So when a study comes out that shows, for example, whey protein to be efficacious for post-workout protein synthesis, or for hypertrophy, or something like that, it's not that the whey protein is useless, but it's simply what you're saying is the fact that not as much of that is utilized as could potentially be utilized if it were broken into its individual amino acid constituents, and if we were to just consume the essential amino acid portions of something like a whey protein or a steak.
Dr. Minkoff: Right. It's the essential amino acids in the right balance.
Ben: Now what is the right balance? When you say the right balance, is that the ratio?
Dr. Minkoff: It's the ratio. Here's an example. In the Canadian FDA, when they looked at this product, they said the evidence is, the scientific evidence is that there are nine essential amino acids, not eight. And we will not allow you to sell this product in Canada unless you add the 9th amino acid, which is histidine. And so a study was done that if you add that 9th amino acid, histidine, to the eight, that the nitrogen utilization goes from to 99 to 94. It goes down. That adding the extra one doesn't help. It makes it worse because now you have extra junk that has to be processed. So the ratio has to be exactly what it is, and if you alter it, it won't be as good.
Ben: Okay. Got you. So this is very similar to actually something else I wanted to ask you about here in a moment, but branched chain amino acids, a lot of times, you'll hear, with branched chain amino acids, which are leucine, and isoleucine, and valine, for example, very popular among athletes and bodybuilders, they'll use, in many cases, like a 2:1:1 ratio claiming enhanced absorption and utilization at that ratio of amino acids. But when it comes to BCAAs, the branched chain amino acids, versus something like essential amino acids, or EAAs, can you explain what the difference would be between the two and why so many people are using BCAAs, a very, very popular supplement?
Dr. Minkoff: Right. It's mostly marketing. It isn't science. But you could take branched chain amino acids in any doses you want all day long, and if you just ate fruits and vegetables, which have negligible other amounts of amino acids, your net nitrogen utilization would be zero. Because with three amino acids, you do not build protein and you can't because you need eight. What happens is is that the branched chain amino acids get used for fuel because they get turned into carbohydrates and they spare muscle. And so you may utilize your other proteins, or you may not catabolize your existing proteins as much. But they're not anabolic in themselves.
Ben: Okay. So it's primarily the absence of an anabolic effect, the maintenance of lean muscle, the building of lean muscle or other tissues within the body that you're missing out with on BCAAs. They're basically burnt as fuel, but don't necessarily give you like an injury prevention effect or something like that?
Dr. Minkoff: Right.
Ben: But when you're taking something like an essential amino acid, you're saying that you're still getting leucine, and isoleucine, and valine, so you're still getting the fueling aspect of something like a BCAA?
Dr. Minkoff: In the what now? Say that again please.
Ben: So with an essential amino acid, that still has all of the branched chain amino acids in it, right?
Dr. Minkoff: Yes. ‘Cause they're all essential.
Ben: Okay. So we're still getting the fueling benefits of a BCAA when we take an EAA. But with the EAA, you have the added anabolic benefit.
Dr. Minkoff: Yeah. But if you take the essential amino acids in the right ratio, it's not going to be used for fuel. It's going to be used for anabolic effect.
Ben: What about if you take it during a workout?
Dr. Minkoff: The repair of muscle starts immediately. It's actually going on all the time, so we usually suggest to people that you take dose before you work out because you're going to get active recovery while you're even working out.
Ben: Okay. Got you.
Dr. Minkoff: And then if you take a carbohydrate with it, you'll have something to burn if you don't have any glycogen left or if you're not a fat burner.
Ben: Now do you personally, because this is what I used to do when I raced Ironman, I would take 5 to 10 of these per hour during the actual race. Do you use them during the race or do you just use them before or after?
Dr. Minkoff: No. I use them both. I take 10 grams before, and now what I've discovered is if I put, we have it available now as a powder too, so if I put the powder in a bottle of water, that's what I drink. So I'm doing 5 to 10 an hour while I'm racing, and it has a great effect, not only on your muscles, but on your head. There's this whole thing of your, your brain stops before muscles actually stop 'cause your brain, if it perceives if something's going to go wrong, it will get conservative. And if it's getting plenty of amino acids, the sort of bonk, or the kind of like I-can't-go-anymore feeling usually is diminished.
Ben: Now that's something that I've heard before, this idea that central nervous system fatigue is what may cause you to slow down during a workout or during a race, and that it's not actual exhaustion of your glycogen stores, but it's central nervous system fatigue due to low levels of amino acids in the blood. I've also heard that tryptophan, the amino acid that can make you sleepy when it crosses into your brain, can be offset or competed against if other amino acids are present in the bloodstream. Now have you looked into either of those theories when it comes to amino acids?
Dr. Minkoff: Well, tryptophan is an essential amino acid. It's one of the eight.
Dr. Minkoff: So it's in the product. So you're getting tryptophan, and tryptophan is in every protein in the body. Every protein in the body has tryptophan.
Ben: Is this one of those ratio issues you were talking about? Like for example, if tryptophan were present in too great a ratio in an amino acid blend, then it could potentially cause sleepiness, or you could potentially experience that central nervous system fatigue if too much tryptophan were present?
Dr. Minkoff: Oh, sure! And we make a sleep product to help you sleep, and it has an activated form of tryptophan called 5-Hydroxy Tryptophan, and if you take tryptophan before you go to bed, you'll get tired.
Ben: Yeah. That's 5-HTP, right?
Dr. Minkoff: Right. And it's a precursor to melatonin, and it gets made into melatonin, and it'll make you sleepy. So, yeah. It'll definitely do that. And these amino acids can be used individually as in sort of pharmacologic doses, like when you use one or two, if there's a specific thing that you're trying to do, you're trying to activate a certain pathway, you’re trying to make dopamine or you’re trying to make serotonin, or you're trying to make melatonin. That usually needs individual amino acids, you can do it. The purpose of Perfect Amino more is for sort of overall general whole body protein synthesis.
Ben: Now a lot of people who are experimenting with carbohydrate restriction, or with ketosis, for example, do experience catabolism or muscle loss because of inadequate levels of amino acids. And I know that many of them are using branched chain amino acids, for example, to fuel workouts in the presence of very low carb intake, or along with something like MCT oil, or ketones to maintain high levels of ketosis. Have you experimented at all with ketosis, or carbohydrate restriction, or do you have any information on how essential amino acids would play into that equation?
Dr. Minkoff: Well, I've been experimenting with it with intermittent fasting. And what I've found is that the, and I'm just taking the Perfect Amino blend, but I find that my workouts are great. If I ate my last meal at 6 o'clock at night, and I work out in the morning, that I can run two and a half hours with nothing except 10 grams of the Perfect Amino. And I'm totally fine. So I think that it does make a difference and that, each person's so different on this, and everybody's doing something different, but it won't break your ketosis. I mean I think if that's the thing that the person's worried about, since these are utilized and they're not turned into sugar, that you don't have to, there's only four calories in 10 grams. So it's really almost nothing. Less than a piece of gum. So if you're trying to be ketotic or stay in ketosis, these won't break your ketosis. I can't say that 100% percent, but…
Ben: There's no gluconeogenesis that occurs when you consume an essential amino acid versus something like a protein power or a steak?
Dr. Minkoff: Well, this blend. Everything else, probably there will be.
Ben: Okay. Got you. The specific ratios that you formulate, they're in the proper blend.
Dr. Minkoff: Right. There is not a lot of research on this, so most of this is anecdotal, but the research is that if it's 99% utilized and there's 4 calories per 10 grams that if you're in ketosis that this amount of calories isn't going to make any difference. It's not going to break your ketosis.
Ben: Yeah. I took them quite frequently during the 12 months that I did strict 90% plus fat-based diet, and that was one of my primary sources of protein, was just these, I would eat them by the handful. They don't taste very good, but I would literally just put 'em in my mouth, and chew and swallow, and chase with a strong glass of water. The next question I have for you, kind of related to chewing and swallowing them is I know that sugar can absorb almost instantly in the mouth. But with amino acids, what are we looking at in terms of digestion. And the reason I ask is a lot of times, I will tell athletes not to consume, for example, an eggs and bacon breakfast prior to a big workout, or run, or triathlon, or something like that because that protein can take four to six hours to digest, and absorb, and for any amino acids to really be available. What are we looking at in terms of time when it comes to how long it takes the stuff to hit the bloodstream?
Dr. Minkoff: Well, with the Perfect Amino, it's 23 minutes. That if you take it with a glass of water, juice, or a sports drink, you take 10 tablets. In 23 minutes, you will see the elevation of amino acids in your blood. It's probably absorbed through the stomach wall, they're already pre-digested so that they don't need any digestive enzymes. There's no digestion process. Once they hit, they go. And when people take 'em, that's why you shouldn't take two four times a day because there just isn't enough “Oomph” to make an impact. You’re best taking 'em as all at once. If you're going to take 6 a day, or 8 a day, or 10 a day, take 'em all at once because that sort of gradient of concentration gets them across better and they're utilized better.
Ben: Should you take them with a meal or apart from a meal?
Dr. Minkoff: Well if you take 'em with a meal, they're going to get mixed up in your stomach with everything else and who knows what's going to happen. So I tell people, “Take 'em on an empty stomach 23 minutes or more before a meal, especially if that meal has fat or protein.” Now you can take 'em with, if you're just eating, if you have, so let's say you want to have a banana or some berries, it won't interfere with them 'cause there's virtually no protein in there, and there's no fat in there, and it won't delay absorption. But with fat meals, if you have an avocado and you take 'em, it's going to get stuck.
Ben: Okay. So my nightly habit of finishing up a workout and having a glass of wine and a handful of amino acids for the protein, the glass of wine is a non-issue?
Dr. Minkoff: Non-issue.
Ben: Okay. ‘Cause that's kind of my little hack, is I generally don't eat dinner for like a good hours after my workout, but I want something as I finish up and I sit there in my recovery booths or stand at my desk, working on an article or something like that. And so I'll just chomp on a handful of these amino acids, you just like take 10 or so, and I do that along with a glass of wine. And what you're saying is don't mix them with proteins and fats. But if you had, for example, a piece of fruit, or a glass of wine, or a sweet potato, or something like that, it wouldn't mess up the absorption of the ratios?
Dr. Minkoff: Right. Stave off the butter on the sweet potato.
Ben: Okay. Got you. Now how many amino acids, or what gram dosage of essential amino acids can you safely take on a daily basis? Do you get to a point where there's any nitrogenous waste build-up?
Dr. Minkoff: Yes. And for the average person, it's 30 grams a day. You can meet your full body requirement at 30 grams a day. If you're a vegan, and you don't eat animal protein, and you're worried about your protein intake, and you want a complete substitute, if you take 10 three times a day, you'll fulfill your whole requirement. There's actually a study on this. There's a desert in China called the Taklamakan Desert, and I think it's 400 and something miles of just very rough terrain, temperature extremes from below freezing to over a hundred. It has never been successfully navigated by an unsupported person. A person with just a backpack, walking across it. It had never been done. And so there was a racewalker gal, who was tested beforehand for her VO2Max, and lactic threshold, and heart rate, and hemoglobin, and all this stuff, and she took eight of the amino acid blend three times a day plus about 3,500 or 4,000 calories of a glucose, fat, vitamin, mineral mixture, and she did it in 26 days. And when she was tested at the end, she was actually anabolic. She had lost some body fat, had gained muscle, her lactic acid threshold had gone up, her hemoglobin had gone up. She hadn't had any catabolic effect at all, and this was 135 pound gal at eight tables three times a day.
Ben: Eight tablets three times a day, and she was just taking those during her actual expedition?
Dr. Minkoff: That was her sole protein source. Now, I had the same thing happen with a couple of the guys on the Tour de France team. Jeff Spencer is a good friend of mine and he was working on the team, and we gave them for a couple of the guys, the amino blend, to see what would happen in the tour because he told me that they were always catabolic no matter what they gave ‘em in terms of IV nutrition, food, that by the end of the tour, they were all broken down. And so they were taking, in addition to whatever else they were eating, they were taking 10 tablets three times a day. And what he reported is that they weren't catabolic at all. They were fine. That they were able to maintain muscle mass, the usual tendonitis, the rest of the stuff that they saw, that the body, with that dose, was actually able to keep up with the metabolic demands of the race and stay even and not break down. And that was also remarkable to me that the body could it if it had the materials that it needed to keep up with protein metabolism.
Ben: Now are you familiar with the appetite suppressing effects of some of these amino acids? Like I know, for example, phenylalanine, which is an essential amino acid, after you eat it, your intestines release the hormone cholecystokinin, and that's like the signal to your brain to feel satiated after you eat. Do you use this much for folks who are trying to lose fat, control appetite, control carb cravings, things along those lines?
Dr. Minkoff: Well what we found is that, and this is also, there's a published study on this that if you put someone on unlimited fruits and vegetables and their only protein source is the amino blend, and they take 10 tablets three times a day, that you get very, I think in one month they had close to 20 pound weight loss, with complete sparing of lean body mass. And they were eating about 2,000 calories a day. So we've used this in the clinic, and it can work. And then in our office, we've done about, I think over 500 patients on like a HCG diet where people are basically on a 500 calorie a day fast.
Ben: Yeah, that's a very low calorie diet.
Dr. Minkoff: It's very low calorie. Fat melts off these people, and we give them Perfect Amino while they're doing it. They lose the same amount of weight, but they don't waste all their lean body mass. They hold their lean body mass. We put them on the scale and we're watching them every week. They don't lose bone and they don't lose lean body mass. So that even though they're calorie restricted, they keep up, what they're burning is fat and not their own lean body tissue.
Ben: So theoretically, if you were using like strict ketosis, intermittent fasting, daily fasting, things along those lines, these, because they are pretty much eucaloric, or not eucaloric, but they're a caloric, they're four calories in a very large serving of them, you can get away with getting your proteins, staving off muscle catabolism, stabilizing the appetite a little bit, and still restricting calories?
Dr. Minkoff: Yeah. And I think if people are doing this, especially if they're trying to do like a detox fast or one of these things, that it's way safer and way better. Because your liver needs these things to detoxify. And if you're not putting it in, it's going to catabolize your muscle, and your body, and your organs. And if you're putting these in, it won't do that. It'll preserve itself, which is what you want.
Ben: Dr. Minkoff, how old are you, if you don't mind me asking?
Dr. Minkoff: 67.
Dr. Minkoff: Yeah.
Ben: Okay. So this will be your 41st Ironman that you're toning the line on, and I guess at the time of this recording, in two days. That race is on Sunday?
Dr. Minkoff: Saturday, yeah.
Ben: Okay. The race is on Saturday. Okay. What kind of time are you shooting for?
Dr. Minkoff: If I did 13, I'd have a good day. If I did under 13, I'd have a great day.
Ben: That's pretty quick for a sub-13 Ironman at 67. That's up there. Are you, do you go to Kona? Do you compete in Ironman Hawaii at all?
Dr. Minkoff: Been to Kona eight times. Haven't been there since, I think, 2010, 2009. My first Ironman was Kona, 1982.
Ben: Okay. Wow. You've been at this a while. I was one year old in 1982. It's amazing. Resilient man.
Dr. Minkoff: Yeah. And I still work a 50-hour week, and I have a busy clinic. I do a lot of other things, so when Tony was coaching me a bit last year and finally we just threw our hands and we said, “We don't think you don't have time to train for an Ironman.” So she said, “Well, you shouldn't do it.” Well, I thought I like it and I'd do the best I can, and my workout hours aren't probably any close to what would be ideal. But it's fun, and I do it 'cause it's fun. And I got a podium last month at Agusta, the half-Ironman. And it's fun. It's a game. I'll just have a good time. While there's old guys sitting on the swim dock, ready to jump in. It's not serious. We're just all glad to be alive, and we're glad to be there, and we're just like, “Thank God we can do this stuff.”
Ben: Although I plan on probably golfing when I'm 67, more power to you. I love what you're doing. And best of luck on Saturday, best of luck from myself and the rest of the Ben Greenfield Fitness audience.
Folks, if you're listening, you can go to bengreenfieldfitness.com/amino to read up on the show notes. I've been taken some notes about everything from these pancreatic enzymes, to the ION panel from Direct Labs, the metal detox, all the previous podcasts I've had with Dr. Minkoff and these amino acids. You can check all that out in the show notes over at bengreenfieldfitness.com/amino, bengreenfieldfitness.com/amino. And in the meantime, Dr. Minkoff thanks so much for coming on the show and sharing this stuff with us.
Dr. Minkoff: Thanks, Ben. I appreciate it. You've been an inspiration to me too, and it goes both ways. So I appreciate all you do, and your knowledge, your book was just amazing. So keep going 'cause people need you and you put out great information.
Ben: Cool, man. Thanks. I appreciate it. Well folks, this is Dr. Minkoff and Ben Greenfield signing out from bengreenfieldfitness.com. Have a healthy week.
Dr. David Minkoff and I go way back.
I first met this MD and 41 time Ironman triathlon finisher at the Half-Ironman World Championships in Florida six years ago, and interviewed him a few weeks later in the podcast episode “A Peek Into The Life of An Ironman, Natural Medicine Physician.”
Then, he helped me with metal detoxification using a metal chelating spray he designed, and I interviewed him about this in the podcast “How Hidden Sources Of Heavy Metals Are Destroying Your Health, And What You Can Do About It.”
He also helped me with my son's exercise induced asthma, which is now completely eliminated using the techniques Dr. Minkoff introduced me to in the podcast “Why More Kids Are Getting Exercise Induced Asthma, and What You Can Do About It.”
Now Dr. Minkoff is back. And he's back to fill us in on amino acids, branched chain amino acids, ketosis, bonking and more! During our discussion, you'll discover:
-The shocking story of how Dr. Minkoff reversed his wife's MS by detoxifying the mercury build-up in her body…
-The exact dosage of amino acids Dr. Minkoff used to completely heal a hamstring injury…
-The important difference between amino acids, protein powder and food-based protein from sources like steak and eggs…
-Why BCAAs and EAAs are much different, and why EAAs are not turned into sugar in the body…
-How to use EAAs during periods of ketosis or carbohydrate restriction…
-How long before a workout to use EAAs and how many to use during a workout…
-How many amino acids you can safely take on a daily basis…
-How to use EAAs for intermittent fasting, controlling carbohydrate cravings and fat loss…
-And much more!
More About Dr. Minkoff:
Dr. Minkoff graduated from the University of Wisconsin Medical School in 1974 and was elected to the “Phi Beta Kappa” of medical schools, the prestigious Alpha Omega Alpha Honors Medical Fraternity for very high academic achievement. He then worked as an attending physician in infectious disease, co-directed a neo-natal intensive care unit and worked in emergency medicine until 1995.
In 1997, his interest in alternative and complementary medicine led him to open LifeWorks Wellness Center, which has become one of the foremost alternative medicine clinics in the U.S. His search to find a source of the highest quality nutritional supplements led him to establish BodyHealth in 2000, a resource that could provide doctors with the best possible supplementation and education for their patients. Today, his BodyHealth products are used by hundreds of practitioners and individual consumers who seek all-natural wellness and detoxification supplements with a demonstrated high level of quality and effectiveness.
In addition to their use by patients looking to heal disease, the BodyHealth products are also used by sports enthusiasts interested in achieving and maintaining optimal performance. As a 40-time Ironman triathlon finisher, (including 8 appearances at the Ironman World Championships) Dr. Minkoff has first-hand experience to help athletes achieve optimum conditioning. His expertise in protein synthesis, detoxification, and nutrition allow them to run, swim, and bike faster and longer.
This episode is brought to you by:
Four Sigma Foods – Visit foursigmafoods.com/greenfield and use code ‘bengreenfield' for 15% off!
Resources we discuss in this episode:
Interview with Dr. Minkoff: How Hidden Sources Of Heavy Metals Are Destroying Your Health, And What You Can Do About It.
Interview with Dr. Minkoff: A Peek Into The Life of An Ironman, Natural Medicine Physician.
Interview with Dr. Minkoff: Why More Kids Are Getting Exercise Induced Asthma, and What You Can Do About It.