Unlock Your Energy with Mitochondrial Testing for Nutritional Gaps and Toxins with Dr. Sam Shay

Episode 85:

Unlock Your Energy with Mitochondrial Testing for Nutritional Gaps and Toxins with Dr.

Sam Shay and Evan H. Hirsch, MD

Evan H. Hirsch, MD 00:01

Hey everybody, welcome back. As you know, we're on a mission to help people with

chronic fatigue long COVID and M casts, resolve, find and fix their real root causes so

they can live the life they deserve. And I'm super excited about today's episode because

we're talking with my good friend, Dr. Sam Shea, all about mitochondrial testing. So if

you've been curious about what the mitochondria is, and how to test for it, and how it

plays a role in your energy, stay tuned. So let's learn a little bit about Dr. Shay. So Dr.

Sham che chiropractor and I have MCP certified solves health puzzles for busy health

conscious moms, entrepreneurs and those on the spectrum so they can exit survival

mode and enter community. I love that Dr. Shay walks his own health journey walked his

own health journey from being chronically unwell from age six to 18, including severe

fatigue, anxiety, digestive problems, chronic pain, severe insomnia, and poor nutrition,

which led to social isolation isolation, which then further compounded his health issues.

He took control of his health starting as a teenager and dedicated his life to natural

medicine, functional testing, and re entering community. Dr. Shay is also a stand up

comic. He's very funny, you check them out who uses comedy as edutainment on his

YouTube channel, along with his other functional testing techniques. Dr. Sam, thanks so

much for joining me today.

Dr. Sam Shay 01:26

Thanks. It's really good to see you. I just it's how do you cuz I just know you as Evan, like,

we all have a lot of degrees and stuff like how do we how do we talk to each other? You

know, it's it's like semi formal circumstances here on these podcasts. So

Evan H. Hirsch, MD 01:44

it is indeed Well, I want to give you your due. And I appreciate all the expertise that you

have to respond or respond to hear you as well. So you Yes, my friend, Sam. Yes, Sam I

am. So let's start off. First, we're going to be talking here about the mitochondria, but

give us like a little bit of a picture of how you got into functional medicine and

mitochondria and mitochondrial testing.

Dr. Sam Shay 02:09

Sure, like like the fellow super nerd that I am. I have I have pictures and a PowerPoint.

And so we're gonna go we're gonna go full Apex nerd here. And so my, my history is a

pretty fraud. I grew up in a community that spouse one thing but did another. And so

there was a lot of gaslighting a lot of I mean, bullying is a very light term. I mean, the

difference between I think the difference between physical bullying and physical assault

is if you're over if you're under 18, and still in school, and you're hit, that's called bullying.

But if you're over 18, and out of school, it's called assault. And so I think that's the only

distinction I could come up with because otherwise, I don't understand the real

difference. And so I had a lot of gaslighting at home and a lot of emotional, emotional

abuse at home a lot of neglect. Even though I was in a very gilded, I was a very gilded

environment with a lot of good educational opportunities. It was not emotionally safe,

and in school wasn't physically safe. Despite the veneer of the community I was in, and I

developed video game addiction and sugar addiction. And I had chronic joint pain from

the injuries I sustained from the violence. And I had two parents that were both

psychiatrists that wanted to medicate me to submission. And they were not interested

in dealing with what the actual problems were. And so I had a father who was de facto

absentee even though he was legally ticking the boxes of the divorce agreement. And

the I just made a decision when I was in high school that I have to take control of my

own health because I had bowel problems, crippling fatigue, I had insomnia so bad,

between the ages of six and 18 that it literally stunted my growth according to the hand

size and foot size, my father's height and the growth charts. I should be at least four to

six inches taller and did not have a good diet and just just other just just all sorts of

problems are just compounding together. So I made the decision to take control of my

own health. And that led me down a very long circuitous road. That led me to doctrine

chiropractic, so got an acupuncture degree, I was a functional neurologist and diplomat

in functional neurology for about eight years and before I went far left physical practice

and now do 100% virtual teleca coaching for functional nutrition and it's hard to do

neurology through zoom, just put it that way. And then I started Eat with the Kalish

Institute for Functional Medicine and the Institute for Functional Medicine as well. And

that's been my primary focus. And I've been doing lab testing now for I think almost 10

years like, and the mitochondria is a very special place. Because I had suffered with with

crippling fatigue. I remember lying to my grade school teachers that I felt sick in the

afternoons because I just felt so tired, I need to go to the nurse's office to lay down. And

I would just literally just go to the nurse's office and just nap because I just couldn't keep

my eyes open in grade school. And, but I couldn't. I couldn't say I feel sleepy because

then I would get chastised and humiliated by my classmates and the teacher. So I had

to say I feel sick, which I did feel unwell because clearly everyone else it wasn't exactly a

lie. It was more like I had to say it in a way they could understand it, which was I'm not

right compared to everyone else. There's something wrong, I need to go to the nurse's

office. And that seems to be the only way to do it. So yeah, it just it came down to a

choice. And I and then I went through I went I got involved in mitochondria because of

my training with Dr. Kalish. And I learned so much about how the mitochondria itself is

kind of at the core of you can kind of draw a straight line back to the mitochondria with

anything that people are struggling with chronically, in most cases, not all but most. And

I found that mitochondria was effective for working on mitochondria and other organ

systems that surround it in general, help people who are chronically unwell people that

are feeling normal and just want to stay where they're at. And also for the optimal

performance, aspirational biohackers entrepreneurs, high performance longevity

enthusiasts. And and they just get all super excited when you mentioned mitochondria.

And for good reasons. And the thing is, is that when people are wanting to assess

mitochondria, they have to look at lifestyle. And they have to look at labs and both. And

what I want to cover today is the labs in much more detail so people have better

understanding of what they're looking at. And just to double back to what mitochondria

are. And this is the way that I define it to the people that I work with. I say that

mitochondria, this is a picture of a mitochondria up here in the top right that it looks like

a weird shaped Jelly Bean, at least in this picture that you cut open. It's got this like

twists and turns and the little rings or the little the the the genetic, the unique genetic

ring, the mitochondria hat and the mitochondria, their own unique genetics. And

basically what happened is that there was a deal struck a way way back in evolutionary

biology that you've got these little what was the fancy word was like symbiotic

prokaryotes, eukaryotes, I can't remember the exact word. But basically, you have this

one organism that's really good at converting protein, fat and carbs into electricity or

ATP. And then you've got this bigger cell, this this eukaryotes, this has a bigger nucleus

that needs a lot of electricity to run the joint. And so the deal is this little organism that's

really good at just like making the electricity, you will live inside this organism and

exchange we will feed you all you want in exchange for the electricity you blast off.

That's it, that's the deal. So there's a symbiosis. And the end, it helps with the analogy.

So if you imagine a human cell is just a city like a microcosmic city, and you've got like

the library and the big library, which is like the nucleus that has all the material, how to

build, it has all the instructions of how to build things. You've got. You've got all sorts of

construction going all around, you've got waste management, you've got nutrients

shuttling in and out, then you got this electricity factory and that's the mitochondria.

Now, if you imagine if a major city lost its electricity, it'd be about three days without

electricity before it turns into Madmax you've got then you got a rice cooker running on

candles and batteries. And until until those things go to full mayhem. And the

mitochondria is it is best thought of as electricity factory very fragile, a very efficient,

very clean and delicate electricity factory and and you want the if you don't have it, what

happens is you can't generate electricity to run the city. And if so give some real

numbers to this. A mitochondria will take, say glucose, just a molecule of sugar, and it

will convert that glucose into 36 units of ATP or energy. So just keep that number 36.

And with no smoke, no lactic acid, lactic acid is that molecule that when you work out

really hard and fast to get that burning sensation in your muscle. Now, if the

mitochondria is not working properly, then you burn that same glucose in it, you burn

that same fuel in the streets, not in the factory in the streets, in this case, it is called the

cytoplasm or the surrounding fluid matrix that's still within this this in the cell within the

city boundaries, but it's outside the mitochondria is outside the factory. So if you burn

that same molecule of fuel in the streets, it's like burning a candle, you get a tiny bit of

energy and a tiny, tiny bit of smoke, but it's not you get like hundreds and 1000s of

people out there with a candle you're gonna get like sunlight to kind of navigate by

you're gonna get some this big smoke buildup. So instead of 36 units of energy 30, you

get two units of energy and two units of smoke lactic acid, so what happens in the

mitochondria breaks down, then what you have are, you have this rapid burning of fuel

sugar, because you've got to make up for the deficit of two units of energy per sugar up

to 36. So you got to burn a lot. And then you got all the smoke you're generating. So one

way to think of things like fibromyalgia.

Dr. Sam Shay 11:56

So one way, one way to think about fibromyalgia, it's the chronic buildup of lactic acid

from this failure of mitochondria. So you're building up all this lactic acid in the streets.

So you have this chronic achy muscle pain with nothing to show for it, there was no

exercise that got you there, there was no high intensity interval training, you're just in

this chronic achy muscle pain, because you have this this buildup of smoke of lactic

acid from this inefficient fuel burning from from burning the fuel on the street. Now, this

is the burning the fuel on the streets. Now this is called anaerobic glycolysis. For the for

the nerds out there, that means anaerobic without oxygen because the the

mitochondria, takes fuel plus oxygen and burns it in to make electricity, hence called

aerobic respiration. Aerobic glycolysis a robot I mean, we using oxygen to burn sugar

glycolysis splitting sugar, so and then you've got sets fibromyalgia, then you got chronic

fatigue, well, if you're getting only two units of energy, instead of 36, you're getting 118

The amount of energy and you're just burning through it, and you're just getting more

and more tired because it's less efficient. And by the way, you burn through a bunch of

your B vitamins through this anaerobic glycolysis in the streets. So you're burning

through your B vitamins, you're you're you're you're creating fatigue. And then if you burn

up your B vitamins, then it's harder to convert say, you know, tryptophan into serotonin,

which affects mood and then you got the maybe B vitamins to convert serotonin to

melatonin. So it's harder to sleep. And this is where you get this constellation of chronic

fatigue, fibromyalgia, insomnia, depression, kind of as a cluster, and you can draw you

have, it's a very logical line, you can draw straight back to mitochondrial dysfunction. So

with mitochondria, how, when you're testing it, it's good to understand the testing, it's

really great to understand the mechanisms behind it. So the mitochondria is this factory,

and it burns three fuels, proteins, fats, carbs, these fuels are delivered to the

mitochondria through three separate truckers unions. Okay, so you've got a fatty acid

truckers union, and they're all paid in different currencies. Okay. So the fatty acid

truckers unit is paid and b two and carnitine. And the really long haul trucks are in

glycine, and some magnesium slipped in here and there, you know, so you've got this

difference. You've got the fatty acid truckers unit, they're paid the way they're paid. Then

you got the carb truckers union, they're paid in. Mostly B vitamins, like folic acid, a

couple minerals, you know, like they're paid and some other stuff. And then the amino

acid truckers union, they're paid in buhbuh buhbuh is mostly be sex. So you can see how

nutritional deficiencies can then stop the delivery of fuel to the mitochondria. So for

example, if you someone is low in carnitine, or b two or glycine, and they're not

delivering fat to the mitochondria, so people who are struggling with With, with getting

rid of fat off their bodies, they may have a issue with the truckers union. They may have,

they're just or they're more tired because they losing a third of their fuel options to go

into the mitochondria. Then the mitochondria themselves has walls like it's a factory. So

those are specialized lipid like sphingolipids and other things. So you gotta have a wall.

So nice integrity, you've got machines in the mitochondria that like, move, you know, fuel

a into burn Biddy, like they actually are doing the things we call those machines and

vitamins. Each machine has its own mineral computer chip, the computer chips or

minerals, and see see how heavy metals can screw up the machines. Because you're

putting a really bad computer chip into a machine. It's like you're trying to run, you know,

a 2023 MacBook Pro off of an 90 to 97 You know, Mac chip, and it's just it's not it's

going to be very slow, if operable at all. Then you've got janitors that run around, that are

trying to put out the sparks from you know, burning fuel all the time. Those sparks are

called free radicals and 95% of all the free radicals in the body are generated inside the

mitochondria. So you've got these sparks flying everywhere. So you need these janitors

that are free radical enzymes that put out the sparks and you've got three main janitors,

you've got mn sod, he's the head gender and then you got glutathione peroxidase and

catalyze mn sada call Mr. Saad, MN for manganese, but just said, Mr. Saad, he's the

head janitor. And he's really important because if the head janitors slow, then the other

two subordinate janitors can't do their job as well. So So look, there's a hierarchy even or

free radical scavenging, so you got to make sure Mr. Side is happy. And so there's

certain nutrients called S S od inducers. That helped promote the expression and you

know, get Mr. Sod going. And people can have genetic variations, where they're janitors

or their head janitor is slower than the others. Then you've got issues with toxins and

pollutants gumming up the machines gumming up like like, tarring over the whole, the

whole endeavor. So this is why toxins and pollutants are problems, we already talked

about how heavy metals can screw things up. You also can have viruses take over the

whole thing. You know, it's just like World War Two, where you know, Russia comes into

Germany and just takes a factory brick by brick and just labels it and sends it back. And

we're just going to take this over. Thank you very much. And this is where you've got the

viral takeover. And so they're manufactured, they're just hijacking the whole thing. And

then you've also got the mitochondria are affected by signals from the outside like

there's like cities are are part of a unit of a nation or a state. So when you had the the

bombers flying over England in World War Two from Germany, the UK just said, Kill all

the lights shutting everything down, so they can't see where to drop the bombs. So you

have mitochondria being affected by things like cortisol, and stress hormones and

specific neurotransmitters that that change how you're if you're getting a warning signal

from the outside, hey, we're under emergency right now. You need to shut down the

mitochondria. But one of the things is important mitochondria. They're super efficient,

super clean. But they're slow. Compared to burning garbage in the streets and lighting

candles are slow. So if you're in an emergency need to mobilize energy quickly. It's faster

just to burn garbage in the street, just so you burn all the glucose quickly, you can burn

100 times you can burn one molecule of sugar, I think it's like 100 times faster or

something in the streets than you can in the mitochondria. If you do the mathematics,

you burn 100 units of sugar. That's 200 units of energy versus 36. But the difference is

you get tons of smoke.

Dr. Sam Shay 19:11

If you burn a whole bunch quickly versus no smoke, but it's 36 units over here. So if

you're if you're under stress, your mitochondria just shuts down. Now, there's

mechanisms behind that, where you gotta also look at thyroid because the thyroid itself

is the business the IS is the signal to the mitochondria, the business end of the thyroid.

And people talk about thyroid as like, oh my god, like it's basal metabolic rate, basal

metabolic rate, no one's defined this. It's just like, oh, it's the amount of energy you

produce. Okay, well, what is it? It's the basal metabolic rate is how much proteins fats

and carbs you burn in the mitochondria. So what happens is that thyroid makes a lot of

these analogies. So thyroid releases T four, it's this little four wheel car that goes you

know, eat meat goes down, you know, through the bloodstream, pulled over into the

factory, and then it does So this like transformer annoys Uber, Uber, Uber, Uber and like

opens one door. And it's now the T fours become T three, you know, and a T three

transformer thyroid robot is the engineer to turn up the dial and flip the switch to turn on

the mitochondria. So, some this is important because some people can have a bunch of

signs of hypothyroidism like low like like the brittle hair, the thinning hair, the thinning

eyebrows, the fatigue, the global weight gain, the tired the whole day, as opposed to the

sinusoids of up and down. Just the the the ambient level joint pain, there's there's you

can you can look up listicles of signs of low thyroid, and they go to an endocrinologist or

to a GP or MD and they get tested, the thyroid is air quotes normal. Now, one, you and I

both know there's a difference between medical normals and functional optimales.

There's a difference, like they were, you know, Western medicine operates on bell curve

biochemistry, where they just have this massive range. And if you're within that range,

it's normal, even though you may feel terrible, whereas functional medicine is we're

looking at optimales, which is a much tighter range. And then it's this and it's as gray

space between the optimal range and the medical range to outside that as pathology

where most people struggle because they're told they're basically gaslit even though you

know, I come from a family medical doctors, they're not trying to gaslight you, they're

just like this is their training. Like if they're within the quote normal, you're fine. What are

you worried about your quote, and it's, but they're not they don't feel well. So what

happens is that with thyroid, you can have quote, normal thyroid, even within optimal

level thyroid, but you still have the signs of low of low thyroid because it's the

mitochondria is busted, not the thyroid. So the engineer can just like button mash all at

once and like spin the dials as much as they can, and nothing's gonna work because it's

the factory that's busted, not the control switch. So that you can see how the

mitochondria like interconnect, you talked about adrenal stress and thyroid, we have

even gotten into gut health and oxygen, transportation and iron and all the rest of it. But

the if you think about the mitochondria as a factory, inside a city, then then the analogy

is near perfect. It's near perfect and complete with truckers unions, like it's near perfect.

So if we understand that, then testing becomes way less overwhelming to understand

conceptually, and we're gonna go over testing and I just want to warn people, unless

you're scrabble enthusiast, or a clinician like these, you will be just like, Oh, my God, what

is this polysyllabic hellscape you're dragging me through, there's just there's just all

these really long bizarre words that make no make no intuitive sense when you read the

names of them. Like Ventile, Mandalay? Sure that makes total sense. Just phonetically

sounding that out or methyl melonite Of course, that relates to be 12 metabolism, you

didn't know it's, it's it's it's this bizarre jaunt through very strange sounding words. But if

conceptually, and that's what we'll do is we'll go through it, but we'll not linger on the

polysyllabic words, we'll just take it by conceptual chunks. So people understand what's

going on. Was that was that helpful? The analogy of the factory?

Evan H. Hirsch, MD 23:33

Yeah, the analogies are, are really great. And yeah, in this next part, as practical as you

can make it I think, will really help people and kind of grounded in

Dr. Sam Shay 23:44

Absolutely. So what I'll, what I'll do is I'll show you a this is what's called the this was

called the ion panel. Now there's a lot of different mitochondrial tests out there.

Evan H. Hirsch, MD 23:58

And just remember to that there are people who are just listening. So definitely,

Dr. Sam Shay 24:02

okay, so I'll just describe, I'll just describe the different pieces and also so there's a

bunch of different mitochondria tests out there so Genova has three of the major ones.

They've got the ion panel, which was the original that Dr. Lord developed in the 70s

under meta metrics labs before it was bought out by Genova later on. In fact, half of all

at least half of all functional tests that we do today in the whole industry were designed

by Dr. Lord. And he's kind of he's he's kind of like the unsung hero next to Dr. Bland. Dr.

Jeff bland, like Dr. Lord is He he's the one Lee's most people know the least about. But

we it is the most directly responsible for all of our functional testing. And so what he

would do is he would develop these tests and then the other companies would sit and

wait to see their life and they do their copies of it. So you have the ion panel, then in

Geneva bought them out so there's Genova has the ion panel. It has the neutral URL,

which is the, which was their version of the ion panel before they bought meta metrics.

Then during the then over the past three years, they developed a version that didn't

require a blood draw. So the ion panel in the new trial require a blood draw and a urine

collection. So over the past 30 years, they developed a my aversion that just required a

blood spot like like a, like a diabetes, bloods spot testing, so you didn't have to go to a

clinic or have a mobile phlebotomist come to see you. Now, that's very convenient. But

you get fewer fewer markers, like like, like a chunk fewer, I'm not going to cover that that

version. But it's the people are either afraid of blood getting their blood drawn, or they

don't want to go to clinic, there is a there is a version of this that you can just do on the

comfort of your own home. And then you've got the oat test, or stands for the organic

acids test by diagnostic solutions lab you've got no sorry. That's That's my Great Plains,

excuse me diagnostic solutions as the Omaxe Oh MX test, which is their version of

checking the mitochondria and just the amino acid portion. And I'm just sharing these

names so that if people are thinking about what is the mitochondria test, and here are

the names, ion neutral, Val metabolomics, oat test Omex, those are the major ones, and

there's this others coming out. But those are the five major ones, or just organics,

organic acids testing. So what we're looking at here on the ion panel is we're looking

first here at the amino acids. Now the Amino we're looking at, there's 20 main amino

acids, and there's some other ancillary ones that are useful as well but not as useful as

the top 20. And what we want to look for in the reason why amino acids so important

are the building blocks, like most people know of, so like, oh tyrosine is, you know, part

for thyroid production? Well, the majority of our tryptophan is useful for tryptophan is

useful for, you know, making serotonin and melatonin Well, the majority of what these

amino acids are doing is building you build building like building tissue building cells,

building a city, it's concrete, it's bricks, it's all the different things. So if you're low, it's

hard for you to repair. So what we're looking for is what is low and what is high. So if the

amino acids are low, you, you give them the the amino acids that they need. So if this

person is low in three inning, then you give them three and eat. But what happens if

they're high, like if it's high glycine, then that's an issue, you've got this backlog of some

amino acids not being able to get into the cells like it's being delivered these these are

minerals being delivered to the cities for to help them build and repair, then you need a B

six, mostly to help because B six is the main is the main cofactor in order to help the cell

use the amino acids. So Sam,

Evan H. Hirsch, MD 28:07

what do you do if somebody can't tolerate B vitamins? You know, oftentimes B vitamins

are grown on some sort of fungal Agere. And if somebody's got mold or yeast,

sometimes they can't tolerate them. What do you do in that situation?

Dr. Sam Shay 28:19

So if they've got if they've got issues with mold that has to do with ordering, so if you

are, if you have another metabolic issue like mold or yeast, then you may have to

address those things first. There are also different types of B vitamins that some people

might tolerate. And maybe like methylated versus unmethylated. I mean, B 12 has four

different types of cyano cobalamin with methyl cobalamin, Denis silk, Denis cocobod,

vino adenosylcobalamin and hydroxy cobalamin. So there's four different versions that

are just a B 12. And there's, there also may be different delivery systems. So some

people the B vitamins may be causing havoc in their gut for whatever dysbiotic gut

permeability issues they got going on. So maybe there's liposomal deliveries where

they're absorbed directly through the cheeks and under the tongue. Some people are so

sensitive via flex, they can take the liposomal but they shouldn't swallow the residual if

the spit it out. Or there's even people I've seen that the intra nasal. I've seen that with B

12. The nasal delivery, so there are other mechanisms to deliver. If the issue is intestinal

distress that the B vitamins are somehow triggering. And there's also if people are

struggling with B vitamins then then there may be an issue with a maltose where they

have to like do individuals individual vitamins and painstakingly dose painstakingly dose

individual ones. until they've made me reach tolerance point. And that's tight, long and

frustrating and difficult. And it's it's really best to work with someone who's has a lot of

experience with that level of difficulty. Did I answer your question?

Evan H. Hirsch, MD 30:14

You did. Thank you. And another one that's related is that there's some of these

protocols that are like, very high dose of B vitamins. And do you think that some of the

success that people are having with that is because they're like forcing the mitochondria

to turn on? Because there's such big cofactors of a lot of these different pathways?

Dr. Sam Shay 30:34

So if I understand your question, it's like, if you, if people some protocols that that do a

meaningful percentage percentage of the time, do you actually help people involve a lot

of B vitamins? And you're asking me how what's the mechanism behind high dose B

vitamins that may be able to really help people? Is that what you're asking?

Evan H. Hirsch, MD 30:50

Correct? Yeah, some of the thymine protocols, where it's like multiple b1 types, and then

some other high doses of other B vitamins.

Dr. Sam Shay 31:01

Yeah, so when. So Dr. Lord, when Dr. Lord came out of retirement while I was still

studying with Kalish, and he actually asked the question, what's the most important B

vitamin of them all? And this is an you have to just just understand Dr. Lord, he was like,

he was in like, I think was University of Austin, like we use getting his PhD were like the

people in the same building, like discovered the six, like several the B vitamins were

discovered in the building, he was getting, I think his bio 10, which is the seven. So so he

had, he had some clout to talk about the vitamins a little bit, so and no one knew the

answer. And he said, b one, b one, so that's fine. It is what you just mentioned. So if

someone is so depleted, you need B vitamins to run the show. Like this is why every

every multivitamin, no matter even these crappy Flintstones vitamins that I was, was

given as a kid which is basically like tar, and some some vitamins that are sprinkled in

there. You need B vitamins to run the mitochondria. And also to run the the emergency

burning faculties of burning the garbage and the candles in the streets with your

mitochondria are busted, you need B vitamins for that. So someone is so depleted. And

they happen to be taking the sufficient volume of B vitamins that that is building up

they're deficient, that that is that is making them replete from like however many years

of depletion, then yeah, that they can, they can feel a lot better now that there's a trick,

there's a there's a warning to the if you turn the mitochondria back on very rapidly, you

are also going to turn on a lot of free radicals, you will start you will start generating a lot

of sparks. And so you so people can have this like massive bump, and then they can go

then they can kind of feel like they're going on a down swoop. And that's because now

the different problems emerged where you're just sparks are flying everywhere and

creating free radical damage. So so it's it's a thing that thinks it's ideal that you pair

things with, you know, antioxidants and, and other things to help support the

mitochondria as it's kicking back on. Additionally, your detox mechanisms may kick

back in because suddenly you have electricity to now move the garbage out. And so so

then people's detox mechanisms can kick back in and B vitamins can also uptake phase

one, they really that's what they do. Also, they attack phase one detox. And if you don't

have enough phase two, detox amino acids, we got to bring it back to me no acids. Look

at that. You need amino acids also to detox like glycine and glutathione is made of three

major amino acids, glutamine, glycine, and N acetylcysteine. If you are lacking in those

amino acids, whether it's Matthias Matthias, there's Muthiah nation slice nation, that

glutathione nation that has the six major detox pathways that require amino acids,

you're going to push toxins harder. And if you don't have amino acids to catch them, you

can also get a hertz reaction. A Herxheimer reaction because you're detoxing fast and

you're able to keep up. So So that's amino acids, where basically you look for what's low,

and then you give what's low, and then you look for what's high, and then you can give

the virus now I'm generalizing. There's a couple exceptions here and there were some

things that are measured how its assigned for more magnesium or some other things,

but in general, that's what you're looking for. Now, some people may say, Well, I eat a lot

meat, I should be fine or I eat lots of rice and beans and whatever. Well, the thing is, this

is where gut comes into amino acids. Where, if people amino acids are like little Legos

that your your cells, like the tiny individual Legos, but your body can't absorb is breaking

down this big hunk of protein into tiny individual Lego blocks. That happens in the

intestinal lining. So when you're, you're chewing food, and then the stomach acid breaks

it down. There's enzymes that break it down further, it breaks it down into what are

called di and tripeptides, which are two and three amino acids that are stuck together.

It's like three different color Lego pieces that are stuck together in any orientation. And

my so if you don't have a good that the last bit of breaking those down into single amino

acids is done in the cells that line the intestines. So if you have a leaky gut or an

inflamed gut, or your gut, or some other issues going on, then you cannot absorb proper

amino acid. You can't you can't just like I'll take bunches of gelatin and that'll be fine or

I'll eat lot more meat. If you've got all these loads. If your guts messed up, you actually

can't properly absorb the amino acids across the gut. So this is where you'd want to look

at the gut along with the mitochondria. Other things to look at with the labs or you've got

homocysteine, which is a really important molecule, because it's like it's kind of a

sharper sticky molecule that affects the blood vessels. It checks for key minerals that

affect the mitochondria remember, even manganese, remember I said mn sod Mr. Saad,

who was the head janitor, and N for m and saw stands for manganese. So if you got a

low manganese that had janitor and ain't working well, this then checks for certain toxic

elements. Now this person right here, she's a smoker. So you see how the cadmium and

the mercury are way up. And because because this is if you see it in the blood, it's like

acute exposure. So this is I'm having a conversation with her actually, next week. This is

fresh off the press, it literally got this one today. And I was like, Oh, look, smoker, this

should be good to show on the podcast. cadmium and Mercury know your heart out.

Alright, then it checks her fat soluble vitamins. And these these are real important.

These are these are other antioxidants to support the whole process. Glutathione I'm

sure you've talked about glutathione ad nauseam on your podcast. And this actually

measures glutathione. Now, just the catch here, this is checking for oxidized and

reduced glutathione the total amount, this is not telling you if it's the reduced or oxidized

form. So if people have globally low glutathione, here, then I would want to give them

exogenous glutathione, like liposomal glutathione. But I'd also want to check back to

see our Do they have enough glycine and acetylcysteine and glutamine to help create

their own glutathione. Because that will lower amino acids can affect that you will also

looking at how your damaged fat markers, and how much free radical damage is

happening to your DNA. And vitamin D is massively important because vitamin D

controls up to 5% of your DNA, most of it related to immunity and inflammation. And if

you're inflamed, it's going to affect the mitochondria. Then we come to the organic

acids, the actual mitochondria itself. And this is where patterns are more important than

than particulars. So where a lot of practitioners get lost is they fixate on particular

markers. And that's a mistake. You want to look for big picture patterns. So if people are

running high, like globally high in all of these markers, and you can see here by category,

this is the fatty acid truckers union, this is the carb truckers Union. This is the amino

acid truckers union This is the actual mitochondria itself. If these numbers are running

high, that means that they're burning through very rapidly the engine is running hot that

TriCity is overworked, the factory is overworking and it's like you're burning through all of

your raw materials. So you need to feed lots of the raw materials that go into like B

vitamins and, and amino acids and magnesium and old on cookie 10 and other things.

But if it's globally low, globally low that's what's called mitochondrial retraction. That's an

actual field that's developed mitochondrial retraction in the past decade and a half or so.

That's newer in the literature where the mitochondria it's like the engine starts to melt.

So if you have a higher pattern, you give the nutrients if you have a globally lower

pattern. The engine has melted, the factory has melted you need to rebuild the factory.

Switch is a different set of protocols to rebuild the factory than merely feeding the

factory. And so that's a that's a that's something Dr. Lord Himself discovered a lot or at

least is teaching

Dr. Sam Shay 40:13

the the difference between running hot and the factory melting down. Then you've got

we mentioned the neurotransmitters where these a neurotransmitter metabolites like

how well they're what's being used, just to give a conceptual difference. This is a blood

and urine tests. So blood tells you what fuel is in the pipes. The urine test is the

emissions test to tell you what's being used. We have no way to go into a mitochondria

knock on the factory door and with little audit and clipboards, like hey, how much are

you using here and there, that that's not a thing. What you do is you collect the urine,

which is the emissions test the certain markers in the urine that are emissions, test out

the mitochondria to know what's being used. So you can tell how the neurotransmitters

are being are being used and that those affect the mitochondria. Then we have toxics

toxic, how well your liver is metabolizing things. So you have markers here for

glutathione. Use you've markers here for how you're getting rid of ammonia. You have

you have markers, also that check your microbiome, and yeast and fungal markers as

well as oxalates, which are very, very important. Because if people have oxalates, it can

affect their diet or their generated by fungal infections. And sometimes and this is real

important. stool tests are not always accurate in identifying fungus. I'll say that again.

stool test was gi map gi FX gi 360 or CDCs. They are not optimized to capture yeast for

two reasons. One, the preservatives are not optimized to preserve these they're

optimistic reserves, parasites protozoa, bad bacteria and so on. But also yeast is usually

in the small intestine and you're collecting a large distal large intestine sample. So the

yeast could die off by the time it gets to the large intestine. And so when you see the D A

rabbit and a tall marker, in in because I've seen this over and over again, where the GI

map is like normal or yeast levels, but the ER D Rabbit's Hall marker is very high that

shows cysts, there's a systemic fungal thing going on. That is not being picked up in the

store sample. So sometimes the the mitochondria test is the more accurate or not

sometimes it is the more accurate test. I feel if there's systemic fungal issue going on,

which is another Jew in the mitochondria to test will also tell you about yeast infections.

And then lastly, I want to just again just emphasize that the mitochondria is downstream

of the thyroid and when you're talking about it, you have an energy I mean, you you have

an energy podcast, you talk about the thyroid a lot and you cannot I repeat, you cannot

separate thyroid from mitochondria, that is not a thing. They are not separate, they talk

to each other they are paired. So I just really want to emphasize that the thyroid and

mitochondria are paired. There are other things that influence thyroid, like like iron and

other nutrient deficiencies. adrenals can affect the thyroid, too much estrogen

dominance can affect the thyroid, you know, gut permeability, computing, it can trigger

the immune response that then create antibodies that attack the thyroid. So there's

other things that can affect thyroid, I fully acknowledge and appreciate that, but but

mitochondria thyroid are paired. So that's, that's the overview of mitochondrial testing.

And with mitochondria testing, there are other tests that are best to done with

mitochondria like thyroid, like gut, you'd want to check adrenals, you know, and we

talked about genetics briefly, like if you've got weak, if you've got a variation in your free

radical scavenging genes, like Ms. Assad, then you need to do things specifically based

on your unique genetics to prop up the expression and to help Mr. Assad, you know,

mobilize that he needs extra support, because genetically, you're in a rougher situation.

Like like me, I've got a red.in My mn side, so and my GPX. So I've, I have a very difficult

time generically dealing with free radicals. But I do a lot of the stuff that I need to based

on my genetics to keep my mitochondria healthy based on my genetics. And I also do

the functional mitochondria test. So that's, that is a very rapid pace, overview of

mitochondrial testing. And I want to I just want to pause there and just like, let the

mitochondrial chips land.

Evan H. Hirsch, MD 44:52

Thank you, Sam. I really appreciate that. We've just got a couple minutes left. And so

where can people go find And you learn more about you. And then if you just want to

share a little bit about your free gift with us.

Dr. Sam Shay 45:04

Sure. So I've got people just go to my website, Dr. Sam shea.com, Dr. S am Sha y.com.

Sometimes you may need just to put https colon slash forward slash forward slash Dr.

Sam shea.com. So there's and there you'll find one or more of my free ebooks one is on

biohacking, which is covers more on functional tests in and my model for health called

the 10 pillars of health, I have other ebooks on there on how to genetically optimize your

diet and how to Genet and on genetics way more detail in genetics. And if people are

interested in my, my comedy, they can just go to youtube put in Dr. Sam Shay, and I have

a YouTube channel, please subscribe. And there's elements that in a comedy and then

there's other playlists of all sorts of other functional medicine talks. I've done a podcast

and some some wheat mean Avenue and I did one I think a year ago on the genetics of

diet and, and just sort of helpful newsletter that covers all sorts of topics related to

natural health and functional testing.

Evan H. Hirsch, MD 46:19

Excellent, and we'll drop the links below. So appreciate this explanation today. And you

know, big picture for folks is that you know, if this was a little bit overwhelming for you

just know that that Dr. Sam is going to explain it all to you when you're when you're

working with him and he's going to give you a plan that's going to be really clear and,

and concise. So thanks so much for being with us today. Dr. Sam and I'll see you soon.

Dr. Sam Shay 46:44

Thanks. I really appreciate you having us.