Mitochondria, the Cell Danger Response, and the Pace of Healing: Transcript

Full Transcript

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In today's episode, we'll be exploring a very important and perhaps underappreciated aspect of health, mitochondria and the cell danger response. A concept that's causing many clinicians to rethink how we consider fatigue, inflammation, and healing in general. The mitochondria are the centers in every cell that produce energy for a given cell. What's interesting about the mitochondria is they have a dual function of being sentinels or purveyors of stress. And this stress could be the form of emotional stress, inflammatory stress, infectious stress, toxins. When the stress persists for long enough, the mitochondrial cells can then shift into a protective state known as the cell danger response where energy production in every cell is turned down. And this can occur and it might be what underlies chronic infections, uh the chronic stress response, impaired gut health, um autoimmunity, long COVID. And so to help us better understand and appreciate this cell danger response, I wanted to bring on Dr. Paul Anderson. He's a physician and educator and really an expert in chronic illness. Today, we'll cover the early warning signs of mitochondrial dysfunction. How toxins, infections, and even emotional stress can trigger that cell danger response. important nutrient

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cell danger response. important nutrient therapies that restore mitochondrial function, including oxygen, red light, and key nutrients. And then how we can help to use these tools to move the mitochondria from stuck in this cell danger response and allow them to regain function, therefore having better energy of the cells and every organ and system those cells comprise. So, let's get started. Dr. Paul Anderson, welcome back to the show. Thanks for having me. You know, it's been a while. I think the uh the last time we caught up in person was a SIBO symposium. This may have been like 2016 going back quite a while, but um you know, we're both still here. I like to think fighting the good fight, helping people understand why their body won't respond. And I think we see both of us people who are I would say at the varsity level, right? They're usually eating healthy, they're well read, they're well educated, but sometimes they're just overlooking a key component of their health. One of which I'm really excited to sort of unpack today, which is the mitochondria. Yeah. I mean, if if you go back and you know, you look at the first chapter of any pathology book, for the most part, most disorders start in the mitochondria and work their way out. So, it's a it's really critical topic. And I have outline for us. I was

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topic. And I have outline for us. I was saying before we started the recording, knowing that you and I get into the weeds, I wanted to help give us some sort of outline just to flow through this with people. So, for the audience, here's what we're going to walk through. Firstly, what are the mitochondria? What do they do? Second, how do the mitochondria become damaged? Third, the signs and symptoms that you might have mitochondrial dysfunction. Fourth, how this relates to the cell danger response, which is I think a really critical shift that if we can help people get out of that is uh very pivotal. And then fifth, what can we do to get people out of that sort of stuck mitochondrial state to improve or or thwart stop that cell danger response so people can improve their health whether it be neurological, gastroenterenterology, what you know, wherever their symptoms are manifesting. And usually it's sort of multiple systems or symptoms that will manifest. But um yeah, let's start with the mitochondrial overview and and kind of give people the rundown of what they are and and why they are important. Perfect place to start. Uh so a couple of things. Usually when you see, you know, drawings of a cell, you see one mitochondria in there to represent what they do. And what's important about that is a couple of things. One is they create the energy units, the ATP that help the cell do anything that requires energy. So that could be membrane receptors, it could be all sorts of operations. The other thing though is

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operations. The other thing though is that different types of cells have different numbers of mitochondria. So it would be impossible for a cell to run with one mitochondria. And when the mitochondria start to become dysfunctional, they decrease the amount of energy that the cells able to use and then that can create other problems. Um, so if you're having mitochondrial problems, the the other side of the coin is your different tissues in your body have greatly different numbers of mitochondria per cell based on their energy needs. So for instance, your brain and your heart have thousands and thousands of mitochondria per cell. Uh our skeletal muscles that we work out at the gym, those are going to have 2 to 500 per cell, for example. You know, GI tracts going to be in the middle. The liver is going to be in the middle. And it just uh depending on, you know, your needs. So if you start to have trouble with your mitochondria, you might notice it in the areas that have high density of mitochondria first. Yep. Which oftenimes is the brain. I think that's one of the most unsettling symptoms for people. And there's an interesting cascade. I mean, there's many cascades in physiology, but what seems to happen is if brain function is impaired, and we'll see this in the clinic sometimes where people, they've been really hitting, let's say, SIBO, small intestinal bacterial overgrowth, quite hard and seen some flicker of response, but there might be a brain component to

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but there might be a brain component to the SIBO that hasn't been addressed. And so to your point, if there's a really high density of mitochondria there and mitochondrial function is being impaired or thwarted by this cell danger response, then what's governing gastro function, the brain might not have adequate signal to allow healthy gut function to to propagate, if you will. Yeah, definitely. I mean, obviously, we're we're all connected. This the tissues don't work separately, uh although we think of it that way sometimes. And I think the brain symptoms uh whether they're obvious like something like brain fog or sleep disturbance or other things like that or the less obvious like you were saying the brain is doing all of this neurological feedback operation to run our GI tract and run all of the uh ancillary organs that help you digest for example. Um and if you run low on energy, you can't do those things in an appropriate manner. So you wind up with, you know, all manner of issues that may come up which are, you know, these these dysfunctions of of multi-system eiology. They seem to be getting more common and it's probably in large part due to the environment and our lifestyles are not conducive to health, including mitochondrial health. What are some of the more common environmental or or sort of modern-day triggers that are not healthy for the mitochondria?

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not healthy for the mitochondria? Yeah, the um I usually like to think of them kind of going from the more uh what you might call hygienic or determinant of health basis towards uh exogenous problems. So, one thing that's easy to forget about is uh we do a lot of recharging and regenerating of our energy apparatus when we sleep. And people who are chronically sleep disrupted uh have a lot of disrupted signals going back to the mitochondria in regard to you know healing and regeneration. The other thing I think that's a modern twist on this because of course people have had trouble sleeping forever, but is um the uh sort of light pollution that we all have. You know, we all have these screens. We now have screens that we can take with us everywhere and in bed and all that. Uh and our brain gets very confused when we have all this light that you know is not set up. But yeah, basic things like that. Um definitely micronutrition is you know the mitochondria run on nutrients so that becomes a a pretty big issue and and that could be you could be trying to eat really well but if you're not digesting and absorbing for many reasons you might not be getting nutrients where they need to go but then I think that the real modern issues uh really are toxicities and toxicants uh that are of a huge

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and toxicants uh that are of a huge spectrum. Um, that could be the common things we think about like metals or certain chemicals. It could be things that are, you know, uh, a little bit harder to put your finger on like micotoxins or other biotoxins in the world. And and if you think about um the amount of toxicity that's just in our environment and in our food and in our air, take now to 100 years ago, it's it's not even the same level of toxicity. And you know, as we about later with cell danger response, toxicants are something that are going to interrupt the ability for everybody to have homeostasis and work correctly. So I think that's a huge thing. Oh, by the way, if this is helpful, please comment. I'm always curious to engage. Subscribe so you see future videos from us. And share with someone you think this might help. And again, you know, this this theme of some of these perpetuating loops comes up again. If your gut function isn't healthy, you can't absorb key nutrients that are needed for the mitochondria. If you're not sleeping well, that can interfere with mitochondrial function, which is in part needed to regulate sleep. So yeah, I guess it's it's good news or bad news. If if the cycle is self-perpetuating in a bad way, then that's not good. But the the silver lining there is once we understand that, we can interrupt that and start to get these cyclists to function for us in a favorable direction. I'm sure people are

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direction. I'm sure people are wondering, well, hey, how do I know if if my symptoms the the grabag that people have, and there's a lot of overlap, but I'm assuming there's also some nuance differences. Sleep problems are common, energy problems are common, bowel and GI issues are fairly common. But are there hallmark symptoms? You alluded to maybe brain symptoms being some of the more common. But what do you look for as sort of keystone symptoms that perk you up to say, hm, you know, there might be a mitochondrial issue present? Yeah, I think and and because you know everything is connected and it's never just one thing that's wrong. You always have to consider what else might be going on. But one of the things is taking a kind of a step back and a macro look at did this person um have a real long kind of slow slide into ill health and their symptoms have been, you know, stacking up over time and they're, you know, 3 years ago or 5 years ago they were 80% better than they are now. Um that's often a tell that regardless of what got them where they are now, uh the long slow slide has taken a toll on the mitochondria in both in the obvious organs. So let's say they're presenting with digestive problems or brain uh but also in probably the rest of their body as well. Sure. Uh so that's that's one huge tell is the overall picture of you

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huge tell is the overall picture of you know how did this go on? Now there's a subtype um which is a more rapid insult. So a person you know seemingly was healthy they didn't have these symptoms before and they get uh some very uh noticeable insult. We see this longcoid patients for example or other people and it's really an exposure and in the case of virus it's an exposure to an immune disruption in the case of other things that could be a toxic exposure like we see this with mold patients for example. Sure. So if they sort of go along, they seem okay and they kind of fall off the cliff health-wise, that's another one where you throw enough disruption into a healthy body and it will just stop operating normally. So those two patterns I think really important. Then there's just the the more symptomatic things which are those global constitutional things like fatigue, uh brain fog or aggravation of other neurological types of symptoms even uh muscle, you know, muscle pain, muscle aches. And what we see a lot is an inability for exercise to be regenerative because they're working uh they're working out and they can't recover like they used to say 10 years prior. That's a mitochondrial deficit as well.

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mitochondrial deficit as well. A few things that I've been thinking about um also curious your take on these. Uh I wouldn't say it's it's the only one. It's it's one of a few and I agree with everything you said, but a couple that I've been sort of reflecting on some cases in the clinic and and seeing people come in banged up and then we sort of got to the underlying causitive factor which you know we're outlining. There can be many of them but it may have been mold, it may have been a chronic infection. There's a sort of uh commonality of chronic inflammation uh that underlies a lot of this uh disruption of mitochondrial function. But um fasting intolerance and low carb dieting intolerance, you know, that they can't do low carb, they can't fast. And there's been a few cases, and I know we'll talk about this more a little bit later, but where hyperbaric oxygen chamber therapy really helped these people be able to hit fasting physiology, whether it be just a true fast or a low carb keto. I'm not saying forever, but if we're trying to do a reset for a month or even a few weeks, if people can't flip into that fasting or low carb physiology because the mitochondria are a huge component underlying that, that to me is one signal that mitochondrial dysfunction might be present. Yeah, definitely. Um, and for people who may wonder, well, what why would that be? Um if you uh certainly if you have a fast either a shorter or longer fast but even if you lower the carbohydrate intake to do say

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lower the carbohydrate intake to do say ketogenic or low carb the the mitochondria's easiest energy source are carbohydrates. And so you'll you'll see this in people where as they get sicker and uh the mitochondria are weaker, they'll actually have more carbohydrate cravings. And that's actually just trying to get simple energy in there. And so people, you know, who maybe studied nutrition will say, well, but fats are a lot more, you know, calories uh per they're a lot more efficient. What's the problem? Then you go to, you know, low carb or keto or even fast. Well, the problem is the apparatus to get the fat in the mitochondria to burn up is a lot more energy dependent. So yeah, a simple thing like that of not just being, you know, low carb intolerant basically uh or you we do a lot of uh uh short you might say or intermittent fasting with people for resets and some the people that really go off the rails with that. Yeah, their mitochondria are not set and there's a number of reasons to use the fats like they ought to. Um, so that's a huge and you know one parallel maybe for our our audience who I know are very astute with gut health, a healthy gut should be able to process fiber prebiotics, right? But an unhealthy gut can't make that shift. So if we have a healthy organ

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shift. So if we have a healthy organ let's say or or organel then you should be able to be metabolically or let's say um you know substrate flexible high fiber low fiber high carb low carb and if you're not you know I I wouldn't say force your way through it but use that as a signal as a clue that okay there's something upstream that's altering GI function or mitochondrial function or what have you. Yeah, definitely. It's it's uh and you can see why if that's going on and you're not really thinking about it and you're the patient, um it could be months or even years where you've slowly shifted your diet just for expediency. Sure. uh you know to to get the uh nutrients in as quick as possible and you're not you know as you say you lose that ability to deal with you know whatever the substrate is. So yeah I see that a lot and the upside is you can undo it. The the downside is you have to stop the ship thing going down that that pathway and part of that pathway is this cell danger response. So, let's let's explain this to people because what's exciting about this is as it's gaining more notoriety, more acceptance, I think it's uncovering a a big perhaps previously missing piece to why some people stay stuck. So, let's define it and kind of start walking through what it is and and what it means. Yeah, the

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it is and and what it means. Yeah, the cell danger response is is quite interesting because it's it's essentially describing what we see clinically in people who often have chronic illness and it it's based uh largely on the work of Dr. Navio uh who has published papers on it and elaborated the idea behind it. Obviously, it's gone on for a long time. and he's just been one of the people kind of championing understanding. But the the simplest way to think about it is we under normal circumstances obviously ourselves turn over all of the time and we have repair mechanisms and all that. The mitochondria have their own repair mechanisms and their own cycles that they go through because they don't last forever either. So under a normal uh non cell danger response, the mitochondria are challenged in some way and they send out signals immune and chemical signals to uh try and recover and in recovery they go through miogenesis of building of new parts or even new mitochondria and they sort of circle back then to healthy. So you start healthy, you have a challenge, you have recovery, and then you go back to healthy. The cell danger response puts a wedge in there. And the the wedge normally um and the lists are

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the wedge normally um and the lists are quite long, but they're they're all the things like we talked about earlier that could be um epigenetic triggers for things to go off the rail. So uh easy ones to think of are all the toxicants and toxins in the world. Those are, you know, real common and probably why we see this a lot more. Others though include chronic stress that doesn't have an outlet and the body's stress hormones uh get out of balance which throws off blood sugar control and all all kinds of other things. Um and then other things that can do that beyond uh general toxicity etc can be either chronic infections or immune problems that derail the the signaling chemistry for the mitochondria to go back to you know the healthy side of the cycle. So whatever the wedge is, it gets in there and then the cell has the the cell has feedback to say, "Oh, well, we're not going through mitogenesis to recover our mitochondria. Uh, we must be having a big problem here." And so then it goes into a dysfunctional state. And what I would try and relate with patients would be, you know, if your mitochondria stop working, you're dead. So you're obviously not dead. you're here with us, but you feel horrible chronically. The cell danger response essentially takes a mitochondria that could be operating at 100%. And maybe it

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could be operating at 100%. And maybe it lets it operate at 20%. And that's its max because it's damaged. Well, if your trillions of cells and all the trillions of mitochondria uh start to operate less than 100%, you get symptoms. So that usually it presents as fatigue and pain and all the things we talked about. But the longer you're in a cell danger response, the more trouble. And then the other side of the coin is if you come in and you do too much treatment to recover the patient, so you push too hard on the mitochondria, you can actually make the cell danger response get worse. M so you have to kind of have this balance of saying okay we got to figure out what put the wedge in here to derail our normal you know cell maintenance mitochondrial maintenance. We have to slowly work those things down or out of the system or you know decrease them and then put the good things in to help the mitochondria recover. Yeah, I think that's well said. We see this a lot with chronic infections where understandably when we help a patient identify some sort of chronic infection, they are really eager to get rid of that as quickly as possible. But I often explain it's it's kind of a dance because when we start treating that infection, it's going to increase inflammation which is going to thwart mitochondrial function even more and also lead to a lot of other systemic inflammatory symptoms. People feeling worse in a sense. So, we

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People feeling worse in a sense. So, we kind of have to make sure that we try to throttle down inflammation and use antioxidants so that we're not letting the sort of microbial killing inflammation greatly outpace what the mitochondria can sort of handle and keep this delicate balance to your point. And I think clinicians have made that mistake. Uh, I would say heed your um your doctor or your clinician's recommendations on this because you make that mistake a few times when someone says something along the lines of, "Doc, I'm desperate. I'll do anything. I want to hit this hard and you try to help them do that and then a few weeks later they're far worse. Maybe there was a honeymoon period of a week or so and then they crash. So heed that warning guys. slow and steady in many of these sort of feedback loop recovery situations wins the race as compared to hard and fast. Yeah. 100%. And and of course everybody has different reserve capacity and you know some people can hit things harder and others like you say there's a little honeymoon period and then they're they're really happy and then two weeks later they're they're not very happy because they crashed. Um, so yeah, a lot of it is personalized feedback in that because you can't from the outside look at somebody and say, "Oh, you're for sure, you know, going to need this amount of time or this amount of, you know, sort of low and slow." Y um the body tells you uh and and I think

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body tells you uh and and I think especially in chronic infections and the same happens with toxicity because it's a chronic problem generally. Y if you if that was the only problem, then just killing the infections would make everything better. And we all know that, you know, that's a piece of the puzzle, but that's not the whole puzzle. It's we're we're trying to take away one of the things derailing the the cell uh response and putting us into cell danger, but we have a lot of other healing to do to, you know, kind of catch up with that. same if you detoxify etc. Yeah. Sure. And you know there are some things that can be somewhat predictive. Although to your point I would strongly agree that a lot of this you won't have a read on as a clinician until you start and you get some bio feedback from the individual. But severity of symptoms and chronicity of symptoms tell you okay you know how much reserve does this person have? How hard can we push? But nevertheless sometimes the body will surprise you and throw you a curveball. So that's where personalized medicine usually wins. Yeah, it's very true. All right, so let's walk through now some of the tools we can use to treat or unravel that cell danger response. Um I think of this starting with the foundation and then working our way up because there's so much here from dietary changes to cool lasers, red lights, and hyperbaric oxygen. Starting with that foundational layer of diet and lifestyle, what do you think about as some of the the most

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think about as some of the the most important foundational supports here? Yeah, I think uh very important to start with the foundational things and a lot of times um patients might get you know uh concerned or or even you know lose motivation because they'll think well I tried to change my diet or I tried to move do more exercise I tried to do this and it's not doing anything right the way I sort of explain it is Um there's there's three big pillars under which there's a lot of little ones that you have to just keep as the base and then all the other cool treatments we do will work better if you're doing that. So I make it simple I say there's three big pillars food muscle and brain. Uh so food is obviously nutrition but also the cleanliness of the food and what you're eating and drinking and your micronutrient all those cool things which can change over time the needs. Um muscle is literally as as we all know muscle and fat have two different sets of signals they send to the body when they're active uh biologically. muscle literally sends healing uh chemistry out to the body. And there's even more recent publications showing that just activating your skeletal muscle, moving your body will heal up things like your bloodb brain barrier problems and

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bloodb brain barrier problems and inflammatory things, muscle when it's real active sends out uh blocks to healing. And so, you know, people will say, well, you know, do I have to become a marathon runner? So, no, it's just you do a little more with your muscle and less to trigger your fat cells to be active. It's going to be a net positive. And then, you know, brain is obviously everything. But beyond the mind body connection, it's it's also um what you're allowing in as far as uh you know, positive and healing sorts of things. Are you always hearing about negative things? you're always hearing, oh, you're going to be sick forever and you know, all of that. Yeah. So, it's a lot of things. Um, and then once, you know, once those areas are kind of looked at, then like I say, all of the stuff on top of it will actually work better. Um, and I usually think of starting then with, well, what would I add to those things? That could be uh more specific micronutrients or you mentioned antioxidants. um could be certain botanicals to help with particular problems a person maybe inflammatory issues etc. Sure. Um and then a layer above that of sort of the external things which might be you know light therapies hyperaric all all the cool things. Yeah. Right. with food, are you trying to go moderate to lower carb and and sort of trying to be cognizant of not pushing someone farther

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cognizant of not pushing someone farther or lower than their mitochondria can go outside of the, you know, the the really important basic piece of clean air, clean food, clean water, right? No toxin. So that that's a given. But from there, where do you go next? Yeah. the the way that and again some people can kind of do all this at once and some people it's really baby steps. Um so we have a patient uh education aid that's a basically a pyramid. The bottom layer actually is working up to a 12 to 13 hour intermittent fast every day. Now, we can't always start there, but the the reason it's at the bottom is because of the ability to help the cells take the trash out uh in autophagy and do number of other things. The next step actually doesn't even get to macros. It's cleaning up. So, taking out any obvious preservatives and dyes and the junk that comes with our food. Sure. And then the next is getting rid of any source of simple carbohydrate to fast burning you know starches etc and making the carbohydrates more complex vegetable you know material um which is help on a number of levels and then the next steps above that we kind of personalize but they're generally a a lower carbohydrate type of a diet. some people it's

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type of a diet. some people it's intermittent fasting and even keto pending. Um but the idea being once they tolerate that then you're allowing the cells to actually take the trash out easier you which helps to decrease the cell danger response. um you're getting high uh sort of high concentration nutrition through say a lower carbohydrate diet and you're retraining the mitochondria that they can, you know, they can actually do this. They can burn the fats and uh have high energy uh needs met. So yeah, it sort of goes in that order. Uh and most of the time that works for folks. Okay. Regarding a brain therapy that I'm pretty interested in of late is veagal nerve stimulation therapy especially uricular or through the ear essentially a set of headphones that will simulate the vagus nerve and the vagus nerve is is the main sort of parasympathetic or rest and digest superighway and it it does go both directions uh and actually most of it goes up to the brain and helps retrain the brain out of a chronic stress response. You can get veagal nerve stimulation through prayer, singing, humming, um, meditation. But for some people, especially if their energy is really low, I'm going to ask you to change your diet, take some supplement, right? You I'm going to give you more to do and then ask you to do additional other lifestyle changes knowing that some people might have limitations. I really like the passive

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limitations. I really like the passive nature of these veagal nerve stimulating earbuds in that you can do it while you're, you know, reading in the evening or washing TV or, you know, washing your dishes, whatever it is. Is this something that you've explored much at all? Yeah. And I I would say, you know, although we've known about how the vagus nerve works forever, um I would say veagal nerve types of therapies have I've been much more aware of them in the last 15 years and I've seen them, you know, develop so people can actually use them more easily, right? Uh there used to be a lot of kind of more invasive types of veagal nerve sort of therapy. Sure. Yeah. So the the ability to have things like a a headset, you know, earbud, uh some of the other external uh types of things has really helped because, you know, anybody who's dealt with chronic illness, it's hard to manage all the things that you're trying to do. And the easier it is for something so core precisely to just be part of like you say reading in the evening or you know whatever you're doing um the more likely you are to do it and also the more likely it is to actually help you out. Um and yeah, the the effect of of the effect of, you know, veagal derangement uh as you say, you got kind of two-way uh messaging, twothirds of your digestive tract is really serviced by, you know,

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tract is really serviced by, you know, the vagus nerve and and uh feedback goes. So, because as we talked about at the very beginning, if our digestive system gets off track, we also aren't going to absorb micronutrients, uh, it's going to be harder for us to do all sorts of things and we're going to be much more inflamed. Getting the vagus, the veagal tone back, uh, is incredibly, you know, important. And I'm just, I'm really glad there's these much more simple, much less invasive sorts of uh, therapies. is available. Yeah, totally agree. Um, nutrition. So, obviously the mitochondria has a a number of components that the the cytool, the KB cycle, the electron transport chain that help take our nutrients and from it make energy. And people have probably heard of things like NAD supplements or molecular hydrogen or carnitine or CoQ10, uh, B vitamins, right? A lot of these either provide precursors or antioxidants or uh just the the co-actors that are needed to to spin these turbines of energy production if you will. There's a lot of options. To simplify, do you have a short list that you think are, you know, the most important for people to focus on on, you know, regarding the 20 or so options that people may have for different supplements or plus? And that's that's always critical because you theoretically you could take

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because you theoretically you could take everything but it's not very efficient and no one's going to do that for very long. Right. So you know kind of to your point earlier where we're talking about well how long have you been sick? How significant is the illness etc. that factors into do we just start with the basics that are real targeted to kind of get the system operating again or do we do that and do an accessory treatment that might be there for a while to help us out. So the the basics at the very least um carnitine I is usually a primary treatment for me because it's what helps get the fatty acids into the mitochondria to burn them the the amino carnitine. And a lot of people like you hear about the keto flu and stuff like that. A lot of times those symptoms come because we're trying to burn more fats for energy and we ran out of enough carnitine. It's sometimes that simple. So, carnitine is a really core thing to help feed the machine, so to speak. Um, if you look at the way the human cell protects itself with antioxidants, you definitely need more of those, especially in cell danger response because you're getting stuck and creating more inflammatory chemistry. The the cell starts with just three things. There's glutathione, vitamin C, and then vitamin E. And vitamin E kind of hangs out in the fatty

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vitamin E kind of hangs out in the fatty membranes, but vitamin C and glutathione help cycle each other in the mitochondria and the cytool, etc. So, if those are not, you know, sufficient um you got to fix those and then all the other, you know, kind of higher level ants will work better. Um then you know once we kind of take care of the redux inflammatory thing and get enough carnitine to get the energy in your mitochondria basically run on B vitamin minerals uh and a couple of other nutrient substances. So then you have to look at well how how much of that am I getting? uh obviously if I'm still sick and tired etc. I need more and uh which ones might be kind of high value. So one that and here's the other thing a lot of these things help the mitochondria but help everywhere else. Right. Sure. So for example um co-enzyme Q10 is actually used in the mitochondrial complexes in a couple places and it helps other stuff in your body. So, it's sort of like that's a that's an easy one to add in. Sure. Um, for some people, uh, alpha lipoic acid is also helpful. It's sort of a collateral, uh, helper, but it does it also does a number of other good things, too. Um, but then you get to looking at,

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too. Um, but then you get to looking at, okay, NAD support. That's that's really big because there's lots of YouTube videos on it and stuff. um NAD uh NAD's family it cycles around um that's actually where you first get the energy units to run the mitochondrial complexes. So if we are low in NAD the mitochondria slow down and NAD is made from a form of vitamin B3 with some other steps and it it's the active form that does that. So because of the other co-actors needed, the first thing you want to make sure is a person enough of all the B vitamins so that that'll work. And then a lot of times and people now now will often come in saying they've tried this or that or the other thing. There's oral precursors that help with NAD. So nicotinomide ribocide or nicotenomide monucleotide, things like that. Those are often helpful. Not that you need them forever, but if again our our energy is running at 20 25%. If we put more um substrate in to run the system and we've got all the other things, uh we're going to get more energy out of the system, you know. So, NAD, it's kind of a core really. Um, another one that people will use, which again is not part of your body, it's an accessory, uh, but it can sort of jumpst start things would be methylene blue.

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start things would be methylene blue. Um, that's a it literally comes in kind of on the so NAD starts at the beginning and just primes the system naturally. Methylene blue comes in on the side and sort of uh speeds the process up. So, it's literally like an adjunct that you don't need that forever. Really fatigue people. Sometimes it'll help. You do have to be careful because there's like methylene blue can carry a lot of toxins. So, you really need a supplement that's been checked and all that. Yeah. Um and interestingly uh the other thing that kind of comes in on the side and supports that is uh red and near infrared light. The mitochondria are very responsive to light. Um and uh we we've doing a lot more of that over the last 10 years as well. Uh especially with people who are really fatigued. Light therapy can be a very gentle but kind of persistent way to wake the system up so to speak. Um, so there's a lot of options really to, you know, kind of get in there. But I always tell people, let's make sure the the core is covered, the, you know, the original equipment sort of nutrients and and antioxidants, and then we can always build on top of that, you know, needed. Sure. And I'll just kind of echo one of the things we covered earlier, which I I think is so easy for the non-clinian to overlook, which is what is the chronic source of inflammation? uh an infection, mold exposure, um maybe long COVID, you

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mold exposure, um maybe long COVID, you know, what is it that's sort of causing this chronic inflammatory response? You're using up all these resources, whether they be co-actors nutritionally or antioxidants. Um because if that's not done, and feel free to disagree with me, but if that's not done, I I don't think any even perfect mitochondrial support program is really going to get you out of the that stuck state. Yeah, I wouldn't disagree with that at all. Um I think that you know that there's there's two things there. One is and we see this with patients all the time be because there's so much information about you know NAD or other things that help your mitochondria. People already tried things and sometimes they'll say well I can't that this is common. I can't take NAD support because I got really sick when I took it. And what I'll usually say is, well, your your mitochondria are running on NAD right now. If you get sick when you do mitochondrial support, it means you sped up a system that has too much interference. It's sort of like putting more gas to a a motor that's, you know, that needs to be tuned up. And so, yes, maybe let's not push too hard on that. But the other thing that people notice symptomatically is we we think about, you know, cell respiration through the mitochondria. Oxygen goes in, CO2 goes out, which is true, energy comes out. But the other thing is when we're doing cell respiration, we trigger the cells to get rid of other metabolic junk

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to get rid of other metabolic junk that's inside the cell beyond carbon dioxide. So, if you're really toxic and I speed your mitochondria up, you're going to suddenly start moving all this trash out. that may not feel good for a while. Um, so yes, to back to your earlier point, raising the level of things that help me deal with that, such as uh antioxidants, for example, but also a lot of people get constipated or bowel dysfunctions if you're not eliminating through your GI tract appropriately. And that could be, you know, your gallbladder and your bile is not moving as well or your bowels are, you know, slow or or intermittently slow, you're just going to recycle all that junk and and feel worse. So, uh, that when I'll tell them, okay, if you had this symptom of mitochondrial support equal feeling bad, we're going to do this really slowly, but we have to start to let your body get rid of this junk so that doesn't happen. Yep. Yeah. And you see that with some B vitamins. People will make a remark that I felt too sped up. I couldn't sleep well. I had a headache. Sometimes with red light, same thing. And um that's actually been a really big gift at the clinic is helping to slow people down and coach them through reorienting and interpreting negative reactions as telling us we're actually we're doing something that we need to do, but we may not have the adequate anti-inflammatory support or detox support on board to allow that uh function to be brought up

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allow that uh function to be brought up to more normal speed because it it is kind of pushing out toxins or maybe kicking up a little bit of inflammation as the mitochondria start making more energy and you just your your stores of antioxidants are so depleted that you can't even handle that transition. Almost like someone who actually to your earlier point about exercise, they start exercising and they're floored by it. Well, in normal physiology, people should be able to recover. So, a common theme here that if things that should heal don't, it doesn't necessarily mean totally avoid those, but look at that as okay, how can I better understand what's going on in the system, remove the monkey wrenches, and then I should be able to heal and improve from those therapies. Yeah, that's a huge uh that's a huge tell and I and once patients actually internalize that and realize it's not a all or nothing thing but that may mean we have to slow down uh the one side of the equation and increase the removal of the interference whether it's infectious or toxic or or whatever which can take some time. Um, and the same with exercise. You know, a lot of our patients that are really sick, we they they will have tried to exercise because it hurts good for you. And then they're just like two weeks of recovery where they don't feel well. We'll literally just say, "Okay, if that was your experience, you still want to move your body, but just a little more than you normally do." And and as you get healthier, your recovery will get better. But don't push yourself into illness, you know, because

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yourself into illness, you know, because of it. Yep. Well said. Uh let's talk for a moment about hyperbaric oxygen. And this is something I've mentioned on the podcast before that once we found a company that will actually ship people a hyperbaric unit to their home and allow them to rent it for a month or two, it really made this much easier for people who weren't near a clinic to be able to do so. And boy, we've seen a few cases where people were just tough, chronic fatigue, exercise intolerance where this really started to bring them back to life. Um, obviously there can be a whole podcast dedicated to this topic, but are there a few highle points about hyperbaric that you think are interesting? Yeah. Um, and I've experienced the same this the same thing. um our uh our various clinics have all all had hyperbear uh capabilities and we still do. Um the thing I think that for people to envision is your your body carries normally its oxygen on your hemoglobin and there's only so many places to carry oxygen and then in normal physiology there's a tiny amount that is free oxygen in the plasma. What hyperbaric oxygen does is a couple of things, but one is it saturates the plasma with more oxygen and also it saturates not just through the normal, you know, circulatory measures. It

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you know, circulatory measures. It saturates your tissue beds with more oxygen. You're getting more oxygen kind of from two different pathways. your mitochondria must have oxygen to run uh oxidative phosphorilation to make ATP, right? If if you then increase the availability of oxygen, you know, at the side of the cell, oxygen naturally goes down a gradient. So, normally it's pretty big gradient just from breathing. If we super saturate your body, the gradient gets bigger and the mitochondria uh are going to process more oxygen, make more ATP, etc. And so that's a very important process. It also helps uh to one way to think of it is kind of triggers your um oxidative reductive cycles. So these are the cycles that you're you oxidize or you get inflamed and then the antioxidants are triggered to go up and uh take care of the inflammation. So hyperaric also is triggering those processes which again are helping to decrease your inflammation and all of that. Um, and you know, like you say, especially where they can do home uh treatment, so it's more available and you know, because it's any treatment you have to drive somewhere for, it's harder to get to do that. Absolutely. Um, and so, you know,

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that. Absolutely. Um, and so, you know, the the home units which are lower pressure, much more gentle, they're um very able to help people kind of stimulate this process. And again, all the things we talked about before apply. If a person is really toxic and they just feel really, you know, kind of bad after a hyperbaric treatment, usually it means that they need more antioxidants, they need more elimination, you know, pathways looked at, etc. But right, uh, hyperaric is an incredible treatment for really all all these things we're talking about. And one point I'll make for for the audience kind of coming back to that principle of don't misinterpret a negative response meaning that you shouldn't use a given therapy. There was one study that was fairly elegant. It found inflammation increased up to the 10th hyperaric session and then it decreased after that. And it's I look at it similar to exercise where you're probably going to have some when you're sedentary and then start exercising some upregulation of muscle inflammation until the body as you were saying increases repair and including in this case endogenous antioxidant production. So at first if you feel a little inflamed, you got some joint pain, you feel fatigued to a degree, right? not severe, but to a degree, you may want to push through that until you get to about the, you know, just over the 10 week mark. And that's when you may see things shift and start noticing better cognition, better sleep, less joint pain, even less digestive dysfunction.

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pain, even less digestive dysfunction. Actually, there was that really pivotal meta analysis finding about a 50% either response or resolution rate of inflammatory bowel disease with hyperbaric, which is fascinating. Uh, and obviously that's going to give us a lot of bang for our buck because we're absorbing nutrients now. We're getting nutrients to the brain. We're reducing inflammation. So, just one more time to reiterate the concept for people not to uh jump ship from a therapy too quickly. Yeah. I think uh you know all the therapies we talked about can can do that and and a lot of it too is you know when the patient leaves our office we try to remind them hey you know this is your journey. your body's going to do its thing. So, if you have one of these responses and we need to adjust, let's let's do that right away. Sure. And make the journey easier, right? You know, you see similar things with fasting therapies. You get more inflamed early on. You're you know, your mass cells really upregulate and then they go down, you know, and all your inflammation. Um and and we talked about, you know, light therapies and heat therapies and things. Same thing happens. Um, most people do really well with them, but they can be a little overstimulating to the system. Yep. We have to go more slowly. Um, peptides is another very interesting therapeutic here. SS31 and M C are two that I think are

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SS31 and M C are two that I think are pretty interesting for their impact on mitochondria. But I'm wondering, do you have any favorites here in this this new exciting world of of the, you know, thousand peptides that are out there available? all all of the peptides. Um they they are I think because they work at such a core level uh in your biochemistry and your physiology. Um so peptides are just you know small short strings of amino acids that are going to plug into a particular place and usually either help a regenerative process or stimulate a process etc. Um, one of the issues as with many things is that the the government regulation around what peptides you can get and how you get them and all of that has been just a it's it's been a moving target uh and and continues to be. There are some really good high quality orally uh available peptides that that I tend to use a lot because people don't have to inject them. They can take them at home, you know, and all that. Um, one that we use a lot to kind of step back away from the mitochondria more, but to help kind of cleaning out the the inflammatory blocks. Um, especially when there's been chronic infectious problems as thymus and alpha for example. Yeah. Helping, you know,

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for example. Yeah. Helping, you know, the especially the cell mediated side of the immune system and all that. Um, so it's sort of like you can work your way from the outside in and then as you mentioned there's some very specific to mitochondrial uh regeneration mitogenesis um and they all can be you know very useful. So people often say well what would be the difference between NAD support and B vitamins etc and then doing say mitochondrial specific peptides. Well, you're one is feeding the system with the normal substrates it used to make energy. The other is going to this area in the cell danger response, especially where you derail because of inflammation, infection, toxins, whatever. And your body has signals to try and heal the mitochondria, but the signals are so slow, you're not healing as well. So these, you know, peptides can be used to kind of reconnect the dots as far as your uh your mitochondria healing. Yeah, great point. Been a huge uh a huge addition to people clinically. Really, I think. Yeah. And to your point, it's nice to see some of the oral options popping up and becoming more available for access. And also some people just, you know, they don't want to do an injection. Even though a subcutaneous, a pinch of of back or belly fat is really literally a small pin prick. Some people just they don't want to do it. So, if we can get decent absorption orally, then

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can get decent absorption orally, then yeah, I'm with you. And we have seen some of those oral peptides work um you know, seemingly as well as the injections. Yeah. I think a lot of it's the delivery mechanism and there's probably a couple companies that have that figured out seemingly. I've I've used more and more of those. Uh again, it's sort of like, you know, a home hyperaric unit is going to get used more. Um definitely though if people Yeah, a subcutaneous injection, especially with most peptides, you almost don't feel it. Uh you know, it's very very tiny stuff. Um, and if that's really helped somebody, they'll be very, you know, excited to keep doing that. Sure. You know, as they go that positive reinforcement. Sure. Yeah. You know, the the oral ones are just a little bit the the bar is a little lower to get over, I think. Right. Um, Paul, this has been a great conversation. Any closing thoughts or advice for people? Yeah, I think uh two things. One would be we we talked in different parts of our discussion about it. Um I would say one of the other things that people can do at home certainly in clinic but at home that have been game changers are red near infrared light therapies and there's so much better you know availability. So they not only help your mitochondria operate better they also um help a number of other processes as far as inflammation etc. one therapy that you know is right up

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one therapy that you know is right up there with hyperbaric etc. Yep. But I think from the macro uh point of view if if you're going through chronic illness and you see oh this concept of the cell danger response and the mitochondria need to be fixed but the cell has all these other issues it it has to deal with. So your point of a negative response is not always bad. it's a signpost that means we need to support something more, speed up or slow down something, etc. That's the kind of feedback you and the provider need to have and you'll get through the process much quicker than just trying to white knuckle through, you know, some uh negative effects. And I think that when you've been chronically ill and you've been sick and you're not getting answers, it's it's really demoralizing if you don't understand that, you know, okay, negative experiences that lead us to better therapy as we go through are actually positive experiences. They're just uncomfortable. It gets smaller as time goes on. So, uh, you know, hang in there to to everybody who's got these things going on. It's takes time. Yeah, and that's a great point also so that people would or will avoid white knuckling, but also so you can bring that feedback to your provider because sometimes I think what happens is is two things. People become hyper accustomed to avoiding anything that doesn't feel good. Um, and also they may just what I

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good. Um, and also they may just what I call provider hop, right? I start with this new doctor had some negative reactions. Oh, they don't know what they're doing. And then you go to the next person. And if the clinician just had that one or two opportunities of the feedback loop, they could navigate you through it. Uh, and I get I mean I get how deciding it can be. Let's say you waited a month to see the doctor and then you went through the whole, you know, hour and a half intake and they they dug and you really felt like this person finally understood you and then the first recommendation they give you, you feel worse. I can understand how that's just totally demoralizing. But just keep in mind that sometimes you're you're one followup and one feedback cycle away from really getting on the other side of that. Um Paul, where are you hanging out these days? Uh anything new, a website, blog, where would you point people? Yeah, uh I I finally got smart and made a hub website that has links to my YouTube and my newslet all the stuff. It's just drdanow. com. And uh we we have a very large uh YouTube patient education uh site that uh has grown a lot. Great. And uh that has all sorts of uh chronic illnessoriented uh topics. Perfect. Well, Paul, I appreciate you and your work. Thanks for coming on and explaining mitochondria and the cell danger response. Thank you. [Music]