Micronutrient status is a foundation of health, performance and chronic disease minimization. This episode looks at how to optimize fat soluble micronutrients status.

In this episode we look at ensuring micronutrient status. Ensuring your body has the building blocks it needs to do what it needs to do. This is an important lever to increasing your health span and current functionality and performance.

Previously we discussed micronutrient status with a focus on magnesium in episode 17 with Dr. Carolyn Dean.

This episode is about fat-soluble micronutrients including vitamin A, D and K. I personally look at micronutrient status as a foundational piece to get covered first. It is easier to do than most things and has wide ranging impacts thus it’s a good place to start.

Something else I wish to highlight for you to pay attention to in today’s episode is looking at the body as a set of dynamic systems. Typically we think we just have to raise one value into an optimum range with blood work or labs or so on.

However, as you will learn today, even with respect to basic vitamins it is often not that simple. It can be personally nuanced (different for each person). There are interplays between different markers to consider, thus the benefits of looking at several markers at one time, which we have discussed before. For instance, making use of a panel to get a realistic picture, by looking at several markers which point out one aspect of functionality in your body.

You focus on vitamin K but you may not realize what’s ultimately missing is something upstream that’s allowing vitamin K to fulfill its function. Just throwing vitamin K at the system isn’t going to do anything. It’s really important that we continually improve our understanding about how to figure out what the weakest link in the chain is because we’re always going to get the biggest benefit from fixing what’s missing.

– Chris Masterjohn

Today’s guest is Chris Masterjohn. He has a PhD in Nutritional Sciences and he is currently Assistant Professor of Health and Nutrition Sciences at Brooklyn College, part of the city university of New York.

In the last five years Chris has been responsible for originating influential ideas and papers on the fat-soluble vitamins A, D and K. The importance of their role in the body and addressing that status, the status of these micronutrients to promote health.

If you follow the Paleo, Ancestral Health or Western A Price Foundation communities it would be difficult to not have already come across some of his work. Chris now has both a podcast as well as his own blog named The Daily Lipid, where he covers his ideas and research on optimum nutrition. His podcast is both technically detailed and has a lot of practical takeaways. I highly recommend you also check that out.

The episode highlights, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

What You’ll Learn

  • How Chris developed interest in researching fat soluble micronutrients (4:16).
  • The health issues our guest was better enabled to resolve by studying fat soluble micronutrients (6:30).
  • Chris primarily researches vitamins A, D, and K all of which are tightly connected in a functional physiological network (7:56).
  • Vitamins are integral parts of a broad system which can be optimized, as opposed to individual separate nutrients (9:32).
  • Examples of how molecular mechanisms involving micronutrients are inter-dependent in regulating a range of functions (10:28).
  • Focusing on improving the most deficient part of an interconnected nutrient system – thus bring about the greatest benefit (15:08).
  • Different diseases often share common root causes, involving lack of micronutrients or improper distribution in the body (17:00).
  • The science of interpreting vitamin K deficiency in children and young people (19:30).
  • The differences between vitamin K1 and K2 in managing risks factors for various health issues (27:02).
  • Pharmacological doses of vitamin K2 and how these are tested and used (28:44).
  • It is preferable to take vitamin K in doses close to the range of maximal concentrations obtainable from food intake (29:29).
  • Micronutrients have independent functions including regulation of gene expression – thus leading to biological complexity (30:13).
  • How the body manages vitamin K when faced with deficient supplies (34:00).
  • Variation of micronutrient intake from various diets and caveats for analyzing outcomes of specific diets (36:00).
  • Managing a healthy micronutrient system with various types of diets (42:28).
  • Testing, supplementing, and understanding the factors influencing vitamin D in complex physiological systems (43:48).
  • Maintaining balanced vitamin intake by diversifying food types and lifestyle changes (49:49).
  • Why adding fermented foods is the optimal strategy for properly managing vitamin K2 intake (52:50).
  • Subscribing to local farms and weekly auto delivery of groceries (54:20).
  • Strategy for maintaining variability in consuming vegetables by weekly rotations (54:52).
  • Parathyroid Hormone (PTH) is a more specific marker of inadequacy in the body’s calcium-vitamin D economy, compared to 25(OH) vitamin D (56:39).
  • Deriving conclusions regarding nutrient intake based on ‘shotgun’ genetic analysis is tricky; often sufficient scientific evidence is lacking (1:02:08).
  • Vitamin A testing and how deficiency influences impaired eye vision (01:07:10).
  • Making nutrient test ranges actionable and novel biomarkers (1:08:52).
  • A Dutch company offers testing specifically for the inactive form of Matrix Gla protein (MGP), as of yet only via research-purpose contracts with clinicians (1:13:02).
  • The broader context in understanding testing for Vitamin K2 deficiency (1:14:16).
  • What projects are the main focus of Chris’s current work (1:15:27).
  • Using of high dose fish oil in resolving inflammation issues (1:18:24).
  • What Chris has changed his mind about in the last few years (1:19:26).
  • What biomarkers Chris tracks on a routine basis to improve his health and performance (1:20:38).
  • The legal aspects of drawing larger amounts of blood from consenting adults, or yourself at home (1:24:26).
  • Chris’s recommendations for routine monitoring of our health (1:25:49).
  • Discovering more about Chris and keeping up with his work (1:29:23).

Thank Chris Masterjohn on Twitter for this interview.
Click Here to let him know you enjoyed the show!

Chris Masterjohn (Ph.D), The Daily Lipid Blog

Recommended Self-Experiment

  1. Tool/ Tactic: Improve your body composition by becoming more aware of your caloric intake. Chris believes is a high impact lever for most people, and will likely have downstream benefits for insulin sensitivity and the other systems discussed in this episode.
  2. Tracking: Build a habit of tracking your waist circumference, your body weight and keeping a food log with an app like MyFitnessPal.

Tools & Tactics

Diet & Nutrition

  • Vitamin AThe physiologically active form of vitamin A is retinol which occurs only in animal foods. However red, orange, yellow, and green colored vegetables are rich in carotenoids – precursors to retinol. To maintain your vitamin A at recommended daily allowance (RDA), one serving of liver per week covers vitamin A nutritional requirement. Liver cod oil is also a rich source.
  • Vitamin K: The general population obtains Vitamin K primarily via cheese and egg yolk consumption. Vitamin K2 is a sub-type of vit K found in animal products and fermented foods. Vitamin K1 is found in green-leafy plant foods. Vitamin K2 is more effective at activating your body’s vitamin K-dependent protective system. The richest source of vitamin K2 is natto, a fermented soy food popular in east Japan. You can use the natto bacteria to prepare homemade fermented vegetables as a good source of vitamin K2.
  • Vitamin D: Different foods contain varying amounts of particular nutrients. A fish’s liver tends to be high in vitamin D and A for instance. The same is not the case for terrestrial animals’ liver meat – because terrestrials store vitamin D primarily in blood and not the liver. You can compensate for not eating traditional sources of Vitamin D (such as fish), by increasing sunshine exposure. Eating UVB irradiated mushrooms is also a rich source of vitamin D.
  • Variety In Dieting: Adding different foods to your diet, such that steady levels of necessary vitamins can be achieved. This can be done by week-to-week rotations of food types.
  • Thrive Market: An online service for ordering groceries ex. for weekly auto-delivery. Subscribing to local farms is another useful tip for increasing productivity in diversifying your diet.
  • Vegetarian / Vegan: A vegetarian diet excludes meat by focusing on plants for food. In addition to excluding all meat products, a vegan diet usually also excludes all animal products, such as cheese and eggs. Genetic compatibility with diet types plays is important for vitamin nutrition. For example, common genetic polymorphisms, dietary and metabolic factors influence body’s ability to convert carotenoids to retinol. Note: Both Damien and Chris experienced exaggerated symptoms of tooth decay during vegan dieting – indicating insufficiency in calcium flow to bone tissue including the teeth.
  • Paleo: A diet focused on foods which paleolithic humans might likely have eaten. It is based on the idea that modern diseases result from a mismatch between our evolutionary and current-day environments (including dieting style). Whether paleo effectively supports your micronutrient system depends on defining the diet. A paleo diet based on restricting foods (often similar to an average American diet except grains, legumes and dairy) is not sufficient. Paying attention to organ meats is a solution because these are rich in fat-soluble nutrients.
  • KetogenicA high fat, moderate protein and low carbohydrate diet. Metabolism is altered so that ketones are used instead of glucose for fuel. See episode 7 with Jimmy Moore for detailed discussion on the benefits of this dietary approach. Carbon dioxide is required for the functionality of vitamin K. Given that carbohydrates produce up to 50% more carbon dioxide than fats do, you must must maintain minimal necessary carbohydrate intake – especially with ketogenic dieting.

Supplementation

  • Targeted Reason: Most-often supplementing an individual vitamin is not necessary solely based on a low result. Upstream factors often influence the functionality of a particular nutrient on a systemic level. Have a targeted reason for supplementing, start with conservative doses, and titrate to higher levels based on response.
  • Vitamin K Pharmacological Doses: Vitamin K supplementation has been shown to be more effective than osteoporosis drugs in reducing the risk of bone fracture. The adequate intake level for vitamin K is set at 90 μg/day for women and 120 μg/day for men. In trials involving very high vitamin K intake (ex. 500mcg doses), it remains unknown whether the effects seen at such pharmacological doses are already achieved with much lower doses. For example, the initial 45mg of the dose might be sufficient to cause equal effects.
  • High Dose Fish Oil: Fish oil rich in EPA has been found to be counterproductive in balancing the inflammatory effects of omega 6-fatty acids. Other interactions alter EPA influence in resolving inflammation pathways. Damien promises to include the topic of resolving inflammation by using high dose fish oil, because this is specific to him.

Tracking

Micronutrient System

  • The System: Consists of vitamin A, D, and E – collectively known as the fat-soluble vitamins. These micronutrients are absorbed in fat and stored in tissues, for example in the liver. The system demonstrates multilayered biological complexity. Understanding the interdependence of vitamin-regulated physiological mechanisms is key to taking action and optimizing micronutrient status.
  • Reference Ranges: In general for fat-soluble micronutrients, Chris prefers people to remain in the middle of a range compared to the lower range portion. Damien argues that it is worthwhile to be in the top third of most ranges, because the general population is characterized with non-optimal health.

Biomarkers

  • Matrix Gla Protein (MGP): A vitamin K-dependent protein which regulates calcium flow. MGP continually removes calcium from arteries (where calcium is a risk factor for plaque formation and cardiovascular disease) and moves it into bone tissue (where calcium is needed for proper bone metabolism and preventing osteoporosis). Quantifying MGP in its activated form is not a useful biomarker for vitamin K status.
  • desphospho-uncarboxylated Matrix Gla protein: This is the inactivated form of MGP and serves as a useful biomarker for vitamin K status. If inactive MGP levels are measured high, this indicates poor supply of vitamin K specifically in blood vessels. Currently this marker is not available in the US.
  • % of Carboxylated Osteocalcin: Osteocalcin binds and moves calcium into bone tissue. Similar to MGP, vitamin K is required to carboxylate osteocalcin – thus enabling calcium binding. Carboxylated osteocalcin levels alone are not useful in determining vitamin K status in blood. Instead the percent of carboxylated osteocalcin is a useful marker – encompassing micronutrient functionality in calcium flow. For example, if vitamin K supplementation produces a notable increase of % carboxylated osteocalcin, this indicates operating in a range of inadequate vitamin K. For a more in depth look, see this article on osteocalcin by Chris on the Weston Price blog.
  • Serum Retinol (Vitamin A): The most effective way to quantify your vitamin A status is to measure the active form of this nutrient – known as retinol. Low retinol levels indicate vitamin A deficiency. The reference range for retinol is based on the role of vitamin A in supporting night vision. The lower end of this range is approximately a concentration at which you can see during night time without symptoms of distorted vision.
  • 25-OH Vitamin D: The most common marker for measuring vitamin D is a downstream metabolite of vitamin D known as 25-OH vitamin D. The Vitamin D Council suggests an optimum level of 50 ng/mL of 25(OH) vitamin D. Chris also suggest that vitamin D optimal ranges are downward of 60 ng/mL 25(OH) vitamin D.
  • Parathyroid Hormone (PTH): A hormone produced by the parathyroid gland in response to changes in calcium blood levels. Compared to 25(OH) vitamin D, PTH is more specific for detecting inadequacy in the calcium-vitamin D system. Deficiency in vitamin D or calcium results in chronically active PTH production (high serum levels). From this perspective, remaining in the lower half of the PTH range (~30pg/mL) is optimal for a functional vitamin D-calcium system.
  • Ferritin: Serum ferritin acts as a buffer against iron deficiency and iron overload. Ferritin levels have a direct correlation with the total amount of iron stored in the body. Chris has a genetic predisposition for hemochromatosis, a condition in which too much iron builds up in the body causing toxicity. By optimizing his blood donation schedule, Chris maintains ferritin levels at around 150 ng/mL. The reference range for ferritin has an upper limit of 500 ng/mL.

Lab Tests

  • Amino Diagnostic Systems: A company working on gaining FDA approval for a test aimed at measuring the inactive form of MGP protein. Therefore, this test in still not available in the US.
  • VitaK: A company based in the Netherlands which offers testing for the dephosphorylated inactive form of MGP protein. However, they offer this test only to clinicians and for research purposes.
  • Quest Diagnostics: Testing of both serum retinol and serum vitamin A palmitate – the main form of serum retinyl ester. A formula for testing vitamin A overdose includes measuring levels of serum retinol and retinol palmitate in fasting state. If serum retinyl esters are greater than 10% of the sum of the values obtained from both tests, then this indicates liver vitamin A overload.
  • 23andMe: The largest personalized genetics company offering testing directly to customers. While health analysis data is no longer provided in 23andMe reports, the obtained data can be used with other gene analytics services. Chris discovered a predisposition for his iron overload condition via 23andme testing. Also see episode 5 with Dr. Ben Lynch featuring the use of such data in optimizing methylation.
  • SpectraCellDamien took this test in 2012 (see full report here) – the report did show a slight vitamin K2 deficiency at the time, which is one of the items he took action on by looking into Chris Masterjohn’s work at that time. Chris disagrees with the micronutrient testing SpectraCell report because it leads to conflicting conclusions. For example, there is very little scientific evidence that nutrient levels inside immune system blood cells.

Devices and Apps

  • MyFitnessPal App: A free application for tracking calorie intake and energy use, including a large database of foods and exercises. A useful tool for optimizing diet and improving fitness. Initial experiments can be tracking weight / waist circumference or keeping a food log to deduce your body composition. The app also integrates with other fitness devices and apps, such as the Fitbit and Withings which we have discussed before. See episode 24 with Troy Angrignon for the value of wearable devices or episode 32 with Paul Abramson on the potential of self-tracking in medicine.

Other People, Books & Resources

People

  • Weston Price: A researcher who documented the nutritional transition that occurred in many different cultures across the globe. He concluded physical degradation as a result of the switch from traditional diets to modern refined foods diets. Chris notes that traditional diets put strong emphasis on nutrient dense animal foods which supplied fat soluble vitamins.
  • Dr. Bruce Ames: A scientist whose major accomplishment is the Triage Theory. In summary, when the supply of nutrients is compromised, the body prioritizes vitamin K usage for acute survival needs over investing in long term health. When vitamin K is marginally inadequate, the liver gets top priority to activate blood clotting factors. Meanwhile the bones, blood vessels and other vitamin K-dependent systems perform with reduced functionality. This is a valuable tool for understanding the functioning and optimizing the vitamin K system.

Organizations

Books

  • Nutrition and Physical DegenerationA book by Weston Price on the micronutrient system, focused centrally on tooth decay. Chris found it useful for understanding the roles vitamins play in bringing about a protective effect on teeth.

Other

Full Interview Transcript

Click Here to Read Transcript
(00:04:16)[Damien Blenkinsopp]: Chris, thank you so much for joining the show.

[Chris Masterjohn]: It’s great to be here Damien. Thank you for having me.

[Damien Blenkinsopp]: I just want to get a little bit of an introduction from you, so that the audience that hasn’t come across you already, although I expect most of them already have, can get a bit of an idea where you’ve came from and how you got into what you do.

[Chris Masterjohn]: Sure, I have a Ph.D in Nutritional Sciences and I’m currently assistant professor of Health and Nutrition Sciences at Brooklyn College, in Brooklyn New York. I had always been interested in nutrition, at least since my teenage years but I sort of got set along my current path when I went vegan for awhile and didn’t have very good health outcomes on it.

I actually really improved my health a lot when I learned about Weston Price who studied, at an opportune time in the 1930’s, and documented the nutritional transition that occurred in many different cultures across the globe from traditional diet to diets of modern refined foods and documented the physical degeneration that took place there.

What struck me from that, that really provided a lot of utility to me at the time, was that in traditional diets that were associated with great health there was a really strong emphasis on nutrient dense animal foods that supplied fat soluble vitamins.

So in learning that and implementing principles that helped turn my health around I became very interested in the fat-soluble vitamins, and that’s why studying vitamins A, D, and K, which is one of my passions and current focus of research, has been something that I’ve been so interested in.

Over the course of, even leading up into graduate school, I had done a lot of work trying to understand the interactions between the fat-soluble vitamins and I published a hypothesis paper about that. When I was in graduate school I actually studied energy metabolism and glycation and antioxidant defense, but then in my postdoctorate at University of Illinois at Urbana-Champaign and now at Brooklyn College, I’m moving back into studying the fat-soluble vitamins.

(00:06:30) [Damien Blenkinsopp]: Excellent, thank you for very much for that. I’m curious, what kind of health issues did you have and you found resolved through this journey?

[Chris Masterjohn]: Most of what I experienced was an aggravation of existing predispositions. As an example, as a child I had been fairly predisposed to tooth decay, when I was vegan this became very exaggerated. So, in one single trip to the dentist I found out that I had over a dozen cavities and I needed two root canals. I had had digestive problems since I was a baby but when I was vegan they became much worse to the point where they were really interfering with my day-to-day function.

I had been predisposed toward anxiety probably at least since my early to mid-teens, but the anxiety and panic disorder really became strong and really started interfering with my day-to-day function when I was a vegan.

And Weston Price’s work actually focused centrally on tooth decay so when I was reading his magnum opus, “Nutrition and Physical Degeneration” I was most interested in, “How can I fix my tooth decay?” What really surprised me was that my mental health was completely revolutionized without me even trying to fix it once I started to incorporating nutrient dense animal foods into my diet.

(00:07:56) [Damien Blenkinsopp]: Very interesting. I had a similar experience I did vegan, for not as long as you probably, I think I did about four months but it was around that time also I started getting tooth issues. I started having all these fillings and so on, so it’s interesting. Maybe that happens to a lot of people and of course today I’m doing much better. I don’t really need to go to the dentist that much these days, so that’s cool.

I wanted to jump into this whole area of fat-soluble micronutrients, which you’ve done a hell-of-a lot of work in, and your work is very well known for this area. Would you say, first of all, just to isolate what we’re talking about, when you say, “fat-soluble micronutrients” what area you talking about? Is it the A, D, and K or a little bit broader? How would you categorize that?

[Chris Masterjohn]: The fat-soluble vitamins there are four of them, they are A, D, E and K. In my research I have also done a lot of research into the antioxidant defense system and I view vitamin E as a functional part of that system.

When I was in graduate school my work was very closely related to vitamin E, but I view vitamins A, D, and K as being involved in a functional network together where there is a whole set of specific physiological functions that those three vitamins cooperate together in, in a way that vitamin E is not as closely aligned with that system. So, most of the work when I refer to the fat-soluble vitamins, technically that includes vitamin E, but more often than not I’m referring to A, D and K.

(00:09:32) [Damien Blenkinsopp]: Right. I find it really interesting, because I noticed when I was doing preparation for this that you talk about it as a system, because a lot of people think of vitamins as separate things but it seems the way you look at it is it’s a system. You look at this whole systemic level and when you’re optimizing or improving it you have to look at it from that broad perspective. Is that correct?

[Chris Masterjohn]: Absolutely. I think that most scientists who actively think about this sort of thing would agree that during the course of the 20th century we did a really good job of breaking things down into fragments and we did not do a very good job putting them back together again.

So the task that lies before us in the 21st century is to take all of this fragmentation and all of this very granular knowledge that we’ve obtained about specific things and then figure out how they fit together in systems. I think that is the frontier of science right now.

(00:10:28) [Damien Blenkinsopp]: Yeah, it’s exciting stuff. If you were to describe this as a system, is there anything else you’d add in, beyond what you’ve already said about it, which gives people the overview of that whole system? Not to get into too much detail, but to get the highlights. Is there anything to add?

[Chris Masterjohn]: Yeah, absolutely. I think biological complexity is kind of like an onion, you peel away one layer and then as soon as you look beyond that layer you come across another layer, you come across another layer, and you come across another layer. To take an illustrative example of how some of these things would fit together into a system lets just take one specific protein.

Matrix Gla Protein or MGP is a vitamin K-dependent protein that’s responsible for putting calcium into our bones and teeth where it primarily belongs and preventing it from going into the places that it doesn’t belong, like the the soft tissues, particularly the blood vessels or the kidneys, where it would contribute to vascular disease or kidney stones.

Now you take this one protein. We call it a vitamin K-dependent protein because vitamin K is necessary to activate it and give it that ability to control calcium, but how do we get it in the first place?

Well vitamins A and D are responsible for telling the cell to make that protein but vitamins A and D can’t do that on their own, because to strip away to the next layer, when vitamins A and D tell the cell to do something they do it because they are metabolized into signaling compounds that then bind to a receptor that then binds to DNA and controls the degree to which genes are expressed.

When they bind to their receptor, the only way the receptor can bind to the DNA is because there are interlocking finger structures that fit together, kind of like if you were to clasp your own fingers together in your hand and you imagine that one set of fingers from the left hand is the receptor and the other set of fingers from the right hand is the DNA.

They fit together basically just like that, but what’s responsible for the finger shapes is the coordination by zinc. So, if you don’t have the zinc there, you can have vitamin A there, you can have vitamin D there and they can bind to the receptor but the receptor won’t bind to the DNA and the function won’t be carried out. So zinc is clearly important there.

Then you could take magnesium. I almost think that trying to get granular about all the specific things that magnesium does would cause you to underestimate its roles, because if you just take two of the roles magnesium plays and ignore all of the other specific enzymes it activates — magnesium is necessary to activate the enzymes that are involved in translating genes into proteins.

So imagine that vitamins A and D, with the help of zinc, are binding to the DNA and telling the DNA to be expressed. If magnesium isn’t there that compromises the ability to synthesize those specific proteins as well as every other protein in the body. Magnesium also plays other roles in regulating the distribution of calcium that would ultimately allow MGP to fulfill the function we were talking about before.

To take another example, carbon dioxide is necessary for the process because when vitamin K activates MGP, what it does is by taking carbon dioxide and adding that to the protein. And that addition of carbon dioxide is actually what allows that protein to start controlling the distribution of calcium.

Carbon dioxide is produced primarily during energy metabolism and that means that supplying that carbon dioxide is dependent on your metabolic rate but also the macronutrient mix in the diet plays a role as well. For example, carbohydrates produce fifty percent more carbon dioxide than fats do. So getting adequate carbohydrates is important.

So I just peeled the layer back to the third layer. I’m sure that we could keep going and ultimately if you just keep peeling it back and peeling it back what you find is that everything is interdependent with everything.

But what I have tried to do in my writing is: we can’t make any use of the information if we don’t simplify it and try to develop a working paradigm to talk about it and to understand it. I think that it’s necessary to have that top layer of the onion where we focus in on some of the key points, or otherwise it would just be information overload and we wouldn’t really be able to do anything with it.

(00:15:08)[Damien Blenkinsopp]: Absolutely. I’m hoping my processing and learning and things like that will eventually be able to get around that and actually understand all of these complex systems. It’s kind of obvious that it’s going to be beyond human level of understanding just because there are so many moving parts and it’s a dynamic system. You change one thing and something else is going to get distorted.

Is it safe to say that anything that would be deficient? Say, it could be one of the vitamins or some of those associated micronutrient minerals you mentioned, like magnesium or zinc, could distort the system and therefore get an output you’re not looking for?

[Chris Masterjohn]: Absolutely. That is one of the reasons why it’s so difficult to really answer questions about what’s going on in many cases. Because you can say, “I’m prone to tooth decay or I’m prone to… my children tend to have a narrow palate.” And you can say, “Well, vitamin K dependent proteins should be necessary to broaden the palate and to supply mineralization to the teeth.”

So, you focus on vitamin K but you may not realize what’s ultimately missing is something upstream that’s allowing vitamin K to fulfill its function. Just throwing vitamin K at the system isn’t going to do anything.

It’s really important that we continually improve our understanding about how to figure out what the weakest link in the chain is because we’re always going to get the biggest benefit from fixing what’s missing. If we take something that’s 80-90% good and we make that 95% then that’s going to be relatively little benefit, but spending the time to figure out what might be really missing at 20%, moving that up to 80% could provide huge effects.

(00:17:00) [Damien Blenkinsopp]: Yeah. Would you say of the things you’ve looked at, this system of vitamin D, K and A is basically a high impact lever for changing health scenarios because you feel like deficiency of any of these can affect a lot of systems in our body?

[Chris Masterjohn]: Yes, I do. If you look at some of the most common diseases that we would be concerned about you can see, particularly with heart disease, fat-soluble vitamins likely play a very vital role in protecting arteries from calcification. Calcification of arterial plaque is one of the driving forces of that plaque which eventually leads to a heart attack or an ischemic stroke. That’s a major concern.

We see a correlation between heart disease and kidney disease and osteoporosis. All of that can be grouped under this general malfunction of putting calcium where it’s supposed to be. If calcium is going into the kidneys and into the blood vessels and it’s not going into the bones.

The wrong way to approach that is to send the person to the bone doctor to look at the bones, send the person to the heart doctor to look at the heart, and send the person to the kidney doctor to look at the kidney.

That may be necessary to manage the disease process but what we want to be doing is figuring out, “What are the commonalities here?” and “What is the central defect in this system that’s contributing to all of these different things?”. That can very easily be explained by a malfunction of the fat-soluble vitamin dependent system of putting calcium where it does belong and keeping it out of where it doesn’t belong.

If you take that out of the area of the elderly and you put it into the area of children then you will see similar things where attaining proper growth and not just getting tall, but also having a broad dental palate that fits all of your teeth, and so on and so forth. All of those aspects of growth are also powerfully affected by fat-soluble vitamins.

Although there is some controversy over how you would interpret the data it does seem, to the degree that we’ve measured it, that there is a very high prevalence of poorly activated vitamin K dependent proteins in children when they’re in their growth phase. So I would say from the cradle to the grave it seems like there is, within the context of modern civilization, there seems to be this lifelong deficit in this system.

(00:19:30)[Damien Blenkinsopp]: Interesting. You’re basically saying it’s pretty common and there are a number of issues you think are quite common through society which are affected by this? Can you give us any example? Are there any studies? Or what kind of evidence is there to show how prevalent this kind of deficiency or these kinds of problems in this system is?

[Chris Masterjohn]: I want to take a step back and say there are two versions of this story. One is the clean version and that’s what I’ve been delivering you so far. That version is the version where you can make a strong case where this is true.

There is another version of this story that gets very dirty, and that is that when we try to assess the prevalence of these issues it becomes very sticky because we’re always learning more and more about how to interpret blood markers.

And if we are honest, that has to force us to continually revise how we’re interpreting those blood markers. We could get into the topic of testing of vitamin D status, which is wildly controversial, but let’s stay on vitamin K for a moment.

One of the ways we could look at vitamin K status in children is to look at the percentage of osteocalcin that is carboxylated. Osteocalcin is a protein that’s made by bone cells and carboxylation is the process where by vitamin K activates that protein to allow it to bind to calcium.

Now through most of the 20th century into the 1970’s no one knew about osteocalcin. Through that whole time we just saw vitamin K we though it was important to blood clotting and nothing else. Then the new era, over the ensuing decades the vitamin K research communities started developing a body of literature around osteocalcin. Then the phase after the 90’s where they started producing reviews that other people could read and this idea became popularized.

Up through the end of the 20th century and into the really recent years in the last decade, what emerged out of osteocalcin research was this idea that under-carboxylated osteocalcin is a marker of vitamin K deficiency because if vitamin K carboxylates osteocalcin then if you are adequate in vitamin K then all of your osteocalcin should be carboxylated.

That seemed totally logical and totally rational. There are multiple studies, I can’t site the exact figures off the top of my head, but what we can do is put links to the studies in the show notes if you would like, for the podcast. But there are multiple studies showing that in children the percentage of osteocalcin that is under-carboxylated could quite often reach sixty or seventy percent.

What this looks like with this simple interpretation of osteocalcin, is that children have massive vitamin K deficiency because two-thirds of their osteocalcin is not being activated by vitamin K. Now what has emerged more recently in the last decade is that we now know that vitamin K is needed to carboxylate osteocalcin so that it can bind to the extracellular mineralized matrix of bone. But during the process of bone resorption that osteocalcin, after it had already been carboxylated, will be decarboxylated and released into the serum.

Not only that, but that under-carboxylated osteocalcin that’s released into the serum is actually a beneficial hormone that acts on, in males, on the testes to increase testosterone production; and in males and females, it acts on adipose tissue and possibly multiple other tissues to increase insulin sensitivity and it acts on the pancreas to increase insulin output. But what that increased insulin output occurs in the context of being very sensitive to the insulin.

So overall it causes a very radical increase in metabolic health. And I would say that no one really knows why this system has evolved the way it does, but you could speculate that it might be a way to link to bone resorption to the anabolic affects of insulin and testosterone.

So you would want bone resorption to be tied to bone growth and if you’re in a process of greater bone remodeling then perhaps the resorption causes osteocalcin to be released into the serum and then provide an anabolic stimulus to help rebuild that bone. That’s just speculation.

What isn’t speculation is that this causes a real challenge to interpreting, “What does it mean that such a high percentage of osteocalcin is under-carboxylated in children?” Does it mean that the children are not getting enough vitamin K?

Or does it mean because those children are engaging in a rapid period of bone growth, that their bones are just producing more of this hormone in order to provide a greater anabolic stimulus, which is exactly what they should need as growing children? Or is it both?

I actually am of the opinion that it’s both, [for] several reasons. One, is that whenever you take someone who has a considerable percentage of under-carboxylated osteocalcin in their blood and you give them vitamin K supplements, you increase the carboxylation status. That seems to provide some proof of principle that they are operating in some range of inadequate vitamin K.

But also, if you look at the fracture rate of children. Growing children actually reach a point during puberty where their fracture rate is equal to elderly people who are starting to have their bones deteriorate. So I believe that probably both of these things are true.

And although under-carboxylated osteocalcin is not a clear, clean, straight-forward marker of vitamin K adequacy; I do think the data overall suggests that children’s bones are growing faster than the mineralization of those bones can keep up with.

I think the reason that the fracture risk temporarily increases is because: imagine that you’re stretching a rubber band. If you are stretching that you are putting pressure on the system and it can break. So you are expanding the bone matrix and you are not at the same rate mineralizing it.

That’s like stretching out that system too thin and in that case you temporarily undergo this position of greater fracture risk, until the bones can eventually keep up. Because eventually you stop growing and then if you just get a little bit more mineral at a time you can eventually fix the problem you created during the time period of rapid growth.

I will say that my working paradigm is that this system is inadequate but I don’t want to give the impression that it’s incontrovertible. I also don’t want to give the impression that, just to be clear, it’s equally controvertible if someone is going to take the opposite position. This is a reasonable debate.

(00:27:02)[Damien Blenkinsopp]: Right. There are two ways to look at it. If you were trying to resolve that — if you did a controlled study through the teenage years, with families where they were getting more vitamin K, getting more nutrients from the system, versus the other, some kind of study like that. Would it help resolve and potentially give us the answers?

[Chris Masterjohn]: That’s another line of evidence that we actually do have. There are multiple observational studies that suggest that higher vitamin K2 intakes. To clarify vitamin K2 is a specific form of vitamin K that is found in animal products and fermented foods, as opposed to vitamin K1 that’s found in green-leafy plant foods. Vitamin K2 is more effective at activating the systems that we’ve been talking about than vitamin K1 is.

If you look at vitamin K2 intakes, observationally people who are in the highest — depending on the study, tertile, or quartile, or whatever they looked at — intakes of vitamin K are likely to have better bone mineralization, a lower risk of heart disease and blood vessel calcification and also, we didn’t even get into this, a lower risk of multiple different types of cancer.

There are cases, to my knowledge I don’t know of a study showing that in children you can reverse that increase in the fracture risk during that period with vitamin K supplementation but there are some, multiple, successful vitamin K interventions in elderly where very high doses, possibly pharmacological doses used in Japan, caused a dramatic decrease in osteoporosis risk that was more effective than osteoporosis drugs.

(00:28:44)[Damien Blenkinsopp]: What would be a pharmacological dose?

[Chris Masterjohn]: If you look at what you’re going to get from food, the highest intakes of vitamin K2 tend to be topping out at 200mcg a day. Most people would not be getting that, but you could find that among people who are eating whole foods. In the Japanese trials they were using 45mg, a microgram is a thousandth of a gram. You’re talking about orders of magnitude higher than what you could get from food.

But no one has tested lower doses of vitamin K. So with the osteoporosis trials, it’s sort of this question, “Was it the first 500mcg that caused the decrease in risk and the rest was just chafe?” Or do you actually need 45mg to cause that effect.

(00:29:29)[Damien Blenkinsopp]: It takes a while to find the minimal effective dose. I’m guessing vitamin K2 isn’t toxic at high doses?

[Chris Masterjohn]: In those Japanese trials there were no reported adverse effects. Anecdotally I have talked to some people who seem to be hypersensitive to vitamin K and seem to anecdotally have negative experiences from supplementation.

I think there is reason to speculate that it would be preferable to keep vitamin K in doses closer to the maximum of what you can get from natural whole foods, because there are some biochemical effects that you could reasonable construe as negative, when you get into really high doses.

(00:30:13)[Damien Blenkinsopp]: Great, thanks. You just mentioned cancer. I guess we didn’t really go through the complete list of things of issues you think could be associated with this system. Are there others that we haven’t mentioned which you would see as commonly or with a high potential associated with this system and a deficiency?

[Chris Masterjohn]: When I’m looking at vitamins A, D, and K in a functional network, I think the system where that really stands out is the system of calcium distribution. When you start talking about cancer it gets a little bit less clear how they interact.

Vitamins A and D are involved in the expression of numerous genes that are not coding for vitamin K dependent proteins. They have independent affects, where vitamin A does something and vitamin D doesn’t do and vice versa, but there are also genes that are regulated cooperatively by vitamins A and D that don’t relate to vitamin K.

In addition to that, although the best characterized function of vitamin K is to activate proteins by adding carbon dioxide to them or that carboxylation process that we were talking about before.

One of the things that for a long time that we could speculate about was, “Why is it that that process occurs in one part of the cell and we actually find most of the vitamin K in the nucleus and the mitochondria?” What we’re finding out now is that vitamin K also plays a role in energy metabolism. Vitamin K also plays a role in gene expression and so on and so forth.

When you start thinking about gene expression then anything that is a failure of the cell to behave in a way that that cell should behave, suddenly becomes a candidate risk of a deficit in that system.

For example, Autoimmune conditions makes a lot of sense to look at when you’re thinking about at vitamins A and D. I don’t know of any studies that have shown when vitamins A and D are given together in humans, will do anything positive in type I diabetes.

But I do know of at least one study where they showed when you take pancreatic stem cells you can regenerate the insulin producing cells that are being lost in type I diabetes by providing the active signaling compounds that are made from vitamins A and D together in those cells. Does that translate into a human affect? I don’t know, but that’s one possible candidate risk that we can be looking at.

When you’re looking at vitamin K, probably the most compelling study was one where they looked at liver cancer in women who are at very high risk and I believe — it’s been awhile since I’ve looked at it — but I believe the risk was caused by the existence of viral cirrhosis. That showed that the incidence of cancer in a controlled trial, that vitamin K supplementation virtually obliterated the rate of cancer, like lowered it by over 80%.

There are also multiple other cancer related endpoints that could be related to vitamin K because we have cell studies where we can say, “Okay, we can drop vitamin K in this specific form on the cell, and this is what it does.” Most of that has not translated into human outcomes.

And most of it has not really — so little is known about the mechanism. When I was telling you about how A, D and K interact to regulate this calcium distribution system; we have a lot more understanding, mechanistically, of how that system operates. I suspect that there are a lot of interactions between nutrients that we could eventually uncover when looking at autoimmune conditions or cancer, but we just don’t have the mechanistic basis to understand it at that level yet.

(00:34:00)[Damien Blenkinsopp]: Thank you for that clarification. It sounds pretty broad spectrum. If you’re thinking about tackling this and are in any of those spots we were just describing it might be worth looking at this because it’s not something really hard to fix or address either. I was just wondering, because you were just talking about cancer, if you’ve looked at the work of Dr. Bruce Ames and his triage theory? And if you think that’s something that could be playing a role there?

[Chris Masterjohn]: Yes. Not exhaustively, but I think with respect to vitamin K metabolism that Ames’ triage theory is pretty well known. I actually know about it from studying vitamin K and I suspect that if you were to talk to leading vitamin K researchers probably most would consider it a very valuable tool in understanding vitamin K metabolism.

If you look at triage theory in that sense the implications of that are — So triage theory is the idea that the body is going to prioritize acute survival needs over investment in long term health when the supply of nutrients in compromised.

In the case of vitamin K what we see is that if that you are marginally inadequate in vitamin K then your liver seems to get top priority to activate blood clotting factors and the bones and blood vessels and all these other systems that are dependent on vitamin K, lose out.

That’s the rational decision of the body saying, “Look, if I get cut and bleed to death that’s much more of an imminent risk than if twenty or thirty years down the road I get arterial plaque, or a heart attack, or a stroke, or osteoporosis with this slow degeneration of the bone matrix.”

So I think there is pretty good evidence that the body does prioritize vitamin K that way and I think it’s almost become standard, in the field, to use that as a working framework to try to understand how that prioritization occurs.

(00:36:08)[Damien Blenkinsopp]: Thank you. I’m always interested how different ideas overlap and where people’s work is using similar frameworks and so on.

I think in my audience people are actually using a variety of different diets. They could be doing whole foods, vegan, paleo, keto, or maybe something a bit more standard. It might be hard to answer this question, but how relevant do you think it is to each of those groups, more or less? Are some of them going to be better positioned to not have a deficiency than others and some, like you were talking about vegan earlier, are potentially going to be more at risk?

[Chris Masterjohn]: One of the issues that comes up here is genetic polymorphisms. One of the areas in which we are starting to get a lot of research in is in the ability to derive vitamin A from plant foods.

So the physiological form of vitamin A, meaning the form that we need in our bodies to fulfill the functions we’ve been talking about, is retinol. It only occurs in animal foods, whereas red, orange, yellow and green vegetables are rich in carotenoids which can act as precursors to retinol.

Since 2012 we’ve been accumulating a small body of evidence showing that there are very common genetic polymorphisms that strongly affect the ability to convert carotenoids to retinol. In addition to the genetic effects there are also a huge number of dietary and metabolic factors that also affect that conversion.

I can list those if you want me to. But even if you were optimize the dozen factors that can affect that conversion rate you may be just be stuck with poor genetics in terms of the ability to convert carotenoids to retinol.

My suspicion is that in vegans, one of the determinants of whether someone is going to do well or not do well on that diet is: what are their genetics like for the ability to derive vitamin A from plant foods? And because this is so dependent on genetics and metabolic health and other dietary factors there’s no saying that a vegan will become deficient in vitamin A.

But I think people who are going to be vegan have to be conscious of how they’re going to respond to that because if they fall into that category of poor derivation of vitamin A from plant foods, then that would likely be a weak spot for them.

A vegan also wouldn’t be eating fish or traditional sources of vitamin D but they could compensate for that by getting sunshine. People can also take vitamin D supplements and I think it could be debatable to whether this is the best choice, but there are also UVB irradiated mushrooms that are on the market as a food source of vitamin D.

For vitamin K I would say that that also would tend to be limiting on a vegan diet, and that’s not because you can’t get it. In fact, by far and away the best source of vitamin K2 in terms of quantity is natto, which is a fermented soy food which is popular in eastern Japan.

But the fact of the matter is when you look at the general population most of the people are getting most of their vitamin K2 from egg yolks and cheese. So if you take out egg yolks and cheese and you don’t put in natto to compensate for that, you’re going to have a huge drop in your vitamin K2 intake. I think that could be very significant.

So in the case of the vegan, for vitamin D and K, it’s really a matter of properly designing the diet in order to compensate for those changes. With respect to vitamin A there is also an element of, “Is your constitution really well matched to this diet?” If it’s not, then you need to either rethink the dietary strategy or you need to supplement with vitamin A.

I think if you look at paleo and keto, it kind of depends on what foods are being incorporated. Some people define paleo based on what foods it’s restricting. Other people might define paleo more based on the theoretical framework: that much of modern disease is caused by a mismatch between our environment and our evolutionary environment.

People who are thinking of it more like that are more likely to say, “How were our ancestors eating?”, They were getting nose to tail and they were getting all the organ meats when they killed an animal.”

I think if someone is doing paleo and they’re doing that then they’re going to be in a much better position than if they’re eating what the standard average American is eating, or average person in modern society are eating, minus the grains, legumes and diary. Just taking those foods out is not at all going to guarantee you good nutritional status, but paying attention to the organ meats will.

Most people, back in the day, paleo tended to be equated with low-carb. Nowadays there is a greater diversity of approaches towards carbohydrates. Keto obviously is low carb.

It is important to recognize that carbohydrates do play a role in supporting the system. Like I was saying before, it results in greater carbon dioxide production, that would be relevant. Carbohydrates also supports greater thyroid status and thyroid hormone helps cooperate to produce vitamin K-dependent proteins just like vitamins A and D do.

Also, vitamin K, you use it one time and you have recycle it. And recycling vitamin K is dependent on NADPH. NADPH is a form of niacin that carries energy from glucose to a variety of other systems. So the glucose is ultimately supplying the energy to recycle vitamin K.

When you look at all of those things, I think there is a grey area there where you want to be careful that you’re monitoring the health outcomes on a ketogenic diet. Because, to be honest, I don’t think anyone has really studied, “How does a ketogenic diet affect the carboxylation of matrix Gla protein?” Or anything like that. You can speculate there are a lot of things you want to be careful of, but ultimately what we need is more research to look at the actual outcomes on those diets.

(00:42:28)[Damien Blenkinsopp]: Right. It sounds like no matter which situation you are in you have to be cognizant of this. As you were saying, people are doing lots of different paleo diets, and it’s the same for keto as well. Some people will be eating primarily cheeses and diary and things like that, and others will be more focused on the meat. I think there is quite a wide variety.

It sounds like you have quite a few principles which can cut across all of these areas and, no matter which diet you’re following, could potentially resolve this system if you keep to those rules? It’s kind of independent of any of these diets.

[Chris Masterjohn]: Yeah, to a degree. You could even broaden that to other diets. So what is the diet that most greatly restricts egg yolks and cheese? It’s the, “I’m trying to be healthy diet.”
You don’t have to be paleo, or keto, or vegan to restrict egg yolks and cheese. You just need to trust the system and be health conscious.

[Damien Blenkinsopp]: Right. Absolutely.

[Chris Masterjohn]: That’s the message: to be heart healthy you get rid of foods that are high in saturated fat and cholesterol. The hell with nutrients, that’s been the prevailing approach to health consciousness. I think this is an under appreciated system that cuts across all of these diets and people really need to pay attention to it.

(00:43:48)[Damien Blenkinsopp]: Excellent. Thank you.

When I was doing preparation for this I was looking at one of your presentations that was really good on YouTube, it went through all of this area. In that, you established some principles behind optimizing this area, or this system. And you already brought up some of them that are important, like genetics, that can play a role in this.

It would be good to cover a few of these to give people an idea of the system. I think there are some misunderstandings. When it comes to vitamin D for example. For many years we’ve just been thinking, “Okay, I have low vitamin D compared to other vitamin D count says. I have to take a supplement to raise it.” Where I think what you’re saying is it’s quite a bit more complex than that, and that doesn’t necessarily help you.

[Chris Masterjohn]: Well that’s true. That’s not only true because of the other interacting factors, but it’s also true because 25-OHD which has been promoted as a specific marker for vitamin D nutritional status, isn’t one.

It is very true that if someone is low in vitamin D status their 25-OHD status will be low and if you supplement them with vitamin D or restore nutritional status it will rise. That is true. And yes it’s useful as a marker of vitamin D nutritional status, but there are also numerous other things that are both good things and bad things, that can affect 25-OHD.

For example, calcium deficiency can lower it because you’re using more vitamin D at a greater rate. Vitamin A supplementation could potentially lower it because you’re increasing utilization of vitamin D to fulfill cooperative functions that they’re needed for together. There are genetic differences that just make some people metabolize it to the active form at a higher rate and that seems to be associated with better health outcomes.

One of the things that I have been advocating especially recently to better understand 25-OHD as a marker of vitamin D nutritional status is to look at parathyroid hormone, or PTH. This is a test that you could very easily ask your doctor for. It is not difficult to get.

But the reference range for PTH is based on diagnosing parathyroid disorders, so it’s sort of not useful for this. But if you look at the rationale for putting the cut-off of vitamin D adequacy at a certain 25-OHD, it’s actually because on a population level that 25-OHD is associated with maximal suppression of parathyroid hormone.

The parathyroid gland is the resident expert within the human body and your individual calcium-vitamin D economy and PTH output increases in direct response to that economy of vitamin D and calcium being inadequate.

Instead of saying on a population level, “This much 25-OHD on average is associated with maximal suppression of parathyroid hormone.” We can take the same mainstream conventional principle and apply it to the individual by looking at, “Is that individual’s PTH maximally suppressed or not?”

My tentative conclusions about this are if you look at PTH you want it to be in the lower half of the reference range. That’s basically thirty, in picagrams per milliliter, seems to be the sweet spot, thirty or below.

If someone’s at thirty-five I don’t know if that’s concerning. But when it’s forty, or it’s fifty or it’s sixty I think that is a very good corroborating sign that that persons’ body perceives itself to be inadequate in vitamin D. I think that can really help us get a more nuanced and sophisticated approach to looking at that. That’s one thing that I would mention.

Also, as we’ve been talking about, you add vitamin D to this system and it needs the other cooperating nutrients to fulfill those roles. One of the problem points here is — Let’s take, “What is the prevalence of low serum retinol in the population?”

Well it’s really low like two or three percent of people have serum retinol below the reference range. So everyone says, “Well people are a lot more likely to get too much vitamin A than not enough.” So they tell everyone to avoid vitamin A.

Then people come in and say, “Lets ten fold increase your vitamin D intake.” Now all of the sudden you are taking that person, if you’re 10x-ing their vitamin D exposure, you’re taking them out of that original population and putting them into a totally different population of “10x vitamin D” status. In that case, what is happening to your vitamin A status?

I think there are a lot of reasons to be concerned that all of the sudden vitamin A intake becomes very relevant to most people when you move them into that high dose vitamin D supplementation. I think that if you’re going to tweak this system it’s really important that you pay attention to the whole system and not just take one element and blast it out of the system hoping that the one element is going to turn things around.

The most important principle of that is even if you’re going to supplement, first of all, have a targeted reason for the supplementation. Be conservative about the dose and titrate it up to higher doses based on how you’re responding to it, if needed. Also be very careful that the background diet is supplying all of those extra nutrients.

If you’re going to supplement with vitamin D, be conservative about it. But also, get your liver once a week, get your daily egg yolks in, get your fermented foods in, get this background supply of nutrients up to par so if you do perturb the system the rest of those factors make the system robust and it can handle the changes that you’re putting into it.

(00:49:49)[Damien Blenkinsopp]: Definitely balance versus saturation of one micronutrient. You’re saying [to] get a good background of foods there. Is one of the principles behind that, that foods tend to be naturally balanced in these nutrients? If you look at liver, it’s got vitamin A and D combined. It comes from a body so you’d think it wouldn’t be completely out of whack with the needs of a body.

[Chris Masterjohn]: I actually don’t think that’s true. If you take a fish’s liver then fish liver tends to be high in vitamin A and D, but that’s not true if you take a terrestrial animal’s liver. That’s because mammals, we store vitamin D primarily in the blood and not in the liver. So our metabolism is a little bit different that a fish’s metabolism.

If you were using the blood in the animal and you were using the kidneys in the animal and you were truly eating the whole animal, that would probably balance out. But it’s not necessarily true that you can say, “My substitute for eating nose to tail is that I will eat liver once a week.” That’s not necessarily doing you any favors with respect to vitamin D.

What it is doing is it’s making you robust to any problems with your derivation of vitamin A from plant foods. Lets take the person who really is terrible at making that conversion. If they eat one serving of liver once a week, [then] they’re meeting the RDA through vitamin A.

You can debate what is the optimal level of vitamin A intake and is it higher than the RDA or not, but if you take that liver out and they aren’t good at getting vitamin A from plant foods, what other foods besides liver or cod liver oil is going to bring that person up par? Nothing.

What you’re doing by doing that is not — the liver isn’t going to magically make the whole balance of the diet. Even if you were to catalog all the potential polymorphisms you have in the enzyme that makes that conversion you’d kind of get stuck no where because every time a new study comes out we identify these new polymorphisms.

So you really have no idea what your conversion is, at all, unless you subject yourself to a randomized cross over study where you’re undergoing multiple diets and collecting data on it, and no one does that. So just including liver in the diet, you can put that question to rest. You don’t really have to care about that conversion if you make that one step.

When it comes to vitamin D you need to get regular sun exposure. That’s not the only reason to go out in the sun. Include some fatty fish, include some pastured egg yolks, get outdoors. That in most cases, in the absence of some constitutional or disease issue, for most people covering those bases covers vitamin D.

Get your egg yolks in, get your fermented foods in, get your leafy greens in. For most people who don’t have a specific vitamin K related problem, just getting the diversity of vitamin K rich foods in covers the bases.

(00:52:50)[Damien Blenkinsopp]: When you say fermented foods, you mentioned natto earlier. Are there other ones you recommend?

[Chris Masterjohn]: Honestly, for the average person cheese is going to the be most potent one if not on their list. Part of the issue is that it depends on the bacteria. If you take the natto bacteria and you make homemade fermented vegetables with it instead of fermented soybeans my understanding is that would be a pretty good source of vitamin K2.

By contrast, if you are eating, say sauerkraut, you are getting some vitamin K2 from that and that’s good but it’s incomprehensibly less than what you would get from natto. Even if you just compare sauerkraut and cheese together, cheese is way ahead of sauerkraut.

I think diversification is the best strategy here. You can micromanage it and you can look at the table and log your K2 intake everyday. But if you want to be practical about it and you don’t want to be spending exorbitant amounts of time thinking about it and managing it, then I think what you do is you say, “Okay fermented foods in general, but particularly cheese and also egg yolks are convenience sources. If I just rotate these in my diet on a regular basis and don’t think about it too much then that secures a baseline level of adequacy.”

[Damien Blenkinsopp]: So variety is a big principle here.

[Chris Masterjohn]: Yeah. The more you restrict your diet the more you need to micromanage it.

(00:54:20)[Damien Blenkinsopp]: In terms of productivity, I think you do this as well. You basically do auto-order. I have local farms I subscribe to. You fill out the stuff you want and it gets auto-delivered every week, so I don’t have to think about it.

On the other hand that means I’m probably not getting the maximum variety because I’m always getting over delivered with food if I was trying to maximize the variety. I don’t know if you, in terms of productivity, if that’s something you deal with? I think you use Thrive Market right?

[Chris Masterjohn]: I do.

(00:54:52)[Damien Blenkinsopp]: In terms of variety do you kind of switch yours up? Have a look at your list and just change it each week or do you leave it on auto?

[Chris Masterjohn]: I actually don’t auto subscribe to things like that, although the way that I deal with it is actually pretty close because I mostly have mobile apps where I just tap, tap, tap, tap, tap on the things that I’ve been ordering recently and it’s that simple.

A lot of the ways that I deal with variety is to deal with it on a week-to-week rotation basis. To take an example, I find trying to get variety in within a day or from one day to the next is extremely taxing. It’s not only taxing mentally on trying to think about what I’m trying to put together but it’s also taxing on my ability to not throw food away, because getting that variety in would mean that I would have to over order things.

I try to get a variety of green leafy vegetables in, but what that means is that on a given week kale will be my cooked vegetable that goes into a big batch of starches that I just take out of the refrigerator and reheat in two minutes each time I use them. And I will get a box of some type of leafy green that I would eat raw and I’ll just eat platefuls of that.

But the next week I will switch out the kale for a different green vegetable that I make cooked and I will switch out whatever those raw leafy greens were, for a different one. So I get my variety in more on a week-to-week basis where I’m rotating different types of similar things into my diet rather than within a day or from day-to-day.

(00:56:39)[Damien Blenkinsopp]: Excellent. Thank you for that. I like to make sure the information is practical. I will probably have to change mine up based on that.

I wanted to go back to the testing, this is a quants show at the end of the day, a lot of the time. When you were talking about the PTH earlier that was basically a downstream marker of vitamin D, kind of like an indirect measure versus a direct measure where you’re looking directly at the blood, D-3 to 25-OHD. Is that a typical strategy you’d take for this area if you were — I think it would be interesting to find if you think it’s actually worth testing in this area because I know in some areas it’s not that useful at times.

So first of all, is it useful to start looking at testing in this area if it’s a concern of yours? And second, is a downstream strategy often best versus going for the direct ones, similar to the D-3 in the other areas?

[Chris Masterjohn]: Well, no one uses the direct strategy with vitamin D. If you consume vitamin D you consume it as vitamin D and measuring vitamin D in your blood is virtually useless as a marker of nutritional status. Everyone is using the indirect strategy of measuring 25-OHD which is a downstream metabolite of vitamin D.

The issue is, in every case, when you’re looking at a biomarker for anything the questions that you’re asking are: is it sensitive? And is it specific? Quite often we may think that something is specific then when our understanding of it increasingly evolves we need to revise that.

I think that PTH is a more specific marker of inadequacy in the calcium-vitamin D economy than 25-OHD is. One of the ways to think about this on an intuitive level is: what is the parathyroid gland doing? It is continuously monitoring the vitamin D-calcium economy using sensors of receptors that sense the concentration of calcium in the blood.

If you have serum calcium dip for even a millisecond the parathyroid gland will sense it. And on a scale of less than a fraction of a second it will respond to that and carry out a downstream cascade of events that will start operating within seconds and basically finish operating within minutes to normalize serum calcium.

If you take someone who is consistently deficient in vitamin D or calcium; what you wind up with is that person will have a higher level of PTH because that PTH is being chronically activated to compensate for that deficiency.

If you’re to compare PTH and 25-OHD. I’m not going to argue that PTH is a hundred percent perfectly specific but it adds a lot interpretive power to the 25-OHD. To take an example of one of the confounding factors, if we look at people from different ancestries we will see that there seems to be differences in how they metabolize vitamin D.

People of white/European ancestry actually seem to be outliers in the amount of 25-OHD they need circulating in their blood to maximally suppress parathyroid hormone. Now remember, when we set the benchmark for, “What is an adequate 25-OHD?”, that is set on the basis of maximally suppressing PTH. That is the benchmark that is accepted.

I’m not advocating a different principle. I’m advocating individualizing the principle. If you take someone who is African-American or someone who has Inuit ancestry, probably if you take someone who has Asian ancestry and you compare that to someone who has white/European ancestry you will see that on average they will have lower 25-OHD.

But they will also have higher levels of calcitriol, which is the fully active hormonal form of vitamin D. They will also have lower levels of PTH. If you trace that further what you’ll find is that there are genetic polymorphisms that are more prevalent in those populations that trace to different ways of metabolizing vitamin D.

One of the ways to interpret that is: different populations are adapted to different levels of 25-OHD needed to maximally suppress PTH. One of the problems with that is that’s just on average. If I take the average of white girls and black girls in Oklahoma then on average all those things that I just said will be true of those groups.

But then when you take the group and you separate them into individuals, the genetics aren’t separated into those two groups perfectly. Some of the African-American girls will have the genes that are more prevalent among the white girls and vice versa. In order to actually treat the individual you can’t just define them by their group.

In that case, what better way to do that than to actually look at whether PTH is maximally suppressed in that person? I think all you’re doing is taking the conventional standard strategy and saying, “Is this actually operating the way we’re saying it should operate in this particular person?”

(01:02:08)[Damien Blenkinsopp]: It’s a great reminder that you have to look at this on a personal level for a lot of things, just as you’ve talked about these complexities.

It reminds me a bit of methylation. I’m sure you’ve looked at methylation a bit, but with all of the polymorphisms and everything, people react completely different to supplementation and when you’re trying to tackle that. It sounds exactly the same with this.

In terms of other tests that I’ve come across, one of them is SpectraCell, the micronutrient testing they have. I don’t know if you’ve looked at that and if you’ve thought it’s useful? It has vitamin K2 and K1 I believe, if I remember from memory.

[Chris Masterjohn]: I do not like SpectraCell. Unless they have radically changed how they do it in the last couple of years, I haven’t looked at a recent SpectraCell report, but I basically disagree with the entire principle behind the SpectraCell report. I also think that it generates pretty bizarre conclusions as well.

I will say that, I don’t want to sound like I’m singling out SpectraCell. I would say it’s generally true of all of the shotgun approaches to practically anything, even genetic polymorphisms. You can take your 23andMe data and run it through various software or web apps that will give you back a report that will give you ridiculously conflicting practical conclusions like, “You have this polymorphism, so take methyl-B12. You have that polymorphism, so avoid methyl-B12.”

I think that’s an inevitable consequence of trying to do too much at once. I think it is possible to do many things at once and I think we’re eventually heading towards that area, it’s just that you can’t sacrifice the integrity of the methodology in order to get more stuff.

In the case of SpectraCell, and I don’t know if they’ve changed this in recent years, but at least a couple years ago when I was looking at SpectraCell reports what they were doing was taking lymphocyte concentrations of these different nutrients. One of the problems with that is that there is practically zero research on that.

Take for example vitamin D. There are thousands of studies that span tens of thousands of people looking at 25-OHD levels. There are at least hundreds, if not thousands of useful studies that are worth looking at in terms of, “How does it correlate with disease risk? How does it correlate with metabolic factors?” and so on and so forth.

And by contrast we don’t have a lot of data on, “How do white blood cell concentrations of vitamin D correlate with these factors?” Although there are huge limitations to interpreting 25-OHD that I was just describing for you, the only reason I even know about those limitations is because there is so much research on it.

With leukocyte concentrations of vitamin D I can’t tell you what those limitations are because we don’t have a huge body of literature assessing its usefulness. But I can tell you is that there is no particular positive reason to assume that is a useful marker.

I can also tell you that I had a consulting client who was taking vitamin D supplements, who had really high 25-OHD and a really low leukocyte concentrations of vitamin D. SpectraCell told him to take more vitamin D.

By any accepted definition he should have been, if anything, cutting back on his vitamin D. What does it mean that his leukocyte vitamin D concentrations were low? To be honest, I have no idea. I don’t know what it means, but neither does SpectraCell.

[Damien Blenkinsopp]: As you were saying it could be some of the things like genetic polymorphisms, people are just different that way. All of these things that aren’t uncovered because there’s no research.

[Chris Masterjohn]: Also leukocytes are a part of the immune system and the immune system uses these things and profoundly affects their metabolism. One of the things we know is that one of the reasons that you can have low 25-OHD is because of inflammatory activation.

Even for example in the recovery for surgery the immune response that is involved in tissue repair will cause a pretty large drop in 25-OHD acutely in that sense. And probably it’s true of chronic inflammation as well.

So one of the things that you want to ask is: Why does a leukocyte decide to concentrate vitamin D and does it decide to do that some times and not others? And does that leukocyte concentration of vitamin D have a lot more to do with what that leukocyte is deciding what to do because of the context of immune signaling in that person and not nutritional status of vitamin D? That’s a question of, we need research studies.

Ideally research studies come before you start practically applying tests rather than after. The ideal time to say, we tested this, now you should go out and do this is when we have a lot of information about what that means. Not so we can ten or twenty years later hope to get some information about it.

(01:07:10)[Damien Blenkinsopp]: Absolutely. Thank you for that.

Are there any other tests that you’ve come across in this area, either bad or good? Ones you don’t think are worthwhile doing or anything good?

[Chris Masterjohn]: Specifically on vitamin D or across the board?

[Damien Blenkinsopp]: Yeah, the whole fat-soluble.

[Chris Masterjohn]: Yeah, a few others that stick out. First of all, for vitamin A status the most useful measure is serum retinol. Serum retinol does not perfectly correlate with vitamin A status but it will tend to be low if you are running low on vitamin A and in general the reference range is pretty good on that.

The reference range if you just get a Quest report for serum — I will warn you it should be called serum retinol and at least Quest Diagnostics calls it serum vitamin A, but in any case it’s the same test. The reference range for that is based on the role of vitamin A in supporting night vision. If you are within the reference range that should preclude virtually all cases of impaired night vision as a result of vitamin A deficiency.

Now, I think there are some big question marks over whether that is actually the most sensitive marker of adequacy? I will tell you from my personal experience, I had some pretty severe eye related signs that indicated to me that I was vitamin A deficient. I made a very intensive effort to improve my vitamin A status over the course of the week.

After I did that, I was still resolving my vitamin A status, but I have my serum retinol tested and it was towards the bottom of the reference range, but it wasn’t below it. You probably don’t want to be operating at the bottom of the reference range.

(01:08:52)[Damien Blenkinsopp]: I think one of the baseline rules that we’ve spoken about before on this show is like if you’re in the top third for a lot of these standard reference ranges because the normal population tends to have a fair amount of chronic illness and non-optimal health. Is that a rule you could take for this test?

[Chris Masterjohn]: I’m not quite sure about that, but I will say I would prefer to be in the middle than on the bottom. I don’t want to encourage people who are in the middle to get up to the top third, but I would say if you’re towards the bottom you should definitely try to get towards the middle.

If you’re at the top sixty or seventy percent, I’m not going to recommend you get down to the middle. The data isn’t really that clear, but you want to keep your distance from the bottom of the reference range in my opinion.

I will also say that in rats, I can’t remember if it was rats or mice, but there was a recent paper that came out that showed that obesity compromises tissue vitamin A status. I shouldn’t say tissue, tissue besides the blood. The blood is a tissue.

But it compromises vitamin A status in many tissues without decreasing serum retinol. So there are caveats that we are just starting to learn about with these tests. I would say in general serum retinol, despite potential limitations, is very useful to have.

I want to say one more thing about vitamin A. If you’re concerned you’re getting too much vitamin A there’s a good formula to use. That is to get your fasting serum retinol and your fasting serum retinyl esters tested.

I know that Quest Diagnostics actually calls these two tests serum vitamin A and serum vitamin A palmitate. That means retinol palmitate which is the predominate retinyl ester. This has to be fasting. If in the fasting state you add those two values together and your serum retinyl esters are greater than ten percent of the sum of the two values then that is an indication that your liver is overloaded with vitamin A and you either need to cut back or you need to correct some backup in your metabolism.

It could, for example, if someone has fatty liver disease that will compromise their liver’s vitamin A storage, then that could play a role in it. If you are lean and healthy with good body composition, the most reasonable interpretation of that would be that you’re overloading your liver with vitamin A.

With vitamin K, I am not happy with any test that’s currently available, at all. I do not think it’s useful to look at leukocyte vitamin K concentrations. I don’t think it’s useful to look at plasma serum or red blood cell concentrations.

What I [do think] would be useful is the carboxylation status of osteocalcin. I don’t remember which lab it is, but last I looked the only lab that was offering this gave you under-carboxylated osteocalcin without giving you, “What is the percentage of the total osteocalcin that’s carboxylated.” Just looking at total under-carboxylated osteocalcin is not useful.

On the horizon there is a company called Amino Diagnostic Systems that two or three years ago told me they were trying to develop a test for desphospho-uncarboxylated Matrix Gla protein, or DCUCMGP which put simply is the inactivated form of MGP. That’s the protein that protects soft tissues from calcification and helps direct calcium into bones and teeth.

If that’s high it’s a very good marker that you don’t have a very good supply of vitamin K to your blood vessels. They told me two or three years ago they told me they were hoping to get this test past FDA approval and I asked them this morning, in preparation for this show, if they’ve made any progress on that. They said, they’re working on it.

[Damien Blenkinsopp]: Wow, awesome.

(01:13:02)[Chris Masterjohn]: I think on the horizon we can eventually see the inactive form of MGP be a very useful marker of vitamin K status in the blood vessel. When that comes out I’m going to be super happy and tout it with fanfare all over the place. But right now nothing is available that isn’t a waste of money, in my opinion.

I will say also, that there’s a company based out of the Netherlands called VitaK. They offer testing of all of these things to people who form contracts with them. I do not know if they would form those contracts with clinicians who are testing it in patients. I do know that I was talking to a clinician who was doing clinical research and he was taking samples from patients to do a research study and he just sends them to them. They measure all this stuff and give the data back to him.

This is not going to be helpful for patients or for the average person but if there are any clinicians listening, they may be worth approaching about this to see if you can come to an arrangement with them to start collecting some clinical patient data.

(01:14:16)[Damien Blenkinsopp]: Awesome. That’s some amazing stuff there. You’ve obviously kept up to date with all of this stuff.

It’s great to hear about the SpectraCell. I did SpectraCell about three years ago and so it would have been the same test you looked at. It had some stuff like K2 deficiency. There wasn’t actually that much that come of it for me. Nothing really interesting.

[Chris Masterjohn]: Just to add one thing. I had someone who had the same result and they said because K2 was deficient they should supplement with vitamin K1 because it’s a precursor to K2. And all of the evidence indicates that humans tend to be relatively poor converters of K1 to K2. So that’s just one more example of how the data is not translated well into practical recommendations in those shotgun tests.

[Damien Blenkinsopp]: I would say with tests, a lot of the lab tests, they have these recommendations which, if you look at organic acids or a lot of different tests, are spit out through an algorithm based on a marker being low or something. I think most people say not to look at those. Just as a general rule across most tests because it’s not very useful. It’s not taken in context of what else is going on.

[Chris Masterjohn]: Right, but there is no reason that that’s not doable. I hope that we will be moving forward into an area where that aspect of that testing can be improved.

(01:15:27)[Damien Blenkinsopp]: Yeah, it would be awesome if it could eventually be automated.

So this has been great. So much great information. I’d love to know what you’re up to right now. Is there some current research, some questions you’re trying to answer? What’s sort of top-of-mind for you right now?

[Chris Masterjohn]: Right now my top priority is putting together a special report that I will be selling once it’s out, on a very practical guide about how to resolve chronic inflammation using essential fatty acids. One of the things that I think has been profoundly misunderstood since at least the 1990’s, is how the inflammatory process works and how it’s resolved.

Many of the things that have traditionally come out of the outdated 1990’s framework, like take high-dose fish oil to inhibit the inflammatory effects omega-6. Or particularly, take non-steroidal anti-inflammatory drugs to inhibit the inflammatory actions of omega-6 are possibilly down right backwards.

So what I’m trying to do is put together a really practical approach to what is the minimal effective dose for a healthy person of different fatty acids, and in different disease states what is that effective dose? What are the factors that could actually be distorting a metabolism that could be fixed? And things like that.

That’s the sort of the longer term project I’m working on. Some of the more immediate things I’m working on are I just started my own podcast, The Daily Lipid. Anyone can search for that in their favorite podcast app. I’m upping my social media game. I finally got back into tweeting. I finally got active on Instagram and most recently I’ve joined Snapchat.

I’m doing some useful content on Snapchat. A lot of the things I hope to eventually put into permanent content I’m snapping as I’m thinking about them. For example, yesterday I snapped a video tutorial about how people who have gotten their 23andMe post-FDA debacle can despite “No Alzheimer’s” report still hack the system to still get their APOE genetics and stuff like that.

Eventually that will become a YouTube video that’s part of a blogpost, but that could be a month down the road. This way, you follow me on Snapchat and you get these cool little things as I’m thinking about them. That sums up what I’m up to at the moment.

I’m also lining up some potential interesting research for the fall academic year. I’m playing with a couple ideas and I am not ready to really say for sure what I’m going to be doing but with the right amount of help I may actually start looking at how vitamin A and genetic polymorphisms and sleep disorders relate in student populations. If that pans out that will be pretty exciting.

(01:18:24)[Damien Blenkinsopp]: Thank you. I’m really interested in the inflammation stuff actually because I’ve actually taken high dose fish oil to resolve some inflammation but we’ll talk about it later because it’s very specific to me. Not necessarily everyone who’s done that. Maybe you know something about it.

[Chris Masterjohn]: There is value to the fatty acids in fish oil it’s just that if you are effectively resolving inflammation then it’s probably through a very different mechanism than what’s been traditionally touted as the mechanism.

[Damien Blenkinsopp]: You’re saying the Omega-6 vs the Omega-3 mechanism?

[Chris Masterjohn]: I mean what the Omega-3 fatty acids are actually doing there. The traditional idea has been that the EPAH should inhibit our arachidonic metabolism and what we’re finding out now is that’s counterproductive. There are other mechanisms where omega-3 fatty acids come into play. But actually understanding why also provides insight into: what kind of dose should we use? What should we take it with? What’s the best way to optimize the process?

[Damien Blenkinsopp]: It sounds very interesting. Maybe we can have you back on the show later whenever that comes out because inflammation is a big topic right now.

[Chris Masterjohn]: For sure

(01:19:26)[Damien Blenkinsopp]: You know what would be really interesting? Is there anything that you’ve changed your mind about in the last few years?

[Chris Masterjohn]: Change my mind about? There’s probably a whole bunch of things. One thing that I’ve changed my mind about that really relates to the stuff we’ve been talking about here today is 25-OHD status.

When I first started looking at vitamin A, D, K interactions I kind of focused all of my critical analysis into those interactions and took for granted what a lot of the vocal vitamin D community was saying about, “You want to have fifty to sixty nanograms per milliliter, 25-OHD” I’ve really revised that downward as I’ve started to applying the same critical analysis to that particular issue.

Moving outside of that, I was never really an advocate of low-carb diets per se. But I think that I did buy in to a lot the theoretical framework of low-carb approaches even though I figured, “I’m lean so I don’t have to worry about that, etc, etc.” I’ve sort of become a little bit more critical of the low-carbohydrate approach to a lot of issues and trying to build a bit more of an appreciation of carbohydrates recently. That’s an unrelated thing that I’ve changed my mind about.

(01:20:38)[Damien Blenkinsopp]: It’s always very interesting to see people going back on stuff. It’s very important to be able to go back on decisions and change your mind. As you’re saying, it’s all developing all the time. It’s hard to stay on one topic and be sure of it.

Is there anything that you track in terms of metrics or biomarkers, for your body on a routine basis? And why?

[Chris Masterjohn]: I try to take the information one at a time because I feel like I could track everything but then I would probably get lost in the information. Also, in the last year I’ve been recovering from “workaholic syndrome” where I was not tracking anything because I was consumed with the work that I was doing.

I’m trying to gently move into targeting the highly specific things that I know I need to track. For me, one of the things I was tracking over the last few months was my protein intake and my caloric intake and I wound up losing thirty pounds and a pretty hefty amount of body fat that I’m pretty happy with, over the course of a few months.

I’ve kind of moved on from that but still actually track my calories most days because I’m trying to strategically move into fat loss and into gentle muscle building without much fat gain, so that’s something that I continue to track. That’s kind of partly a health thing, partly a vanity thing.

One thing that’s much more straight out health related is my iron status. I am homozygous for the relatively common allele that interferes with the hemochromatosis related pathway. It’s thought that it only causes hemochromatosis when it’s paired with a more severe allele. I just have two of the minor ones, but that puts me in the top three percent of dysfunctional iron absorption in the population.

Theoretically I shouldn’t get diagnosable hemochromatosis. But what I find is that if I do not give blood regularly my serum ferritin is high-ish, but no where near even the middle of the reference range, so maybe it’s 150. A lot of people say it should be lower than that, but the reference range says that if it’s under 500 it’s fine.

What I find is that my transferrin saturation starts getting out of the upper end of the reference range and my unbound iron binding capacity starts getting out of the bottom of the reference range. That means that relative to my capacity to deal with the iron, my iron is being overloaded and that increases the risk of free iron running around, that can contribute to oxidative stress in my body. I actually think that that has a huge impact on my metabolism.

I discovered this slowly over the course of several years. Before I knew I had these genetics and before I had ever tested my iron what I noticed was when I was a guinea pig in my doctoral lab and people would take my blood, I would always feel better.

One of the best responses I ever felt was when I was a guinea pig for a pharmacokinetic study where my lab mate put a catheter in me so she could take twelve blood draws in a single day. Then a thirteenth blood draw the next morning and I felt awesome.

That was when I started thinking about it but then it was a year or two after when I got the 23andMe and that showed me I had those alleles and that motivated me go out and measure my iron status. Once I got a full iron panel that’s when I really put it all together.

With balancing work and life it’s been difficult to maintain a regular schedule of blood donation. That’s my number one health priority right now, is just trying to stay on top of donating blood every eight weeks. And next time around I think I’m going to try my first double red cell donation, so we’ll see how that goes.

(01:24:26)[Damien Blenkinsopp]: Cool. Is it legal to do that at home? Because just recently I’ve been basically forced to get my own blood samples at home because I’m traveling sometimes. And in the UK sometimes sending stuff to the US because the tests are over there.

[Chris Masterjohn]: Oh, for testing?

[Damien Blenkinsopp]: Yeah well you could take more blood out. That’s why I was wondering if there was a legal repercussions?

[Chris Masterjohn]: I honestly have no idea. I know that if you were a student in the high school the teacher would be legally bound to report that. But for a consenting adult that knows what they’re doing, I don’t know why that would be illegal, but I am not a legal expert.

[Damien Blenkinsopp]: Yeah, I guess they’ve never thought to do a rule about it. Probably, I guess they’ve never given the number of people.

[Chris Masterjohn]: When I was in grad school – the rules in Connecticut, they differ state-by-state, were anyone who gets properly trained can take blood. People would just practice on themselves just to get practice. I don’t know.

[Damien Blenkinsopp]: This iron error sounds like something you’re going to have to monitor.

[Chris Masterjohn]: For sure. Right now, I have a sense of how often I need to do it but it’s definitely something that after a few times I’m going to monitor and try to get a precise idea of how many times I need to donate to bring it down to the level that I want.

(01:25:49)[Damien Blenkinsopp]: Excellent. Very interesting.

It’s funny how the number of people I interview on this show that end up with something like this, a very specific thing that they found out about themselves that they then begin to start monitoring very routinely. It starts to make me think that everyone in the world has one specific thing, just for diversity, that a little bit out of whack. Once they look into the numbers a little bit they’ve discovered there’s this one strange thing. It just seems it comes up more than it should.

If you were to recommend one experiment someone should try to improve their body, whether it’s for health benefits, performance, or longevity with the biggest payoff, what would that be and how should they track it to understand it?

[Chris Masterjohn]: Do you mean in terms of measuring something or in terms of intervening without having any data about it?

[Damien Blenkinsopp]: Just taking some kind of action. Ideally having some kind of way of knowing that it’s actually successful. Or it could be something in your opinion where you say, “98% of people, if they do this it’s going to be beneficial in some way.”

[Chris Masterjohn]: For the very reason that you just said, I suspect that there isn’t one thing that 98% percent of people can do and have it equally payoff among them because they all have one particular weak thing to work on.

I would say, to be honest, if we’re talking about the general population, then I think that biggest payoff would be a self-experiment to find a sustainable way to modify your body composition. A few things that I would toy with would be protein intake and habit formation.

I think you have to look at your self and your individual psychological traits. I will say that for me tracking my calories with MyFitnessPal is one of the most effective things that I’ve ever tracked because I always had a problem where if I didn’t eat enough food I would have insomnia from it. Because of not tracking my calories I would constantly overshoot in order to preempt any possibility of not falling asleep because I didn’t eat enough food.

I was always eating a little bit more food than I needed. I was able to titrate my caloric intake to the sweet spot that allowed me consistent weight loss but also to optimize my sleep. Had I not been tracking calories there is no way I would have found that sweet spot.

I don’t want to make a blanket recommendation that everyone track calories, but I do think that, maybe this isn’t true for your audience because everyone so is on top of tracking everything, but if I were to go out to the general public for sure, I would say that self-experimenting, if you track waist circumference, and body weight to get some insight into your body composition and you keep a food log, and experiment with: is there a specific set of very simply habits?

Or actually tracking calories and serving sizes and those things that can come together to produce a consistent movement in a positive direction with body composition is where I think the biggest payoff would be because there are so many downstream metabolic dysfunctions from carrying the wrong mix of fat in the wrong places in your body.

Even the systems we were talking about today, normalizing your insulin sensitivity and your thyroid hormone and all that stuff that can come from managing your body composition can make the fat-soluble vitamins work much more effectively than they would otherwise. That’s what I would give.

(01:29:23)[Damien Blenkinsopp]: Thank you, that’s a great takeaway. This pretty much winds it up. You’ve mentioned your podcast, your podcast is great. You started it recently and it’s extremely detailed. If you guys listening today enjoyed this talk, there is even more detailed stuff on the podcast which is The Daily Lipid.

Is there any specific other requests? We already mentioned your Snapchat, I saw you’re on there, and some others. Is that the easiest way for people to connect with you? Facebook, Twitter?

[Chris Masterjohn]: If you want to follow consistently everything that I get, I think the best way to do that is to go to my blog, blog.cholesterol-and-health.com. If you subscribe by email or to the RSS feed there, you will get all of my long-form content that way. Anything that I write, any of my podcasts and so on and so forth.

Definitely I would say I’d love to have you following my Twitter, Snapchat and Instagram, but of course that’s kind of a different way of following me. When people follow someone on Snapchat or Twitter they don’t see everything that they put out. They stream it at a given time and if something’s there they see it, if something’s not there they don’t.

On Facebook, one thing I’m trying to do consistently now is to do Facebook Live, once a week. When I do Facebook live that shows up in 150,000 to 300,000 people’s newsfeed. If I post something on Facebook it shows up at something like 500 people’s newsfeed. You can follow me on Facebook but if you do that probably what you will actually see in your newsfeed is my Facebook Live Q&A sessions, so check those out as well.

[Damien Blenkinsopp]: Cool, thanks so much for what you do Chris. It’s been a great conversation with awesome details. Thank you so much for your time.

[Chris Masterjohn]:Yeah. It’s great to be here. Thank you so much, Damien.

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Micro-nutrient deficiencies are prevalent today, and prevent our biology from functioning optimally by limiting its activity. The most common and most severe micro-nutrient deficiency for most of us is Magnesium.

A hundred years ago we were able to get five hundred milligrams per day of Magnesium. Today we get closer to two hundred milligrams per day because of changes in food nutrient composition and diet that we’ll discuss today. The impacts can be subtle and long term, to severe and immediate.

As Magnesium has an important role in over 300 enzymes throughout the body, it can effect performance and health in everything from cognitive to muscle performance, and as with many other micro-nutrient deficiencies, increases our risk of cancer by causing DNA strand breaks. For the more severe, but not so uncommon deficiencies in this nutrient, symptoms can include headaches, fatigue (lower cellular energy output) and muscle cramps.

Today, we dive into the bioavailability of magnesium sources, the different types of tests available and their accuracy, and figure out the significant biomarkers.

“[Magnesium] really is the one supplement
that everybody should take.”

– Dr. Carolyn Dean

Dr. Carolyn Dean is both a medical doctor and naturopathic doctor with thirty plus years of medical experience. She is the author/coauthor of over 30 health books (print and eBooks) and 106 Kindle books. Currently in its third edition, the Magnesium Miracle has been Amazon’s #1 best selling book in both the Alternative Medicine and Vitamins & Supplements categories. She is on the Medical Advisory Board for Nutritional Magnesium Association, President of Hallmark-Dean Laboratory, and contributing editor to Natural Health magazine.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • Magnesium is involved in 700-800 different enzyme systems within our bodies (05:09).
  • Diverse roles of magnesium (05:33).
  • Magnesium has a “push-pull relationship” with calcium.  Calcium causes muscles to contract, while magnesium relaxes muscles (05:41).
  • 80% of the population is not getting the recommended daily allowance of magnesium (07:25).
  • There are two reasons for this common micro-nutrient deficiency: (1) The soil doesn’t have magnesium. (2) There is more stress/higher demands of magnesium going on (07:37).
  • Medications, diet choices, and water sources can “bump” away, deplete storages, and bind to magnesium (08:47).
  • Amount of magnesium required to metabolize table sugar and high fructose corn syrup (08:54).
  • Common electrolyte products do not replenish magnesium (09:54).
  • Neither farmers nor organic farmers replenish the soil with minerals. Farmers would need to use rock dust on the soil to do this(11:09).
  • The soil is much lower in magnesium currently compared to ancient times due to: (1) overuse of the top soil and (2) the recycled water we use today has not undergone micronutrient accumulation (11:54).
  • When fluoride (a molecule found throughout our environment) and magnesium bind – a compound of magnesium fluoride called sellaite is created (13:15).
  • Sellaite is able to replace the magnesium found in bone and cartilage, overall making bones more prone to fracturing (13:30).
  • 20% of prescription drugs have added fluoride molecules to assist in drug delivery to the cell (13:49).
  • The highest amount of magnesium can be found in the heart (14:36).
  • Explanation of the magnesium depletion cycle (16:01).
  • Dr. Carolyn Dean defines terminology: skipped beat, arrhythmia, and palpitations (18:35).
  • Additional symptoms of magnesium deficiencies (20:45).
  • There are many seemingly unique symptoms or symptom combinations that can appear in a magnesium deficiency. The appearance of these symptoms is based on the individual and that individual’s vulnerable areas (23:45).
  • Doctors and specialists often see and treat the various symptoms individually, and may be unable to put it all together as a magnesium deficiency (24:14).
  • Magnesium deficiencies have contributed to ending the careers of professional athletes due to severe muscle cramps (26:20).
  • Advice Dr. Carolyn Dean gives to parents of teen athletes on muscle cramps (26:44).
  • The typical test administered by doctors is the blood serum magnesium test.(27:57).
  • The red blood cell magnesium test (28:09).
  • The gold standard test is the ionized magnesium test (28:24).
  • Like many lab tests, the blood range of the tests represents the average of the population and the not the optimum (30:15).
  • What to use and how to track your own magnesium (35:30).
  • Reasons why some people feel better taking magnesium and then feel it is no longer helping (38:00).
  • How to slowly introduce magnesium, tracking symptoms and/or RBC measurements as they increase slowly and steadily (38:24).
  • The dynamic between treating the symptoms of magnesium deficiency and other medications (39:24).
  • Table salt compared to sea salt (41:40).
  • Magnesium sources through the skin (42:48).
  • If one is taking a magnesium supplement able to be properly absorbed, then it should not produce the laxative effect (44:58).
  • Foods high in magnesium (46:48).
  • How many milligrams of calcium Dr. Carolyn Dean recommends (47:22).
  • Once treated, feeling symptomatically better can occur overnight, within a week or after several months depending on various factors (51:29).
  • Herbicides and pesticide can also bind up minerals found in the soil (55:17).
  • Discussion of German New Medicine and Total Biology (57:16).
  • Dr. Carolyn Dean does not track biomarkers on a routine basis (57:30).
  • Dr. Carolyn Dean’s one biggest recommendation on using body data to improve your health, longevity and performance is to track magnesium (58:50).

Thank Dr. Carolyn Dean on Twitter for this interview.
Click Here to let her know you enjoyed the show!

Dr. Carolyn Dean

The Tracking

Biomarkers

  • Red Blood Cell (RBC) Magnesium Level: This biomarker indicates the amount of magnesium located within the RBC. This can give a more accurate result then serum magnesium levels. Dr. Carolyn Dean advises an optimal range of 6.0-6.5 mg/dL.
  • Serum Magnesium Levels (or Serum Total Magnesium): This is the most common biomarker tested for when clinically evaluating of magnesium levels currently. It is expressed in Milligrams per Deciliter (mg/dL) and is very limited in its ability to reflect total body magnesium levels. Less then 1% of total body magnesium is found in serum.
  • Serum Ionized Magnesium Levels: This is the measure Carolyn recommends for the most accurate assessment, for which unfortunately tests are not accessible outside of research currently. There are many studies over the last decades using this marker – see pubmed reference.

Lab Tests, Devices and Apps

  • RBC Magnesium Test: Able to be ordered online without a prescription and used to evaluate magnesium levels in red blood cells.
  • Exatest: This test is the most accurate and most expensive test. Magnesium levels present within the tissue cell are determined through a cheek swab.

The Tools

Supplements

  • Transdermal Magnesium Chloride: This is Damien’s described method and is an oil to be placed on the skin and is comprised from super saturated magnesium chloride and distilled water.
  • Magnesium Citrate: Often in powder form, may be dissolved in water and sipped throughout the day.
  • Sea Salt and Himalayan Salt: Carolyn recommended using sea salts because of their high mineral content. Options include Sea Salt and Pink Himalayan Salt.
  • Epsom Salts: Traditionally used to replenish magnesium levels, this is a magnesium sulphate source. Dr. Carolyn Dean recommends placing one to two cups in a medium hot bath and soak for 20-30 minutes. (Note from Damien: Some people, particularly chronically ill with methylation issues may be sensitive to sulphur and get some negative symptoms from magnesium sulphate. So monitor for symptoms if this is your situation.)
  • Magnesium Oxide: One of the cheapest and poorly absorbed sources of magnesium. In this form only 4% is absorbed, while contributing to the laxative reputation of magnesium.

Other People, Books & Resources

Organizations

  • Remineralize the Earth: Dr. Carolyn Dean praises this organization’s focus of soil amendment with minerals.
  • The Heart Rhythm Society (HRS): The Heart Rhythm Congress organized by the HRS awarded, “The Arrhythmia Alliance Outstanding Medical Contribution to Cardiac Rhythm Management Services Award 2012” to Dr. Carolyn Dean.
  • Nutritional Magnesium Association: A non-profit educational site Dr.Carolyn Dean is a part of the Medical Advisory Board.

Other

  • German New Medicine: Dr. Carolyn Dean has studied a version of this, Total Biology. This describes the connection between brain and physical symptoms in the body.

Full Interview Transcript

Transcript - Click Here to Read
[Damien Blenkinsopp]: Carolyn, thank you so much for joining us today.

[Carolyn Dean]: Oh, you’re welcome Damien. Good to be here. Always love to educate people about magnesium.

[Damien Blenkinsopp]: Yeah, and the first time I came across magnesium as being something important for our health was your books. So thank you very much for putting that out there, because it really was something that was a bit different. I’m not sure how you first came upon all of this, because you were the first person to start talking about magnesium.

It’d be interesting just to see, where did this all start? And when did you decide to start focusing on magnesium, and see it as something so important?

[Carolyn Dean]: How I became interested in magnesium is, it actually came to me. Random House, the publisher, wanted me to write a book on magnesium. At the time, I didn’t think that you could find 300 pages to write on one mineral, but I was completely amazed. This was in the late 1990’s.

And I realized that I had magnesium deficiency symptoms of heart palpitations and leg cramps. So for me, it was very serendipitous, and really helped my health. And, as it turns out, has helped hundreds of thousands of people who’ve read the book.

[Damien Blenkinsopp]: Yeah, that’s great, that’s very interesting. Why did Random House decide that magnesium was something worth talking about?

[Carolyn Dean]: Well one of their editors, I was told, had migraine headaches, and found when she took some magnesium, they helped her migraines. And she was so amazed she wanted more information. And as it turns out, it can help literally hundreds of symptoms, and many dozens of conditions. So, it’s quite an amazing mineral. As you said, not many people know about it.

[Damien Blenkinsopp]: Yeah, yeah. So, what is the role of magnesium in the body? Why is it important? Basically, if a deficiency in a mineral – or micro-nutrient, as we sometimes call them – is able to cause a lot of symptoms, it’s because it’s taking on some important roles in the body. And then when it’s lacking, it’s obviously us all these symptoms.

So what is the magnesium doing in our body? Why is it so important?

[Carolyn Dean]: Right, we’ll you’ve laid it out quite well. Magnesium is necessary for the activation and function of between 700 and 800 different enzyme systems in the body. So, it’s catalyzing most chemical reactions in the body.

It synthesized protein, transmits nerve signals, relaxes muscles. And I should throw in here that calcium contracts muscles. And so they have a push-pull relationship, magnesium and calcium. And magnesium also produces and transports energy called ATP.

And yet in medical school we’re just told that magnesium is a laxative. So, that’s why I write the book, and do a lot of interviews, and a lot of papers to describe the importance of magnesium, and to show people how they can improve their magnesium intake.

[Damien Blenkinsopp]: Excellent. Interestingly enough, I’ve had magnesium deficiency myself. I’ve had all the tests you recommend and everything. Also, some additional tests relating to mitochondrial functions. So you just mentioned ATP, and magnesium. And I had issues of my mitochondria and energy production, which caused all sorts of symptoms.

So my own personal story, I’ve come across this directly. And it was coming across in those tests as well, that I needed to build up my magnesium. So we can talk a little bit later about how you get people’s magnesium status to be raised under these things. But certainly for me, it was, and still is, very important to maintain my health.

So, why is it that they, there are many people… Because it’s counted as the second most common deficiency, in terms of micro-nutrients, in the Western world. Why is it today that we have this issue, where it is so deficient? Are there reasons that, either our intake of magnesium has changed, is it lower than historically, or, somehow is maybe the demands for magnesium higher?

[Carolyn Dean]: I think both contribute to the extreme magnesium deficiency to the point where 80% of the population is not getting even close to the recommended daily allowance of magnesium. Number 1, there’s very magnesium in the soil anymore. So, when a plant grows and it’s supposed to pull up minerals into it’s tiny, tiny plant rootlets, if the minerals aren’t there, the plant is not going to have minerals.

I’ve had cases of people on these crazy 140 ounces of green drink a day. And they come to me with heart palpitations and leg cramps – two of the major symptoms of magnesium deficiency – and they can’t believe it when I tell them they’re magnesium deficient, because they’re eating all these plants, all this greenery. And they go and get a blood test, and well and behold, they’re low in magnesium. And it’s because even if they’re eating organic plants, if the soil doesn’t have magnesium, the plants aren’t going to have magnesium.

And number 2, the demands from magnesium are much higher. I suppose there was always stress, of course, but now you see magnesium can be bumped away by medications that contain fluoride. The fluoride binds magnesium. Fluoridated and chlorinated water can bind up magnesium and make it unavailable. The diet, for example with sugars, it takes 26 molecules of magnesium to metabolize one molecule of table sugar.

The quarreling there with fructose, it takes twice as much. So it’s 52 molecules of magnesium required to metabolize one molecule of fructose. So people who turn to these high-fructose corn syrup sweeteners and say, well it’s fruit sugar; they’re actually in worse shape. They’re using up more magnesium.

So, we’re not getting it in our diets, and we continue to dissolve it with our behavior, and with the food. With alcohol you drain it, coffee drains it. Even in the athletics, the sweating where we lose sodium we think, we’re also losing magnesium. And when we just replace with certain electrolyte products that are high in sugar, and maybe high in sodium, we’re not replacing magnesium. And we’re causing people, actually, to have blood sugar imbalances.

You take an elite athlete and their intake of one of the major electrolyte products. They could be taking about 60 teaspoons of sugar a day, which they’re not able to metabolize, which ruins their magnesium balances, and they’re sweating out their magnesium and not replacing it.

[Damien Blenkinsopp]: Wow, that’s a whole host of conditions. I guess one of the most interesting ones is the soil, this input. Why is the soil so much lower in magnesium today? Is it because of overuse? We all hear about how we’ve been overusing the same amount of soil, and the top soil is disappearing steadily. Is that one of the main reasons?

[Carolyn Dean]: Yes, exactly. In ancient times, or even just a hundred years ago, they tell us that we could get about 500 milligrams of magnesium in our daily diet. Now we’re lucky to get 200. And it’s because the soil has been completely depleted of certain minerals, like magnesium, and the farmers don’t replace minerals. Even organic farmers, they don’t necessarily put what we need, which is rock dust, on the soil.

Hundreds of years ago when the spring thaw would bring water down from the mountains, the water and the tumbling of the rocks would create a high mineral content water that would end up in the deltas before it landed in the ocean. And the plains around the mouth of the rivers would flood, and in those plains with high mineral content water, they would grow the crops.

Now, that’s where everybody lives. And the farms have been relegated to places where they have to irrigate. But they just haven’t put the minerals back in the soil.

[Damien Blenkinsopp]: Right. Of course, and we’re using recycled water, which hasn’t gone through that whole natural process of micro-nutrient accumulation. It’s very interesting. I think there’s a business out there for someone, agricultural organic crops with micro-nutrients added. I don’t know if it’s possible. Have you seen that today? Does that exist somewhere?

[Carolyn Dean]: Yes, there’s a great website called Remineralize.org. And they do a lot about reaching education, about amending the soil with minerals. Remineralize.org.

People definitely know there’s a problem. In my Magnesium Miracle book, right at the beginning I talk about a 1934 Congressional Committee that reported on the enormous deficiency of minerals in the soil that just lead people to eat more and more food to try to get the nutrients they needed, which just ended up making people fat and mineral deficient.

[Damien Blenkinsopp]: Yeah, yeah. Exactly. And another interesting aspect that you mentioned was the fact that some molecules aren’t natural to our body. You brought up fluoride actually bind to magnesium. And of course, there’s a lot of fluoride around us in the water, the toothpaste, and so on today. Is that a very tight binding? Are they strongly attracted, those two molecules?

[Carolyn Dean]: Yes, very strongly. They form a complex called sellaite, and it’s brittle. And sellaite, this magnesium fluoride, it’s insoluble. It replaced magnesium in bone and cartilage. And it can make bones prone to fracture.

And what I found when I was doing the recent research for this third edition of Magnesium Miracle, 20% of our prescription drugs have added fluoride molecules, but those drugs are the majority of the commonly used drugs. They added the fluoride molecules to drugs because it increases the drugs ability to dissolve in fats, and therefore go across the fatty cell membranes. Which means it can be built up in stronger levels in the cells.

So anyway, what we’ve ended up doing is what 70% of Americans taking prescription drugs, we’re giving them all this extra fluoride. It’s binding up the magnesium. And when you look at the side effects of the commonly used drugs, a lot of them are cardiovascular side effects. The highest amount of magnesium in the whole body is in the heart. So, when you start to experience magnesium deficiency, you can start to get heart symptoms. Mine were the heart palpitations. That’s very common. I won an award actually in 2012 from the Heart Rhythms Society for my work with magnesium on heart arrhythmias.

But most doctors don’t understand the magnesium picture because we did not learn about it in medical school. You were mentioning – and I know I’m jumping around here, but there’s just so much to say – you were mentioning about the Krebs cycle, the energy cycle, in the mitochondria. Six out of eight of the steps in the Krebs cycle require magnesium. So, when anyone ever talks to me about mitochondrial problems, and they take about all these esoteric supplements they’re being told to take, and that, of it’s so dangerous. You need a lot of magnesium, mainly, to get your Krebs cycle going.

And so what happens with the vicious cycle of fatigue in terms of magnesium deficiency occurring. People go to doctors, and they’re fatigued, their heart may be palpitating, they’re under stress, their magnesium is deficient so they may get high blood pressure. So what happens is they start on this round of medications. They’re given a diuretic that drains out fluids, including magnesium.

They’re not even tested for magnesium – and we can get into that later – but there’s a cycle of blood pressure medications, and then they come back and all the sudden their blood sugar’s elevated. Well one of the signs of diabetes is low magnesium. And then their cholesterol is elevated. Well, the enzyme that helps balance cholesterol in the body requires magnesium. And if it’s deficient, then your cholesterol level will go up.

So, we’ve got people on things like Prozac because they’re fatigued, and they’re not sleeping, so they appear depressed. Well Prozac has three fluoride molecules. They’re put on cholesterol drugs; Lipitor has one fluoride molecule. They’re put on anti-arrhythmia drugs; one of them called Flecainide has six fluoride molecules.

And they irony of putting someone on an anti-arrhythmia drug that actually binds incredible amounts of magnesium is incredible. Because even when you look at the side effects of Flecainide, it’s fast, irregular pounding or racing heartbeat, shortness of breath, and tightness in the chest. The nerves, you have burning, crawling, itching, numbness, prickling pins and needles, or tingling feeling and chest pains. All of those are magnesium deficiency side effects.

Even the shortness of breath. When the smooth muscles in the bronchial tubes tighten up, because without magnesium your muscles get tight because you have relatively more calcium. Calcium tightens muscles, magnesium relaxes them. So that’s where you get all the tightening in the heart muscles, tightening in the calf muscles. And then people think you have a heart problem, whereas you have a magnesium problem.

[Damien Blenkinsopp]: Great, great review there. Just for some people at home, you mentioned palpitations and arrhythmias a couple of times. In kind of layman’s terms, how would you explain that to someone at home?

[Carolyn Dean]: Well, it would be… You don’t even notice your heart beating, number one. That’s normal. But when you start feeling your heart pounding, or going fast, to me that’s magnesium deficiency, until proven otherwise. Unless you’re running down the track or something. But if your heart’s starting to pound out of the blue, it can make people feel anxious for that to happen. They can actually go into an anxiety attack.

Anxiety itself can be a magnesium deficiency. And then your heart can sort of pound along, and then stop for an instant. And then resume again.Well that’s a skipped beat, and when that happens more frequently then it’s called an arrhythmia, or a heart palpitation.

When I used to get my little run of abnormal beats, it would make me have a little cough. I’d just cough as my body tried to re-adjust the rhythm. And it’s mainly that the heart has several pacemakers. The natural pacemakers of the heart keeps the steady beat. If and when the heart muscle is in tension from magnesium deficiency, or it’s damaged by a heart attack, then the accessory pacemakers of the heart can be pulled on or tweaked, and they can start firing out beats inappropriately, and that is an irregular rhythm that’s created.

[Damien Blenkinsopp]: Great, thank you very much for that. That helps clarify it.

So, have we covered all of the symptoms? For people at home, if they were asking themselves a question right now, do I have a magnesium deficiency, and how serious is it, potentially.

[Carolyn Dean]: Right. I can quickly run through a list Damien, because even when I say, well anything that can tighten a muscle can be a symptom. And you see that can be: acid reflux; if your stomach is in a spasm you can push stomach contents up and give yourself some heart burn; the angina I talked about, that’s the heart muscle going into spasm; anxiety; high blood pressure; cholesterol elevation, we mentioned; constipation, where the muscles of the intestines are kind of tighten and spasm, and they won’t push along your intestinal contents; depression; diabetes; fibromyalgia, that’s a huge magnesium deficiency problem. There are other things involved, but that’s where we start.

Headaches and migraines, I’ve mentioned. Even irritable bowl syndrome, where you have these incredible abdominal pains and either constipation or diarrhea. Any sort of inflammation, insomnia. I tell people if you have insomnia then you should take magnesium. If you don’t think it’s working, take more magnesium. Kidney stones, any sort of nerve twitching, PMS, seizures. A lot of some birth problems like eclampsia in women, that ‘s a magnesium deficiency symptom.

I have in my blogs, and in my books, I’ve put down 100 factors where you can gauge your magnesium deficiency. And we’ve gone over a couple, like alcohol intake. If you’re angry, you could be magnesium deficient. If you have any brain trauma, the first thing a person needs to do is have a magnesium intravenous, but not a lot of doctors understand that, or realize it.

If you’re eating a junk food diet, you’re making yourself magnesium deficient. Even infertility. If the fallopian tubes are in spasm, then they won’t allow the sperm to go along the fallopian tubes up to the ovary.

[Damien Blenkinsopp]: Right. So a lot of, it comes across that really there’s a lot of bits of your body that can malfunction if they don’t get the magnesium. And that’s basically what’s going on, they’re not functioning optimally, and it’s causing spasms and different things like this.

Just out of interest, I know my friends and I growing up – because we grow up in the coffee-stimulated management consulting area – we used to get a lot of pains in our chest. I was just wondering, as you said earlier, could it have been coffee induced magnesium pain, or was that just something completely different?

[Carolyn Dean]: It’s quite possible, because if the chest muscle – it doesn’t have to be heart, but the lungs, even the muscles around the ribs can go into spasm, some magnesium deficiency. In my case it was leg cramps. I have big calf muscles from dancing when I was younger, so it would hit me in my calves.

And everybody’s different. Some people who are typing a lot, they’ll say they’re getting carpel tunnel. And often that can be a magnesium deficiency.

[Damien Blenkinsopp]: Right. So it can depend where you’re basically using your body the most, because then, obviously, the magnesium’s getting exhausted to a worse extent in that part of the body, in that area.

So, are there severities, like if you continue to be magnesium deficient you’ll get more and more symptoms. Is that something you’ve seen in your practice?

[Carolyn Dean]: Right, yes. When you were saying that, I thought, you see different people will experience it in different areas. Why would one person get migraine headaches, and another person get chest pain, another person asthma, another person leg cramps? So it can be your vulnerable area.

And then what happens, it just seems to escalate where you start having different body parts effected. By the time people get to me, they have insomnia, they have anxiety attacks, they have irregular heart beat, they’ll get migraine headaches. So when you go to a doctor and you have that whole list, and you’re off to see a half dozen different specialists, and nobody puts it together that it’s all one thing: magnesium deficiency.

[Damien Blenkinsopp]: Great. So, do you understand the mechanism behind the headaches? Is it because there’s too much calcium versus magnesium in the brain, and that’s causing damage? Or how does that work?

[Carolyn Dean]: When I go into that in the book I have a whole chapter on headaches, and it can be muscle tension and spasm in the neck and head muscles. That’s sort of a common one. But it can also be, with migraines, a serotonin imbalance, because serotonin, the feel good neurotransmitter, is magnesium dependent. So if you have a deficiency, it can result in migraines and depression.

So there’s lots of reasons for a person to get headaches. And it can be injury; I remember a patient of mine, she was hit with a baseball bat in the head when she was young, and she began to get headaches. Well, 20 years later the doctors wouldn’t believe that a baseball bat to the head could still be bothering her. But, what had happened is the muscles in the scalp will just clamp down, and create this chronic tension and pain.

[Damien Blenkinsopp]: Okay, so we’ve talked a little about negative health. Right, chronic health conditions. So, being normal, like less than normal. Now, in terms of performance, have you looked at all into the impact of, or have you come across people who their performance has been impacted with various cognitive performance, athletic performance?

[Carolyn Dean]: Absolutely. I’ve had a couple of former NFL players who’ve had to quit the sport because of extremely severe muscle cramping, and then come to find out many years later that it was magnesium deficiency.

[Damien Blenkinsopp]: Wow. So their career’s finished because of magnesium deficiency. And it could have been fixed.

[Carolyn Dean]: You look at Kobe Bryant in the first game of the NBA finals. He was taken off with muscle spasms. So I wrote a big article about Kobe Bryant Has Magnesium Deficiency. And that’s where I was quoting earlier about when you take these electrolytes, you’re just getting sugar and sodium back. But anyway, yes players can be very much effected in any sort of team sport where you’re sweating a lot.

I’ve had a lot of teen athletes whose parents have come to me for guidance in how to get over their spasms. And it’s increasing their hydration, putting sea salt in the water, getting liquid magnesium, and liquid multiple minerals into water. And that is all that it takes to turn them around and keep them in the game.

[Damien Blenkinsopp]: That’s great to hear that. That’s really bad news for the guys who quit the game just for magnesium deficiency. It’s unfortunate that things weren’t known back then.

So, we talked a lot about the symptoms now, so people can have an idea if it’s a possibility. But, if you really want to know, I guess the first thing people do is they go to a doctor and they get their magnesium tested. And what is the standard way of testing that if you go to your doctor he’s going to test you, in terms of labs?

[Carolyn Dean]: Right. Unfortunately, it’s a blood serum magnesium. And the serum, it only has about 1% of the total body magnesium. So it’s the wrong measurement. It’s the wrong dipstick to put your needle into, because you’re not getting any accuracy in that test.

I’ve been recommending people get the red blood cell magnesium test. You can even go online and get it yourself, if your doctor doesn’t know about it. And I tell people to go to their doctor and keep asking and asking for the red blood cell magnesium test. I would love to see the ionized magnesium test, because that is the gold standard. And it’s still in the research stages.

But one of my articles online about kidney disease and magnesium. A magnesium researcher worked with a kidney researcher, and they found that people with chronic kidney disease of all varieties have the highest levels of serum magnesium. But in that same sample, the lowest level of ionized magnesium. So, in the serum it’s looking high because you see the serum has to perfuse the heart. So the serum magnesium is always going to be in this very narrow range, and it’s always going to look pretty normal, unless you’re really far gone, because it has to keep the heart perfused.

So, it will take extra magnesium out of your bones and muscles as needed. So every time you measure the serum magnesium it’s going to look normal. And doctors have gotten to the point of saying, well we don’t bother testing magnesium because it always looks normal. And you will notice in any electrolyte panel you’ve ever gotten, there’s never a magnesium level. It’s calcium and sodium and fluoride, but never magnesium.

So, I’m pushing for the ionized magnesium. In the meantime, I do the magnesium RBC blood test. But, Damien, it’s so crazy out there. The range for the magnesium red blood cell test, it used to be 4.2 to 6.8. And one year later, it’s 3.8 to 6.0 because the population is getting more and more deficient in magnesium. And what a blood range is is just the average population that the lab serves. They don’t look at the optimums, they just look at what’s out there.

So, I have to educate people, “Okay, right. The range may say 3.8 to 6.0, but we want you to be 6.0 or even higher.” I used to tell people with the old range – it would go up to 6.8 – I said, I want you to be 6.0 to 6.5. But it’s a huge educational leap to say to people, well you want to be higher than the range; It’s all marked with red flags that it’s too high. So it’s a huge educational challenge to make doctors, and the public, understand that they really are very deficient in magnesium, and need to take it.

[Damien Blenkinsopp]: This is a big problem with many labs. I mean, it’s the fault of the labs as well, but their normalizing based on the population instead of studies saying that optimum levels, healthy levels, are what they tend to do. Just a normal curve of what they receive in the door. And then they say you’re in the middle.

Even if – as we’re saying – 80% of the population is deficient, so clearly the average is going to be far, far from optimum, in this case. As many tests were in this case. So it’s just, even if you’re getting tests back from labs, you should check what is the reality of benchmarks. And that’s why I wanted you to talk about that a bit.

So what units of measurement are the RBC magnesium?

[Carolyn Dean]: The measurements of the RBC magnesium, how do you mean? The average range, I just mentioned it.

[Damien Blenkinsopp]: But how are they measuring it? Just in case different labs use different units.

[Carolyn Dean]: Ah, yeah. Milligrams per deciliter.

[Damien Blenkinsopp]: Okay. Great. And so you’re saying six or above is what you should be aiming for.

[Carolyn Dean]: Is optimum. I use the word optimum.

[Damien Blenkinsopp]: Yeah. Is there any case where you could have too high magnesium?

[Carolyn Dean]: Well, when I’ve seen – I think it’s twice out of the hundreds I’ve seen – it’s been a bit over the range, and then when I asked the person, they’ve taken magnesium the morning of the test. And in terms of having too much magnesium, the body does have a fail safe for magnesium, where it will give you the laxative effect if it’s got too much – either at that point in time or just too much in general. But no other mineral has that fail safe in the same way, so I consider magnesium an extremely safe mineral.

[Damien Blenkinsopp]: Great, great. And you’ve just dropped another little gold tip there, which is don’t take magnesium before your magnesium test. If you want to get a realistic value there – which goes for most things we’re testing – make sure you’re not interfering with the test results.

So the other test you mentioned was ionized magnesium, and you say that’s better. What are the issues with RBC magnesium first?

[Carolyn Dean]: Well, the RBC magnesium tests what’s in the red blood cells, and that is a different entity than a tissue cell, or a muscle cell. So it may give – and I don’t know, I’m just making this assumption – that maybe it’s 40 or 50% accurate. Whereas the serum magnesium test, it’s only measuring 1% of your total body magnesium.

You see there has not even been enough research comparing them all. This anecdotal study I’m talking about, with the magnesium researcher and the kidney researcher, and finding that kidney patients have high levels of serum magnesium. You see, they’d be warned to not take magnesium. “Oh, it’s going to be too high.” Whereas that same sample had a low level of ionized magnesium. So they had magnesium in their blood, but not in their cells.

And then the study went on to give people liquid magnesium that was ionized. It went into their cells, and their health improved. These kidney patients actually got better. So, when the magnesium researcher asked if the kidney specialist would write about these amazing findings, he said he couldn’t because it was so well known that magnesium can’t be taken in kidney disease.

So we’ve got another instance where people aren’t being given information because it goes against the grain of what doctors have learned all these decades.

[Damien Blenkinsopp]: Right, right. So is this ionized magnesium test available with many labs?

[Carolyn Dean]: No, it’s only about, at the last count, 125 labs out of the 5,000 in the US. And they’re all in research institutions, as I understand it.

[Damien Blenkinsopp]: So that’s like LabCorp, CorQuest, which are the typical ones people go to.

[Carolyn Dean]: No, they wouldn’t have it. I mean, you’re lucky to educate them about magnesium RBC test. I tell people to go to an online site called Requestatest.com. And without a doctor’s prescription you can order your own blood test, which I think is fabulous. And then people can follow their magnesium. The price of it is often less than the copay you’d have to pay your doctor to go in and get a prescription.

[Damien Blenkinsopp]: Right. Because when we order directly, we can’t get insurance to cover it?

[Carolyn Dean]: I don’t know about that. I just talk about the copay in the sense, well insurance doesn’t cover your copay. So, people make up their own minds. But I do ask people to talk to their doctors about it, just to educate the doctors, because doctors don’t even know about it.

[Damien Blenkinsopp]: So it sounds like the ionized magnesium test is pretty hard to get at. Maybe if you are a typical citizen, we can’t actually get access to it right now? Or is there one lab that we can get it from, perhaps with a prescription? There isn’t right now?

[Carolyn Dean]: No.

[Damien Blenkinsopp]: Okay, great. Well, not great, but it’s good to have the clarity on that. Hope it’s coming soon.

The other test I heard you mention in the past, maybe you’ve kind of dropped it now, is exit test? Where you have the scraping of the inner cheek to see what is in the bio-sample. Is that something you don’t recommend though?

[Carolyn Dean]: Well, it is a very good test, you can measure more than the magnesium. It’s getting right into the tissue cells, so I think it is more accurate than the magnesium RBC, but it’s very expensive; it’s hundreds of dollars. However, insurance does cover it. And then there’s another however, you have to get a practitioner to do the scraping. So you have to pay for an office visit to get it.

[Damien Blenkinsopp]: Right. So it’s inconvenient.

[Carolyn Dean]: Inconvenient, that’s the word. Right.

[Damien Blenkinsopp]: Right. So you’re just saying people should get RBC magnesium. I got my RBC magnesium done, I haven’t done the exit test.

[Carolyn Dean]: Oh good!

[Damien Blenkinsopp]: Probably for those reasons, because it was the easiest one to get set up, and the exit test is quite a lot of money considering. If you’ve already decided to supplement with magnesium, because, say you’ve got a few symptoms, then thinking about it, what’s the cost benefit of me doing the exit test versus the RBC.

Because the nice thing is, you can trend the RBC, and if it’s going upwards then you should be making improvements. Is that an assumption you could make?

[Carolyn Dean]: Oh yes. I see that all the time, people improving. And when they don’t, then I just have a conversation about, are you taking medications? Yes, usually. Are you under more stress? Yes. Are you taking your sea salt in water? No.

I have a blog called When Magnesium Makes Me Worse. And I go through this sort of thing where people will start taking magnesium and they’ll feel better, and then they say, well it’s not helping anymore. And it’s often because they’re not taking enough.

When you’re starting to wake up 700 to 800 different enzyme systems in the body, you’re body is crying out for more and more and more. And it doesn’t go on forever. You certainly come to a point where you have a daily requirement. And in fact, as you build up your stores you need less magnesium as time goes on.

So, in the beginning you really, in my opinion, you have to go slowly into magnesium, because it can actually help detoxify the cells, detoxify the liver. So I tell people to go slowly and steadily, and increase as they either watch their symptoms, or watch the magnesium RBC test.

I only started really pushing the magnesium RBC test because I put it in my book. I don’t know the people who are taking magnesium, they’re not my patients. So I’m just trying to be very cautious, and be scientific about it. Especially with people on a half a dozen medications, and then they’re saying, “Well, is magnesium going to be dangerous?” I’d like to say to them, well did you ask that question about your six medications?

Because if you’re on medication and you start taking magnesium for magnesium deficiency symptoms, you’re not going to need as much medication. The medication might start to appear toxic. And then you’re going to say, “Oh, the magnesium is making me sick.” Whereas it’s your body is trying to get rid of the drugs.

So, it’s an education. That’s why I’ve written so much about it. Because we’re in the situation now, as I mentioned, where you have a little bit of high blood pressure, and all the sudden you’re on six medications, and that’s going to start really depleting your magnesium.

[Damien Blenkinsopp]: There’s some very good points on how you’ve taken a personal approach to this, to consider all the factors in your life. So it’s difficult for someone like you, who’s written a book trying to address the general population to just say, everyone do this. It’s not bad.

But I guess having an RBC magnesium test, and judging by your symptoms, you can make a start of understanding where you’re at, and what could be necessary. So what kind of things do you recommend to increase our magnesium? You’ve mentioned sea salt. Is that Himalayan salt, or is that just natural sea salt? (40:19)

[Carolyn Dean]: Himalayan is good, Celtic salt. Yes with the stress that people are under, the stress that makes them lose magnesium, you’re also losing sodium. And I tell people that sea salt, it has the sodium, it has some magnesium, a bit of calcium, but not that much. But it does have 72 minerals. So, there are tiny amounts of minerals that we may not even know we’re lacking.

I have people on sea salt, and overnight they’ll say they’re not getting up to go to the bathroom. They’re retaining their fluid in their cells more than it just running through them, and claim all kinds of benefits. So it’s a great start in terms of water intake. I tell people to take half their body weight measured in pounds, take half that weight in ounces of water a day.

With all the filtering and reverse osmosis, even distilled water out there, people are not getting minerals from their liquids anymore. So I add the sea salt, and of course people say, “Oh my doctor told me not to take salt because of my blood pressure.” Well, table salt is just sodium chloride, and that is almost like a drug. We’re not talking about sodium chloride, we’re talking about sea salt, which has 72 minerals. (41:40)

[Damien Blenkinsopp]: Right, right. And then, the rock salts as well. They’re balanced, basically, instead of being concentrated, many-made synthetic. That’s why you’re saying it’s a drug, because it’s refined compound. Which I guess you could compare to refined food, which often doesn’t have positive impacts on the side because it’s unbalanced, at the end of the day.

So, in terms of athletes, you also mentioned that they have issues with electrolyte drinks. Are there any electrolyte drinks out there which have a more balanced profile?

[Carolyn Dean]: I have not found one yet. I’m more keen on an electrolyte liquid myself, but we don’t have to go there. Because I just couldn’t find anything out in the commercial world that wasn’t loaded with sugar and sodium.

[Damien Blenkinsopp]: Right. So, in terms, are there foods we should be eating? Personally, I use transdermal magnesium oil, magnesium chloride oil from some of the seas, so it’s supposedly pure. Could you talk a little bit about that? Is that one of the better methods to raise your levels?

[Carolyn Dean]: It is a good method. When you put magnesium on your skin, you’re actually stimulating the DHEA receptors in your body, so it helps your hormone balance. Myself, before I got into my liquid magnesium, I had to use so much magnesium oil on my skin it became irritating. So, some people have to dilute it with distilled water.

All of magnesium oil is super saturated magnesium chloride in distilled water. And, the transdermal approach, that was started centuries ago, probably, with Epsom salts baths, where the midwives would use it for all their pregnant patients. And what you do is put one or two cups in a medium hot bath, and soak for about 20 or 30 minutes. And you can begin to see the effects of magnesium immediately just by doing these baths.

It’s a way for people to sort of get introduced to magnesium, because I just said, they may be on half a dozen drugs and afraid to do anything that their doctor doesn’t recommend. So, you do the Epsom salts, you feel better, and then you may feel like going to a transdermal magnesium oil, or some of the oral magnesiums.

In terms of the most common and the cheapest magnesium, it’s actually the least well absorbed. And this is where magnesium will get the reputation for just being a laxative. Because the magnesium oxide is only 4% absorbed, and that means the other 96% will find its way into the intestine and cause diarrhea. Now, that’s okay for a certain percentage of the population that’s constipated, but you do have to be careful to not create too much of a laxative effect.

[Damien Blenkinsopp]: That’s interesting. So if you are magnesium deficient, and you’re taking a supplement – I don’t know which ones you’d recommend – but, I don’t know, magnesium glycinate. There’s many different varieties, there might be a more available one you’d recommend.

But if it’s getting absorbed into your body then it won’t produce the laxative effect. So, is that really based on the economic ones right?

[Carolyn Dean]: Correct.

[Damien Blenkinsopp]: That’s interesting, because I actually had that problem where I was trying to induce… And obviously I had the wrong type, because I had to buy an available type, and wasn’t aware of this connection. Because it never induced the laxative effect I was looking for.

[Carolyn Dean]: And the way around the laxative effect too, there are forums. People can check on my website under resources for the different forums written about them. But you can take, for example, a magnesium citrate powder and put it in a liter of water, and shake it up and just sip it through the day. If you take small amounts of magnesium through the day, then it will gradually get into the cells, and will build up.

But if you take two or three teaspoons of a magnesium citrate powder all at once, then you could overwhelm the cell’s ability to absorb, and then it runs out the other end. So. And that’s a waste of money, and also you could be pulling out other nutrients when you have diarrhea.

[Damien Blenkinsopp]: Yeah, that’s key. In terms of foods, are there higher magnesium foods which you recommend people start to incorporate into their diets?

[Carolyn Dean]: Right, there are, but I’ve already had the caveat about if they’re grown on mineral depleted soil it’s hard to say, but seaweeds are high in magnesium. In the ocean there’s three times the magnesium compared to calcium. So there’s a lot in seaweeds, in chocolate. 100% cacao is high in magnesium, that’s why some women, especially, have chocolate cravings before their period, because they’re craving magnesium.

There’s different herbs. I have it in my book, purslane, for example, is very high magnesium, again, if the soil is high. Cilantro is high in magnesium. Nuts and seeds, deep green leafy vegetables. Some grains. But again, I always have to hesitate and say, but if the soil is depleted, I can’t confirm.

But I do know food has a big impact. For example, I’m telling people not to take calcium supplements, but get your calcium in your diet, but get your magnesium in a supplement. And calcium, for example, we’re told that we need 1,200, 1,500 milligrams. Whereas in the UK and the World Health Organization, they’re only saying 500 to 700 milligrams of calcium.

Well if you look at a cup of yogurt, that’s about 300 milligrams of calcium right there. I’ve done experiments with myself, and I find if I have two or three cups of yogurt in a day, I actually start getting a bit of heart palpitations and leg cramps, because it’s really pushed on my magnesium. It’s kind of bound up my magnesium.

So I know that you can get your calcium from your diet, just by looking at some food list – I have a couple of free e-books that people can get on my website – and you can figure out if you’re getting enough calcium in your diet. Usually from dairy, or bone broth, or fish with bones. But with magnesium, you have to be very, very wary that you’re probably only going to get about 200, maximum 300 milligrams. And I’m recommending people get about 700 milligrams, equal amounts of calcium and magnesium.

[Damien Blenkinsopp]: Great. We’ll put links to all of these things you mentioned in the show notes so that people can find them; the free e-books, and you mentioned something else earlier, about some of the tests. Make it easy for people to find.

Thank you for all of those clarifications. It really sounds like we shouldn’t really trust the food, and go the supplementation route. And you brought up magnesium citrate. Is that you’re preferred supplement?

[Carolyn Dean]: It’s one of them. I have my own product, but again, this is not a commercial broadcast, so people can search sites.

[Damien Blenkinsopp]: But do feel free to point out any… Is there something specific you’ve done with your product that you feel is better?

[Carolyn Dean]: Well what happened with me Damien is I couldn’t get enough magnesium therapeutically, without stimulating my intestines and getting the laxative effect. What I did was work with a chemist to create a magnesium that is absorbed 100% at cellular level, and does not cause the laxative effect.

So that people even, I’ve had people who’ve been forced to live on an IV magnesium drips, where three or four times a week they have to take an IV drip, or their levels become so low they develop heart symptoms and cramping. And they can switch from IV onto a good magnesium that’s absorbed fully. And that’s what we’ve been lacking; all the research in medicine is in drugs, and we haven’t had enough research in the supplementation that people absolutely require.

I mean, the other thing I’m working on is the balance of the other minerals. I’ve found that the thyroid requires nine minerals to make the hormones properly. And instead of using mineral supplementation of the type of mineral that can be absorbed fully into the cells, doctors wait until the thyroid is barely functioning, and then give thyroid hormone replacement, either a synthetic or natural. And the natural doesn’t make that much difference, if you consider that what the thyroid really needs is it’s nine minerals to create it’s own hormones.

[Damien Blenkinsopp]: Yeah. I mean, this is a really recurring theme on this podcast, is micro-nutrient deficiencies across the board are causing many symptoms. So I think it’s really something people need to think about, in terms of their diet and supplementation, trying to maximize how many of these micro-nutrients they’re getting into them. And testing, where possible.

So, if someone has a deficiency, how long does it take to resolve that? If they’re implementing the types of recommendations you’ve just announced? And how often do you think they should get tested? If they’re doing RBC magnesium testing, trying to figure out how close they’re getting to six.

[Carolyn Dean]: Right, I mean. There’s such a range that I get a lot of emails – I have a radio show too, so people call in – in people who have, what I would consider, minor symptoms. They can lose those symptoms overnight. They can be sleeping the first night. But then the people I get in my consulting practice – I do telephone consultations – they’ll be the ones on a half dozen medications, and sick for 40 years. And they’ll start feeling symptomatically better within a week, but then it’s going to be probably several months before they’re completely symptom free.

The way nutrients are approached in our society is as if they’re drugs. And some people will say, “Well I’ve been taking magnesium for two weeks, and I have another heart palpitation. Why is that?” And it’s because magnesium is not suppressing your palpitations, it’s actually trying to heal your muscles, and you’re building up your magnesium stores. And when I get the story of, “Well yes, I forgot to take a couple of doses.” And, “Yes, I had a lot of sugar,” or, “I had some alcohol.”

There’s a balance; when you’re taking nutrients you want your nutrients to be absorbed, so you want really high quality nutrients. And you want the basic nutrients. I have people come in to me who are on dozens and dozens of different supplements, where they read about, “Oh, this is important. If you don’t get it, you’ll surely die.” The advertising for supplements has gotten people so scared that they think they have to take everything. And they end up actually coming to me with stomach distress, because they’re swallowing all these pills.

[Damien Blenkinsopp]: Right. And as you mentioned, there’s ratios involved with many of these. Calcium to magnesium ratios, zinc to copper ratios, and in some cases it’s actually the ratio that’s really, really significant as well. One of the first episodes we had on here was talking about zinc and copper imbalances, and how they can actually create anxieties. and also some conditions in the brain.

So you’ve covered that from a different aspect, but the ratios can be very important too. So, supplementing just one single nutrient can be a problem also. Have you ever come across anyone supplementing magnesium who get problems with calcium balance?

[Carolyn Dean]: In the past number of years, I think I’ve had two people where they’ve just thought that the magnesium was all they needed, and took higher, and higher, and higher amounts. And I don’t know if we proved that there was a calcium problem, certainly, when they did their blood tests. Their calcium levels were not low on their blood test, but that’s where, in my writing, I make sure people are getting their 700 milligrams of calcium every day in their diet. And if not, to take a well absorbed calcium supplement.

I think I’m going to have to work on… They’re called picometer minerals. Picometer is like a trillionth of a meter, so that’s the size of the minerals I work with. And that is actually the mineral ion channels size in the cells. And it’s actually the diameter of the plant rootlets, picometer.

So, what’s supposed to happen is the soil is supposed to be flush with worms and organisms that break down the minerals to a picometer size so that plan rootlets absorbs them into the plants. And then we eat the plants, and we get our minerals. And it’s all supposed to go brilliantly like that. And, we’ve stopped that from happening. Its not occurring anymore, because the soils are so dead.

I mean, we didn’t even talk of the different herbicides and pesticides that actually bind up minerals. The Roundup Ready by Monsanto, it binds up 50% of magnesium, even in the soil, and it has a half life of 23 years.

[Damien Blenkinsopp]: Yeah. What we are doing these days is pretty crazy, to look back on it.

Thank you very much for your time today, and I’d really like to wind down the interview with a few slightly different questions about you, and your ideas about the world of health.

First of all, are there other people, besides yourself, that you recommend to go to for advise and insights on areas around health, or testing, or any of these types of areas we’ve discussed today?

[Carolyn Dean]: Well, when people come to me, for example, with cancer, I don’t treat cancer. I’ve studied something called Total Biology. Have you heard of German New Medicine, or Total Biology Damien?

[Damien Blenkinsopp]: No, I haven’t.

[Carolyn Dean]: It’s the conflict that basis of disease, where a conflict in somebody’s brain, a worry, an unsolvable problem, can actually be downloaded in the body as a physical symptom. Like, if you’ve got a boss who makes you sick to your stomach, then you can develop a stomach ulcer. Or, if somebody’s a pain in the neck, then you can get neck pain. So, there’s simple comparisons like that. And then solvable conflict can also put itself into the body, and unless we deal with the conflict, then physical medicine really won’t be able to completely solve the problem.

So, beyond what I do in my books and my products and my website, I have a two year online wellness program. I really don’t know that anybody is covering the water front in the way I do, but, you know, I’ll refer out to people for the Total Biology, and that aspect of the psychology and physiology of the body that was never addressed in either allopathic or even my naturopathic training so far.

[Damien Blenkinsopp]: Great, great. Thank you very much. Are there biomarkers or labs that you track on a routine basis to monitor, or improve, your health, longevity, or these kinds of concerns?

[Carolyn Dean]: No.

[Damien Blenkinsopp]: Nope? Nothing you look at. Okay. Great.

What would be your one biggest recommendation to people for health, longevity, and performance?

[Carolyn Dean]: It would have to be magnesium, really, seriously. When you look at the products that some of the doctors have these days – and I’m not saying… I’ve been active for over 40 years, and it’s only in the past year or so, I’ve decided that I had to get into products because the ones I needed for myself weren’t available. And people were getting so desperate.

I spent two years creating a two year online wellness program for people, because I wanted to educate, and give them all the information I knew. People don’t have time to do a two year course. They’re desperate, they want something now. And so what I realized when I look at a lot of the supplements that, even the medical doctors are selling, you can’t even find magnesium in their products.

And so that’s where I really come back to start with magnesium. It works on nearly 700 to 800 enzyme systems, it supports the energy of your body, it helps you sleep, it gives you energy during the day, it relaxes you enough to help you sleep at night. So it really is the one supplement that everybody should take.

[Damien Blenkinsopp]: Thank you very much for that. So, in terms of people connecting with you, you just mentioned that you have a radio show. I think it’s also a podcast, correct?

[Carolyn Dean]: Yes! You’re right, we did podcast it. People can just go to drcarolyndean.com, and I have a little radio on the side where people can click on to get my radio show. I do blogs periodically. I used to do them more frequently, but everything really slows down in December when we’re of course doing this taping. So, drcarolyndean.com, you’ll see my wellness program, I have a free online news letter, a couple of my products are listed there that takes you to a website.

And actually, under the wellness program, people can pick up two free e-books on minerals with their pdf format. Under my wellness program.

[Damien Blenkinsopp]: Great. And of course, your book is called the Magnesium Miracle, and it’s in its third edition, I believe?

[Carolyn Dean]: That’s right. The 2014 edition, and it’s on Amazon. And actually, Amazon is doing a great job now, I heard they’re doing same day delivery in some major centers. It’s amazing.

[Damien Blenkinsopp]: Yeah, they are. I mean, I use Amazon every single day, it’s crazy. If you’ve got the iPhone app for Amazon, it’s dangerous.

And if you use the Amazon lockers, you can get stuff literally shipped next to a 7/11 next to you.

[Carolyn Dean]: But then even worse is having a Kindle, where you can order the next book in the series while you’re lying in the bathtub. They’re making a mint on Kindle, because you can’t lend them. So everybody has to buy a new Kindle, where as with books you can lend them all over the place.

[Damien Blenkinsopp]: Yeah, that’s true. I’m not complaining, I love Amazon. It makes everything very convenient.

So Carolyn, thank you so much. Of course we’ll put those references you just spoke about in the show notes, so people will be able to find you easily. But thank you so much for your time today. It’s been a pleasure talking with you, especially after having read your books so long ago. And using magnesium as a result for these many years. So thank you very much for your time, and great to connect with you.

[Carolyn Dean]: Thank you Damien, good interview. Great questions. I enjoyed it. There’s a lot of information out there, and I appreciate being able to do that, so thank you.

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