Predictive Biomarkers with Dr. Russell Jaffe: Rational Wellness Podcast 100
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Dr. Russell Jaffe discusses Predictive Biomarkers with Dr. Ben Weitz.
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Podcast Highlights
5:25 Dr. Jaffe is an advocate for looking at eight biomarkers that he believes are the best measures of the quality of our health and predictors of longevity. He notes that life in the 21st century results in more internal and external toxic load, which requires more nutrients than it used to to maximize your epigenetics. Epigenetics is the expression of your genetic code.
10:25 The Telomere length test has been shown to be a valid test to help predict long term. It measures the end of the chromosomes and it’s length does correlated with survivability.
12:11 Dr. Jaffe believes that the most important eight biomarkers are: 1. Hemoglobin A1C, 2. High Sensitivity C-reactive protein, 3. Plasma Homocysteine, 4. Lymphocyte Response Assay, 5. First morning urine test for pH, 6. Vitamin D, 7. Omega 3 index, 8. 8-Deoxyguanosine.
14:33 According to Dr. Jaffe, Hemoglobin A1C should be less than 5 percent.
17:37 The second predictive biomarker test is High Sensitivity C-Reactive Protein (HsCRP), which is a marker for inflammation and repair deficit and the optimal range is below .5. Dr. Jaffe discussed the benefit of doing a vitamin C cleanse by taking vitamin C to bowel tolerance levels. He also mentioned that it is a good idea to check your bowel transit time by using charcoal capsules. He mentioned that these are both written up on his website, Perque.com. Dr. Jaffe mentioned that he has a company betterlabtestsnow.com that offers these biomarker lab tests.
21:38 With regard to the Lymphocyte Response Test for food sensitivities, the goal is to be tolerant and not to have any delayed sensitivity reactions. Lymphocyte Response Testing measures three types of delayed sensitivity reactions through lymphocyte activation, which includes reactive antibodies (IgA, IgM, and IgG), immune complexes, and T cell direct activation.
21:56 The first morning urine pH test, which is a way of measuring the risk of magnesium deficit in the cells. Magnesium and potassium are the minerals that help to alkalinity in our cells. According to Dr. Jaffe, when we get into a slightly acidic state our cells become depleted energetically. You need one molecule of magnesium for every molecule of ATP and when magnesium is depleted, the cells shift from an active elective-protective mode to survival mode. Our morning urine pH should be between 6.5-7.5 and below that means metabolic, cellular acidosis.
24:06 Optimal vitamin D levels should be between 50 and 80 ng/mL. Vitamin D is really a neurohormone and it communicates with cells and has an anti-cancer function and a pain-relieving function.
27:07 The omega 3 index should be more than 8 percent. This can be accomplished by reducing or eliminating edible oils, which are sources of omega 6. Dr. Jaffe recommends not cooking with oils and instead use wine, broth, or freshly made juice to cook with. He points out that the oil in nuts and seeds is protected from oxidation, but after expressing such oils, oxygen tends to create rancidity. He avoids such oils including extra virgin olive oil. He recommends eating fish and taking fish oil capsules to raise your omega 3 levels and he explains that we need both EPA and DHA, so we should take the fish oil that contains both and not just one.
31:28 The final biomarker is the 8-oxo-guanine, (aka, 8-hydroxy-2-deoxyguanosine), it’s the measure of oxidative damage in your DNA, in the nucleus of your cell, including the DNA in the mitochondria and this test has been validated. If you have too much 8-oxo-guanine it means you need to take in more antioxidants.
32:58 Dr. Jaffe believes in order to be healthy you should avoid added sugar and cut out almost all packaged and processed foods. You should eat whole foods and if you eat processed or packaged foods, you should know every ingredient on the label. Processed foods have a long shelf life, but they are not real food. They have too much sodium and too little potassium. They have too much calcium and too little magnesium. They tend to feed diabetes and fluffiness. Dr. Jaffe said that he does recommend complex carbs and fiber. In fact, he recommends eating 40-100 grams of prebiotic fiber and 40-100 billion probiotic organisms per day.
Dr. Jaffe recommends taking the Perque Endura/PAK Guard supplement, which recycles glutamine. This product contains glutamine to feed the cells that line the intestines, but this glutamine will get turned into glutamate, which is an excitatory endotoxin. The PAK in this product then recycles the glutamate back into glutamine up to 10 times. This makes it safer to take glutamine. Dr. Jaffee said to have lifelong good health you should eat what you can digest, assimilate, and eliminate without any burden.
39:18 In order to lower HsCRP Dr. Jaffe recommends to take more of the good stuff and less of the bad stuff. He said that you can do the urine pH test and then take enough magnesium and choline citrate to get your pH in the optimal range. He explained that only choline citrate uniquely enhances the uptake and chaperones the delivery of magnesium to the cell, correcting the metabolic acidosis and the metabolic syndrome, recharging the cell’s ATP, protecting essential fats in transit where magnesium functions as an antioxidant. And allowing the battery of the cell to recharge. And other things as well, including hundreds of enzyme catalysts that require magnesium to work, and if magnesium runs down, they’re pro-enzymes. They’re potential enzymes. While Dr. Stanley Hazen from the Cleveland Clinic is recommending that people avoid consuming choline to lower their TMAO levels, which is a marker for heart disease risk, Dr. Jaffe says not to worry. You will only make TMAO if you have a long transit time, which you won’t if you do a quarterly C-cleanse and have enough prebiotic fiber and probiotic good bugs. And he also recommends choline citrate over choline bitartrate. And with respect to vitamin C, Dr. Jaffe explained that you want to take the fully buffered L-ascorbate and not the D-ascorbate, which much of the vitamin C on the market is. And ascorbate will also raise you glutathione levels.
42:10 Your homocysteine level should ideally be below 6 and in order to lower it we take methylfolate, methyl B12, and vitamin B6. We should also eat garlic, ginger, onions, broccoli sprouts, and eggs.
45:15 When it comes to urine pH, you want between six and seven and a half. To facilitate this, you want to take 2 dosages of Perque Mag Plus Guard and Perque Choline Citrate, which enhances the uptake of the vitamin C to get into the cells. Dr. Jaffe does not think that taking baking soda to alkalinize your system is a good idea because it may reduce the acid of the stomach, which reduces stomach acid and impairs digestion and reduces the uptake of minerals and B vitamins.
Dr. Russell Jaffe has an MD and PhD from the Boston University School of Medicine and he is also board certified in Clinical Pathology. He worked at the National Institute of Health and he has published over 80 scientific papers. Dr. Jaffe is a pioneer in Functional Medicine and he developed the first lymphocyte response assay for food sensitivities and is the lab director and owner of ELISA/ACT Biotechnologies (betterlabtestsnow.com) and the founder and chairman of Perque Integrative Health supplement company Perque.com. Here are the phone numbers for the Dr. Jaffe’s lab and for Perque Integrative Health: 1-800-525-7372 or 1-800-553-5472.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or by going to www.drweitz.com.
Podcast Transcripts
This is Dr. Ben Weitz with the Rational Wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health. Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us a ratings and a review. That way more people can find out about the Rational Wellness podcast.
Our topic for today is predictive biomarkers with Dr. Russell Jaffee. Predictive biomarkers are things that can be measured objectively that will be the best predictors of our long term health. These are typically measured through blood or urine or saliva tests, and from the hundreds of thousands of lab tests available Dr. Jaffee has selected approximately eight tests that he feels the evidence shows are the best predictors that we’ll still be alive in 10 years.
Dr. Russell Jaffee has an MD and a PhD from the Boston University School of Medicine. He’s board certified in clinical pathology, he’s worked at the National Institute of Health, has done research and has published over 80 scientific papers and was originally quite skeptical of functional medicine. He developed the first lymphocyte response assay for food sensitivities and continues to be the lab director of ELISA/ACT Biotechnologies, as well as the founder and chairman of a nutritional supplement company Perk Integrative Health. Dr. Jaffee, thank you so much for joining us today.
Dr. Jaffe: Thanks for inviting me.
Dr. Weitz: So, Dr. Jaffe you’ve worked at The National Institute of Health and you were fully immersed in the conventional medical model of care and somehow you made your way over to the progressive side of things, to the Functional Medicine side of things. Can you tell our listeners what changed your thinking in how you’ve come over to this different way of understanding the body?
Dr. Jaffe: Well, thanks for asking. In the early ’70s I arrived as a public health service officer at the Clinical Center at The National Institutes of Health, that’s my full-time job, but I heard that there was a man named Quing Loo, an acupuncturist who would needle people and get results that we couldn’t get at NIH and as a skeptic I went and then I did a seven year apprenticeship with him, and then taught a program called Oriental Medical Strategies in Western Medical Practice, which was a part of the foundation of continuing medical education to licensed medical acupuncture in New York and California.
Then I heard about Dr. Ramamurti Mishra and the Yoga Society of New York and the Textbook of Yoga Psychology. An MD PhD cross trained in Banaras and I went to debunk him and I had five years as his student, and then I met a Cambodian Buddhist monk named Bhante Dharmawara. I met him at his birthday on Sunday. On Tuesday he moved in because he had decoded a non-invasive color healing system that the Buddha taught that was practiced for 500 years, lost for 2000 years, and he, from his study of the ancient text deduced what it was and brought it forth and I’m one of his students.
So I did come as a skeptic. My experience taught me that my skepticism came out of my ignorance not out of wisdom, and that yes the analytic skill, whatever I have as a methodologist, as a clinician, as a diagnostician, as somebody who’s made up … Every year at NIH we introduced what became a gold standard of laboratory testing because there was a lot of need at that time. A lot of support for the kind of work that I was doing. So I did, indeed come as a skeptic. I did apprenticeships that taught me to respect wisdom traditions, observational science, as well as double-blind placebo controlled studies, and our super-multi, the Perque Lifeguard tabsule, an all active novel delivery system. It’s a super B complex with a super mineral complex and 40 active ingredients, not 20, in meaningful amounts because we don’t have any binders, fillers, excipients, filling agents and shmootsy stuff or need it because as a biochemist and a physical chemist I know how nature brings foods together and there’s no glue involved, and we do the same thing with all of the Perque products. And we did this double-blind placebo-controlled trial at the military medical school in Bethesda, Maryland because someone was going to say to me, “Did you do a double-blind study,” and I was going to say to them, “Yes,” and it came out and it was published by my colleague back at Patricia Deuster and it was done at the military medical school, which means it was done properly with proper controls.
So, yes, I’m an advocate for these predictive biomarkers that cover lifestyle, they cover choice, habits of daily living and most of us don’t have perfect habits as reflected in the value, the test value, being above the ideal. Now, I want to make a very clear point that labs produce ranges and you compare results to ranges making people into statistics. Now, that’s fine for population studies. It tells you almost nothing and may actually be confusing with regard to the healthy value for that test. So my suggestion is, instead of even looking at the range, just fold it under so you don’t have to look at it, look at the value of these eight biomarker tests and yes, we did a funnel analysis starting with over 100,000 tests and we wanted to cover all of epigenetics, all of lifestyle, all of the things that your habits control which is 92% of your lifetime health, and each of these eight tests is an all-cause morbidity mortality marker and when you put them together you cover the 92% of lifetime quality of life and health that is determined by epigenetics. Now, the simplest I can explain epigenetics is–it’s not genetics. It’s not the DNA. It’s not the RNA. It’s the products. It’s the functional quality of your cells. It’s the acid/alkaline balance. It’s whether the essential, and by essential we mean the nutrients you must take in because your body can’t make them, and yes, the 21st century is more intoxicating and intoxicated over five different categories so therefore you have to increase the anti-toxic nutrients that get consumed, and chewed up, and spit out by the toxins of every day, the stresses of every day living. Technically it’s called the allostatic and homeostatic load for those of you who are into Greek and Latin, but that means the internal and external total toxic burden which requires more nutrients than it used to because the 21st century is, spoiler alert, more toxic than the 20th, and the 20th was more toxic than the 19th.
Dr. Weitz: Cool. So can you explain which predicted biomarkers you think are most important, and I just wanted to point out for the listeners who are still a little confused about epigenetics. Your genes are the things that are laid it down in your DNA and the epigenetics basically has to do with how you lead your life and whether or not those genes get expressed. Whether or not they get turned off or turned on.
Dr. Jaffe: Right. That’s right. The environment, your attitude, your nutritional status, your toxic load all modulate the expression of your genetic code.
Dr. Weitz: Right.
Dr. Jaffe: And that’s what epigenetics is and it turns out it’s much more important than even we thought a few decades ago. In fact, it’s probably where the opportunity to feel and function better because not only are we looking at the 10 year horizon and your probability of living 10 or more years, but we’re also talking about the functional age, the functional age, at which you operate and perform. As an example, I can tell you that by the measures that we do, and I get to do a lot of measurements on myself, I am functioning mostly as a 35-40 year old which means half my biological age. I get restorative sleep, I can preach the value of restorative sleep, I eat moderately. I’m a reformed fluffy person. I used to weigh 65 pounds more and, I think it was Mark Hyman who taught me this, if you look at yourself in a full length mirror and you wiggle your tummy and it jiggles your fat pads are too fat. So, it was not a simple resolution one day and resolved the next day. It took me time to lose the weight. I don’t plan to find it again, but I can tell you that after I got down to the weight I choose, which is more or less what you see, it took another year before the leptin hormone, the hormone that causes raging appetite, to come back to normal. So because of having had that humbling experience I can advocate for it. I can explain to people what happened to me as an example and how much better I feel and function and how much more able I am to get at least 8000 steps in a day, as my current goal, because when I wake up in the morning first I stretch in bed, then I get up and I stretch in the shower, and then I’m ready for the day.
Dr. Weitz: Hey, before we get into the specific biomarkers, have you heard of the telomere length test? This is a test that people have come up with to measure the end of the chromosome and this one test is designed to be a predictor of long term health. What do you think about that test?
Dr. Jaffe: I can tell you that my telomeres were shorter when I was fluffy. My telomeres have gotten much longer, which is better now that I’m more moderate in my habits. So yes, I think the telomere test, in general I do not recommend genetic tests. I can explain why Eric Lender and I agree. He’s a geneticist, I’m an an epigeneticist. However, I do think that telomere length is validated on every ethnic group, on every socioeconomic group. That’s what you need. You need a test that’s been around long enough that people who have skepticism about split sample precision, measuring telomeres is not easy. It has a variance. It has to be done right. So if someone is selling you a telomere test on the street corner, be skeptical. But it is the one test, ’cause I wanna get onto the eight that cover for epigenetics.
Dr. Weitz: Yes. I know.
Dr. Jaffe: It is the one test that I think you’re absolutely right. Telomere length correlates with your survivability. And it’s not that expensive. It won’t break the bank. But if it’s okay, let me list the eight predictive biomarkers.
Dr. Weitz: Yep, let’s do that.
Dr. Jaffe: And then we’ll come back and talk about what the best outcome value is. What is the goal value and what does it mean, in terms of ten year survival but also short-term quality of life.
Dr. Weitz: Sure. Sounds good.
Dr. Jaffe: The first is a very familiar test. Hemoglobin A1C. The second is a pretty familiar test. High-sensitivity C-reactive protein. HSCRP. The third test, familiar but you have to follow the rules on how to do it correctly. It is a plasma homocysteine. That’s not a political statement, that’s an amino acid. And there’s the ratio of methionine to homocysteine that predicts cardiovascular events and other potential catastrophes. The fourth test is the lymphocyte response assay. This is the cell culture to measure T and D cell function. Not the physical chemistry of an antibody because you can’t tell if it’s good or bad, but lending white cells called lymphocytes react ex-EVO just as they do in the body to tell us where you’re tolerant. Foods, chemicals, environmental substances. And where you’re intolerant, where you’ve broken tolerance. Where you have the body attacking itself, inducing repair deficit called inflammation. Inducing self-attack called autoimmune. The fifth test is a self-test. This is a urine test. After six hours of rest, and you can go to the bathroom, you just can’t go to the kitchen or the gym, but after six hours of rest, the fluid in the bladder has equilibrated with the lining cells, and it’s the one time of day when you get a meaningful pH that correlates with your magnesium at the cellular level. We’ll come back to that, so it’s first morning your own pH. And we’ll come back when I go through what the goal values are. That’s the fifth. The sixth is a vitamin D level. The country is low in vitamin D. That’s quote statistically normal. But it increases your risk of everything from pain to cancer, so we recommend having a healthier vitamin D level. And how much vitamin D should you take, well enough to get into the health to your range which I’m gonna give in just a minute after we get through the eight. Number seven is the Omega 3 index, this is Bill Harris’s test looking at the Omega 3 to 6 ratio. And the last is an unfamiliar one to most people but it’s the test of DNA oxidative damage, which by the way, correlates with telomeres. It’s called 8-oxoguanine. It’s a urine spot test and it rounds out, it adds the only other piece that wasn’t covering everything in your lifestyle.
So now, let’s go back through the eight, and I’m gonna give you the best outcome goal value and how we know that that’s true. So hemoglobin A1C should be less than five percent. I can tell you that mine was getting up into the high fives and that means pre-diabetic, that means fluffy, et cetera. It means insulin resistance, it means metabolic syndrome. And now I can tell you the last two tests I had, I have my tests done about every six months, was four point five percent. And what did I do, well I ate the foods that I could digest, assimilate and eliminate, and I stopped adding sugar. I’m sweet enough as I am and so are you. We don’t need to add sugar in our diet. And just to nail that point, the average American today eats as much sugar in a week as our great grandparents ate in a year. That is a metabolic formula for problems. So hemoglobin A1C, less than five percent, and every one of these tests as I said had been studied on every ethnic group, every socioeconomic group, every geographic area, and they are all caused morbidity mortality tests. That’s a very high bar standard. But-
Dr. Weitz: Now, why did you pick hemoglobin A1C versus fasting glucose or postprandial glucose or fasting insulin?
Dr. Jaffe: Right. Now, when we did our studies and we have successful published studies in type one diabetes and type two, starting from best standard of care, our approach, this comprehensive integrative approach, lowered their hemoglobin A1C by one percent which adds 20 quality years to life, and we measure the glucose and insulin. We measured the HOMA IR, the ratio, we measured the kinds of things you’re asking about. As you know, I was just at the Integrative Health Symposium in New York and was talking about this subject, and the American Diabetes Association was the other half of the hotel conference area and they now agree that we know about white coat hypertension but we need to remember about white coat hyperglycemia. Because just the stress of seeing a needle or going to a doctor causes an adrenaline release in most people, enough people that this is a known phenomenon, and so it turns out the fasting blood sugar overstates the issue of concern and is not predictive, is not anywhere near as predictive as hemoglobin A1C, because hemoglobin A1C, this is Paul Gallop from the 1960s, this has to do with how much extra sugar gets stuck onto proteins, including hemoglobin. And if you have healthy red cells that live three to four months and you’re a very calm person who meditates every day, and you’re well hydrated and so forth, well then you can measure glucose or insulin or the ratio. But, if you want the most predictive tests, the high-value tests, the one that isn’t all cost morbidity with very few quote pre and post-analytic complications, it’s hemoglobin A1C. Absolutely.
Now the second test, same parallel discussion, Paul Ridker and Nader Rifai noticed that C-reactive protein was an index of repair need or inflammation. And they noticed that at the low end was very important information, that the standard CRP was missing because it wasn’t very sensitive, in fact it was very variable, at the low end. So we want HsCRP, high sensitivity C-reactive protein. And the goal value is less than .5. And above that, you have repair deficit, known as inflammation, and I’ve seen numbers way above that indicating substantial and continuing, pervasive repair deficit where the quality of life goes down, and as my grandmother used to say the rents are going up and the ceilings are coming down. Now you want to take in enough polyphenolics and enough ascorbate based on your C-cleanse and enough of the essential B-complex and other nutrients, full B-complex, super B-complex, enough to keep your urine sunshine yellow. Most people have glass clear urine, indicating a deficit of B-vitamins. So HsCRP-
Dr. Weitz: That’s kind of interesting, ’cause everybody talks about, “oh you have expensive urine,” as though that’s a bad thing, and so what you’re suggesting is if you have clear urine, that’s a problem.
Dr. Jaffe: And I got to say that to Abe White, the man who was quoted as saying, “taking supplements makes expensive urine,” and I said, “Abe, does that mean that eating food makes expensive poop?” And he was a nice guy! He liked to be quotable. And he was. Anyway yes, the body gives us many opportunities to make simple self assessments or measurements, test measurements, compare them to the best outcome or known goal value, that is what healthy people have, because that optimizes your short and long-term survival. It’s only about quality of life and survival and I hope that’s of interest to everyone who’s listening.
Dr. Weitz: And just because you’re urinating out vitamin C, doesn’t mean that on its way through your body it’s not quenching free radicals and then taking those out of your body, so .
Dr. Jaffe: Or corrective, we have one little footnote, we had just one little footnote. You need to protect the kidney, the bladder and that whole genital urinary system by bathing it in ascorbate. So you need ascorbate in the urine. And some other time I’ll talk to you about how I came as a skeptic to ascorbate and how I met Linus Pauling and why I’m not a big advocate for the C-cleanse, the next generation after bowel tolerance, Bob Cathcart’s approach. So you very quickly ramp up and then flush out waste, water and toxins that get pumped by the rectum because remember that’s kind of like the kidney embryologically. Pumped by the rectum when you do a C-cleanse. And you might want to measure your transit time to see from consumption to elimination. It should be 12 to 18 hours. You can do it with charcoal capsules. Yes, you can do it with beets, you know when we have roast beets for dinner, and that’s the main course, I often see red in the commode in the morning but I’ll tell you after these years, first time I see red in the commode, my first thought is, “oh, I had beets last night.” Do it with charcoal. And we have this written up online, people can download it from Perque, p-e-r-q-u-e dot com. You can also get information about these tests from betterlabtestsnow.com, betterlabtestsnow.com. That’s all one website.
Dr. Weitz: Yeah.
Dr. Jaffe: That has information and will go into much more simple detail about why this can save your life or the lives of people you love.
Dr. Weitz: Okay.
Dr. Jaffe: So, gotten through most of them in terms of what their goal value is. With regard to the LRA test, the goal is to be tolerant. The goal is to have no delayed hypersensitivities. To have your innate immune system repairing you and defending you sufficiently that you don’t need to call in the reserve troops. So that’s the LRA test. Now, with regard to the first morning urine pH, so that we can measure the risk of magnesium deficit in the cells which everyone agrees is important but most physicians and scientists correctly for years have said we don’t have a simple way of measuring that, we don’t have an inexpensive way of measuring that. You can’t do arterial or venous pHs on everybody all the time, it’s just too cumbersome, too expensive and I think that’s probably true. But it turns out, Mother Nature almost always gives you a window of opportunity into some aspect, and in this case it’s your magnesium which is the alkaline element and mineral like potassium that is mostly inside the cell. And, if you’ve ever heard of ATP in the work molecule of the cell, you need one molecule of magnesium for every ATP molecule, otherwise the ATP just lays there. And the cell shifts from elective-protective mode which is what you want, ’cause it can repair you and defend you. It shifts from elective-protective to survival mode. It just hunkers down in its slightly acidotic state, protein synthesis is not very efficient, the cell energetically is depleted, the mitochondria cannot push more energy in because the so-called proton gradient. And that is complicated, they gave Mitchell the Nobel Prize for figuring out that you need magnesium so that the cytoplasm, the juice of the cell can accept the acid proton along with the ATP and then kick that acid proton out with the help of magnesium.
When you lack magnesium and or potassium then the cell becomes more acidic and small changes in pH have dramatic effects on the vitality, the functionality of the cell. So morning urine pH, 6.5 to 7.5 is the healthy range. Below that means acidosis, metabolic acidosis, cellular acidosis. It means functionally you need to increase magnesium. And we’ll come back if it’s okay to talk about, what are the first line comprehensive care approaches if you’re above the goal value for any of these tests. But we’re at the pH and the next one is vitamin D and the goal value is 50 to 80. Now, the vitamin D council has a slightly different range but almost the same. My colleague and other experts in vitamin D research, including my colleague Susan Brown, she and I have written articles about building new bone by having a healthy vitamin D level. 50 to 80 is the range. And that gives you some latitude, if you’re a little above that or a little below that it’s probably okay but 50 to 80 is the goal range for 25-hydroxy-D, that’s clearly the right analyte, that’s what you measure.
Dr. Weitz: Whereas most labs would say 30 or 32 put you in a normal range. We’re looking for the optimal range, not the normal range.
Dr. Jaffe: Yes, and one of the things I did when I was at the clinical center is I changed all the reports, ’cause we were using the term normal range, and I knew that was a mathematical term, that it was statistics that doctors, so it had to do with normality, like common parlance. Normal. So I changed the reports and they all said usual range ’cause that’s accurate. All over NIH doctors called up and said, “we don’t want the usual range, we want the normal range,” and so I had phone banks of people who just explained to the doctor, “it’s the same thing doctor, we want you to know that this is a statistical range. It has nothing to do with function, it has nothing to do with a healthy value.” So you’re right. America, probably the upper range for most labs is 30, some of that time….
Dr. Weitz: Wait, you were causing trouble back then, doc!
Dr. Jaffe: Yes, yes, yes. And again, it was out of a combination of skepticism but also, I went to people who knew a lot more than I did about these issues and I was just the messenger of the message but if you give me a message, my mother said, “stand on the street corner and sing! Get people to pay attention.” And fortunately, when you’re on the permanency of your staff of NIH you can get people to pay attention. So, very important point. You want the healthy value, not the quote normal statistical range. In fact there was an article not too long ago in the New York Times that said because it’s normal to have a low vitamin D, you shouldn’t even measure vitamin D and it’s normal to have a low vitamin D. And I did write a response, and if anyone wants you can see online why that makes you into a statistic and increases your risk of pain, it increases your risk of cancer. It turns out that vitamin D is really a neurohormone, we call it a vitamin but it’s really a neurohormone. And it has two arms, and what it does is one arm touches a cell over here, the other arm touches a cell over here and vitamin D says to them, “we have enough of you, I can reach across and touch, my two arms are now each touching a different cell. We have enough cells. Stop dividing.” That’s a neurohormone function. That’s a very important function. That’s an anti-cancer function. That’s a pain-relieving function. So vitamin D, very important, 50 to 80 is the goal value range.
Then omega 3 index. Bill Harris was sitting with my colleague Patty Deuster, who helped do that double bind study of the Perque Life Guard tabsule and he was complaining to her that there are too few people taking enough omega 3 to be in the healthy range, which is more than eight percent, and Patty, without missing a beat, just pointed at me, he took a lancet out, took a little spot of blood, analyzed it in his lab and sent back that mine was 13 percent. And I said, “well is that better than eight?” Sometimes you plateau at a certain value. He said, “oh no no no, 13 is definitely better than eight.” I said, “well next time someone is higher than 13 let me know.” And it turns out someone else, actually a relatively young person with attention deficit disorder and some special needs, had a mom that was just getting an awful lot of omega 3 and then when you asked her, she said, “because it helps him think, sleep and be kind.” And I thought that was a good reason to have, okay. So omega 3 index, more than eight percent. And what does that mean, it means reducing or eliminating edible oils. As a hint, we cook with wine, broth and a little juice from time to time, usually fresh made. And we don’t use edible oils. I think edible oils is kind of a term to make you think that it’s edible.
But it turns out that seeds and nuts protect the oil that’s inside with antioxidants and other protectors. And when you express the oil, air, oxygen begins to make it rancid. And what commercial companies do is they mask the rancidity in edible oils, and we don’t include those in our diets. Not even EVO, not even extra virgin olive oil. Talk to anyone who really knows EVO or has been to Tuscany as my family and I have at the time when you harvest the olives and you bring them to the Oleandro and at night they crush the olives and make this dark green, cloudy, delicious olive oil. So what we see as EVO on the market is something that were totally another commercial companies call EVO, but talk to any Italian who knows their oil and they’ll tell you that extra virgin olive oil is a kind of made-up situation, it’s like a fraud waiting to be exposed.
So, edible oils, take a pass. But cook with wine, with juice, cook with broth, cook with what nature provided great chefs the opportunity to concentrate flavor and nutrition. So that’s the value of more omega 3, less omega 6 and if you just reduce or eliminate edible oils, that’s most of the omega 6 and if you increase your omega 3, taking say Perque EPA/DHA Guard, to still under nitrogen because the fish are swimming in the ocean, and yes there’s red mercury and other shmootsy stuff in the raw oil but if you take the middle fraction, the pharmaceutical-grade EPA/DHA it’s near-pure EPA/DHA. Now, you have nature’s original omega 3, it turns out the precursor, there is an upstream molecule that most people cannot convert into the active EPA/DHA and while your brain has a lot of DHA, I say and I think most omega 3 researchers agree with me on this, you need DHA for brain and body, you need EPA for body and brain.
And don’t assume they inter-convert. Don’t assume that these very easily inhibited enzyme systems will be operating at peak capacity or efficiency. In fact, just take the distilled under nitrogen EPA/DHA, isolyzed in a soft gel because that gets the uptake, enhances the uptake and then chaperones the delivery to the cells who then use the EPA and DHA to build their membrane, to build their very fundamental structure. And about one third of the white matter of your brain is DHA. And a lot of people who get forgetful, and are diagnosed as having a neuropathy to be polite, or forgetfulness episodes or senior moments, they’re just deficient in DHA and I’ll bet they’re also deficient in EPA.
So that’s the importance of the omega 3 index test, and then we have the last, this is the urine test, the 8-oxo-guanine, that’s eight, dash, O-X-O, dash, G-U-A-N-I-N-E. See, I really am a biochemist. 8-oxo-guanine, it’s the measure of oxidative damage in your DNA, in the nucleus of your cell, including the DNA in the mitochondria and so it’s a very important test that’s been validated. It may be unfamiliar but it is just a non-invasive urine test and since you were good enough to raise the question of telomeres, I’ll mention again that a low 8-oxo-guanine correlates with longer telomeres. I can tell you from both personal and professional experience. And so we recommend at this point the 8-oxo-guanine. If a colleague wanted to do telomeres and omit 8-oxo-guanine I’m happy to consult with them and applaud. But the 8 that I’ve listed are what we published as the ones that cover epigenetics. It turns out that while the telomere test is one that I would support and encourage people to do, it’s just coming into its own. It’s not yet clear that it really has the ten year morbidity, mortality, all-cause kind of thing that the 8-oxo-guanine has. And so now, if you want to we can go back to the 8 and very briefly say what are the headlines, or what would you do if you were not at your goal value for hemoglobin A1C.
Dr. Weitz: Yeah, great. Let’s do that.
Dr. Jaffe: Okay. So I already gave you the headline which is, “You’re sweet enough as you are. Cut out added sugar.” Now that means cutting out almost all packaged and processed foods but that is helpful because they look like food and they have a long shelf life, that’s a hint. And I’m recommending that you eat whole foods, that you know everything that you’re eating, you know every ingredient on the package, if you buy anything with ingredients and we do occasionally, but I want to see whole ingredients. I’m very skeptical, having worked with the food industry at their request, I am very skeptical about these crisped, chipped, and extruded foods. They look like foods, they have calories but they usually have too much sodium, too little potassium. Too much calcium, too little magnesium. I could go on and on about why whole foods are made for people and, and here is to me the surprise and the pleasant surprise. Come into my kitchen, you will see lots of whole foods that are easy to make into really yummy things, and fairly quickly. So this notion of oh, fast foods are convenient. Well, fast foods feed diabetes and fluffiness and a sedentary lifestyle so I’m skeptical of fast food-
Dr. Weitz: And with avoiding the sugar I’m assuming that you want to stay away from high glycemic carbs in general, right?
Dr. Jaffe: That’s correct. Now, I’m a big fan of complex carbs and fiber. You need prebiotic fiber, 40 to 100 grams a day. You need probiotic organisms, 40 to 100 billion a day. Easy to remember. 40 to 100 grams of fiber, that means chewing your food, and 40 to 100 billion probiotic organisms but then there’s the symbiotic, recycled glutamine, what we call Perque Endura/PAK Guard, E-N-D-U-R-A, P-A-K. It recycles the glutamine ten times. It gives the energy to the lining cells of the intestine that use glutamine for energy. They need energy so fast they have to pull the amine off the glutamine creating a glutamate. With the help of PAK, you pick up the amine, transfer it back to the glutamate so you never build up glutamate, excito-neurotoxin, and now the cell can use the glutamine to extract the energy again. It’s a recycle ten times, so now one and a half grams on rising and before bed, because you want amino acids taken on an empty stomach. One and a half grams is equivalent of fifteen grams of free glutamine but now you keep the physiology, you don’t use it pharmacologically with the potential collateral adverse effects.
So a very important, simple message, that nature, nurture, and wholeness will bring you lifelong good health. Especially if you eat what you can digest, assimilate, and eliminate without any burden. And that would relate to the LRA test where your goal is to have no reactions, no intolerances. And I’ll give an example, a friend called me up and said that her friend, dear friend, had multiple sclerosis, was in a wheelchair. Multiple sclerosis is known as an autoimmune condition. She went through four six-month cycles and at the end of two years, she sent me a photograph of herself rock-climbing. Not only did her MS go into remission but she was able to physically get back to climb … She wasn’t going to climb Yosemite, but she was rock-climbing and enjoying her life.
Dr. Weitz: Right. That’s great.
Dr. Jaffe: Yes. And we see that all the time, we’ve got 80,000 cases in our database, we did the signs first before we came forward to talk the message, to carry the message. But at this point we’re very excited about the possibility of restoring tolerance in the immune system, and as a consequence, restoring digestive health, restoring the ability to repair on the inside so your innate immune system activates and does what it’s supposed to do, defends you and repairs you. And you can think of it this way. During the day, on the defense. At night, restorative sleep is the time when abnormal cells and things that are worn out need to get repaired. And if they don’t get repaired, you get inflammation. And if you get enough inflammation, you can have autoimmunity, self at that.
Dr. Weitz: So just to clarify, you’re talking about a food sensitivity test that tells you which foods that your body doesn’t digest and doesn’t process properly and so then you eliminate those foods for a period of time and …
Dr. Jaffe: Six months to restore digestive competence, metabolic detoxification abilities. It includes good hydration and you can do a self-test for hydration. It means improving your digestive competence and transit time. It means exactly what you said. Eating the foods you can digest. Assimilate and eliminate without immune burden or distraction.
Dr. Weitz: Okay, so now HSCRP is the next one, that’s a marker of inflammation.
Dr. Jaffe: Right, HSCRP is exactly right. It’s a marker of inflammation. Less than point five is the goal value which means your innate immune system is able to repair you. And your liver-
Dr. Weitz: And point five is kind of an extreme figure. A lot of labs
Dr. Jaffe: No.
Dr. Weitz: Say under three is normal. Most functional medicine practitioners say under one is the goal. Under point five is really pushing it.
Dr. Jaffe: With respect my friend, I’ve reviewed 300 scientific articles about HSCRP. I know who Ridker and Rifai are. He’s the editor-in-chief of Clinical Chemistry, that’s where you want to publish if you have something really worthwhile for clinical laboratorians like me. The literature’s very clear. Healthy people all over the globe, at any age, of any ethnicity, healthy people, there are not many of them, but the healthy people have less than point five. And I’m glad to tell you that mine has been less than point five for some time.
Dr. Weitz: Mine too.
Dr. Jaffe: Great! Now, with respect I understand statistics enough to know why some labs will say less than three is quote normal. Statistically normal. I’m sorry, I don’t take care of statistics. And I don’t even any more use statistics when there’s one individual sitting in front of me and I know the limitations of lab ranges. In fact, that individual may not be among the population where the range was standardized.
Dr. Weitz: Right. What’s the best way to lower CRP?
Dr. Jaffe: Yeah. Best way to lower CRP is to have enough of the good stuff and less of the bad stuff. So you might start with the self-test that I mentioned, including the urine pH. And take enough magnesium and choline citrate. ‘Cause only choline citrate uniquely enhances the uptake and chaperones the delivery of magnesium to the cell, correcting the metabolic acidosis and the metabolic syndrome, recharging the cell’s ATP, protecting essential fats in transit where magnesium functions as an antioxidant. And allowing the battery of the cell to recharge. And other things as well, including hundreds of enzyme catalysts that require magnesium to work, and if magnesium runs down, they’re pro-enzymes. They’re potential enzymes.
Dr. Weitz: But if we take supplements of choline won’t we have elevated TMAO levels which will increase our risk of heart disease?
Dr. Jaffe: Oh I’m so glad you asked. If you had a long transit time, which you won’t if you keep a C-cleanse and have enough prebiotic and probiotic fiber and good bugs. If you have a long transit time, and you have toxic metabolites, of quaternary amines, of all sorts in the colon, you too can produce TMAO. But I can tell you how to make it zero, how to make it go away, have a transit time of 12 to 18 hours, do a C-cleanse once a week and take three quarters of that amount on a daily basis to cover antioxidant needs because as you know, and I think people will be interested in this, ascorbate is the maternal antioxidant that protects and regenerates all the others.
So if you want glutathione, look at Alton Meister’s work. The best way to raise glutathione is to have enough ascorbate. But it must be the fully reduced, fully buffered L-ascorbate. 90 percent of what is sold as vitamin C or ascorbate acid or ascorbate is synthetic, half of it is D, if you take enough of it it’ll irritate the intestines, ’cause D-ascorbate isn’t taken up, believe me, I’m a biochemist. And the point is that when you respect nature and therefore use the fully buffered, fully reduced L-ascorbate, based on your individual oxidative burden or antioxidant need you have, as you correctly said, lots of systemic benefits and you now reduce the potential of the oxidation of the quaternary amine into the TMAO so you can make the TMAO you should go away. And if anyone is interested, I think there’s a Youtube video of me talking at length about the subject of why choline deficiency is a big problem in America. So get the choline, but it must be choline citrate, not choline bitartrate for a lot of reasons. Get the choline as the citrate and have a healthy transit time so you don’t have to be at all concerned about the TMAO. But I’m glad you asked about that because that is very, very important.
Dr. Weitz: Cool. So how do we lower homocysteine levels?
Dr. Jaffe: Right. Thank you. Homocysteine should be less than six. Now, very important that the plasma homocysteine be measured, not the serum. And very important that you process the specimen and the labs will tell you this within half an hour because once you draw the blood, homocysteine tends to leak out of cells into the plasma giving an artifactual elevation. So follow the instructions, measure the plasma homocysteine, you want it to be six, which is low. Most lab ranges go up above ten, which is well into the cardiovascular and stroke risk and heart attack risk, autoimmune risk zone.
Dr. Weitz: A lot of labs say over 12 is abnormal?
Dr. Jaffe: Okay.
Dr. Weitz: Yeah.
Dr. Jaffe: Okay. Kilmer McCully, the man who wrote the Homocysteine Miracle with his daughter, the man who put homocysteine on the map in the 1960s. What he pointed out is that really it’s the ratio of methionine to homocysteine and you want the methionine to be up and the homocysteine to be down. And why do you want that, well because this is what regulates methylation. Now we’re not gonna get into the details, but trust me, methylation is very important. More important in regard to translating the DNA through the RNA to the products, the proteins and the glycoproteins and the lycoproteins that need to get made. So very important. We want the methionine to be up, you want the homocysteine to be down. And there’s lots of literature that less than six is clearly the healthy range for healthy people. Again, all over the planet. Every ethnic group, all-cause morbidity and mortality measure. Just get an accurate homocysteine.
Dr. Weitz: And so we lower it by taking methyl-B vitamins, B6, B12, folic acid and …
Dr. Jaffe: Well yes, we start with enough of super B complex and full mineral complex such as the Perque Life Guard tabsule to keep your urine sunshine yellow, so now you got enough B-complex. Then, in order to get the homocysteine down you wanna have a lot of sulfur foods that are nature’s detoxifying foods. This is GGOBE, that’s the acronym for those who like little memory hooks. GGOBE stands for garlic, ginger, onions, brassica sprouts, that’s broccoli sprouts. Now all sprouts are good but broccoli sprouts are particularly good. And eggs. And I can tell you in my home, we have goose eggs, we have duck eggs, we have quail eggs when they’re available. We’re skeptical of chicken eggs. If they’re biodynamic chickens, if I know the chicken then I would have a chicken egg. But I can tell you they’ve done terrible things to chickens and to chicken meat and be careful.
The healthier the food, the healthier the fuel of your body. The more caring you are of your body. And therefore, we can be even more friendly with each other because this is information we had to uncover, recover, validate. It took years to find the eight and cover all about your genetics. And I’m glad to tell folks what the healthy people’s value or range is. So now we’ve covered hemoglobin A1C, HSCRP, homocysteine and LRA, now let’s move onto urine pH. Six and a half to seven and a half is the goal range, and you take two or more doses of Perque Mag Plus Guard and Perque Choline Citrate. Two capsules and a teaspoon. The teaspoon goes into the liquid or water of your choice. You can put vitamin C in there if you want, you can put most anything else in there if you want because the choline citrate is going to marry up with the magnesium and form little inverted micellar nanodroplets, (I really am a biochemist), and we have the global patents on enhanced uptake and chaperoned delivery of magnesium to the cells that are hungry for them.
Dr. Weitz: What about taking baking soda?
Dr. Jaffe: Right. Can we fool the body by taking baking soda? No. Any time you try to fool the body you’ll end up fooling yourself. The body has a very elegant control of bicarbonate and CO2 called the carbonic anhydrase system. Those of you who are technical will have heard of it. But for everyone’s knowledge, if you take bicarbonate by mouth, you reduce stomach acid which impairs the uptake of minerals and B vitamins. You decrease the quality of digestion because the stomach should be very acidic. It should have a pH very low, like 2 or below so that the acid product of the stomach stimulates the bicarbonate and digestive enzymes from the pancreas. So there’s lots of reasons why you don’t want to swallow bicarbonate to try and alkalinize yourself. I know that people use, there are tri salts out there they’re trying to use instead of sodium bicarbonate, they use potassium and other salt bicarbonate. But bicarbonate, it impairs digestion and it doesn’t do the job.
Dr. Weitz: Okay.
Dr. Jaffe: You want minerals to alkalinize you, you want short and medium chain fatty acids like butyrates that you’d find in ghee, clarified butter and other natural foods. And, let’s see, the third alkalinizing element I should remember, and when I do I’ll bring it up but anyway, you want to alkalinize or, well Shelley Rogers wrote a book called …
Dr. Weitz: Green vegetables, right?
Dr. Jaffe: Yes, yes. Fruits and vegetables, whole foods will alkalinize you. Then eat the foods that you can digest to assimilate and eliminate without any immune burden.
Dr. Weitz: Okay. I have to rush you along ’cause we only have a few minutes minutes here. So we got vitamin D, omega 3 and oxidative stress.
Dr. Jaffe: Let me combine them all because what you’re hearing and what our message, our takeaway message, our cold action message. If your body is efficient, everything locks together and it works really well and now you’re in the moment to thrive, not just survive. You wanna be in elective-protective, not survival. Now the last three tests all have to do with either lipids, fat, and you want to increase the good fat. The deep water oily fish, have fish. Maybe the collar of the fish if you can get it ’cause that’s really oil. But the eye of the fish should be clear when you get the fish. If it’s been frozen and the eye is now cloudy like it has a cataract, uh, I’m not so sure that’s still a healthy fish. And when we go to the market to buy a whole fish to poach in our fish poacher in our nice little kitchen, there’s only, usually there’s only one or two. And the people behind the counter know the never-frozen, clear-eyed fish. So the last three tests have to do with optimizing your diet and attitude and lifestyle.
So we’ve talked about the eat and drink part. Be well hydrated. I do like wine, that’s an option. Do not take a lot of juice because the fiber goes away when you make the fruit juice. But have a lot of fruit which has pectin and fiber, and now you get your 40 to 100 grams of fiber, turn into 100 billion fermented organisms. How about like kimchi, you get that in many ethnic markets. Any fermented food. How about a pickle, it’s such a delicious dill pickle but it’s gotta be a live pickle. If it’s been pasteurized or simonized it’s no longer a pickle. So the takeaway message is, have these eight predictive biomarkers done through your office or through Better Lab Tests Now or through Perque Integrative Health or ELISA/ACT.com or DrRussellJaffe.com. There are many ways of finding our work and we’re grateful for the opportunity to serve and especially to be with a colleague like you today. So thank you.
Dr. Weitz: Excellent. Thank you so much, Dr. Jaffee. And you’ve given us your contact information and so-
Dr. Jaffe: If I could give a toll-free number I’ll do that too.
Dr. Weitz: Oh sure, absolutely. Go ahead. Yep.
Dr. Jaffe: Please call now, or soon. You have two. 1-800-525-7372 or 1-800-553-5472. 1-800-553-5472. And those-
Dr. Weitz: Alright, are those the numbers for your office or your lab, or your-
Dr. Jaffe: That’s for the lab. That’s the for the lab and for Perque Integrative Health.
Dr. Weitz: Okay.
Dr. Jaffe: For full disclosure, I’ve had the privilege of teaching and doing research but I do not have a private practice. We have a referral network of doctors who are certified in the Well Guard Program through the Health Studies Collegium and that keeps me off the streets and out of trouble.
Dr. Weitz: Excellent. Thank you so much. Talk to you-
Dr. Jaffe: Thank you. Thank you, Doctor.
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