Inflammaging with James LaValle: Rational Wellness Podcast 187

Weitz Sports Chiropractic and Nutrition
Weitz Sports Chiropractic and Nutrition
Inflammaging with James LaValle: Rational Wellness Podcast 187

James LaValle speaks about Inflammaging with Dr. Ben Weitz.

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Podcast Highlights

5:10  Inflammaging is related to metaflammation or metabolic inflammation. To understand metaflammation we have to look at various systems in our body ask if our nervous and immune systems are in balance?  Is that in balance with our hormonal system?  We do this by taking a systems or network biology approach to understanding our health.  Are we absorbing things correctly?  What’s going on with our detoxification system?  Is our stress load too high?  Are we sleeping well?  Are we well hydrated?  And we need to consider all the toxins we get exposed to, such as atrazine, which is the most used pesticide in the United States and extremely prevalent in California.  Many things can put us into a state of chronic inflammation.  We are supposed to have short spurts of inflammation but the problem is when inflammation is not turned off.  This can happen just by overtraining. 

9:29  One of the things that may start to happen is that ferritin, the storage form of iron, becomes low, even though their serum iron is normal, and we lose our ability to make EPO and new red blood cells.  Patients with low ferritin are more prone to anxiety and arrhythmias and fatigue and headaches.  And their thyroid receptors can’t function right because you need ferritin to allow your thyroid hormone to penetrate the cell.  But these patients don’t need more iron.  We need to figure our why they are metabolically inflammed and correct that. On the other hand, elevated ferritin can be a sign of inflammation as well.  If we stay chronically inflammed, we will be more likely to develop plaque in our arteries, lose bone, lose muscle, become insulin resistant, and lose the neuroplasticity in your brain. If you are insulin resistant you tend to make too much ferritin.

12:25   The other factor are your lipids and when you are metabolically inflammed, you end up making more bad actor lipids, like apolipoprotein B and Lp(a).  By the way, did you know that when you are diabetic, have Lp(a) that’s too low, that is associated with more progressive damage.  Also, if there is elevated oxidized LDL, this also indicates increased inflammation.

17:27  People eat too much, they eat too often, and they eat too late. They pick the wrong foods. They don’t get enough sleep, which triggers inflammasomes in their body. When we eat too much, eat too late and eat too often we turn off autophagy. Autophagy is when you bring out the vacuum cleaner to clean out the waste products of your metabolism.  Without it they get lymphatically stagnant and they don’t clean out waste proteins.  A virus can trigger the NLRP3 inflammasome and if this is uncontrolled–if it is not balanced by NLRP6, it can lead to a cytokine storm.  This is because we are so unhealthy. 80% of our population is overweight, 42% is obese, and 50% is pre-diabetic or diabetic.

24:28  James pointed to his I watch and said that this tells me that I have to breathe, which ridiculous that we need a device to remind us to breathe.  He pointed that it is important that his clients breathe deeply, so he teaches them box breathing, so they can breathe deeply for 2 to 3 minutes.  This helps put them into parasympathetic mode. If your resting heart rate is above 62, you are sympathetic dominant.




James LaValle is an internationally recognized clinical pharmacist, board certified clinical nutritionist and the author of more than 20 books including, “Cracking the Metabolic Code.”  He lectures around the world, when we did have meetings before COVID-19, including for the American Academy of Anti-Aging Medicine and for the George Washington University Masters of Integrative Medicine program.   

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, 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 go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness podcast for weekly updates and to learn more, check out my website, DrWeitz.com. Thanks for joining me and let’s jump into the podcast.  Hello, Rational Wellness podcasters. Thank you for joining me again.

Dr. Ben Weitz here and we’re here today with James LaValle and we’ll be talking about a topic called inflammaging. James LaValle will explain how chronic inflammation contributes to chronic disease and accelerated biological aging. And of course, all of us want to slow down our biological aging so that we can have a low biological age in a old chronological age.  And so this topic is inflammaging. So what happens is that excess inflammation plays a role in many of the most common chronic diseases, including heart disease, diabetes, neurodegenerative diseases, chronic kidney disease, and even cancer. And among the causes for inflammation, of which there are many, include stress, blood sugar imbalances, obesity, gut dysbiosis, chronic infections, periodontal disease, diet, poor sleep, toxins, and many of the topics we regularly talk about in the functional medicine world.

                                                James LaValle is an internationally recognized clinical pharmacist, board-certified clinical nutritionist and the author of more than 20 books. How do you write so many books, James? Including Cracking the Metabolic Code. He lectures around the world, or at least he did when we used to have meetings, including for the American Academy of Anti-Aging Medicine and for the George Washington University Master’s of Integrative Medicine program. Thank you so much for joining me today, Jim.

James LaValle:                    Oh, it’s great to be here, and I got two more books coming this year, man.

Dr. Weitz:                            Is that right?

James LaValle:                    I’m churning and burning, buddy.

Dr. Weitz:                            Wow!

James LaValle:                    It’s….

Dr. Weitz:                            What two books do you have coming out?

James LaValle:                    I’ve got Metabolic Code 2.0, which is kind of the updated version of Metabolic Code, which kind of goes through metaflammation, how do we get there, how do we look at it? And then I did a book on biomarkers in sports performance to really … I work a lot with athletes and I think there’s still just such this ignorance of where the biomechanics and biochemistry need to intersect in order to really have a healthy person who’s training. And it doesn’t matter whether you’re an amateur athlete or a pro athlete. You can start an inflammation cascade with an injury or you can get injured because you got inflammation chemistry in your body.

Dr. Weitz:                            Right.

James LaValle:                    I don’t think people have quite got that yet. So I’m really excited about that book.

Dr. Weitz:                            I think that’s great. That’s a book that’s definitely sorely needed because I’ve done some work with some professional sprinters and some other athletes and trying to put together which things are best to track is a bit of a challenge right now, so giving us some guidance on that would be helpful.

James LaValle:                    Yeah. No, it’s exciting and the world’s changed. I think we’ve got some really good awareness now of what chronic inflammation is and I don’t want to get into too heavy of a discussion but I do want people to understand that we’re all moving towards inflammation as we age. That’s what happens. Our immune system kind of starts to decompensate. As we age, things don’t work as well. Just like you said, we want our chronologic age really up there and our biologic age really back here. And when we don’t really take care of ourselves the way we need to or become aware of what’s going on with our chemistry, things slip away, people start developing chronic illnesses. 

Dr. Weitz:                            Yeah. Actually, I think the last week of political-flammation and obsessive screen-watching and-

James LaValle:                    Oh my God.

Dr. Weitz:                            … lack of sleep is probably contributing to the–we’ll add that–political-flammation.

James LaValle:                    Yeah, and you know what? I think that may be number one. I don’t want people coming in here that are just … they’re beside themselves. Just try and tell them, “Take a deep breath.” I turned 60 this year, right? And so I’ve seen a lot in my 60 years. Politics never ceases to amaze me. I’ll just put it that. It’s something else.

Dr. Weitz:                            So outside of politics, what are the biggest contributors to inflammaging and what is inflammaging?

James LaValle:                    Yeah, it’s a great question so we can set up what we’re going to talk about. There’s a process called metaflammation. Metabolic inflammation. We used to hear a term “metabolic” and you’d think, “Oh, I burn calories or I don’t.” And this is what I wrote about when I wrote the Metabolic Code book and obviously, what I teach about is systems biology or network biology thinking, which is, you have to look at the relationships in your body and understand, is my nervous system and immune system in balance? Is that in balance with my hormonal system? Am I absorbing things correctly? What’s going on with my detoxification pathways? What’s my stress load like?  Am I sleeping?  What’s my hydration like?  All of these facets. What I get exposed to. I mean, if you’re living in California, atrazine, a major pesticide.  We spray more atrazine in the state of California than I think the next three states combined. It’s crazy.

Dr. Weitz:                            And it’s interesting. Everybody talks about glyphosate, but atrazine doesn’t seem to come up as much.

James LaValle:                    Yeah, I know and atrazine’s number one. It’s the big one. It’s making all those tadpoles deformed. And humans, by the way. So there’s issues with it. So my point is that everything that’s going on with you right now. If you’re listening, where you are right now with your metabolism is really the sum total of everything that’s gone on since the time you’re in your mother’s womb to today. Exposures, emotional stress, physical stress, impact of diet, all of these things. Environmental burden. All of these things are flying at this high level in our body and they’re all trying to keep us sound. You know, just able to age gracefully.  But the problem is that as we start to get into … I get an infection, I’m on a lot of antibiotics, maybe I start to develop dysbiosis from candida. Maybe my diet’s skewed. Maybe I’m a big ketogenic dieter and I don’t take in any fiber and maybe I’m starting to make more endotoxin. What happens is, we start to push our body towards triggering a neuroinflammatory response, meaning we get sympathetic dominant, so as your blood sugars go up, you make more adrenaline. And at the same time, you start to release more inflammatory cytokines.  Inflammatory cytokines are basically the signals that tell your body, “Hey, we got to fight a good fight.” Your body’s supposed to turn those off, right? You know. You treat patients every day. An appropriate inflammation response should stop and a person resets back to normal, and the problem that we have is that when people stay in a chronically inflamed state … Now, that can happen just by over-training.  You can be perfectly healthy and train too much and put yourself in a chronically inflamed state.

Dr. Weitz:                            Right, and we need to make clear here, I think that there’s a tendency for us to say, “Inflammation’s bad.” And we need to understand that inflammation is how the body heals. When you have damaged tissue, the body sends-

James LaValle:                    Exactly.

Dr. Weitz:                            … the inflammatory cells, and that’s part of the healing process. Inflammation is how we fight infections. So short-term fluctuations of inflammation are super-important for our health. It’s just that when those short-term inflammatory states become chronic that it really becomes a problem, right?

James LaValle:                    And that’s the issue, is that when you don’t turn the inflammation off, when your body doesn’t have the reserve … I like to use terms like “metabolic reserve” and “resiliency” and “durability.” When your body’s losing its durability, when it’s losing its capacity to turn the inflammation off and say, “Okay, back to normal, back to homeostasis” there’s a bunch of things that start to happen.  And so one of the things that starts to happen, and I’m seeing this a lot and I bet you are too, is we see disturbances in iron absorption and metabolism. So people have really low ferritin. They don’t store their iron any more so their reserve for iron is low. But yet their iron store itself is okay. And that’s a sign that you’re metabolically inflamed. Inflammatory compounds turn off your ability to store ferritin and make EPO, erythropoietin, so you can make new red blood cells. A lot of people don’t look at it that way but I see it in lab tests. Every day, I see it in lab tests.

Dr. Weitz:                            I see that too and that’s kind of interesting, especially because we also think of ferritin as an inflammatory factor.

James LaValle:                    Right.

Dr. Weitz:                            Elevated ferritin being an indication of inflammation.

James LaValle:                    Yeah, and it is, right? So once again, if your ferritin’s really low, you’re more prone for anxiety and arrhythmias and fatigue and headaches. And your thyroid receptor can’t function right because you need ferritin to allow your thyroid hormone to penetrate the cell. But when it’s high, it’s toxic. So that happens a lot in insulin resistance. People that are insulin resistant, they make a ton of ferritin. Or if you’ve got hemochromatosis, but metabolically, when I’m insulin resistant, I make too much ferritin. When I’m chronically inflamed, I can have high iron and low ferritin and therefore have the signs or the feeling of being anemic.

Dr. Weitz:                            And when you see that adding more iron’s not helpful, the key is trying to conquer the inflammation.

James LaValle:                    That’s exactly right. So it’s understanding what’s going on. Now, the next thing that happens is that you lose bone. So when people are under metaflammation … because remember, inflammaging is … Well, what’s inflammaging? Okay, I develop heart disease, plaque in my arteries triggered by inflammation. I lose bone. You get osteopenia. I lose muscle. Sarcopenia. So the “inflammaging” term, it’s really accurate because all this inflammation that’s being driven by your metabolism is what’s driving those chronic illnesses.  So we have bone loss and then the insulin receptors don’t function appropriately any more. So all of a sudden, you have a disorder in your iron metabolism. You start to lose bone. You start to become insulin resistant, which is one of the worst things that can happen to your aging process, is if you’re insulin resistant. You start to lose your neuroplasticity in your brain. Your neurons don’t communicate under chronically inflamed states.

                                                And the other one that’s really easy to see action steps … everybody says, “Oh, your lipids don’t matter. Your lipids don’t matter.” Turns out that when you’re metabolically inflamed, you end up making more bad-actor lipids. So if you look at Sinatra and Bowden’s new book, they’re talking about apolipoprotein B and oxidized LDL and all these kind of hidden markers. Well, yeah, those hidden markers? Those are the things that are showing you that you’re chronically inflamed, so if you’re oxidizing your LDL cholesterol, you got a problem with inflammation.

Dr. Weitz:                            And that’s oxidation as well.

James LaValle:                    Absolutely, you’re getting your redox potential is destroyed, right?

Dr. Weitz:                            Yeah.

James LaValle:                    And so the point being is, people, they look at their lipid panel. Lipid panel, LDL, HDL, trigylcerides and most of the time, even that’s messed up. Their trigylcerides are too high, their HDLs are too low. Their LDLs are really high. But even if they’re not, you really have to look at-

Dr. Weitz:                            Doesn’t it drive you crazy when the patients come in and say, “Look, I had all my labs done.” And it’s like, “No, you had five done because that’s all your insurance company wanted to pay for.”

James LaValle:                    Exactly, exactly, and so what we run … advanced lipid panels on everybody. I want to know if they’re making those little bad-actor lipids, like apolipoprotein B. Interesting. Everybody hears about lipoprotein little A, and Lp(a) in a non-diabetic population, when it’s high, it shows excessive inflammation. Once again, it’s what’s interesting about labs. In a diabetic population, the lower the Lp(a), the more progressive the damage.

Dr. Weitz:                            The Lp little A?

James LaValle:                    Yes.

Dr. Weitz:                            You’re saying if that goes lower-

James LaValle:                    In a diabetic.

Dr. Weitz:                            Interesting.

James LaValle:                    That’s a big, big study that just came out. Literally, that rocked me too because I was-

Dr. Weitz:                            Really?

James LaValle:                    … all about the high Lp(a), high Lp(a).

Dr. Weitz:                            Yeah, can you send me a copy of that? Because I had a pretty detailed discussion with Dr. James Khan about Lp little A. He wrote a book about it and that’s a new concept.

James LaValle:                    Oh, I can send you that. It’s on over 10,000 diabetics’ tracked.

Dr. Weitz:                            Really?

James LaValle:                    Yeah. It’s pretty compelling data. I’m in a lab [crosstalk 00:14:51].

Dr. Weitz:                            So how low does the Lp little A go? Normal is under 40 or 30 or something.

James LaValle:                    Yeah, so the lower it goes, like in the 20s, the more you see problems with a diabetic.

Dr. Weitz:                            Interesting.

James LaValle:                    In their vascular network. Yeah. And I’m a lifelong student of biomarker trends. That’s why I wrote the book Blood Never Lies, was because we need to look at trends. And so it never ceases to amaze me how we see these issues like, “Really low ferritin, bad, really high ferritin, bad.” Lp(a) in populations that are non-diabetic, when it’s high, it’s bad and then when it’s low, it’s bad in diabetic populations. So I think it’s important because when you look at metabolic inflammation. The end game, when we cut right to the chase, you get mitochondrial destruction and then you get dedifferentiation of cells.  So what does that mean? It means that you’re going to be in a degenerative process and whether that’s a degenerative process that leads you towards heart disease, an autoimmune disorder or cancer, as soon as you start to uncouple mitochondrial capacity in your cell, that’s where the trouble hits, and that’s what happens when your metabolically inflamed. And I’m sure we’re going to talk about, well, what do you do about it? But that’s the essence of it, is, we’re on this path as we’re aging. You got to rage against the night, man. You got to rage against that inflammation.

                                                You got to really work it. Every day, I’m learning something different about what I can do to help people turn back that inflammatory signaling. And here’s the bottom line: why’s it important? I can hear metaflammation, inflammaging, mitochondrial, neurogenesis, big words. Bottom line is, when you turn inflammation back, people feel better. Your hips don’t hurt. They don’t have colitis any more. Their brain’s clearer. Their fatigue lifts.   These are big things. For me, when I’m working with people, I’m wanting to know how, do I change their life?  I can change their Lp(a). I can change their Lp little A and they’d probably look at me and go, “Oh, wow, that’s really cool.” A little more than me. But if I get them to poop better and they feel less stressed and they sleep better and their hips don’t ache any more, they’re going, “Yeah, man, you are the man.” And that’s why I try to always buffer highly complex metabolic discussions …

                                                Look, we haven’t even talked about the fact that people eat too much, they eat too often, they eat too late. They pick the wrong foods. They don’t get enough sleep, which triggers inflammasomes in their body. They’re going to have inflammasomes that, once again, some inflammasomes are good, some inflammasomes, when they’re being released too frequently, are not so good. But when we do that, by default, just the fact that we eat too much, we eat too often, we eat too late, we’re turning off autophagy.   So autophagy, I’m bringing the vacuum cleaner out and cleaning up the waste products of my metabolism. Now my lymph is congested. Why do I have this lymphadenopathy? Why is my lymph congested? Why am I a puffy sponge? Because I ask people that all the time. “Do you feel like a sponge? Do you feel puffy?” “Uh, how’d you know?” You know what I mean? And it’s because they’re lymphatically stagnant. They’re never giving their body an opportunity to clean out waste proteins, nor do a metabolic reset on their inflammatory activity that’s dictated by what’s called inflammasomes.

Dr. Weitz:                            So why don’t you explain? What’s an inflammasome?

James LaValle:                    So inflammasomes are basically another immune defense. Say you get a bug. I just got a flu bug. You will have inflammasomes release, which is good. They release to say, “Uh oh, there is foreign body in you and we need to attack that thing.” And so they tag it. So the inflammasome’s sitting there going like a paintball gun. Boom! Attack. The problem is when they start to attack our normal tissues and we trigger inflammation. So their paintballing everybody, right?

Dr. Weitz:                            Right.  Or when a virus triggers the NLRP3 inflammasome, right?

James LaValle:                    Right, and if you don’t have enough … and here’s the interesting thing.  When you do NLRP3, there’s … when it’s unrestricted, it creates a cytokine storm.  So you make all these cytokines, just like what happened with COVID and even in other viruses.  We’ve seen it in other things.

Dr. Weitz:                            Exactly. Right, right, right.

James LaValle:                    But you’re supposed to have NLRP6, which is a countermeasure to that that says, “Hey, you know what? It’s not that bad.” But what happens is that if our liver’s congested, if our gut has dysbiosis, we down regulate our counter-regulation of inflammasomes that are helping to kind of balance out that response to a vector. And that’s why we got into trouble … Everybody’s talking about COVID, but it’s just a perfect example of people that have fatty liver, people that have … or diabetic or pre-diabetic, so they’re not efficient at detoxification. People with heart disease. It’s one of the reasons why this inflammatory storm took place, is they didn’t have all their soldiers in line.  What I’ve been really trying to do is get out there and talk to people about, “Hey, you’ve got to start take care of your immune system. You’ve got to take care of your nervous system because they’re driving the bus. They’re sending all the signals that tell you, ‘Are you going to defend appropriately?'” Not just for COVID. Let’s face it; it’s everything.

Dr. Weitz:                            You know what?  I know everybody’s been talking about COVID, but really, the message you still don’t hear very much is the message you just expressed, and the best thing that could come out of this COVID crisis is if we understand that the fact that our society is so obese, has such high rates of blood sugar disregulation, diabetes, all these chronic diseases, from out of balance immune system, et cetera, et cetera from eating a horrible standard American diet, not exercising, et cetera, et cetera. And realize that if we turned around our health, we would be much more resilient and able to deal with viruses like COVID-19 or coronavirus.

James LaValle:                    And just live a healthier life, right?

Dr. Weitz:                            Right.

James LaValle:                    Enjoy your life, because I think one of the biggest issues we see is, look, 80% of our population’s overweight. We got 42% of our population’s obese, 50% of the US population is pre-diabetic or diabetic.

Dr. Weitz:                            Seventy percent are overweight, I think.

James LaValle:                    It’s up now. It’s up to 80.

Dr. Weitz:                            Eighty? Wow.

James LaValle:                    It went up.

Dr. Weitz:                            Eighty percent are overweight? Wow.

James LaValle:                    Yeah, yeah, it’s 80%.

Dr. Weitz:                            Wow.

James LaValle:                    Yeah, I wish it was better, but it’s not. We are the statistic breakers. We better go get some chicken wings, some nachos, some chili cheese fries and a thing of sour gummies right now. We got to get caught up. It’s a problem. Look, my brother was a-

Dr. Weitz:                            Yeah, and take your gummy vitamin with it because that’ll balance the whole thing out.

James LaValle:                    Oh yeah, those are so good. They’re really good for you, those gummies.  My brother was a 476-pound man.

Dr. Weitz:                            Wow.  And you say “he was.”

James LaValle:                    He was obese. He was obese. He was big. He was big. He was just a big mountain of a man, but he was obese. And God rest his soul, he passed away at the age of 62 and didn’t want to listen to younger brother too much.  He tried.  He tried hard but it was just difficult.  He had a lot of things that were in his way. And I think for a lot of people, they don’t realize that there’s a way out, but the way out involves work. There isn’t going to be a pill that gets invented that fixes the situation we’re in.  Yes, you can manage symptoms.  Obviously, I’m a clinical pharmacist.  I understand drug therapy really well and that’s why I try to avoid it with people as much as possible.  Use it when you need it but when you don’t need it, try to change your lifestyle, try to take some nutrients, try to manage your stress.  In general, I find that these are the big things that people miss out on, is … On the standpoint of getting people to walk, I’d love people to walk an hour a day. I start them on 10 minutes. Can you walk? Okay, cool. Can you get in a pool? Okay, cool. Can you do something for 10 minutes? Can you just stand up?  It’s pretty sad, honestly. 

Dr. Weitz:                            Yeah, before I started my chiropractic career, I worked at a health club and we used to do sales and we always had the magic pill close that we would occasionally use and that was, “Wouldn’t it be great if there was a magic pill that you could lose weight and get in great shape?  Well, there’s not, so sign here.”

James LaValle:                    Exactly!  It’s kind of crazy when you think about it.  Once again, I kind of grew up in that space a little bit too and this has to tell me to breathe.  I’m like, “What’s up with that? Really?”  I can’t tell you how many times, when I talk to people, I teach them box breathing, just simple, because they’re not going to meditate for 30 minutes.  Everybody’s in a rush, but if I could get them to breathe deeply two three minutes.  So you wanted to know.  Let’s get some usable stuff here.    Number one, you got to breathe deep. When you don’t breathe deep, you shut your parasympathetic nervous system down, you don’t oxygenate your tissues, you make more lactate in your blood and that means you’re going to be more prone for anxiety, you’re not going to oxygenate all your tissues. And then you’re going to end up staying pretty anxious. When your diaphragm gets stuck and you don’t breathe deep, it’s not good.  So box breathing.  Box breathing a couple times.   Look, you could take … Who is it? Ben … It’s another Ben.  He’s got a great breathing course.  I’ll have to think about who that is.  But he just posted it.  I’m not a big advocate of the Wim Hof stuff, where you breathe till you pass out, to be honest.  I just think that you might hit your head or something. I don’t know.  But for the average, everyday … and I’m kind of tongue and cheek. I’m kidding, but-

Dr. Weitz:                            Yeah. No, I know what you’re saying.

James LaValle:                    But not. But the point is, for the everyday person, they don’t even have a normal respiratory quotient, and that-

Dr. Weitz:                            No, and they’re breathing through their mouth, not their nose and they’re not breathing deep and they’re …

James LaValle:                    Right. So that’s big. That can help your immune system, and it helps you to restore balance in your nervous system because the number one thing that will take you to metaflammation … My opinion. Not an external toxin. It’s obvious that mercury and lead and cadmium and atrazine and glyphosate and any kind of number of things you get exposed to is going to pump you towards inflammation because it’s shutting down enzyme systems in your body that then cause a countermeasure of inflammatory saline. That’s one thing. But to me … Uh oh, what did I do? There we go. See that? You see how I kind of zapped out there? I went and did my deep breathing.  

Dr. Weitz:                            There you go.

James LaValle:                    I kind of zapped out. I was was actually on a break. You didn’t even realize it. So the biggest thing, it’s stress response, man. I look at blood pressures and heart rates on everybody. So point number two … Breathe deep is one. Point number two, look at your resting heart rate. If your resting heart rate is above 62, you are sympathetic dominant, period. It’s that simple.

Dr. Weitz:                            Yeah, unfortunately, that’s a lot of patients I see in my office.

James LaValle:                    It’s so many people. They don’t understand it. Like, wait a second. I’m going to see if I’m a good citizen. Let me see. Where am I at? It’s going to be scary. Uh oh. Fifty-five beats per minute, baby. And that’s when I’m excited right now, you know?

Dr. Weitz:                            Yeah. No, my resting heart rate is about 50 and I had surgery in August and every time my heart rate went below 50, it started beeping and they were freaking out because that’s considered so rare.

James LaValle:                    You’re an athlete! You’re an athlete! But my point is, for everybody out there, if you are measuring your heart rate and say you got a heart rate of 70 and a blood pressure of 132 over 88, those are very early signs that you’re pumping out too much adrenaline, too much noradrenaline, so epinephrine, norepinephrine, your blood vessels are compressing. You’re going to end up with … typically, the number one type of hypertension is renal hypertension. You lose blood flow to your kidneys, which is going to cause damage to your kidneys and lead to chronic kidney disease, of course, and that’s why people with diabetes end up with chronic kidney disease, because they pump out so much adrenaline and noradrenaline in their blood vessels.   So watch your heart rate, watch your blood pressure. And then, okay, I’m breathing shallow, my blood pressure’s up, my heart rate’s up. What am I going to do about that? Before we take a single pill, I got all kinds of supplements I can talk to you about. All kinds of ingredients, man, but you got to get this stuff down. I need you to walk a little bit. You don’t have to tear it up. You don’t have to carry your crossfit dumbbell while you’re walking on down the street. It’s okay. You can just walk. It’s okay.

                                                Everybody has this all-or-nothing thing these days where it’s like, “Hey, if I’m not doing HIIT training, I’m not really doing a good job.” And I’ll tell you what, I’ve been pulling people back from their intense exercise, because remember, I got a lot of population of non-athletes. Not athletes. They should be doing undulating periodicity, meaning alternating their tension, their intensity, their duration, their type of training. All that stuff should be being done for them anyway.   But for us everyday people out there, you know what? Just start with walking briskly. If you can walk, if you’re not in pain, you can’t walk, then we got to figure something else out for you. Because I have a lot of people that are just flat-out over-trained and they can’t figure out why they’re not losing weight and they can’t figure out why they’re not sleeping. And they’re keeping their nervous system completely jacked up because they’re training hard every day, which is silly, right?

Dr. Weitz:                            Yeah. You need that rest. You need that recuperation. So you were talking about stress. What about the whole cortisol adrenal situation?

James LaValle:                    Well, I spent a lot of time talking about cortisol in my life and I’m a big proponent that people need to get it measured because there’s a couple aspects to cortisol that are a problem. So first of all, you hear this term “allostasis.” This is really important to understand things. Allostasis, for people listening, it’s the balance of your stress response from your brain, called the HPA axis. Your brain takes in stress appropriately-

Dr. Weitz:                            Hypothalamus-pituitary-adrenal axis. Yeah.

James LaValle:                    Adrenal. Yeah. And it takes in that stress and it kind of dictates what to do appropriately. When you get under sustained stress, and that could be due to infection, it could be due to stress, it could be due to any number of things that we’ve already discussed. Sustained stress creates something called allostatic load. And the reason I use these terms are these are the terms that are in the literature. They’re not like terms like “adrenal fatigue,” which is a good marketing term but it’s not a real term. It’s a marketing term.  Allostatic load is when your brain changes the way it responds to the rest of your body due to sustained stress. So it either turns off your stress response. Uh oh, my cortisol curve just flattened and now I don’t make enough cortisol and I’m chronically fatigued. Or, it puts you in a hyperperseverated state where you’re like, “Oh my God, I got a white tiger chasing me all the time. I’m anxious, I’m nervous, I’m panicked,” which leads to being tired and wired versus tired and flat. And the big point of it all is that you’re supposed to have a diurnal rhythm to your cortisol. Up in the morning, down at noon, down more into the evening. Turn on your melatonin so that we balance this circadian nature of our body.

Dr. Weitz:                            And that you measure with a salivary cortisol test.

James LaValle:                    You have to do a four-point salivary cortisol or a five-point urinary cortisol.

Dr. Weitz:                            Or six, yeah.

James LaValle:                    Yeah, you can do the [crosstalk 00:31:53]-

Dr. Weitz:                            Cortisol awakening response.

James LaValle:                    Exactly. Which is pretty important. But the big thing is when you flatten your cortisol curve. It doesn’t matter whether you’re low and flat or high or flat, but when you lose this up, down and down, when it flattens, more risk for heart disease, more risk for diabetes, more risk for cancer, more risk for dementia. So when I lose my body’s capacity to go up and down, that’s a problem. And a lot of people don’t realize that your ability to go into deep sleep is basically regulated by the dip in your cortisol. When you lower your corticotropin releasing hormone enough at night, you release growth hormone, you release melatonin and now, all of a sudden, I can sleep deep and repair my body.  And when you don’t do that, when you’re having trouble sleeping, when you’re stressed out, when you’re making too much cortisol, when you’ve flattened the cortisol curve, you do not go into that repair cycle that we talked about at the start of our discussion. You go into repair to turn off that inflammation and now I don’t have a metabolically inflamed state; I have a recovered state because of my sleep pattern. And there’s a lot of folks that don’t realize that when your melatonin, it goes down, it actually controls all of your insulin signaling for the next 24 hours. That’s crazy, right?

Dr. Weitz:                            That is crazy, yup. And that’s a big issue with diabetics who either see their blood sugar drop too low while they sleep or they get up in the morning and their blood sugar’s 150 or 180 and they think they’re doing right and sometimes that stress is an underlying factor.

James LaValle:                    Yeah, it’s a big culprit. Look, a lot of this is why I ended up developing the Metabolic Code platform, why I did the cloud-based informatics platform, was to take all this data. Because here’s what happens. We see a study on vitamin D. Then we see a study on astragalus. Then we see a study on metformin because metformin’s the new anti-aging drug. It’s the darling of the new world. Other than the fact that it can raise methylmalonic acid in your body if you’re not careful, which leads to … contributing [crosstalk 00:34:10].

Dr. Weitz:                            B12 deficiency, yeah.

James LaValle:                    Yeah, it’s a B12 deficiency. And you lose CoQ10 too. And B6. But the thing is, nobody measures all of it together. And that’s kind of what we embarked on, was putting an informatics system together that said, “What’s your symptoms? What’s your labs? What are you taking? How are you eating? How are you exercising?” So that you can start to see how all of that comes together, because look, doctors always say to me … traditional medical doctors will say, “Well, you have no evidence of dietary supplements. There’s no evidence.”

                                                And I go, “Well, okay. So give me the evidence of when you give somebody ibuprofen, Luvox, metformin, a statin and their Propecia for their hair loss. Those five drugs.” Oh, wait, there’s no studies that show those five drugs together in your body. Oops. We’re all living in this fish bowl. And we’re trying to figure out what are the things that move that person.

                                                For stress, I got to tell you, I got three big things I use for stress. So once again, you made it clear. You’re like, “Hey, make sure you’re telling people something they can get and do. I already told them how to breathe. I told them the importance of sleep. Told them about measuring their pulse and their blood pressure.” Just reviewing it, Dr. Ben. Just reviewing it, buddy. I got to make sure you’re not going to invite me back sometime. I don’t want to be caught in this trap [inaudible 00:35:39] esoteric.

Dr. Weitz:                            Thank you, Jim. Brother Jim! Tell it, brother Jim!

James LaValle:                    That’s it. That’s right, man. We’re brothers from another mother, man. Look, I think there’s three big ones. Theanine is fantastic for people who are perseverators. So if you’re somebody who I just can’t stop making that list, man. I’m going to bed at night. My head is rolling. I’m anxious. I’m even on the verge of panic but sometimes you got to add kava to theanine in order to really get somebody out of a panic-panic.

Dr. Weitz:                            How much do you need, do you like?

James LaValle:                    I’m going to tell you right now. I’m a big hitter on this stuff because theanine has no adverse event limit. I start people … if they’re significantly anxious, like they’re saying, “Oh yeah, I’m really anxious. I’m nervous. I don’t sleep at night.” I start them at 400 milligrams three times a day.

Dr. Weitz:                            Wow.

James LaValle:                    So I give them a very healthy dose.

Dr. Weitz:                            Do you use GABA as well, or just theanine?

James LaValle:                    I’ll just start with theanine. I love GABA. GABA’s great. You could do it. You could add it to it if you wanted, but theanine does such a good job that if you get it at the right dosing threshold, [crosstalk 00:37:01].

Dr. Weitz:                            Okay, 400 milligrams three times a day. Okay.

James LaValle:                    It nails it. As they feel better. I teach people as they’re learning to breathe deep and understand their stress response, get themselves thinking right about the issues they have in their life, now they start to bring that theanine back and I start to get them to say, “Hey, use it when you need it.” If you’re managing your everyday life, don’t feel like, “Oh, I got to take my theanine or I don’t have my act together.” Use it as you need it because you’re going into a heavier week. I had a really heavy week this week. And fortunately, I was taught how to give stress and not take stress on, so I don’t need to take anything. But everybody around me, I give a bottle [inaudible 00:37:42].

Dr. Weitz:                            I think my staff would tell the same story.

James LaValle:                    Exactly, man. I know. I can tell already. So the next one is Relora. Relora, I did a lot of the human research on initially, when it first came to market-

Dr. Weitz:                            [crosstalk 00:38:00].

James LaValle:                    … and actually did some good human research on it. And the reason you go for Relora is if you’re stressed and eating. So if you’re like, “Hey, man, I get home at 4:00 and I hug the potato chip bag. I just love my potato chips. I love it. I eat the potato chip bag and I lick my finger to get the last crumbs out of it.” Or it’s that person that eats that cookie and they go, “Oh wow, that’s a good cookie. I’m going to have just one more cookie.” They eat a second cookie and they go, “You know what? I don’t like even numbers. I think I’m going to just go to three because I don’t like two. Three is a better number for me. I won a lottery with it once. So I’m going to have a third cookie.”

                                                So we rationalize our need for that food and literally, what’s happening is you’re taking that food and it’s almost like you’re rubbing it on your head. And I know almost everybody’s experienced this because I’ve been asking this question for a long time. People eat past the gastric sensation of being full in order to turn off the reward cascade due to stress in their brain. Relora is without a doubt, hands down, the best herb to shut down hedonic eating urge and reduce stress induced weight gain, which occurs when people start to have that kind of behavior of eating for stress response.

                                                The third one, holy basil for stress, and that’s mainly … I’ll do that more if people are having more GI symptoms, like irritable bowel. I’ll use it. And then I’ll combine them. “Hey, I got irritable bowel and I eat out of control.” “All right, Relora plus holy basil.” So those are the three biggies. Dosing-wise on Relora, it’s 250 milligrams three times a day. The dosing on holy basil, typically, if it’s a standardized ursolic acid, it’s 200 to 400 milligrams unless it’s a super-critical extraction, then it gets a lot smaller. But the typical holy basil out there, 200 to 400 milligrams three times a day.  So that’s a biggie. And then the other one is, don’t be afraid to dose your melatonin high to send that signal to turn that body’s circadian rhythm around. I’ve taken melatonin up to pretty high doses on some people in order to-

Dr. Weitz:                            What’s a high dosage? Twenty, or …

James LaValle:                    I’ve done up to 30, but I’ll do 20 pretty regularly, but once again, it’s all about-

Dr. Weitz:                            Sometimes patients get nightmares with that?

James LaValle:                    Usually, they get nightmares or they’ll get vivid dreams when they haven’t had enough, so they usually get nightmares and dreams at six milligrams and then I give them 10 or 20 and they go, “Bam! I was out.” So that’s a transition state and it could also be low B vitamins when that happens. What the interesting thing is, is I don’t want them to stay … although there’s a lot of evidence that staying on higher levels of melatonin for viral support, kidney support, intestinal support, helping with neural regeneration. It’s kind of coming out now that melatonin’s not a bad thing to take, but I still end up encouraging people, as you sleep better and manage your stress better during your day, that really helps you to cut back on your melatonin. See how little you need. Do you need it at all? Are you sleeping restfully without it?   The purpose of all this is to really get people back to homeostasis. You turn on inflammation, you’re supposed to turn it off. When I have too much stress coursing through me, when my insulin is high because of my eating practices, eating too much, eating too often, eating too late, drinking fruit juice, eating too much fruit. Holy cow, there’s so many things. But the point is, you’re trying to get that lifestyle corrected and yeah, what else can I do? Look, black ginger. Man, black ginger, one of the best things. Five times more potent at turning on the SIRT1 pathway for your mitochondria of [inaudible 00:42:05]. Black ginger. And one of the hallmark traits of being metabolically inflamed is the downregulation of that.

Dr. Weitz:                            Black ginger is different than the typical ginger root that people buy in the store?

James LaValle:                    Yes, it is. Yeah, it is. So it’s Thai ginseng is the other name for it.

Dr. Weitz:                            Oh, okay.

James LaValle:                    Yeah, it’s different. Yeah, so it’s different. So there’s some I think really cool compounds that are coming out that I think if we start to look at this metabolic model and go, “All right, where is the inflammation hanging out? What are the levers that I need to pull in order to help that patient.” Or if you’re trying to help yourself, “Where am I falling short? Am I feeling stressed? Do I feel edgy? Am I having trouble sleeping? What’s my diet like?” And we got a lot of pundits out there on diet. Everybody gets on and if they’re good at Facebook, they can be the next big diet, and it may have only been that it worked on them. There’s no science behind it.

Dr. Weitz:                            [crosstalk 00:43:07].

James LaValle:                    Do you remember the cabbage soup diet?

Dr. Weitz:                            Oh yeah, what about the celery [crosstalk 00:43:12].

James LaValle:                    Oh, the celery juice [crosstalk 00:43:14].

Dr. Weitz:                            Celery juice, yeah.

James LaValle:                    Did you know celery juice fixes everything? We should really go find some [inaudible 00:43:18].

Dr. Weitz:                            Seriously.

James LaValle:                    Right? [crosstalk 00:43:22].

Dr. Weitz:                            Absolutely.

James LaValle:                    … everything. Yeah and then the ice cream and tuna fish diet. That was the funniest one.

Dr. Weitz:                            That one, I don’t remember.

James LaValle:                    It was like, eat all the ice cream you want, eat all the tuna fish you want. Three days later, you throw up. You’re not hungry. You lose weight. I can’t imagine it. It’s crazy but honestly, I’ve become really passionate about trying to get people to understand that controlling your HPA axis, regulating cortisol, and here’s the thing: cortisol’s pretty interesting. You know pesticides, like atrazine has had studies that show that it raises your cortisol and resets your HPA axis.

Dr. Weitz:                            Is that right? Interesting.

James LaValle:                    Yeah. Yeah, I think we really have to start to step back and go, “You know what?” The guys that I learned this stuff from 45 years ago … Dr. Wood just recently passed away. Super-bright guy and he made it pretty simple. It’s like, do the inventory. Have you been exposed? What have you been exposed to? What is your stress like? What is your sleep like? What is your absorption? Is your gut broken down? A lot of people don’t realize, you get a TBI or you get under a lot of stress, your gut gets leaky automatically.  So if you hit your head, your gut’s leaky within 10 minutes. If you’re under stress, sustained stress, those inflammatory cytokines go up and it sends a signal to the tight junctions … you got those tight junctions in between our mucosal cells. And it breaks them.

Dr. Weitz:                            And when you get leaky gut, you often get leaky brain as well, so those psyllium chemicals end up affecting your brain function.

James LaValle:                    Exactly. Leaky gut, leaky brain, leaky arteries, right?

Dr. Weitz:                            Yup.

James LaValle:                    And I think it’s incredible when you think about it, because one cell layer thick, one cell of the enterocyte of the intestine, the endothelial lining of your artery, the blood-brain barrier, it’s only one cell layer thick and they are incredibly vulnerable to inflammation and immune attack. And when you compromise those one cell layer thick borders, that’s when we start to really get into trouble.  And I’ll tell you one of the big things I do for people today, I’m always doing food allergy panels where I’m looking at not just IGE and IGG, but I’m looking at IgG4 and I’m looking at the C3bd complements because what I’m finding is that people’s immune systems are loading up significantly. They’re reacting to peanuts but because their IgG4 is protecting against that reaction, you don’t have anaphylaxis but you have a lot of immune disregulation going on and if you look at the immune complement pattern against IgG, if you’ve got a C3 complement activation, you have 10,000 times higher immune response to trigger inflammation than if you don’t create that complement yet. So working on people’s guts and understanding their [crosstalk 00:46:41]-

Dr. Weitz:                            So which food sensitivity panel do you like to use?

James LaValle:                    Well, the only one that does that’s Infinite Allergy Labs.

Dr. Weitz:                            I’m not familiar with that one.

James LaValle:                    Yeah, they’re out of Georgia. They really just started testing … I don’t know, the last six months. I do some education for them because I really like the data that they’re putting out on that C3 complement, because it shows a high affinity towards the development of autoimmune disorders. So you have a complement immune response to your food and then you have an allergic response. So you’ve got an inflammatory process going on and an allergic process going on. And when you characterize the two of those together in people, man, it’s gold. It really makes a difference for people.

Dr. Weitz:                            I wanted to touch briefly on some of the labs that you mentioned in … I looked at your slide presentation on metaflammation and one of them I thought was really interesting was this MPV. Mean platelet volume is not something I normally pay a lot of attention to.

James LaValle:                    Nobody does. That’s why I’m a blood geek. You know? It’s interesting. Mean platelet volume, it goes up. It is a marker for metabolic inflammation. So we’re changing the volume size of our platelet, that is happening because of inflammatory signaling and so you can look at MPV on your regular … I think it’s funny. I know because we’ve talked previously. You look at labs and so many people, they look at a CMP and a CBC and they go, “You don’t get anything from that. You got to do an organic acid urine. You got to do [crosstalk 00:48:39].” I’m okay with that. I’m not criticizing that. I think that people have not learned how to read labs that are actually very well validated, easy to get and cheap and have big science behind them that proves the metabolic model. So MPV, that one … in getting a differential with your white blood cells and looking at your monocytes, eosinophils and basophil percents, you can tell if somebody’s metabolically inflamed.

Dr. Weitz:                            So an elevated MPV, you’re saying, is an indication of meta-inflammation.

James LaValle:                    That’s correct.

Dr. Weitz:                            Okay.

James LaValle:                    That’s right.

Dr. Weitz:                            And then, when it comes to the white blood cells, I know there’s different ratios, lymphocyte-to-monocyte ratio. Which one or ones of those ratios do you think are most significant?

James LaValle:                    My big driver’s two things. Where are your neutrophils at? Are they below the second quartile? If you’re under the second quartile, your immune system is being chronically loaded and you’re basically overstimulating your immune system all the time. So that neutrophil dropping’s not good. I go by percent monocytes, eosinophils and basophils because I know once there’s an inflammatory process going on, I add the three of those up, MEBs, and if the MEBs are greater than … I used to try to get people to get down to seven. Now, I’m happy if I can get them under 10 because so many people have chronic eosinophilia, which is a hallmark trait of metaflammation. Their eosinophils are trending high but they’re not full-blown enlarging.  And then their monocytes are activated because of their gut food response. And then you look at their basophils because when that gets high, you even have a deeper immunomologic shift, so you add the three of those up. If it’s over nine, you got metabolic inflammation going on and it’s really a simple thing that you can do.

Dr. Weitz:                            I always screw up these ratios, but is it the lymphocyte-to-neutrophil ratio that’s a bad prognostic marker for heart disease and for cancer and certain other conditions?

James LaValle:                    Yeah, that’s correct. That’s right.

Dr. Weitz:                            I think it’s also a marker for immune [crosstalk 00:51:12].

James LaValle:                    It’s autoimmune [crosstalk 00:51:13]. Yeah. Exactly.

Dr. Weitz:                            Yeah, because that’s one of the things that happens with aging, is our thymus gland tends to shrink. We get a decrease in our immune function, which is why older people tend to be more vulnerable to infections.

James LaValle:                    And that’s why everybody’s jumping on that bandwagon and taking peptides, right? Because everybody’s injecting thymus and alpha-1. They’re looking at thymus and beta-4, which I think are great. I think peptides are kind of the new, undiscovered frontier. Who knows how the regulation’s going to go, but what you could do? You can take thymus extract, freeze-dried, lyophilised thymus extract from New Zealand. I’ve been doing that for patients and giving that out for cold and flu season for years. Never failed me. You got to strengthen that thymus. You’re 100% right.

Dr. Weitz:                            Is there a particular brand that you trust for that?

James LaValle:                    I use Professional Health Products for that because they’ve been importing New Zealand’s glands, freeze-dried, lyophilised glands and they’re medical grade over there, so they’re veterinary extracted. If any of the animal is diseased, all of it gets destroyed, so the glands go, the meat goes, it all goes. There’s none of that risk that I see. “Oh, the glands over here are fine. It’s just they’re ate up with cancer in the rest of their body. But the gland’s good!” Yeah, you don’t want that. And the lyophilisation and freeze drying is important because it keeps the signal substances that are within the gland intact and I think that’s really where the value of the gland is at, is that you get-

Dr. Weitz:                            So this freeze dried thymus gland is a way to get some of these intact peptides without-

James LaValle:                    Yeah.

Dr. Weitz:                            … actually getting a prescription.

James LaValle:                    Having to do the injection. Yeah, without getting a prescription and having to do the injection. I teach peptides at A4M, at the American Academy of Anti-Aging, and obviously, they’re under scrutiny. California right now, you can’t even send peptides in here right now, so patients can’t get peptides in the state of California.

Dr. Weitz:                            What?

James LaValle:                    Yeah. Yeah, we got shut down.

Dr. Weitz:                            Oh, really?

James LaValle:                    They shut us down.

Dr. Weitz:                            You can’t get the BPC-157 either?

James LaValle:                    Orally.

Dr. Weitz:                            Orally, yeah.

James LaValle:                    But not injectibly. And I’m a big guy following pharmaceutical laws. You know what? There’s plenty of things to use that you can get that are safe, especially if you’re a practitioner that you help with people. It’s a transition experience right now as I see with peptides because you got a lot of them on the market with big pharma. A hundred and fifty applications for new drugs are all peptides right now. And so obviously, there’s some finagling going on around the, “How are we going to apply this? How are we going to use them?” But they’re interesting compounds, I have to say.

Dr. Weitz:                            And BPC-157 seems to be one of the most popular or probably the most popular peptide.

James LaValle:                    It’s very popular and it’s interesting. It’s incredibly popular I think for good reason. When my son got injured, he had a Lisfranc injury. I got him back in five months.

Dr. Weitz:                            Wow.

James LaValle:                    And he was spinning on the foot that was injured and he won the state discus championship in the state of California, five months out from a Lisfranc. And you know, that’s pretty impressive, right?

Dr. Weitz:                            Yes.

James LaValle:                    And I wish I could say it was me. He had a great orthopedic surgeon, but he was using BPC-157 and it worked really good to help restore tissue and help him in terms of his inflammation on his ligaments and tendons. So he did great there. It’s great for healing the gut. But once again, BPC-157, not a lot of human data on it yet and that’s the criticism for it.

Dr. Weitz:                            Yup, yup, yup.

James LaValle:                    That’s a fact. It’s like, “Let’s give it to a couple hundred people and let’s see what they do. Let’s just bubble something.” They take a lot of heat off that. Now, I do understand that several of those are being nominated right now in the compounding world and I think that’s going to help with availability for it.

Dr. Weitz:                            Right. Okay, cool. I think that’s a wrap, Jim. Any final thoughts you want to leave our listeners/viewers?

James LaValle:                    Well, I think the biggest thing is taking care of your body, it’s work, but it’s worth it. You got to take care of yourself. Yes, it’s work. If you got a nice car, you go out and you wash it every day. If you take five months to decide what your next refrigerator you’re going to buy is, take a little time each day, apply it to your health and it’ll be the best thing. It’ll pay off for you is when you feel good, you’re in less pain, you feel more clear, you lose some weight and you’re less vulnerable to a lot of the things that take us down as we’re aging.

Dr. Weitz:                            That’s great, and how can folks get a hold of you?

James LaValle:                    Obviously, JimLaValle.com is very easy. And then if they’re interested in our cloud-based information and what we’ve done, metaboliccode.com. So those are the two easy ones that they can get a hold of me.

Dr. Weitz:                            And then your books are available from Barnes and Noble, Amazon, et cetera.

James LaValle:                    Yeah, Amazon, all of that good stuff. And got new ones coming out. Just repurposed 16 eBooks that I’m bringing out this … launched the first seven so we’re rolling.

Dr. Weitz:                            Looking forward to seeing those. Thanks, Jim.

James LaValle:                    All right. All right, Ben.


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