Improving Fertility with DNA Testing and Functional Medicine with Dr. Peter Kozlowski: Rational Wellness Podcast 423

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Dr. Peter Kozlowski discusses Improving Fertility with DNA Testing and Functional Medicine with Dr. Ben Weitz.

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Podcast Highlights

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Dr. Peter Kozlowski is a leading Functional Medicine practitioner with over a decade of experience dedicated to transforming healthcare.  He is the creator of Root Cause Practice Pro, an advanced AI-powered platform designed to empower both functional Medicine practitioners and individuals seeking answers to chronic health issues. Dr. Kozlowski has written two books, Unfunc Your Gut and Get the Func Out. He lectures for the Institute of Functional Medicine about fertility and how using a Functional Medicine approach that includes looking at genetic SNPs, that is a very compelling way to help patients.  His website is doc-koz.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

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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. Today I’m excited to be having a discussion about genetics and fertility with Dr. Peter Kozlowski. He’s a leading functional medicine practitioner with over a decade of experience. Helping to transform healthcare.  He’s a creator of Root Cause practice Pro and advanced AI powered platform designed to empower practitioners and individuals seeking answers to chronic health problems. He’s written two books, Unfunk Your Gut and Get the Funk Out. I heard Dr. Kozlowski lecture for IFM about fertility and how using a functional medicine approach that includes looking at genetic polymorphisms is a very compelling way to help patients.  And I thought it was really a. Fascinating. And I also appreciate the way Dr. Kozlowski is able to blend DNA testing with the overall approach especially when it correlates with testing because there’s genetic testing out there, but a lot of times it’s hard to correlate it. And I have found personally in practice, when you’re trying to take all this genetic data and blend it with lab data and everything else, and do it in a reasonable amount of time, is definitely a challenge. So while Dr. Kozlowski is dedicated to transforming he, his healthcare, his proudest achievements are family related, being a father to his daughter Sawyer, a husband to his wife Mackenzie, and a soon to be father of a baby boy. So Dr. Kozlowski, thanks for joining us today.

Dr. Kozlowski:  It’s an honor. Thank you so much for having me.

Dr. Weitz:  So why is it important to include a genomic analysis and fertility care from a functional medicine perspective?

Dr. Kozlowski: Yeah, I think, honestly, I think it’s the most important thing to include, and this is coming from somebody for that for 12 years, told people not to do genetic testing.  Because I, as you you heard me at IFM, but the gene when I first started training that everybody talked about was M-T-H-F-R which one of my patients famously called the mother EER gene. Right. And because when you read about it, it was like it was. The root cause. It was the root cause of everything.  Right? Right. If you had M-T-H-F-R, it would cause heart disease, infertility, inability to detox. And when I dug into it, it just didn’t make sense to me that one gene could explain everything. And over my [00:03:00] years of telling people not to do genomics, not to do genetic testing, genetic labs got. Way more advanced.  We know a lot more about genetics and now the testing is incredible. When we order a genetic profile, you can get hundreds of SNPs that are related to your ability to detox your risk for dementia, your risk for what kind of diet you should follow, r regards to your weight whether you’re at risk for heart disease, diabetes, clotting.

My own personal story is anxiety and depression. I, that, those, that’s how I ended up in functional medicine. And I found that genetically I don’t make serotonin. And I was able to use my genes to then optimize, like my supplement protocol to help my body make serotonin. And I feel like it’s really helped balance my body people’s ability to absorb vitamin D, magnesium.  There’s B12 and then, you know, not just M-T-H-F-R, the full methylation pathways. Autism is something I work with that I have not yet tested a child with autism that didn’t have significant predisposition to autism. So the reason for testing is to opt. You know, unfortunately in my practice, everybody I’m seeing is already with.  Disease. So 99% of my patients have a chronic disease and I’m like their last hope for reversing it before they’re out of meds or surgeries or things like that. Ideally, genetics to me should be used preventatively, right? So we did a full genomic panel on our daughter when she was two months and. I have an idea of what she’s set up for.

So I have a strategy that I’d like to take as she’s growing up to hopefully prevent disease. Right. So, right. We know she doesn’t detox well, so you can put her on binders in certain situations. You can upregulate phase one and phase two detox. Whether it’s deciding how to supplement, right?

I think that’s one of the hardest things is like determining which supplements what people should be on. And I was always a minimalist. It was like, [00:05:00] well, let’s test what’s wrong with you. Let’s get it rebalanced and then you don’t need any supplements. And then I found for myself, like I don’t absorb magnesium at all.

So I’ve now on a magnesium three and eight, which I think has totally changed my life. So I would love to use genetics as preventative medicine, but I’m using it with my families that, you know, the kids have autism and we’re optimizing. Do they need high dose folate? Do they need oxytocin for infertility, endometriosis?

How do we down regulate it? How do we optimize hormone balance? How do we optimize detox? For patients who have a family history of dementia, you know, are you at risk? Right? Do you have the genetic predispositions? What we know about dementia is the changes in the brain happen start 20 years before disease starts.

So using it that way. So there’s so many different ways. So the way I use it now is typically to, you know, with, again, to optimize a condition that we’re treating, whether it’s optimizing [00:06:00] a mold detox or cardiovascular care, or dementia prevention or autism or detox or whatever. But. I would love to use it primarily just as prevention to let people know what they’re at risk for and how we could prevent that.

Dr. Weitz: Yeah. It’s interesting how many of the common chronic diseases today, particularly neurodegenerative diseases, actually start to present some of the early signs. 20 years earlier, the Parkinson’s, same thing. You know, patients get constipation. They have certain symptoms that are very characteristic, that they have a higher risk in 20 years of ending up with Parkinson’s.  Let’s intervene. Then. Let’s not wait until the person is officially diagnosed.

Dr. Kozlowski: Yes, exactly.

Dr. Weitz: And the same thing with autoimmune diseases. You know, these things gradually, slowly, you have this chronic inflammatory situation where the immune system’s attacking the body. And let’s not wait until there’s enough damage where you are now officially diagnosed with the disease.

Dr. Kozlowski: There’s so many genes related to like the immune system and inflammation and certain people are just way more prone to autoimmune conditions, right? So again, it’s whether that’s, if it’s already developed, you kind of optimize an anti-inflammatory plan or you do what you can to prevent it right.  I really think, like, you know, when I, as I was trained with the Institute of Functional Medicine, it was all about like personalized medicine, right? Like, that’s what makes us different as, right? Like practitioners, like this is like we focus on personalized medicine. Well, genetics like truly makes it personalized, right?  Right. You treat the same condition differently. Like, I have a heavy metal detox protocol or a mold protocol or a glyphosate protocol, but when I know somebody’s genetics. It completely can change based on what that

Dr. Weitz: person needs. In your presentation at IFM, you showed some statistics about the [00:08:00] rising rates of infertility from, you know, less than 1% to over 19% in the us over 40 years.  Over 40 years. Yeah. Still, that’s a shocking number. 

Dr. Kozlowski: That’s insane. There’s not many diseases that go from less than 1% to 20% in 40 years.

Dr. Weitz:  Right. So what do you think are some of the contributors?

Dr. Kozlowski:  I think the argument that the genetic haters will say is, well, our genes haven’t changed. Right?  So why do you talk about genetics? When you talk about infertility, what, why I think the rate has gone so crazy is our environment. And. Our environment is way more toxic. And the books that I wrote, one of them get the funk out is it’s the whole point of the book is how our hormones are being damaged by the environment, right?  And it all comes down to mitochondrial dysfunction. I really think most chronic disease is based in mitochondrial dysfunction. There is nothing more [00:09:00] damaging to our mitochondria than environmental toxins. And so when I say toxins, I mean there’s lots of ’em, right? There’s millions of them.

Unfortunately, right now there’s only a few that we can really test. We can test heavy metals, we can test mold, we could test levels of glyphosate we can test herbicides and pesticides and plastics. So there flame retardants there. You know, there’s a lot we can test. There’s still a lot we cannot but, you know, over the course, if you look at, you know, again, the rate of infertility in 1990 being less than 1%, and now, 19%. There’s not like a causation study, but when you look at the correlation of the amount of toxins being released into our environment you know, it’s a straight up curve with the correlation of what’s happened. So it, you know, my, my theory of why it’s so out of control now is. We have an increasingly toxic environment.

We have more stress. Our guts are in worse shape, right? So most people are familiar with that term, leaky gut. Our gut is a barrier to keep the outside world out, just like our skin is a barrier, just like our lungs are a barrier. Because we have these leaky guts, because we’re putting all these chemicals on our skin because we’re spraying our foods with all these chemicals we’re breathing in this stuff.

There’s gateways of that outside world that’s way more toxic to get inside. Toxins are fat soluble. They look for fatty places to get stored. When our detox is overwhelmed, every cell in your body is surrounded by a membrane that’s made up of 50% fat. Right, and particularly one of their favorite place to go.

Those toxins are our reproductive organs. So for men it’s the testes. For women, it’s the ovaries. Thyroid disease is the most common autoimmune disease. So toxins surround these reproductive glands. Our hormone glands create mitochondrial dysfunction. Those glands don’t work the [00:11:00] way that they used to, and now you have an infertility problem.

Right. And I do believe it’s very multifactorial. It’s not just one thing, it’s all of these things. The bigger picture, creating this toxic world inside of us that is, you know, different people affecting different things. But one of the things that’s really affecting is people’s ability to reproduce now.

Dr. Weitz: Yeah, and those of us who are paying attention to what’s happening in the environment, it’s clear that there’s all these increases in toxins. I’m living here in Santa Monica, in Los Angeles, and we live through these horrific fires, and there’s all this data about how particulate matter from smoke. Leads to all sorts of damage to the body.  We have all these floods and hurricanes and that inevitably leads to mold buildup afterwards. And the way we build our homes that are airtight leads to increased mold. And [00:12:00] there’s so many reasons why we are. We’re hearing about microplastics and the brain and the other organs. It’s clear that we live in a very toxic environment and that those toxins are getting their way into our bodies.

Dr. Kozlowski: And so, and unfortunately there’s not causation studies yet. But you know, like I said that you perfectly explained the correlation, right? We know that this is getting worse and worse. They’ll admit it when there’s fires. They don’t admit it from our day-to-day exposure, but.

You know, what we do see is the infertility rate was less than 1%. It’s now one in five couples. Right. Right. So it, you know, we could just say, we have no clue what’s going on. Or we could say, Hey, we know these things are getting into our bodies at way higher rates. We know these things once they’re in their body damage or mitochondria, we know mitochondrial damage leads to infertility.  Right, right. 

Dr. Weitz: So, yeah.

Dr. Kozlowski: And it, I mean. So the reason I became so passionate about this subject is my wife and I had to go through infertility [00:13:00] treatment. My wife had stage four endometriosis for seven years, had pelvic pain going to the doctors saying that she had pelvic pain, that she thought she had endometriosis, and they kept telling her, no, you don’t.  No you don’t. Finally, the last OB told her to go to a physical therapist. For pelvic floor exercises. Right. It wasn’t until she saw an IVF doctor that they did a tubal study and her tubes were so scarred that they had to remove them.

Dr. Weitz: Yeah, that’s sad.

Dr. Kozlowski: And she, when we went back and did her, because I didn’t get to do her genetics until she was pregnant, but when we did her genetics, what we, well, I knew the whole time when she was 20, she had moved into a moldy building, worked at an airport.  She had really nasty environmental toxin exposure. We did her genetics. We found out she doesn’t detox well, specifically the chemicals that are present at airports, and that’s where she worked. We saw she had four different [00:14:00] genes that gave her anywhere from like a two to five times risk of endometriosis.  We know endometriosis is a mitochondrial disease, so, you know, that was, you know, that story is kind of what got me so passionate about getting into infertility. ’cause it was, you know, it was, it’s a, it’s our story and it took us four year, three years of trying before we actually got pregnant and we have a daughter now.  But the, and I guess why I wanted to get started on that is like, this is something with the one in five, like. Everybody knows somebody now going through IVF, right? Whether it’s a family member or a friend. Like you know, the, at 19% we all know someone affected by this issue, right?

Dr. Weitz:  So let’s go through some of the genetic factors.  One of the factors is the project progesterone receptor gene, which can contribute to miscarriage or infertility.

Dr. Kozlowski: Yeah, so there are a lot of genes, [00:15:00] right, that are connected, and so the, there’s not like one specific one that I would just focus on. Of course, like when we do the. Like a, we, what I, what it’s called is a female health panel.  Right? And so then we start looking at ways, how can we optimize a woman’s fertility? And what you’re talking about the progess, PGR when women have a snip, which is a polymorphism maybe that, you know, I don’t know if everybody, every listener is totally familiar with. 

Dr. Weitz:  Sure. Why don’t you explain what a single nucleotide polymorphism is?

Dr. Kozlowski: Yeah, to keep it I like to keep things super simple. We have about 23,000 genes. There’s what’s, what most of the population has, and you get one copy from each parent. So, when it comes to looking at a gene, you can have what’s typical. You could have one variant, or you could have two variants, meaning that you have a variant from mom, you have a variant from dad, or you have both.  Sometimes having two variants from the, what’s [00:16:00] most common is good. Most of the time it’s. Bad. So when you look at a genetic, to me, when I look at a genetic report, what I look at first is what is the prevalence? What percent of the population has that combo? Right? So what percent of the population has zero copies?

What percent has one or two copies? And now what the research has where the research is basically when you have one copy, what does that increase your risk for? When you have two copies, what does that increase your risk for? And then what? The most important step of all of it is how can you intervene on that gene?

Right? So that’s probably the most important thing to understand is if you have a gene, the importance of knowing is what can you do about it? So, for example, somebody with the progesterone receptor gene has an increased risk of infertility. Basically, they need more progesterone to bind up their receptor and.

So if you’re, if you have the PGR [00:17:00] gene. Your receptors don’t bind, the progesterone doesn’t bind as well, so you need more progesterone. You’re gonna be more predisposed to having problems with too much estrogen. And so somebody with that, the first thing I would do is I always test for estrogen dominance, right?

So if I test someone for estrogen dominance, I’m looking at their progesterone levels in the second half of their cycle to see if their progesterone’s high enough. Somebody with the PGR receptor is gonna need higher levels of progesterone. Progesterone is your first pregnancy hormone, so there’s a lot of women who can get pregnant, but then they miscarry, and after a couple miscarriages, the doctor will then be like, well, let’s put you on progesterone now to maintain your pregnancy.  There’s probably. People listening that it was either them themselves or their husbands listening. It’s like, yeah, my wife needed to go on progesterone after we had a couple miscarriages. The benefit of knowing a gene like that is, is, and I’ve had patients who have this, who have not yet started their [00:18:00] fertility journey.

But they can take that to their OB doctor and be like, listen, I need extra progesterone when I get pregnant. So if they find out they’re pregnant, they could go on progesterone early and maybe prevent a miscarriage.

Dr. Weitz: So, and that’s because progesterone helps get the uterus ready and helps prepare for implantation and.

It’s the main hormone

Dr. Kozlowski: During the luteal phase. After ovulation, exactly right. So progesterone is what gets exactly like you said, gets the uterus ready. And then once there is actual fertilization and there’s pregnancy, that hormone skyrockets before the woman starts making HCG. So it’s a vital hormone right at the beginning to get pregnant and to maintain a pregnancy early on.  Right. So that’s a great example of a gene that it’s be very beneficial for a woman to know whether she has it early on, so she knows. And then, you know, that gets into the whole discussion also of estrogen dominance where, [00:19:00] you know, the classic symptoms of PMS, bloating, anxiety, insomnia in the two in, during the ltil phase you would be more, I would be more aggressive as a physician.  To treat the estrogen dominance early on in more natural ways through like detox through supplements to help keep that balanced.

Dr. Weitz: Yeah. One of the supplements you mentioned in your discussion, which I looked up subsequently, and it’s an amazing amount of data around resveratrol. Yeah. Talk a little bit about the impact of resveratrol and how that can impact fertility and how it can modulate some of the hormones involved.

Dr. Kozlowski: Yeah, I mean, resveratrol when they say drink one glass of wine a day, right? That’s, that, the point of it is resveratrol, right? So obviously if you’re working on pregnant, I mean. One glass of wine, I guess would be okay. You don’t wanna overdo it if you’re [00:20:00] trying to get pregnant with wine.  Right. In general. Yeah. I usually don’t tell people to start drinking wine to get resveratrol, but it’s a, it’s an amazing anti-inflammatory. Right, right. And and really the way to think about. Estrogen progesterone for me as a functional medicine doctor when I’m working with a woman is estrogen can be very inflammatory if it’s not balanced right.  Too much. It’s just kinda like that thing of, too much of anything is a problem. So too much estrogen is a problem when it’s not balanced by progesterone. So we try to do things to lower the inflammation related to that, and resveratrol is a way to do that.

Dr. Weitz: You mentioned variants in the FSHR and the FSHB genes that affect hormonal regulation affect endometriosis.  And then I think you mentioned resveratrol is something that can help regulate in that regard.

Dr. Kozlowski: Yeah. So [00:21:00] FSH stimulus follow helps the eggs mature and. Women who have this FSHR gene, the follicle stimulating hormone receptor, have been found to have a lower number of healthy eggs, right?  And so that’s another gene where my kind of argument is to protect the egg production or to optimize the egg production. One of the things resveratrol has been shown to do is to basically, downregulate that gene, so it’s not as much of a problem. So a woman makes a healthy amount of eggs, right?

An example I gave during the discussion is I have a woman right now, a patient going through IVF therapy that she’s young and she can’t get. A lot of eggs, right? When you go through IVF, the first, one of the first steps is to get the eggs out of the woman. And she’s not getting them. And they can’t really figure out why.

Well, she has this gene that [00:22:00] kind of predisposed her to not making enough eggs. She also has extremely high levels of glyphosate that we’ve tested for, and she can’t detox it. Well, these are all things that we’ve found out kind of too late, right? It’s already, she’s already too late in the process. Now we’re using that to hopefully lower inflammation, to hopefully down regulate it.  But it’s hard, right? Like, you know, with any disease, once it’s started it’s hard to reverse it. And so the goal would be to prevent things like this. So when a woman with this gene is definitely like at a young age, can go on a resveratrol to help protect

Dr. Weitz: her eggs in such a situation, what’s a range of dosage that you might use for resveratrol?  Typically like a hundred, 150 milligrams is what I would go with. Oh, really? That’s a pretty low dosage.

Dr. Kozlowski: Yeah, I’m, I mean, I try to be conservative

Dr. Weitz: usually. Oh, okay. Yeah.

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Dr. Weitz:  So let’s talk about a few other, what are some of the other important genes, whichever ones you want to highlight.

Dr. Kozlowski: Yeah, I mean, the one that I kind of made fun of that you know, that everybody knows MTH ffr, it is connected to infertility, right? But both men and women,

Dr. Weitz: right?

Dr. Kozlowski: The a 1298 C mutation is particularly a problem in men. It can affect their sperm production. So, for example, a young man right now or that gets their genetics done and he has them THFR.  That’s an important one to know. I just think it was overstated, but [00:25:00] that’s something he can go on. A daily methylation support, which every nutraceutical company makes to basically help support his sperm production right now in a woman. The C 6 77 T mutation was found to be a problem with implantation failure lower ovarian responsiveness.

So again, a very simple. Affordable supplement you get on methylation support if you know you have this to again for a man’s support is sperm for a woman to support the fertility cycle and support like the. Embryo implanting into the end endometrium. So M-T-H-F-R is an important one. I think one of the most interesting genes that I’ve found that is almost, it should be called the m mothereffer, is factor five laden.

Okay. Which we traditionally, you know, think of factor V [00:26:00] laden for like blood clots, right? It’s people with factor V laden clot really easily. So that’s somebody that could get a blood clot in their leg when they’re flying or if it’s worse, it can go to their lungs. And that’s called a pulmonary embolism.

And those people take medications typically to decrease clotting. There’s also supplements you can use. I really got into the factor V in regards to heart disease. I’ve had a few patients with Factor V where we’ve done scans of their coronary vessels and they actually have significant coronary artery disease.

But then the interesting thing was, is that one of the patients with this, she’s a woman in in, in her sixties, but I asked her, I’m like, when you were younger, did you ever have a miscarriage? And she’s like, yeah, I had three before I got pregnant. And it, there’s studies that show having factor five can be associated with it.

Two to four times risk of recurrent fetal loss. And that’s something that if she [00:27:00] had known that as a kid, she could have been on something like Olol, which comes from pine bark or Nattokinase as like a natural anticoagulant. And maybe she wouldn’t have had those, you know, multiple miscarriages when she was trying to get pregnant.

Right, right. So that’s like factor five. I just connected it in a couple seconds to clotting, to heart disease and infertility. Right. So that’s a bad one. That if you know it, it’s very easy

Dr. Weitz: to manage. Right. And is the mechanism for affecting fertility related to clotting as well? Yeah.

Hypercoagulability. Yeah. Okay.

Dr. Kozlowski: Yeah. Yeah. What is, that’s where another, like other, you know, again, people listening to this might be like, well, oh yeah, when I was trying to get pregnant, I was having miscarriages and my doctor put me on aspirin. Right. Right. And so that’s a common one that’s known in the OB world.  It’s like, oh yeah, multiple miscarriages give the patient aspirin. They don’t really know why, when there’s actually could be a genetic component to it.

Dr. Weitz: Right. What are some of the other genes [00:28:00] related to nutrient status that can affect fertility?

Dr. Kozlowski: Vitamin A beta carotene, oxygenase is the name of the gene.  That one is also one that affects men and women. You need vitamin A for healthy sperm production. You also as a woman, need it to regulate ovulation? Vitamin A is something that I, in my opinion, is difficult to test for. I don’t really fully trust any of the lab tests to measure someone’s vitamin A levels.  I mean, you can measure a toxicity, I think. A deficiency is harder to find. So that’s something when I have a patient with that gene, I will put them on 10,000 IUs of vitamin A daily for a man again for sperm. For a woman to regulate ovulation, vitamin A is one that I would be very careful with though, because it is teratogenic, so Right.  A woman, you know, that does, if she’s on it, she, I mean, vi to me 10,000 units should be a safe dose. If I have a woman on it, I’m gonna just check her [00:29:00] levels to just track it to make sure. Typically, like for it to be teratogenic you, you’d have to be on over a hundred thousand units a day or more. But I’d be

Dr. Weitz: cautious with it.

Why are you skeptical of the testing for Vitamin A and which tests for vitamins have you done? Have you done some of the micronutrient panels like vibrate or some of the others?

Dr. Kozlowski: Yeah, so I’ve done the urine testing, I just think, you know, I haven’t as had as much time to dive into the validity

Dr. Weitz: of those tests as I would, you should look at the vibrant micronutrient tests because they do serum and then they do white or red blood cells, so you got shorter, longer term, and they have a pretty robust panel that I have found really helpful.  Does it measure a specifically. It measures, yes, it measures a, it measures many different nutrients. Offhand, did you remember if you found any people with deficiencies? Yeah. I’m working with a woman right now who’s pregnant and she [00:30:00] has that gene that doesn’t allow her to convert betacarotene ol, so we put her on a prenatal.

Yeah, with retinol in it directly, because when you look at prenatal, some of them only have betacarotene. Some of them have retinol, some of them have both. And so yes, I, we found that helpful. And then we found out she, she needs even more. Yeah. Nice. Yeah. I’ll look. And then we’ve been testing at the beginning and then halfway through the pregnancy because the nutritional status tends to change during pregnancy.  Right? Yeah. You typically need to up things. So you’ve seen her levels normalize? Well, they improve when we put her on re retinol, but then during the second half it’s starting to go down again. Okay. She needs even more.

Dr. Kozlowski: Yeah. Yeah. Yeah. That’s definitely, it’s obviously ’cause they’re growing another human, so they’re gonna need more nutrients.  Right. Yeah. I, yeah, I’ll take a look at that test. I mean, that’s, I guess that’s the thing is like, I like to see consistency with my labs is like, yeah, [00:31:00] I find a deficiency, I treat it, the levels go up. And I guess I haven’t felt fully confident in that, but I’ll take a look at that.

Dr. Weitz: Yeah. What are some of the other nutrient status genes?  Coq 10. Okay. A gene is called

Dr. Kozlowski: coq two. Okay. Individuals with that have lower coq 10 production. Men, coq 10 improves sperm motility in women coq 10 I think, through the mechanism of protecting the mitochondria, but can protect against oxidative stress. And then there’s studies that suggest it could thicken the uterine lining.

Dr. Weitz: So coq 10, some fertility experts are

Dr. Kozlowski: just recommending coq 10 now. Yeah, exactly. Right. And so that’s the, I think that’s been like the beauty of using genetics is there’s these, you know, something like that. Like it’s being recommended and it doesn’t work for everybody. Right. And now with genetics, you at least that’s what I’ve found is like, it makes sense now why certain interventions work in certain people, right. And

Dr. Weitz: [00:32:00] then Right. You get somebody 5,000 units of vitamin D and their vitamin D goes up a little bit. Yes. Not in range. Somebody else goes to 120. Exactly.

Dr. Kozlowski: So that’s where like, yeah. That there’s, you know, there like you’ve been in this field even longer than me and it’s, you know, there’s certain interventions that we know that work for a specific condition, but it’s like they don’t work in everybody. And that, I think genetics is kind of putting the ribbon on that of like, okay, now I get it. Right. Yeah. I would rather do genetics before I’m working with a woman going into, you know, optimizing fertility or like, again, a, a family with a boy with, or a girl with autism like.  I know how to then target my high yield interventions based on the individual and success is faster. Instead of like, listen, like we’re gonna try these high yield things first, and then if these aren’t working, then these are kind of usually the second tier of things I would try. But now it’s like we could just jump to, these are all the best things for you because [00:33:00] we know your genetics

Dr. Weitz: right.

And what are some of the more common genes that affect detoxification and how do we deal with toxins? And and then this whole question of toxins and detoxification for some reason has been extremely controversial.

Dr. Kozlowski: Yeah. I’ve tried to, that that in general, I think that’s a good comment is just like, why is the discussion of detox so controversial?

You know, my, my career trajectory was like I was a family practice doctor. And then I went straight into a functional medicine practice on my own. And I had no problem doing like nutrients. I had no problem doing diets and gut, but I was like scared to do detox. I, and I don’t even understand really why like, why I was cautious to go into that field.

My approach to detox in general has always been let’s test your level of toxins. Right? Right. So, I like anything I do, I [00:34:00] like to do it objectively. And so that’s where I personally with that, like, you know, I would do the glyphosate test. I do pre and post urine chelation testing. I would do mold testing if someone has exposure history.

And for me, my, my exposure questionnaire, well, my exposure question is, have you ever lived in a building that had water damage? I don’t like to ask people whether they have mold exposure, because most people will say, most people I tell that I treat for mold. Well, adamantly tell me they don’t have mold exposure.

And so I just ask them, did you ever live in a water damaged building? Right. And then like I use Mosaic personally for the toxin testing. And so they have the tox detect panel which has the phthalates and the plasticizers and the herbicides and the pesticides and. So that for me, I would start with that personally.

Right? Like I would like to get the phenotypical expression are, do you have toxins? Right? Sure. [00:35:00] Well, at the meantime, I want to get your detox genetics. And I don’t think I’m going to be able to name all the genes related to detox. There’s hundreds of them, right? Yeah. So that’s where a genetic report, you know, when you get one back.

There’s a section labeled detox or toxins. Right?

Dr. Weitz: Not to mention that we have this whole family of P four 50. Yes. Detoxification, enzymes, and even apart from genes, there’s all these other things, even foods that can upregulate or downregulate these different enzymes and that can all affect your ability to detoxify various toxins, drugs, et cetera.

Dr. Kozlowski: Exactly. So, well, the way I handle it is I’ll get the toxin testing if we have a positive result, then I go to the genetics and I’m like, whi, which genes are deficient? A pretty common one actually, that you see is inability, in inability or a reduced ability to make [00:36:00] glutathione. Right, which is a huge problem, right?

Because glutathione is our master antioxidant. Like if correct, if I could pick one thing personally to give someone for detox, I would use liposomal glutathione, right? And because when we, when you look at phase one and phase two of detox, glutathione is the only thing that affects both pathways, right?

Right. You can’t find another nutrient that affects phase one and phase two. So that, I think that’s why it’s so effective. And it’s been shocking since I’ve started doing genetics. How many people have reduced ability to make it or recycle it. And so that, you know. You can debate going on a higher dose.

Right. I think there’s typically I wonder what your opinion is. A lot of people like to use NAC n acetylcysteine, which is, you know, what you use to make glutathione. Yeah. That’s a precursor. Right. And so I’ve personally, like I’ve always been, I’ve always chosen glutathione over NAC because I’m like, [00:37:00] what’s the point of giving the precursor if we could go straight to the source?

But I do think a lot of people like to use nac. And so you can make those kind of decisions genetically how to optimize. Sulforaphane is something that I’ve started using a lot more since seeing people’s genetics. You know, you can focus. You always need to balance, I think, phase one and phase two.

So I’d cautious to overdo like, support for either phase and then. Obviously phase three of detox is actually getting the stuff out, peeing, pooping, right. Sweating. So I don’t ever like to, like, if I have a patient who comes in with constipation issues, we are not going to go through detox.

Right, right. You’ve gotta get them, I gotta fix the cut

Dr. Weitz: first.

Dr. Kozlowski: Yeah. So that’s the overall approach I take towards toxins. I don’t, how about yourself? Is there anything that you kind of

Dr. Weitz: do very differently? I mean, I definitely, I am a big believer that you gotta fix the gut if you can’t excrete and you don’t wanna [00:38:00] detox.

So I totally agree with that. I tend to find glutathione more effective than NAC, though sometimes we use both. Some people, claim that they’re getting side effects from glutathione and they can only handle NAC. It’s tricky to find out if the side effects are really coming from glutathione or not, but, you know, if they’re convinced that they are, then I’ll go along with that.

Yeah, absolutely. Yeah. It is funny though that it’s so common they’ll be talking to a patient and one day they’ll have a symptom and it could be. They got a headache. Yeah. And they just happened to start taking vitamin C, so obviously the vitamin C caused a headache. But yeah, it’s not easy.

Right? Yeah. Well, I try to ask ’em to stop taking vitamin C. Give it a few days, try it again. If it keeps happening over and over, then there must be something about their body. But a lot of times you just. Have, you know, some [00:39:00] some symptom that day that really probably had nothing to do with it, but anyway.

Dr. Kozlowski: It’s a good reminder too, ’cause like when I, if I take somebody through a detox, right? Like I was just doing this yesterday for a woman that’s got a lot of mercury plus glyphosate. Right. And, but she’s known that she typically can be pretty sensitive to adding new things. Right? So So you gotta do a little bit one at a time.

Exactly. We did the same thing. Yeah. Yeah, so you kind of do one, add in one new thing every few days or one a week and right. And lower the dosage. It sucks when you

Dr. Weitz: maybe do like, you know, one spray once

Dr. Kozlowski: a day and, yeah. It’s frustrating when you start someone on a full plan and it’s like, well, three days later they have a complaint and it’s like, well, which thing do I stop?

And it’s like, you know, we probably should have done this one at a time. And that, yeah. The

Dr. Weitz: tricky thing though is here you are saying, do I want this patient to take months and months to get this stuff out, or do we wanna Yes. Hit ’em with the full program and they [00:40:00] tolerate it and a few months later they’re feeling great, you know, so, yeah.

Dr. Kozlowski: Yeah.

Dr. Weitz: You gotta make that call. Exactly. What else, what are some of the other genetic factors? You talk a lot about mitochondria. How do you like to assess mitochondria?

Dr. Kozlowski: I typically, you know, as far as phenotypically, you know, I think mitochondria is another thing that’s hard to test. I mean, I use an organic acid test Okay.  To look at the kreb cycle. Okay. I think to me, that’s the best test I know of to, to assess mitochondrial function. Right. I do think there’s lots of people with mitochondrial dysfunction that can still test normal on an organic acid test. So the way now I like to approach the mitochondria, that’s one where I think really looking at the genetics makes a lot of sense.

It’s amazing. The amount of people now I’ve tested who have like specifically like either like infertility issues or chronic neurological issues that seem to be the [00:41:00] people who have genes that predispose them to mitochondrial dysfunction. Right? Right. The, I think the tricky part is, and I think different practitioners would take a different approach is, so let’s say you have a patient who’s predisposed and that’s another one where there’s a number of genes that could predispose you to mitochondrial dysfunction.

But let’s say you do have that genetic risk. Is the strategy to go straight on supplements, right? To support the mitochondria, which coq 10 we talked about is pretty famous. You can use alpha lipoic acid, you could use B vitamins. There’s different ways to glutathione could support the mitochondria.

1. When I see mitochondrial risk in the genetics, I do then want to go back to my root cause Functional medicine approach is what’s the thing that’s going to be affecting your mitochondria the most? And that is toxins. And those toxins, again, could be the environmental ones, but also they could be food [00:42:00] sensitivities.

Right? Right. It could be dysbiosis, it could be candida, it could be sibo you know. A leaky gut with a standard American inflammatory diet. So when, if I, ’cause I don’t typically like to just order every test for every person. Right? Like if you’re, if you have no history of mold exposure, I’m not gonna do a mold test.

If your gut. Is balanced. Like you’re moving your bowels every day, you don’t have symptoms. I’ll do a microbiome test ’cause someone could have dysbiosis and not have symptoms, but I might not do like a full SIBO test, anode test and all those things. But if you are someone that. Tests for mitochondrial dysfunction, genetics.

To me, I would recommend you then really, you probably need the full gauntlet of tests. Like you don’t want to be messing around because because of the fact, there’s not like to, in my opinion, the perfect way to test, are you expressing this right, because I right. With any [00:43:00] gene I want is the, my first thought is there a way to test for expression, right?

So again, for me, I would do an oat test to see if they, that’s indicating mitochondrial dysfunction. But like I said, I do think there’s lots of people who are normal on that test and still might have it. So then my best next step for phenotypic expression is do you have diseases that could create inflammation in your body?

And so I’m gonna, then at that point, I’m gonna be like, we need to test you for food sensitivities. We need to do a full look at your gut. We need to do a full gut look at your environmental toxins. We should, we need to look at your hormones. We, you, if you are gen genetically pre. Exposed to mitochondrial dysfunction.

I think the best thing you need to do is really make sure your body is as balanced as possible. ’cause to me, those people are the ones that are really susceptible for the chronic diseases that you just don’t want to be dealing with.

Dr. Weitz: Which genomic testing platform [00:44:00] or panels do you like to use for fertility?

Dr. Kozlowski: So I use, personally, I use the women’s health panel with Telex, DNA. The lab is based outta Austin, Texas. Okay. That’s the main lab I’ve used. They, we have a conference coming up, I don’t know when this is coming out, but end of July there will there’s a full three day weekend talking about all the different panels that in Inte X has.

So that’s the, typically, specifically for like women’s health, they’ve designed like a custom panel that all my women are getting that are whether. Hopefully before they’ve started their fertility journey or if they’re in the middle of it, we’ll do the women’s health panel with Inte X. ’cause it’s very targeted at exactly what a woman needs to know about her mitochondria, about her hormones about mitochondrial dysfunction, about nutrients.

So it’s very targeted exactly what that person needs. What’s your favorite prenatal vitamin? My wife has taken the plus one from Metagenics. Okay. [00:45:00] Yeah I know there’s a lot of good ones out there. I don’t even know why, honestly, that’s just one historically that I was introduced to many years ago.

And yeah,

Dr. Weitz: one thing it has is extra L-carnitine, which can be very helpful and I think mitochondrial support often overlooked. Yeah. Do you have one that you like? I’ve been toying with different ones. We’ve been using the Designs for Health one, but it’s hard to find the perfect one and we always have to add stuff to it

Dr. Kozlowski: That’s exactly kind of what we’re, because my wife is actively pregnant right now.  She’s doing plus one, and then we’re optimizing it a little bit based on her genome, so Right. That I mean, I, we’re definitely in, in agreement there on that plan. I, you know, most of the good nutraceutical companies make a good product and it, you know, you kind of pick one that’s worked for you. I mean, we have the healthiest daughter in the world, so I don’t want to change anything.

So that’s what worked for us the first time and we’re sticking to it this time. Right.

Dr. Weitz: Good. [00:46:00]

Dr. Kozlowski: Yeah.

Dr. Weitz: You know, we’ve been talking a lot about women, but the role of men in fertility is super important and I think often overlooked.

Dr. Kozlowski: Yeah. Yeah, it’s typically right, we go straight to the woman. But yeah, I mean there’s a large percentage of the infertility stories that are related to men and that’s why with the genes specifically that I could mention that, that do have an association with male fertility.

I try to mention it ’cause it’s not just the women you know, for. The mechanism is basically the same for us as the environmental toxins are destroying our testes. And you know, when the testes are surrounded by toxins, we’re not gonna produce sperm as well, or the sper sperm we produce are not gonna be as modal.

Right. And so it, it’s. You know, if you do a genetic panel on a man and it’s like he does need more vitamin A, he does need methylation support, he does know need coq 10. And that’s again where genetics has kind of changed my life. Personally and with my patients. ’cause [00:47:00] I would typically say, well, you know, until there’s a problem, you know, it’s, again, I don’t fully, I guess, you know, if you have a micronutrient test, you can, you trust you can run that.

But for me, like, I would do the genetics and be like, well listen, like we are gonna get you on, you know, 200, 300 milligrams of coq 10, we are gonna put you on 10,000 units of vitamin A. ’cause your genetics are saying you need it and let’s optimize your sperm. At the same time I, you know, if we do the genetics and the mitochondria at risk, then we know the sperm are at risk.

So let’s, that’s again, that’s getting you into, let’s get you on mitochondrial support, but most importantly, let’s protect your mitochondria. So the, I think luckily the mechanism is the same. And I, like I said, I think the biggest variable in all of this is our environment. So that’s where. Our genes have not changed, but our gene, we are more susceptible to these genes being activated because of our [00:48:00] environment, right?

Our mitochondria weren’t as risk the way they used to be to the way they are now. How nobody’s ever come out

Dr. Weitz: with a men’s prenatal. I think that could be your product. There you go. Yeah. So, thanks Peter. This has been a good discussion. Thank you. What are your contacts for people?

Dr. Kozlowski: Yeah, so my website is the best way to get ahold of me doc cause.com.

I don’t do social media. That’s for my own mental health. So, but I have been I do podcasts pretty frequently, so just. Googling my name. There, there’s lots of podcasts that show up. So there’s, I have a couple videos I’ve made on my website but really through just doc cause.com.

My books are on Amazon and everywhere. They’re, so that, that’s the best way. And what

Dr. Weitz: about that AI platform you’re working on?

Dr. Kozlowski: Yeah, so that currently is, designed for practitioners. So if there’s practitioners okay. That are learning how to optimize [00:49:00] applying functional medicine, right, or integrative medicine.

That’s really what my AI agent has been designed to do. I mean, is it currently available? It is. So the website is rcpp ai.com, but there’s a direct link from.cause.com. So, okay. You can sign up and really. The way it’s designed is so that if you have a new practitioner that’s like, I’ve never tested someone’s glyphosate levels before.

I’ve never done an organic acid test before. I’ve never done a microbiome test. You can, you know, type, and that’s the more advanced, I mean, you can type in my patient’s or ribose levels where 105 on their oat, what does that mean? Or their glyphosate levels were this, what does that mean? And then how do I treat it?

So I have. All my protocols in there of how to detox things, how to treat SIBO and mold. And I just think that there’s so many practitioners now that want to get into functional medicine. They’re in the middle of a practice. They go to a conference for a weekend, and then they, you know, try to apply it and it’s very hard.

So, right. [00:50:00] I train my, and then traditional AI is just not trained. The knowledge base is not. Up to date with functional medicine so that I used my books and everything I’ve learned over 13 years to train my own agent. So that’s available. Yeah, it’s through my website. It’s, I’m very excited about it.  It’s so yeah, people can go on there and use it.

Dr. Weitz: Sounds great, Peter. Thank you so much.

Dr. Kozlowski:  Thank you for having me.

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Dr. Weitz:   Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.  As you may know. I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity. Please call my Santa Monica Weitz Sports chiropractic and nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.