2952: Dr. Cabral Reveals the 7 Blood Markers That Predict Heart Disease Better Than Cholesterol

If you want to pump your body and expand your mind, there's only one place to go. MindPump. MindPump. With your hosts, Sal DiStefano, Adam Schafer, and Justin Andrews. You just found the most downloaded health, fitness, and entertainment podcast in history. This is MindPump. Today's episode, we had Dr. Stephen Cabral back on the show. We love him. He's the best functional medicine practitioner we know of. And in today's episode, he talks about an inflammation test. In fact, we all took the test, and he talks about our results. In fact, we took the test a while ago. So did we improve our score? By the way, if you go to stephencabral.com slash inflammation, Stephen is spelled S-T-E-P-H-E-N, and then Cabral, C-A-B-R-A-L, so.com forward slash inflammation, they will send you an at-home inflammation score test for free. They'll send it to you for free. And so you can take this test and see what your score looks like. 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Enjoy the rest of the show. Dr. Braul, welcome back to the show. Great to be here. Yeah, it's always fun to have you on. Okay, so today we're going to talk about some health markers that you say are far more important to look at than cholesterol. These are ones we should pay attention to because they can predict risk of things like heart disease and heart attack. Yes. So let's talk about these. What are they and why are they important? So there's seven markers that we've found to be important. One of them is just far more valuable for predicting the number one cause of death for both men and women, which is sudden cardiac death, heart attack, or heart disease. And these are typically a slow burn, meaning they happen over decades. So men can start having real heart disease in their 50s. If you're predisposed, that's why genetics do matter, but all of genetics are able to be overcome with a lot of the healthy lifestyle factors that we talked about in the previous podcast. But when we look at what causes the plaque to build up in the arteries, or those arteries to become more stiff, these markers are going to be better for that. Okay. The first one, and anyone has access to these now. So five years ago, I wouldn't be able to say the same thing, but now anybody can run these markers for blood work. So you can go get tested for these? You can do them at home. You can do them, just blood work at a lab corp, a quest, wherever you want. Cool. So the first one is ApoB. So it used to be called, or sometimes referred to as ApoB100. And I'll give you scores for all of these. Okay. So your score should be ideally below 100. The new metrics are 70 to 90 you want your value at, or ideally below that. So the lower the number, the better. Now, what ApoB is, is looking at your LDL cholesterol. So LDL, we often refer to as oxidized cholesterol or bad cholesterol, putting that in air quotes, but we need LDL cholesterol. Conventional medicine, they want to get your LDL below a 55, which is really low for your cholesterol. But we do need LDL for cell membrane. We need LDL for cell membrane health. We need it for testosterone production. We need it for vitamin D conversion. So it's not the enemy, but the more of it you have, and the more it's in your bloodstream, along with inflammation in your arteries, the more damage that it could cause. Now, it's not the LDL cholesterol's fault. It's the actual damage to the arteries that we'll get into a little bit later in the show. Okay. So ApoB is a part of LDL? So it's actually looking at the number of particles. So the potential. The potential damage for atherosclerosis. The higher the number, the more particles there are that could cause damage to the arteries of LDL. Is this the same thing as looking at particle size of LDL? It's looking at total particle number. Just total. But it also takes into account LDL, and then its size, which is VLDL, very low density lipoproteins. Okay. So these are all specific proteins. And then apolipoprotein little a, which I didn't put in my top seven. But I'll tell you why. It's a very important marker that takes into account with this ApoB, and that's the genetic predisposition to heart disease. So if you have a high apolipoprotein little a, like above 100, you're definitely more susceptible to heart disease and plaque buildup in your arteries. Okay. So it doesn't mean you're going to get it. It just means that you need to be more conscious about your diet and your exercise and making sure that you're doing the preventative measures. I was just going to ask, if my ApoB is higher than 100, what are some things I can do to lower it? So it is the typical recommendations that we went over previously, but it is getting enough fiber, 30 to 35 grams per day, getting in three to four days of aerobic-based cardio every single week, which are typically 30 to 40-minute sessions, two of the Norwegian protocol that we talked about, which would give you the vigorous exercise, and then we're looking at your daily steps every single day, which is important, and then you're getting in enough sleep, enough antioxidants, things we're going to talk about today to combat that. Olive oil is another great one. And they're finding lycopene from tomatoes, part of the Mediterranean diet, is extremely important for heart disease as well. For people who react poorly to things like saturated fat, because it depends on the individual, but would this be, in this case, lowering saturated fat intake help with ApoB? It is going to help for a specific segment of the population with that ApoE genotype, 3, 4, or 4, or 4. They do not process saturated fat well, and it stays in their bloodstream longer. Got it. So for them, that fiber will help pull it out a little bit more. So intermittent fasting will help, but they also want to bump up their HDL with all the things that we just spoke about as well. Okay. Yeah. So ApoB is the big one to look at. It is the one now all cardiologists look at as the most, it's the most prevalent factor in what will cause heart disease if that number is high. Wow. So of all the measurements, this is the one. This is probably the one. Wow. All right. What's next? The next one that we're going to look at is high sensitivity CRP. So HSCRP. When we look at that, we're looking at nonspecific inflammation in the arteries. Oh. So when we look at, so high sensitivity CRP, we used to look at only CRP before. Now the number and the value hasn't changed. We still want it below a 0.5, but it's saying anywhere in your body you have some type of inflammation. The inflammation could be from autoimmune issues, gut issues, viral issues, food sensitivities. We don't know, but we see an elevation. Got it. Why this matters is that if inflammation is elevated in the body, it's elevated in the arteries. If it's elevated in the arteries, now that cholesterol moving by the LDL is going to be able to insert itself, embed itself in that endothelial tissue, which then starts over time. So essentially what happens is then your immune system begins to go over that after those fatty acids. Okay. And so it literally converts to these things called foam cells. The foam cells expand. They start to create collagen, fibrin, and calcium, calcification around them. That's what creates the plaque. Okay. So we need to keep inflammation down in the body. And this is in their, their H. They're highly specific? Highly sensitive. High sensitive. That's the name of the test. Got it. So CRP is just another type of protein. CRP is the C-reactive protein. High sensitivity is the new test that came about, about a decade ago. It became more prevalent. Got it. Used to just be CRP before that. Now, really specific. So for example, let's say you got a common virus. Your CRP might go up to a 30 or 40. Right. Not ideal. Right. But after two weeks, it'll go back down. Right. But when you run it, you just have to take into account, okay, do I have a virus? And I'm running my lab. It should be below a one. Got it. In our practice, for our clients, we want it below a 0.5. Low inflammation, less chance of plaque building up in the arteries. Got it. Got it. Okay. Next. What's another one? Next one's homocysteine. So homocysteine is part, it's amino acid. So it's part of methionine metabolism. Okay. Some people more susceptible to it. You've talked about MTHFR, G-mutations before the show, right? Is this showing methylation issues? Methylation issues, kidney issues. Thyroid issues. But people that have the MTHFR gene, heterozygous, one-copier, homozygous. 2 copies, going to be more susceptible. We'll talk about how to fix it really easily in a moment. Let's say that they have MTR, which is kind of like an MTHFR issue or a COMT issue with detoxification. All of these people have to be a little bit more, again, cautious when they see their homocysteine above a 9 or an 8.5 or 9. Now, on your blood work, though, it'll say you're fine until a 15. It's way too high. So in our practice, we want people between a 6.5 and a 9 at the highest. And the way that you're able to bring that down is not just through methylfolate. So methylfolate used to be kind of like the catch-all. It's really B6, B9, B12, and B2. So just essentially a B complex. All methylated. Well, methylated would be for like the B9 and the B12, methylfolate and methylcobalamin. Got it. The B6 should be what's called P5P, paradoxal 5-phosphate. Okay. And B2 is riboflavin. I've heard that supplementing with creatine helps with methylation issues because it reduces the amount of methylation that can happen. Are you familiar with that? I'm not familiar with that. That might be true. Trimethylglycine, we use that in our creatine. So it's called an advanced cell force. It has trimethylglycine at two grams. That has been shown to drive down homocysteine. Got it. We use taurine, which helps with detoxification as an antioxidant. We use citrulline malate, which increases nitric oxide because part of getting older, you produce less nitric oxide. Yeah. But nitric oxide, also gives those vessels more elasticity. So it can help improve blood pressure and improve vasodilation. Got it. And then we add creatine. So it's possible that there is causal factor there. I haven't seen that. Okay. And not to go too sidetracked here, but what about the use of low-dose PDE5 inhibitors like Cialis for nitric oxide and blood vessel health? There are some studies showing that that might be beneficial even just prophylactically once a week, maybe twice a week. Okay. So it's interesting. I haven't started using that, with individuals in my practice. Now, some people are using that for erectile dysfunction and other factors as well. But some people now are using it prophylactically for cardiovascular reasons. And it might be appropriate, maybe microdosing in the future, or just using it once a week or so. But right now, 100%. Okay. Yeah. What's the next one? Next one is, sorry, let me look at my list. Yeah, yeah. Go ahead. Pull it up. I had these in order because I wanted to do them in order. Yeah, don't worry about it. They'll edit all that out. I have the list up there if you want to take a look at it. All right. So the next one is going to be total cholesterol to your HDL levels. So that's a ratio. The ratio, exactly. So this one right here is a better look than just what your HDL is. Because when you go into your doctors, they're going to say, we want your HDL above a 59, which that is great to have. Challenging for a lot of men to get their HDL levels above a 59. But when you think about what is HDL, the high density lipoproteins versus the low, is that it's essentially taking your HDL levels above a 59. So it's taking your LDL cholesterol and bringing it back to your liver for recycling. So it's helping to pull it out of your blood. So if you have a lot of LDL, but low HDL, then there's more LDL building up in your bloodstream and circulating. Again, LDL is not bad until the tissue is damaged, and then it becomes a real problem. So what conventional medicine says is like, we're not going to worry about the damaged tissue. We're just going to make your LDL so low that there's not enough to be able to go in and patch up, we'll say, the arterial tissue in the first place. That's why even if you have a lot of LDL, you're not going to be able to patch up the arterial tissue. Even people with low cholesterol still have heart attacks, right? Because they didn't fix the underlying root cause, which is the damaged arteries, the damaged endothelial tissue. But if we look at your total cholesterol, and let's say it was a 240, which is like the upper limit of normal, right? So usually doctors want to blow 200 or cardiologists, they typically want to blow 180, and they try to drive it down below 120, believe it or not, which I think is just too low for cholesterol. But that's what they're looking for because they're essentially saying the lower the cholesterol, the lower the LDL. The lower incidence of heart disease. Not the lower incidence of mortality, but the lower incidence of heart disease, which the research does actually back that up. Doesn't mean they live longer, but they get less heart disease. So there's that. And it does lower your coenzyme Q10, which makes your heart weaker. But again, that's a story for another day. So what we say is, okay, let's say that your cholesterol is 240. Well, if your HDL is 80, it's a three to one ratio. And so that's great. So we look for a cholesterol to HDL ratio, of a three to one. Got it. Got it. All right. And the next one, the next one is now going to be another ratio. It's triglycerides to HDL levels. Okay. Triglycerides are fascinating because they are essentially packaged fatty acids. They're packaged energy. And so they raise from excess caloric intake of regardless of basically calories, specifically from alcohol, high sugar process, carb intake, and not a lot of movement, not a lot of exercise. So that's a recipe for because it's leading to metabolic disease. Metabolic disease would be your high cholesterol, high blood pressure, high blood sugar. And that's the worst of all conditions, but that's likely where two thirds of the United States, at least population moves to by the time they get to their late fifties, early sixties. And that's what decreases life expectancy the greatest. Because again, if we look at all the reasons for dying at 75, which is average life expectancy for a male, 78 for women, it really comes down to, did you get high cholesterol? Did you get type two diabetes? Did you get high blood pressure? The other factors are cancer and Alzheimer's, but it's harder to get cancer and Alzheimer's if you don't have those first three, because obesity typically comes along with them. High blood sugar comes along with it. Hard to get Alzheimer's if you've got good hemoglobin A1C, which we'll talk about in a moment. What was the ratio for triglycerides ratio? Ideally a one-to-one. That's what we look for in our practice. So in an ideal world, triglycerides are a 70, HDL is a 70. That would be absolutely perfect. Now, because triglycerides are little packets of energy is one of the go-to ways to lower triglycerides to be in a calorie deficit. Absolutely. Intermittent fasting, great way to do it. Getting enough sleep. So your fasting glucose levels are a little bit lower. Exercise, getting in your 10,000 steps a day, especially walking after dinner helps to soak back up and doesn't allow your postprandial blood sugar spike to be as high. It's actually found that not only does your blood sugar not get as high in terms of the peak, the overall time it stays elevated is less. So if you only do one walk a day, post-dinner is probably the best time to do it. Would a diet that is devoid of carbohydrates, because I know triglycerides, packets of energy, stored glucose possibly, would a ketogenic diet help lower that even if the calories are high, or is it more about the calories or the total energy? Calories do matter. If you drive up your calories high enough, your fatty acids still could go up. However, a lower carbohydrate diet can't fix this in the short term for sure. Okay, cool. So we are typically using a lower. People don't. I don't think that I use low-carb diet. People are like, yeah, but you believe in a high-carb diet. Well, it's kind of like when you do the math and you look at all your macronutrients for the day, like the best protein is typically somewhere between like 20 and 30% of your macros is your protein. And if you're eating 3,000 calories a day for an individual and you take 30% of that, 900 calories from protein, like that's going to be probably plenty for most people, right? It's like, okay, like how much protein do you really need? It's like, even if you're doing one gram per pound of body weight, like you're still going to meet that. And then it's your fat. Well, again, it goes. It goes back to basically how your body processes fat, but most people do really well between 15% and 30%, 35%. So all that's left is carbohydrates. And so it's like, I'm not necessarily a high-carb individual, but like that's what's left. And so then it can come from mainly vegetables, from fruit, like however you want it. But we try to get in that fiber per day because we show that lowers cancer incidence, cholesterol, et cetera. But there's a time and place and many of our clients do a low-carb diet for anywhere between three weeks and 16 weeks where we're trying to improve all of these markers. As we then reverse diet and get carbs back into their body once their cell membranes are better. Wow. Okay. So you use a reverse diet as well. So you're taking people's calories down in the short term initially to solve an issue. And then you start to raise their calories or you just increase carbohydrates or is it both? We do both. Okay. Yes. So we absolutely believe in phases for weight loss. So a lot of people just chronically put you in a deficit until you're eating 800 calories a day. That's a miserable existence. You're not going to maintain that and you're going to lose a lot of muscle and bone. So we're always thinking about, okay, you're 40 years old. You want to lose 50, 60 pounds. We'll get you there, but we don't want to do it at the detriment of keeping that weight off or your health for the next 30, 40, 50 years. So we'll have an initial weight loss. Then we need to then actually add calories back a little bit and carbs, put on more muscle to boost the metabolism, improve overall thyroid and hormones. Then we'll start to dip again, but ideally more through exercise output than dipping of calories at that point. And then we'll just keep phasing it until we get them exactly where they want. And the body transformation is amazing. That's awesome. They literally look better. Yeah, that's awesome. You sound like somebody who's worked with a lot of people. And that didn't happen overnight, right? Because we did that in the beginning too. When I was 18 years old and working as a personal trainer, it's like, this is what you do. You just cut people and make them move more. That's right. Exactly. And so then they, and they do lose weight, but then, you know, you start to get all the ill of it. You plateau hard. And then what do you do? You've got nothing left. Yeah, you run out of days. You're going to do nothing. 90 minutes of cardio a day or two hours a day. And some people do. Then the new thing is like walking for like three hours a day. Sure. Is that really the new thing? Yes. You're walking forever and not doing cardio. And they're just doing walking sessions of an hour twice a day. And also, you know, being a little bit of caloric deficit, like look at my six pack abs. I get it. But is that maintainable? Can you maintain that? That's a lot. I love to walk and you know, it's good for your health, but three hours a day is a bit much. All right. What's next on the list? So the next. The next one is hemoglobin A1C. - Okay. - So this one right here is all it your blood sugar. It's essentially your ratio of average glucose over the past two to three months, basically 90 days. So this is better to look at than just blood sugar, rather. Sometimes this could be high, blood sugar could be good, but this is high, right? You know, I find in my practice, and I don't know if you've seen this, I have a lot of people wear a continuous glucose monitor, but I'm doing less of that now. And really just looking at the hemoglobin A1c. And the reason is I work with a lot of athletes. I've worked with Olympians. I've worked with all sorts of individuals and their blood sugar is all over the map. And they get their hemoglobin A1c back and it's like a 4.4. I'm like, how is this possible? You're averaging, you know, 65 for your glucose all day? No, because I see their continuous glucose monitor. So what happens is, for lack of a better term, the cells themselves are less sticky. Your arteries are less inflamed. There's less oxidative stress. They're exercising a lot. They're eating pretty well, but their blood sugar is up and down. So what we want to look at is when your blood sugar is elevated for a chronic level of time, it creates these advanced glycation end products, these ages. That creates oxidative stress, which then damages your arteries, your vessels, your tissues. Then over time, then that allows for that cholesterol and that plaque to build up. So it always comes back to inflammation, but inflammation always is the root cause. In this case, it's blood sugar. Now, they don't worry about pre-diabetes until you get to a 5.7 5.8. In our practice, we're looking at a 4.8 to a 5.2. That's what we want. A lot of people come into our practice of 5.4 to 5.6. So they're trending in the wrong direction. We just need to make sure every six months they're down another 0.1. And we just get them down into that 4.8 to 5.2 where the likelihood that they're going to start to then build up more inflammation or, and by the way, the inflammation in your arteries and your heart is going to your brain. Yeah, because this has got to be correlated to Alzheimer's, dementia, because I've heard researchers refer to those as type three diabetes. Exactly correct. Well, not to take you off track here, but just you said something I'm so curious about now with the glucose monitors. So with what you've seen, is there a correlation between people that work out and have a lot of muscle mass and they have these crazy spikes, but then they don't have this negative taste? What are you seeing? Yeah. Tell me what you see. So again, I work with many professional athletes. Yeah. And they're not even eating always the best. Right. And, but a lot of these, I'm not talking about 20, you can get away with a lot at 22 years old. I'm talking about, I'm working with athletes in their mid thirties to early forties, like people that have been doing this for a while and all of these things should have caught up. The exercise is very protective for glucose levels, blood sugar levels. And so although their blood sugar levels are spiking, their average overnight is great. No doubt about it, but they're getting to like 180 after a meal. Yeah. And they're, but they're hemoglobin A1C is a 4.4 to 4.8. It's fantastic. So it is not affect, those spikes are not affecting them and they don't need to try to drive their blood sugar levels down, which is then detrimental to their athletic performance. So that's what we're finding there because they're, people are worried about eating carbohydrates, but if they're the right carbs with the right fiber, also getting enough protein per meal to balance those glucose levels, I'm not seeing that, that a direct correlation. Now continuous glucose monitor for someone trying to grow the best foods for them and they're 50, 60 pounds overweight. No problem with that. That makes a lot of sense. Makes a lot of sense. Yeah. When you're looking, there's a bit of a, like there's an athletic bias, I would say with athletes, more muscle mass, stronger, sensitive, insulin sensitive muscle because the exercise and performance. But the biohackers that are wearing CGMs all day long, probably not necessary. Yeah. That's why I'm asking is you have a lot of fitness people that are utilizing a tool like this and it's just like, you know, trying to manage their level at this perfect all day long. It's like, you know, it's just like, you know, it's just like, you know, I mean, you got, you know, 50 pounds of muscle more than the average person. It's like, is it really that important for someone? If you run your blood work and it's dialed in for that 4.8 to 5.2, you most likely don't need to worry about it. Especially if you're doing a 12 to 16 hour fast overnight, eating the right foods, unlike it's likely leading to more stress and more dysfunction around food than it's worth. That's what we found. I mean, we've run every year, we run between 60,000, a hundred thousand lab tests. And so, the amount of, we have 6 million biomarkers of data. And I can assure you, all of these things are far more necessary if you're overweight. And that's why, again, the number one thing that we try to do is just get people to a healthy weight, not for vanity standpoint, but it's the number one thing you can do for your health and longevity is get to a healthy weight. Okay. And then I think we have one more left, right? One more is the omega-6 to omega-3 ratio, which this is looking at inflammation from another standpoint versus blood sugar is looking at it from fatty acid profile. So, our job is to make sure that the cell membranes, which essentially control what comes in and what goes out are healthy. And the right balance is less than a five to one, but ideally a three to one ratio. There's one other metric as well. So, basically omega-6 to omega-3. So, we've done a previous show a couple of years back on this. We're going to do a little check on your labs, which will be fun to look at where you're at. But what matters is that these cell membranes control a lot of the inflammation. And when those cells become damaged, they're not as sensitive to insulin. And this is when you're not able to get the glucose into the cells and you have more inflammation in the arteries. The other part to this is what people are talking about is omega-3 index. Because if you're above a 9%, which I just like to refer to as like saturation of omega-3s in your blood, if you're above a 9%, you have a 90% risk reduction rate for cardiovascular death, sudden cardiovascular death. 90? 90%. Yes. Wow. So, all because here's why they're looking at it. Think about the stenosis or tightening of the arteries, or you're thinking about the plaque that's building up. A lot of this is happening based on inflammation and stiffness over time. Omega-3s are the antidote to that. They allow for, as an anti-inflammatory, and they allow for elasticity. So, this is in the, no one marker is the end-all be-all. That's why we look for all of these seven markers. But if you're getting your ratio to a 3 to 1, you can get away with a lot more. Oh, cool. I think I asked you this a long time ago, and I can't remember how you answered it, so I'm just going to ask it again to you. Because I think I remember seeing an article on this before that the omega-6s out-compete the omega-3s. In other words, if you were eating so much of the omega-6s that you can't take a supplement like an omega-3 and still get all the benefits from it, is there truth to that? You're saying if you're eating too many omega-6s, you can't take a supplement? And get the benefit. Well, you can take the supplement, but you're not going to get the same benefit. Yeah, it's not going to make that much of a difference on all the benefits that we talk about from omega-3s because your cell is basically being out-competed. The ratio is too far off. Yeah, the ratio is too far off. You would have to take more and more. That's why the test is so important. Yes. But you don't want to take more and more. It always is whole food first and then the supplementation. So we previously spoke about the DoHealth study on the top nutritional supplements that improved overall basically aging and mortality. And omega-3s was at the top of that list. Vitamin D3 was the second place essentially. And it showed people taking only one gram a day, but it improved essentially rate of aging by about 3.3 to four months every three years. That essentially, if you kind of do the correlation, you're getting about one more year of life every decade. And so omega-3s are, it shouldn't be the panacea, but it should be one of the number one supplements in your arsenal. Now, you can overdo omega-3s just like you can overdo anything. In the last show, we talked about natokinase and proteolytic enzymes. Okay. Back in the day, 15 years ago, we were still using this 2,000 to 4,000 FUs, fibrinolytic units per day, empty stomach. That was great. New studies should be 10,000 for six to 12 months to reduce arterial plaque by 36.6%. Great. But if you do 30,000, it doesn't mean that it's better than 10 and it may lead to too much thinning of the blood. Too many omega-3s might lead to too much thinning of the blood. So we look for that three to one ratio. That's really what we're looking for. Yeah. Testing is so important. That's right. And so let's say you were taking 10 grams a day of omega-3s. Not only do I not think it's more beneficial, I actually think it starts to go the other way. It's essentially a U-curve. Not taking omega-3s, not good for you. Taking too many, not good for you either. It's that this is a sweet spot of about one to three grams per day. That's so important. And for you guys, we'll look at your tests, but it might be three grams instead of two because you have more muscle, you eat more meat, and that has to balance. So maybe that's where the article is coming from if you have, because basically it's saying if you have a crappy, poor diet, right, and you're throwing these omegas on there. So then the amount you would have to take to get the positive benefits from omega would be higher than what you would probably recommend. Absolutely. But there's still all the detrimental effects of those omega-6 foods. So when you look at omega-6s, they eventually, we spoke about this before, come down to arachidonic acid. Since we chatted though, I did a whole about 90 minute teaching on pain. So arachidonic acid, people come to chiropractors all the time and they say, why do I have this pain that just kind of moves around my body? Why do I have neuralgic pain? Why do I have migraines? Why do I have all these issues? And that's because arachidonic acid from omega-6s can actually turn into leukotrienes. It can turn into thromboxanes. It can turn into eicosanoins, prostaglandins. And these things cause inflammation in the body and it's nonspecific. It goes to wherever your genetic weak spot is. Could be allergies, could be migraines, could be. Back in the day for me, it converted to leukotrienes. I had my first seasonal allergies, debilitating seasonal allergies every April in Boston when things started to bloom. Got that under control, got my omega-3 to omega-6 ratio under control. Gone. And fixing my gut as well. And then it was gone. Wow. So I had to do both of those. I think I told you this last time, but you know, acaracodonic acid was sold as a supplement for a while for people to try to build muscle. And because there is truth to that, right? So that's why there's always truth to all of these things. They didn't tell you about all the inflammation it creates, but it does help build more testosterone. As a stupid kid, if something, you know, when I was a kid, if something built muscle, I would take it. And I did. And I took it and I got so stiff. Oh, that's interesting. Yeah. I got stiff and super sore from my eyes. This sucks. I don't care how much muscle it puts on. All right. So let's go over our test. And what's this test looking at again? This is looking at omega-3. Yeah. This is a very simple blood spot test that looks at your omega-6s to omega-3s. And it's not judging your diet. It's not judging anything. It's simply saying, what is your ratio of the omega-6s you get in your diet to omega-3s? Okay. That's it. That's all it is looking at. Now, am I, because of my autoimmune, at a higher risk here than these two knuckleheads? Does that put me at a disadvantage? This is just looking at the fatty acids. I'm trying to build up your excuse case. No, this is not measuring your CRP. It's not measuring anything like that. Yes. I already know I'm probably going to lose. But the higher the ratio will make you more susceptible to autoimmune issues with those omega-6s because it's creating more inflammation. So this is giving you basically a root cause of inflammation. Okay. So omega-6s. Okay. Omega-6s are going to come from like roasted nuts, oxidized nuts, those types of things, which are a little higher than raw nuts. It's going to come from non-grass-fed meat, non-pastured chicken, non-wild fish. That's where a lot of these omega-6s are coming from. Vegetable oils, et cetera. I'll tell you, again, you might've find something different. I have difficulty even find anyone that will show me the ratios of omega-6s to omega-3s in grass-fed meat. I know there's more, supposedly, more omega-3s in grass-fed than they're in- In conventional. Yes. Without a doubt. So usually conventional is anywhere from an 18 to like a 25 to 1 of omega-6s to omega-3s. That's how detrimental it is. Right. They're fed corn, they're fed soy, they're fed all sorts of different things. Most people, for grass-fed, it's about a 6 to 8 to 1, most likely. I've tried to see people that have said that it's a 3 to 1, like it is for more like fatty fish, but I haven't been able to see that. It's still better than the- Way better. You're talking about half. Half. That's crazy. Oh, no. It's so much better. And that'll get you close to the ratio. Got it. So anyway, just saying that that's what it's from. Okay. All right. So let's start. Let's go from highest omega-6 to omega-3 ratio to lowest. And then also this test looks at arachidonic acid to EPA. So arachidonic acid would be the. We need arachidonic acid, so I don't want to say that we don't, but it's the most inflammatory, the most egregious to create prostaglandins. Okay. And then EPA, we look at that as, the most anti-inflammatory, even though DHA is part of that as well. Got it. All right? Okay. All right. So Justin came in, and again, we're shooting for 5 to 1. Told you. Or less, ideally 3 to 1. Just don't want to be last place. Is it all the cotton candy? So cotton candy will definitely raise it. The vegetable oils. I don't know what I said. Barbecue sauce? Barbecue sauce. He dips it in. So 7.5, which I'll go back to your. Two years ago, we did this. So it's been two years. You're in 8.1%. 7.1, down to 7.5. You went down, dude. Going in the right direction. He switched to grass-fed cheese. That's winning, you guys. I know cheese was the big one. I could eat only with myself. Yes. And then the arachidonic acid, EPA, we still want this below a 5 to 1, ideally a 3 to 1. It was a 15.5. So when we look at this, you'll see most people's ratios are higher on the second one. Yeah. And the reason is, is that their EPA is lower. Okay. So remember, omega-3s could be from flax or chia, and those are your alpha-linolenic acid, your ALA. But not necessarily converting the most anti-inflammatory. So the AA to EPA is really the one that we're looking for. So that's the one we want to do a little bit more work on. Justin was wondering if fish sticks count. I think the outside offsets the inside. It's cod. It counts, right? No, cod does have omega-3s. There's no doubt about it. So I should say, the best way to get your omega-3s are the small fish, the sardines, the mackerel, the anchovies, the wild salmon, the wild trout. The salmon are a little larger, but they're lower in mercury. So we usually recommend those, and they're higher omega-3s. All right. So they're great to get. Cool. Now, I'm assuming you weren't supplementing with omega-3s when you took this test. No. Okay. So for you, based on your numbers, probably only need two grams a day of omega-3s. Well, that's not much at all, dude. Yeah. Okay. So that's it. Or a can of sardines. I'll do the two. Yeah. So you could do a can of sardines a day. That is true. Yeah. And as long as you have no purine issues or histamine issues, that'll work great. In our practice, we see people that eat, a can of sardines four to five times a week can achieve the three to one levels. Awesome. Okay. All right. Next up is Adam. Adam, two years ago, you were a 7.3. Now you're a six. Whoa, dude. What you been doing? Look at you, buddy. Almost at the 5.1 ratio, which we like. I put you on there right now. Huh? I feel like I'm there. Have you been supplementing with the fish oils? I just did right now. No, no, no. Have you been? No, I have not. No, I have not. So we have no idea how you dropped this. Yeah. Okay. Better diet? Better diet. Yeah, better diet. Oh, yeah, for sure. I'm a better dieter now. So I will say the majority- You were a lot fatter before. The majority of people that are not supplementing, but eating a healthy diet, come in around six and a half to seven and a half. Yeah, I'm super curious if I just consistently did omegas. You'll be, well, your arachidonic acid EPA is a 19.7 though. Okay. So this is usually more eggs, more red meat, more pork, higher arachidonic acid foods. Okay. So high EPA fish oil would be good. Okay. I have a lot of those things right there. Two, again, two grams a day, maybe three for you, but probably just two. Yeah. We'll knock that right down. Okay. Without a doubt. That's all that it will take. Cool. All right. And these are important too, just because you've shared before in the show. Obviously, I wouldn't share this, but you've said you have psoriasis and other factors with that. That'll help tremendously with that. But you'll start slow and you'll just ease it up. Okay. Nice. Yeah. All right. So let's tell, let's see where you were in 2024. So we're at 7.8 two years ago. Today, 4.9. Oh, that's amazing. Right? Yeah. It's a big difference. They're sardines. That's what they do. Yes. And the arachidonic acid to EPA was, I remember it being high before, 13.8. That's not bad, but it's higher. It went down to 11.6. Good. So we're at the five to one, which we like. We still want to drive down the arachidonic acid to EPA. Same thing, two to three grams maximum per day. I know that you eat a good amount of eggs or at least used to eat a fair amount. I still, I still eat, we'll probably eat a couple eggs a day. Are you still eating sardines though? You used to eat a lot. It depends. I'm in it. So sardines for me are just like, enjoy them. So I go through like bouts of enjoying them and then where I don't eat much of them. Maybe before this test, you're eating a little bit more if you weren't supplementing. I think I was taking, I might've been taking omegas at the point. Some omegas. Yeah. Okay. Now, and that's the thing with omegas is just like, you should eat, in an ideal world, eat fish two, three times a week. The only reason I wouldn't say is more is just because of all the microplastics out there. It's just, and if you are, if the small fish, then they're not going to have as many microplastics, but can be great for your health. Good protein. But you do just, again, take a good quality, high EPA to DHA, ideally a two to one ratio of EPA to DHA to get you there. And that'll be the best way to do it. All right. Doug in 2024 was a 3.9. The winner. And he's a 3.7 now. So ideal ratio, arachidongastate to EPA to 3.4. So fantastic. You're already there. I'm assuming you're taking omega threes. How many are you taking today? Yeah. So I'm going to sell your product because I use your brand. And I take one in the morning and one in the afternoon. There you go. Every day. Have you been consistent with that for a long time? Oh yeah. For several years now, since we started this. The best way to do is just be regimented. Same with your vitamin D3. Even if you get sun, you can just take your vitamin D3. With low, with something like this, like really good, you know, arachidonic acid, EPA ratio, really good omega three, omega six. When it's really good, are you more resilient to stress? Physical stress? Yes. Emotional, mental, emotional. You're still going to have those. You're still going to have those cortisol levels. Because what's happening is your hypothalamus inside your brain is telling you to do it. I was just trying to make the case. But it will offer what it's doing to your arteries for sure. Can I do the same with my omegas as I do with my vitamin D? I didn't know that I could, like, if I missed two or three days in a row, I forget to take my vitamin D, I can take the 3X, the dose. Can you do that with the omegas? I wouldn't necessarily do that. No. I mean, you could take- I know it's probably not ideal. The reason is, so think about like vitamin D3. If you take a high dose of vitamin D, you're going to have a high dose of vitamin D. Like a lot of people say 50,000 IUs at one time. It's going to pull more calcium into your bloodstream, which could then, not ideally, stick in the arteries if the environment is right. So I like what we would get from nature. So if you're eating a good six ounces, eight ounces of fish, you're going to get your couple grams of omega-3s. That would be totally natural. Vitamin D3 from the sun, maybe 10,000 IUs. For us in our practice, typically it's 5,000 IUs of vitamin D3 on a daily basis. That's what's going to get you, which we spoke about in the last show, the 38% reduction in many types of cancer, prostate, colon being one of those, and the 85% reduction in breast cancer if you get your vitamin D3 levels up to that 60 milligrams per deciliter. So that's really, it's all based on lab testing. We do the vitamin D3 test independently or with the stress and metabolism test. This one is a simple at-home omega-3 inflammation test. When we, back in the days, we did vitamin D with you a long time ago. And I was taking 5,000 IUs and still tested low. And so I take 10,000 IUs. it but i'm also can be inconsistent i can miss like three days and then i'll take 30. is that okay or do you think that i should should just chalk it up as though i missed it and then get back to taking my 10 or i really like to work on the consistency so yeah it's just that's good to know because i i've had i had heard that i could i could take it uh like that so you can but there are then the side effects sure so let's just say you took 10 grams of fish oil yeah to make up for what five days yeah right then what happens is you get one big dose but you miss the anti-inflammatory effects for those previous four days yeah and now you get a massive blood thinning effect okay that you may not it might be detrimental to your recovery workout and you haven't tested your vitamin d in a while i'd be i'd be curious to see how especially with all the sun i get to see how it is yeah it'd be interesting because we when we tested way back in the days i lived in a different place and uh i get hella sun yeah i get a lot of sun now and it's funny because a lot of people they think that their vitamin d levels are adequate because they get a lot of sun and oftentimes they are but some people are not great at converting that vitamin d3 in their liver which is the that transformation is taking place and so they don't get the conversion now again i'm always whole food and sun first if you can do it yeah but it's usually not enough for everybody yeah and it's not enough year round yeah so um most people get sun on the weekends like when they're out and about not during the week that's not gonna be enough they're not getting a full body tan they're getting kind of their arms and legs but the the way that we know is you just test that's it yeah and then the co-factors for vitamin d3 are your k2 your magnesium your zinc there's other factors that allow you to better absorb that that d3 yeah yeah it'd be interesting now yeah you should test it because you've been taking vitamin d for a while consistently and you get sunlight be interested to see if you're at that number now 60 and test all the blood markers that we we spoke about today you know these are becoming just much more prevalent that you're able to just look at these and there is no one end-all be-all marker but when you look at them in their totality that's what ultimately leads to a longer healthier life and when things start to then go off track you can correct them right away because you know those underlying which one of your tests test vitamin d because that's that's one i think everybody should do we have a standalone so all of these are just at you can just do a vitamin d test that's right at home finger stick that's what we did back when that's one of the first tests we did with you and then we do it with the stress motor metabolism test which looks at all your thyroid markers like your t3 looks at all your cortisol throughout the whole day testosterone estrogen dhga so that's like the big anti-aging and hemoglobin a1c yeah so that's the big test that we always recommend in the show notes we'll give you a link for that too i know we always offer like 50 off that for your listeners we weren't going to do that this time but we'll make that happen oh cool and i mean because that is the test to look at blood sugar vitamin d3 cortisol hormones all the things that are this one's what is it called the stress stress mood and metabolism now with the now some of these things uh you really have to change your lifestyle to move but what we're talking about right now this omega-6 omega-3 ratio supplements make a big difference like a big difference one of those very few things you could change just by supplementing right yes so when i talk about like what do we do for our clients okay it's called the de-stress protocol diet exercise stress reduction toxin removal rest emotional balance scientifically backed supplements success mindset like all the things right but supplements is 10 seconds of your day just putting them in your mouth you don't need to take 50. but there are a few that really do matter that move the needle omega-3s is one of those yeah it just is like it's there are 30 000 studies on how much omega-3s improve your overall health i mean sure it does attest to the fact that he's been able to maintain his diet that he's just been consistent with that what do you what are this uh what do people report they get their omega-6 omega-3 ratio better they get their academic aspa ratio better what do they report uh in terms of how they feel because so cool the test says i'm better right what are they noticing that's a good question sleep inflammation recovery mood those are the big ones just like off the top of that what i can think and they they work fairly quickly about six weeks to 12 weeks wow and the reason is that you need enough time for them to start to integrate themselves into the cell membrane which right now if there's more omega-6s it becomes more what's called diserobic so less oxygen is able to enter those cells the cell membranes get a little bit more gummed up with sterols again we need sterols we actually need more of them than we need these polyunsaturated fats which i know you know the people say are detrimental again there's no there's no black and white there's nuance to this you want less polys than you want of the sterols but you still need them for waste coming out of the cells and nutrients coming in okay and so the anti-inflammatory effect helps with the pain the mood is the more omega-3s helps with the overall mood like that is just again clinically proven it's been shown to help with adhd it's been shown to help with autism so these are just our bodies are meant to have these omega-3s in them in a ratio of about three to one at least less than five to one let's talk about uh your supplement for because you guys have a high epa fish oil yes of course i'm going to give you a little bit more detail about that but uh it's is it true that one of the challenges with fish oils is uh supplements is you're taking one and they're rancid they went back because it's like a food product right so how do we like how do people know what they're taking is good and not gone bad like what's what how do we know this so one of the biggest issues like just like you said is the oxidized cholesterol so the oxidized fish oil that's in it themselves so one is you want to use more of a cold process so the less that you heat up the oil itself the less rancid it gets okay if you think about all the oils we cook with people always rate the oils right so it's like is olive oil better than tallow better than whatever it might be high temperature and that's at a high temperature right so the lower temperature always the better regardless of the oil an avocado oil or an olive oil are unique especially olive oil has the oleic acid a coconut oil a little higher smoke point same with like butter or ghee or whatever it might be with this more of a cold process more triglyceride bound so that you can actually absorb it and then you want to look for low mercury or a daily no mercury so we third-party test all of our products so there's no mercury and the reason is is that if you're getting your fish oil from fish which you should be then there's a higher likelihood the more compressed fish oil there is the more mercury that's going on oh so really important that you're not putting mercury in your body which creates inflammation and potentially could lead to inflammation in the brain causing dementia alzheimer's does it help to refrigerate or freeze your fish oil capsules does that make a difference not anymore all of these even probiotics are more stable for the most part now okay so you can leave them out even the oil i use so you can use a soft gel or an oil small bottle dark bottle so the light's not off it's all about oxidizing that oil the gelatin now that's used on them helps prevent that oxidation should be in a dark bottle uh would it make sense to when you're taking your vitamin d to take it with your fish oil since the vitamin d is fat soluble does that make a difference we actually it's a great question we actually recommend taking your vitamin d earlier in the day just like you would get it from the sun take it at lunch so to time it like you're hey i'm up and the sun is out that's right and they've shown that if you take your vitamin d at least at a higher dose at night it might detrimentally affect melatonin because you're saying like oh the sun more studies need to be done on that but that was interesting and it makes sense to me you get your vitamin d peak time is 10 to 2 right so take in the morning let it absorb it's in your body from that 10 to 2. that makes sense so we tell all of our clients simple take it at breakfast with food vitamin d3 is absorbed better with a fatty meal or just it doesn't have to be like 50 grams of fat right just fat at that meal we vitamin d3 we put ours with a little bit of medium chain triglycerides so it's already got the fat so yeah because you don't need a lot and then omega-3 take it any time of the day um totally fine you're taking it at you said uh breakfast and lunch yeah breakfast and around five o'clock okay so that's great so you're kind of spacing it out myself a lot of clients i just take two at dinner you can take one at lunch one at dinner i just take it mid meal for anybody who has trouble digesting it always take your supplements mid meal little food under it little food on top you won't get as much if people are prone to reflux or whatever it might be okay okay you might if i ask you a question a little off topic but i think you might be the person to ask okay so right now you're hearing all this news about this parasite uh that's on the lettuce you know it was a cyclosporium something like that yeah okay uh can the can parasites be treated naturally or does it always have to be pharmaceutical to get rid of them like well here's the interesting thing about this particular parasite so in you're right it's called cyclospora but it's not a parasite it's just a parasite it's just a parasite it's just a parasite so it's always been around it's just now we've got a concentrated number of cases seems to be around the ohio-based area but spreading throughout the country last time i checked there's about 4 000 cases which is much more than normal the problem is is that it's not at least they say responding to normal anti-parasitics like ivermectin or mebendazole or whatever it might be and they're saying it's responding to bactrim yeah but it's an antibiotic right exactly it's an antibiotic so that's fascinating that it's responding to that and also bactrim is a sulfa-based drug which a lot of people have massive reactions to it's extremely strong it's detrimental to the rest of your body so i can't recommend taking it so in our practice we use a natural protocol first and only go for the pharmaceuticals as needed so we use it's called the power support protocol uh first thing is the actual people have had parasites since the beginning of time right right so what have they used they've used artemisia or sweet wormwood they've used mimosa pudica there's i mean people just look it up we don't have to go through every single one black walnut hulls yeah these are all things that have always worked pumpkin seed or something like that pump actually raw pumpkin seeds works great garlic crushed garlic works great for parasites um and then we use a biofilm disruptor to help remove if it's embedded itself in your intestines and then a binder universal binder that's low histamine so that's basically what we're doing and then we're going to go ahead and basically our parish support anybody can can take a look at what that looks how effective is the natural uh approach to getting rid of parasites or should i say how often do you have to then go pharmaceutical because parasites can be hard sometimes that's right i would say effective if i'm being honest 70 to 80% of the time. That's not bad. No. That's not bad at all. Because we do stool testing. So that's how we know for sure. So if someone has an autoimmune issue or real, like they've been sick for a decade, it's not part of our big five labs, but we'll add it on, which is a bacteria and parasite stool test. If they have H. pylori, it's going to make them more prone to cancer. It's going to make them more prone to autoimmune issues. If they have a parasite, again, more prone to inflammation, autoimmune issues. So we test for that. We always do our protocol. We'll do it one to two times as needed. If they're still showing up, okay, we'll use a 21-day course of an antiparasitic. Teeth clenching is one of the symptoms of parasites, right? Yes. Anal itching, teeth clenching, night sweats, adult acne on the neck and back. Yeah. Wow. Interesting. All right. I just want to bring that up because it's like top of mind right now because everybody's talking about it. Now I will say- The diarrhea lettuce. Exactly. They have been able to locate what it was from now. And so it's going to be eliminated hopefully very quickly. Oh, so it's not from, workers pooping on the lettuce? No, no. Well, we don't know. It's from one particular company, I won't note them right now, that supplies lettuce to Taco Bell. So it is Taco Bell. So they don't break it from Taco Bell. Oh, man. But now they're producers for other things as well. So you mean you get diarrhea from Taco Bell from the parasite? That's bad. I thought it was just saying not the Mexican pizza. I thought it was the chalupa. Now they have said that it's potential on raspberries and basil and all sorts of different things. But hopefully that did it. They did a mandatory, a recall of all of their lettuce and produce from this company. So hopefully now that that's going to put an end to it. And it's not person to person transmissible. All right. Which is good. All right. Meaning like from, wife to husband. Exactly. It is permissible from fecal matter on these food that transmit the parasite. Yeah. Which is gross. But literally workers don't always wash their hands. It gets onto this. It then begins to multiply. And then we have parasites now. All right. All right. Well, Dr. Grawl, this was awesome. Appreciate you coming back on. Yeah. And so I love this. So you're going to offer one of these tests at a discount. I'd love to be able to get your audience. This is just for your audience at stephencabral.com slash heart 50% off the same omega-6 to omega-3 inflammation test. Run your labs. And again, if you think you have the best diet in the world, great. You can literally prove that to be true. And if you do that, then you don't need any supplementation, but it'll tell your exact ratio. And this is the easiest thing to do, everybody just listening. It's literally, it's at home. There's some drops of blood. You put in a card. You mail it in. It's a piece of cake. You don't have to go into a lab. And then you can use one or two grams, three at the very most of a good quality. We use the daily omega-3 support by Equal Life. You can do that. But again, wide guess, just do a simple lab test done right from home. The whole family can do it. My daughters have done it and you'll be able to see your levels and then you're good to go. You don't need to worry about it. Very cool. Thanks again. Yeah. Thank you for having me. Appreciate it. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Super Bundle at mindpumpmedia.com. The RGB Super Bundle includes MAPS Anabolic, MAPS Performance, and MAPS Aesthetic. Nine months of phased expert exercise programming designed by Sal, Adam, and Justin to systematically transform the way your body looks, feels, and performs. 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