What is the Difference Between Health and Disease?

HOST: Have you ever pondered the question – what is the difference between health and disease? How do we measure our health? Is it just lab work, or is there more to the equation? How do we truly optimize our health? And, once we reach optimal health, how do we stay there?

Our guest has been asking these questions for many years. He’s a PhD neuroscientist, biochemist, synthetic organic chemist, inventor, and clinical research expert. In 1999, he invented a patented diagnostic technology that made it possible to monitor human biochemistry comprehensively for the first time in history. His innovations led to an extensive patent portfolio of diagnostic tests for early detection and screening of diseases such as cancers, autism, multiple sclerosis, Parkinson’s, ALS, Alzheimer’s, dementia, bipolar disease, schizophrenia, unipolar depression, cardiovascular disease, and others.

We are pleased to have you on the podcast today; I’m very excited, Dr. Dayan Goodenowe. Dr Goodenowe, thanks for being here. You have a very impressive resume.

DR.GOODENOWE: Well, thank you, Mike. I’m really happy to be here and discuss these important topics with your viewers. For your listeners, if you will.

HOST: Yeah, yeah, it’s great! I mean, some of the research you’re doing is so fascinating. We have a regular contributor to this podcast, Dr. Linda Wright, who helps us so much behind the scenes with content, and she discovered you. She shared many notes that she had on your research, and it’s just been so helpful. She’s such a huge help to this effort, and I’m really excited that she found you. And, you know, I want to start with the basics here. You view human wellness a little differently than most researchers and most doctors, so I want to ask you the question: How is disease a deviation from health?

DR. GOODENOWE: Yeah, it’s a really good question, and as you start, you know, peeling back the onion on that question, like the whole concept of health and longevity, and how we live a long healthy life, has been a question that has intrigued humans since the beginning of time because we’re one of the few species that can actually ponder our own existence, if you will. And so, we look at that in greater detail, and I think as you start unravelling that, the biggest thing that we have been kind of programmed into is this symptom-based concept of health, right? And it comes from the fact that most people see a doctor when they’re not feeling very well. They have something wrong with them. So, you have a pre-ordained problem that a doctor’s job is to find out what’s wrong with you. So, medicine is primarily designed to diagnose an individual with the presupposition that you’re supposed to have something. So, it’s really not designed for thinking of health and optimized health.

And as you start going back into this, we think of disease as something that we get. We think of it like a bacterial infection, and that’s really just not true. As you go back and start thinking about these things in greater depth, the biggest concept is that the absence of a thing is not a thing. And if you get back to the basic physics, for example, there’s no such thing as cold; there’s just either heat or lack of heat. And there’s actually no such thing as darkness; there’s either light or the absence of light. So, the absence of health is disease. This is where, even when we talk about longevity and immortality, what we’ve talked about, people think about, if I just stop all the bad stuff from happening, okay, I can live forever. But that’s just not true. If you remove all the negatives, the best you can achieve is a zero. If you want more love in your life, you have to add more love in. You can’t just take hate away and expect love to fill the hole. And health is the same way.

When we think about this and how human lifespan has changed, we’ve done very little on the ability to extend the maximum lifespan of a human being. We have improved the average lifespan. So, we’ve done a really good job at reducing premature death, right? Infant mortality has gone down, deaths from infections have gone down, and deaths from accidents have gone down. And people forget, for most of human history, the rate of death was pretty well constant across all platforms. The same number of 50-year-olds died as 80-year-olds if you will. And it’s only been the last century or so that all of these early mortalities have been reduced, and we’ve pushed all of these mortalities to a very tight window now, such that everyone is really dying at the same time.

And so, as you go back to this because we start chasing our tail thinking of disease, and we don’t realize what the core operating system of life is, and kind of the natural progression of this thing is, you know, can you live forever? Because that’s function. And so, people think, ‘Oh, you know, I’m going to have an anti-aging approach,’ or they think that its disease or aging, is actually a disease. And that’s an incredibly dangerous concept to allow into your brain because it’s not something that you acquire; it’s something that you lose. And so, when you’re born, you have life. And life is basically function and purpose. And that function and purpose permeate from your own decision-making process in your fully functioning lives or down to the actual cellular level, which cell provides purpose for what function, for what purpose. And so, deviations from health mean that you’re really dealing with the second law of thermodynamics, which is entropy. So, the first law, that’s why, for me, chemistry and biochemistry are kind of ground zero for understanding cellular health. But what actually builds upon your total health is that the first law is that matter cannot be destroyed or created. So, we just move things around. So, the sun hits the chloroplast of a plant, and the plant converts that electromagnetic energy from carbon dioxide and water, creating a glucose molecule. All that sunlight energy is stored in the hydrocarbons, and then we take in those hydrocarbons, and we burn it just like a furnace, and we create, we regenerate the carbon dioxide and water. And that heat and that energy we use to live.

But what are we using that energy for? Okay, so what we’re using it for is to maintain order, and that’s where the second law of thermodynamics is. The complex systems require more and more energy to maintain order and structure. I normally tell people health is like the difference between having a messy bed and a made bed. You get up in the morning, you make your bed, it looks so great, and the rest of the day conspires about unmaking your bed, right? You sit on the bed, and it gets all wrinkled. You put your clothes on the bed, and it gets all wrinkled, but then you have to put energy in. So, you have to get up, and you have to go, and you have to fold, you know, smooth the bed out. So, in order to maintain that order, you have to put energy in.

Same thing if you say you like collecting ceramic dolls, for example. And you have this great doll collection, and you have it displayed on a shelf in your house. Well, it takes a lot of energy to keep that shelf clean, right? You’re there cleaning it, dusting, and whatever. And then sooner or later, five years, ten years, you know, you get tired of cleaning your shelf, and you get this dust accumulating. So that is the universe around us. Like, your house will degenerate into chaos if you don’t continually put energy back in. And so, that’s really where the health deviation comes from. We lose that order, and the question is, how do we maintain that structure and order indefinitely? And the way to do that is, first of all, to understand when things deviate from normal and then be able to apply strategic energy. This is where the purposefulness and the function are in interplay. We forget about this as we get older because, for the first, say, 50 years or so of our lives, our purpose is pretty well determined for us by our society, right? You know, you go to school, you want to get a job, you want to get a relationship, you want to get married. So, there are things you basically need to do to have a spouse. And then you work, you have a family, and all of these things kind of drive your purpose. And we say, ‘Oh, that’s all stressful, and I can’t wait till I retire,’ but we forget that that purpose is what has been driving you to do things, and the function of your body will adapt to it. This is the other part of longevity and maintaining health that’s so critical for people to understand.

The other false concept that you fall into is this evolution versus adaptation. Evolution takes this very passive approach where some infinite amount of time of random mutations of gain of function has somehow created this organism of us that has no self-direction associated with it. And that’s fundamentally just not true. If you think about just the human body itself, every single cell of your body has exactly the same DNA, but it performs different functions. Okay, so your cardiac myocyte versus a neuron versus a lung cell versus an adipose tissue storing energy, these all have the exact same DNA, but they have adapted to a purpose or a function, just like humans can do incredibly various things. Like, you and I can be having a conversation like this: people are policemen doing their job, a person working at the grocery store is doing their job, and they become skilled at it, they become adapted, they learn based upon the environment around them.

But it’s dependent upon the function, and so this is the other part, because we have the wellness clinic in Canada, we’re dealing with more severe illnesses, and we deal with late-stage illnesses from a trauma perspective because sometimes purposefulness is really important. And human beings, I know we’re getting really philosophical, but human beings are one of the few organisms that actually commit suicide. So, for a human to kill themself, it means that they have reached a point of no purpose. And so, that tells you how powerful purpose is in driving our life because it’s so powerful that people will actually kill themselves for lack of purpose or lack of feeling that they are important enough to be alive. And so, as we go forward, purposefulness is important. We have to have a reason. So, one of the biggest things is that you have to have a reason to get up. So, no matter how much health you want to create if a person does not want to be alive, that person will not stay alive.

Then, the next part is the functional capability of maintaining that, and this is where it’s basically like a race car driver and a pit crew. They work hand in hand. If I want to design a better and better race car, the driver will drive and say, ‘You know what, this brake pad doesn’t work well, whatever,’ and your pit crew has to be able to build it for the driver. And you’re the driver; your biochemistry and your health are your functional capabilities. And what happens as we get older – this is the other part: people look at genetics, they look at epigenetics, they look at things that change with age, and they misconstrue some of these changes with age as causative versus adaptive. A lot of the genetic changes that we have are the body adapting to our level of function. Most people, as they get older, mentally don’t lose their desire to do young things; they lose the functional ability to do the young things that are in their minds. What happens then is as your body reduces its function, the purpose that you can perform in this life shrinks, and as that shrinks, your function of the body shrinks as well. Same thing with the human body; like the brain, for example, the brain shrinks as we get older, and it shrinks due to an inability to maintain its neuronal firing rate.

So, back to this deviation from health process, is that the pit crew, which is your biochemistry, which is building the membranes of your body, making sure that the heat and the mitochondria are working, making sure that the proteins are being made, that functional capability drives our extent of purpose. When we’re talking about deviations from health, that’s what we’re looking at. So, the powerful thing we know is that we know how the human body is supposed to work. It works very, very well for many, many years. So, we don’t have to play God. What’s happened with the pharmaceutical industry over the years, not in a real negative way, just things happen, the things people think have a great idea. It really happened with chlorpromazine, okay, Thorazine, in the 50s, when they were using it potentially for tuberculosis and realized it really cured people with psychosis. And people forget we used to have psychiatric hospitals virtually on every corner in this country.

And so, this drug was developed, and say we had, you know, penicillin in the decades before that. So, there’s a mindset that we can block these bad things. And so, we come, and we stop things, right? So, we take a statin to block cholesterol, we take, you know, so on and so forth. But that is kind of us tinkering with the operating system versus actually saying health means restoring function. If you restore the function of those cells, you don’t need to be blocking these features. So, the deviation from health is basically being able to understand that the scientific job is to understand: how do I supply the pit crew with the tires and the brake pads and the fuel to make this race car fully functioning? Because if it is, it should run forever. And that’s where the deviation from health comes from.

So, where biochemistry becomes really the ground zero of all this is because that is where basically the first law of thermodynamics, and the second law of thermodynamics collide. One is being biochemical transformations because we don’t live on air and oxygen and water, right? We take hydrocarbons in, we convert them into proteins, and we convert them into lipids. We are a very active organism, and it takes a supply and demand chain. Aging is just a probabilistic feature of anything. If I take 500 brand new ’66 Ford Mustangs off the line and don’t really do any kind of maintenance, I can fairly accurately predict how many miles the brake pads will fail and how many miles the engine will fail. That’s just because if you don’t do anything, this is exactly what’s going to happen. But then, once you start intervening by proper maintenance, understanding, diagnosing car problems, and then having very specific actions. So, when you restore a car, you restore your house – you don’t just block bad things; you add back in the function that is required for maintenance.

So, when you’re dealing with optimal health long term, this is where the problem has been. We’ve been trying to stop death, right? We’ve been trying to stop disease, we try to block all these negative things from happening to us, and we forget the other side of the coin is that you have to put life in. This is where, when we talk about optimizing health and restoring biochemistry, it’s really just feeding the body, providing it with the materials and the direction. So, for example, it’s about adaptability. So, when you work out, for example, you have to trick the body, like the whole concept of adaptation… You need to create an environment for your body and your mind to adapt to a higher level of function. So, if you exercise, what you’re doing is tricking the body. You’re basically saying the body doesn’t know the difference. And you’re lifting 100-pound weights or whatever it is, and now the body thinks, ‘Oh my goodness, this guy lives in an environment that requires 100-pound weights being lifted all day long, so I better adapt to this environmental demand.’ And so, it builds the muscles and adapts to that environmental demand you’ve put on it. So, when we’re sitting here having a conversation on my butt here all day long, I’m clearly not… my life generally does not require that level of physical strength, right? There’s really nothing in my life that requires that level of physical strength in my daily activity. So, I am totally tricking my body into thinking that it lives in a place where I have to lift weights all day long, and so it adapts to it.

HOST: So that’s a good thing, right?

DR. GOODENOWE: That’s exactly right, so that’s creating a reserve capacity. So, the same thing happens with your mitochondrial strength. So being able to maintain oxygen levels, you know, these exercises and everything are very, very powerful. But that also goes down to the micro, the biochemical level of your cells. As time goes on, we can chase our tail to say, okay, why do plasmalogens go down as we get older? You know, our hormone levels will change, oxidative stress obviously gets elevated. We have oxidative stress markers that go up. Type 2 diabetes increases with age, cardiovascular disease and all these age-related diseases. The incidence of cancer increases with age. And we say, ‘Well, look at that, that’s so powerful, age is causing all this.’ But no, it’s not what it is; it’s not the same thing for every person. And even if you take a 110-year-old person who dies, the light switch doesn’t get turned off. Their brain, and their eyes, and their heart, and their lungs, and their toes, the whole body doesn’t instantly die on the same day. And so, clearly, even a 110-year-old person who’s dying, 80% of their body is still functioning. But one critical system isn’t. And so, we forget about that. We get so focused on the negative side of the equation that we forget to add things in. Cancer is a really good example where we focus on ‘kill the cancer, kill the cancer, kill the cancer,’ and you forget the fact that you have an entire body around that cancer that can pretty well drive it out if you restore the health of the system around it.

So, back to this whole concept of deviation from health versus disease, the disease is a symptomatic outcome. It is the difference between a bald tire and a flat tire. Disease is that flat tire. And if you go to a tire shop and you look in the back of the tire shop, look at all these flat tires. You’ll say, ‘Wow, look at all this. Like, most of these flat tires are bald.’ So you say, ‘So, the bald tires cause flat tires,’ Right? Well, probabilistically, yeah, but you can’t predict if I put four bald tires on your car and say, ‘Go drive,’ I don’t know which one’s going to go flat first. And if you live in a place where you have no rocks and you sweep everything around you, you can run on bald tires for a very long time before you get a flat tire. So, this is where the concept of deviation from health can lead to multiple outcomes. And so, measuring bald tires and saying, ‘You know what, I know that this is not healthy, this is not normal. I don’t really have to wait for the flat tire.’ So, what we do in the health system right now is we wait for the tire to go flat. And we put a patch on the tire, and we put the bald tire with a patch back on the road again. And that’s why people with cancer who’ve been technically cured of cancer, their recurrence rate is still much, much higher than the regular population. Because there was a reason why they got cancer in the first place, and we can actually measure and we can describe that biochemistry. So, when looking at optimized health. It’s really quite simple conceptually. The tricky part is learning how to supply the right nutrients to the right parts of the body—and being able to measure that. So, that’s kind of where it all comes down to. That’s kind of where measuring deviations from health are highly predictive. What’s good about measuring health versus measuring disease is that you focus on the positive, and you don’t really have to worry about all the downstream effects. Like a type 2 diabetic, there are ten different complications that arise from that, all of which are avoided if you deal with the upstream circumstance. And so, that’s kind of what I’ve been working with and showing people. Even brain restoration and restoring brain structure and volume with time. That’s the concept of health versus disease. If you want to live a healthy long life, it’s those pieces of the puzzle. Quite often, we deal with the biochemical side and forget about the purpose side. People need purpose in their lives, and they get programmed, ‘Oh, just go retire, do nothing with the rest of your life.’ Like, change your purpose, fine, but you have to have a reason to get up in the morning.

HOST: Yeah, that’s like fuel for us. Just having purpose and waking up to do something.

DR. GOODENOWE: Well, exactly. And if we look at the centenarians, the super-agers. Super-agers have very interesting characteristics. They have a higher, positive social environment. They view personal relationships in a much more positive way. They have their cardiovascular; their blood cholesterol levels are higher. Their brain atrophy is lower. So, all these things are contributing. The social interaction is important for humans because we’re very social organisms; it’s very complex. Social interaction, like just having a conversation and all the things that go around getting up and going out for coffee and getting dressed and having a decent meal, all those things contribute to improving someone’s health. Because just the fact.. just the process of going out for dinner with your friends, if you’re 80 years old, has a whole myriad of things that go around with it. It’s like, ‘What am I gonna wear? I’m gonna get dressed. I’m gonna.. and all, and those are, that’s executive functioning, right? You’re making decisions, and we forget how rich just our social environments are. How important those things are to maintain. And we can see it if we take a look at children with autism. That’s what blocks the autistic process because of their lack of myelination, the disturbed myelination of development in autism caused by neurological inflammation. That prevents them from interpreting the signals from their parents or their peers. So, they use their playmates like action figures, right? Because when they play with their playmate, or they interact with their parents, they can’t interpret the signals coming back from them.

HOST: They cannot? Is that what you’re saying? They cannot?

DR. GOODENOWE: Cannot, no, they don’t have the spatial resolution. So, when you learn socially, right, if I say this word, do I get a smile, do I get a frown, okay? If I do this, do I get a hug, do I get a, you know, slap on the butt? How do I please somebody? The only way that you can learn those interactions is if you can interpret the facial recognition and the context coming back to you. The impaired myelination of an autistic child prevents them from actually feeling and interpreting the sensory stimuli coming into them. So, they can’t learn because they can’t titrate their activities, and so they end up shutting off; they become inside themselves because they can’t actually interact with the environment. And so, when you start restoring the myelination in children with autism, all of a sudden, they can actually interact, and they want a hug from their mom and their dad, right? And they realize that feels good. And it’s just a shockingly positive experience when you restart the myelination process in children with autism or even adults with autism. They can actually start this process.

So, this is back to this understanding of health, okay? You’re not blocking anything. Restoring an autistic child or adult, all you’re doing is you are restoring the health of their myelination. The reason why they can’t myelinate their axons in their brain is because the inflammation is degenerating their plasmalogen levels, which is a critical molecule for the myelin sheath, and this mitochondrial insufficiency has been the underlying issue. So we don’t have to block the symptoms of autism. What we have to do is restore the mitochondrial function and restore the myelination function, and all of a sudden, the human body takes care of the rest. The body will heal itself if you provide it with the materials that it requires.

That’s our job as scientists and medical professionals, is to really understand those things and find tools to put them into the system. What’s amazing is we have so many decades of research. We do not suffer from a lack of knowledge. The scientific literature and the scientific studies on these various topics are very robust. What we lack is the infrastructure and the ability to implement these in systematic, easy-to-follow instructions in educating individuals. And that’s kind of where my passion is. You know, obviously, we do the discovery work, we invent, we develop things that aren’t available, but the biggest thing is educating people about how to do these simple things. And a lot of them are cheap as dirt like your N-acetylcysteine to maintain your glutathione levels, the carnitines and the CoQ10. There’s creatine, simple creatine, and phosphatidylcholine to lower your homocysteine levels and maintain neuromuscular strength. These are very, very simple, straightforward molecules that are available. They’re part of our diet, but as we get older, we just need to make sure that we’re providing extra nutrition. Our basic environment does not supply sufficient sustenance to maintain optimal health. You just can’t physically eat this and get everything just from a pure diet alone.

HOST: Right, and you know, you hit on something so important to stress, and that is that the medical system is designed to, like you said, block processes through pharmaceutical means or even surgeries. You know, it still doesn’t look at the underlying cause. Not to undermine those things, we need pharmaceuticals and we need surgery. They are life-saving in many aspects, but the problem, if we weigh too much on the pharmaceutical side, is that we’re blocking metabolic processes. Whereas research that you’re doing and the products that you’re designing and engineering and pioneering really help support those metabolic processes, is that right?

DR. GOODENOWE: Yeah, and they go hand in hand. It’s like the ‘good fences make good neighbours.’ The medical community is actually very, very good at acute care medicine. If you have a heart attack, if you have a broken bone, if you have an infection, our system is actually very, very good at dealing with acute care situations, and it’s gotten better and better at doing that. It’s not designed for chronic care issues; it’s just not. And you’re right, part of it; we’re to blame for asking a system that’s designed for one thing to do something else. And so partly, we’re to blame for that because we shouldn’t be asking the acute care medical system to deal with these long-term chronic care issues. And this is where public health has failed us fundamentally. We don’t really have public health anymore because this is where you can have more complex, integrated protocols. The pharmaceutical path is designed to protect the consumer from someone selling you, you know, antifreeze. It takes a single molecule for a single indication. It’s dealing with molecules that are not natural, so they’re not naturally occurring. If I want to give you a molecule of, you know, fluoxetine, which is the active ingredient in Prozac, for example, that doesn’t exist in nature. You can’t eat it from anywhere. So if I’m going to start giving human beings this, I’m going to want to control how it’s made. I want studies to show its safety, and I want to show that it has efficacy for a defined purpose. Okay, and that’s a single-molecule process. But the human body is like a brewery, like it’s a cooking show, right? So you’re dealing with multiple ingredients, and like, you know, every time you have a different recipe, you’re going to get a different outcome, and you can’t FDA that. It’s not designed for that. That’s not what was its purpose. The purpose wasn’t for the FDA to evaluate a ketogenic diet versus a carnivore diet. Like that’s not its purpose, right? And so, people think we can’t stand outside and just throw stones at these institutions. Obviously, all institutions will creep into areas that they’re not supposed to be in. It’s just the nature of any organism that kind of tries to find more and more purpose for itself. And so, it’s our job to kind of keep the FDA and that regulatory system in the box it was designed to deal with. And that’s where the public health has fundamentally failed us because we just don’t do that work in the community anymore.

HOST: Right, so yeah, you also mentioned adaptability and that our bodies adapt to the environment that we put them in, but clearly, there’s a disconnect there. Correct me if I’m wrong, in your professional opinion, but we seem to put demands on our bodies that they can’t necessarily take. Do you think that’s a fair statement?

DR. GOODENOWE: It is. A good example is exercise. I tell people exercise is bad for you, you know, recovering from exercise is good for you. And so, you can exercise to recover from it, and it’s the recovery process that gives us a physiological benefit from it. That’s exactly right; that is pairing your purpose with your function. Your function will rise, but you need to feed it. For example, I can get better and better at racing, or I can get better and better at my sport through practice, but I can’t do that with malnourishment. And so, in terms of enhancing your performance and enhancing your purpose, the other side of the coin is that you have to have functional capacity to execute. That’s where, if you push the body using a purpose that’s beyond its capability.. if you take, you know, a little economy car and try to run it in NASCAR, it’s going to blow apart. And so that’s exactly what happens. Sometimes, some people think that they can just think their way through it, right? They can push their way through it, they can mentally overcome a biochemical deficiency, and that’s false logic. If I put you out at minus 60 degrees butt naked, you’re not going to survive for long. I don’t care what you think, I don’t care what you, how much purpose… So, the whole concept of your genetics, our job as stewards of our body and as stewards of our genetics, is to create the environment that is compatible with our phenotype. And so, that’s where our job is. This is where the biochemical testing comes in. You know, you’re the guy who has to go to the store and choose the pint of ice cream versus the chicken breast or whatever it is. And so, your body can’t do that, but it does speak to you. Your body is communicating with you, and it communicates with you via biochemistry. Your blood work, the molecules that are being transformed through this first law of thermodynamics; whatever comes in has to come out. You are a closed system, and so, it’s telling you, it’s speaking to you in a language that’s actually quite interpretable, but you need to learn it. And then, you can go, like, if your HDL levels are low, it says your reverse cholesterol transport is not working properly. There are systematic step-by-step: phosphatidylcholine, DHA, plasmalogens, niacin. Like clockwork – you can restore your reverse cholesterol transport, and we know that if we maintain that, our risk of cancer goes really low down. Cardiovascular disease, our endothelial function improves, and so on and so forth. If we look at oxidative stress markers, we know for a fact if we maintain N-acetylcysteine, some mitochondrial function, those will come down and other things. So, your biochemistry testing will tell you what parts of your human body are underperforming. It’s your responsibility as a steward of your biochemical health to restore those things. Someone has to do that. So, yes, your point is absolutely true. This is why people like professional athletes, for example… these individuals who are just in the prime of their life. They are the epitome of perfect health when they’re in their mid-years, and then they age like crap, right?

HOST: That’s a very common thing.

DR. GOODENOWE: Right, exactly, because they have burned themselves out. That happens with diseases like bipolar and autism as well. These high-functioning autistic or high-functioning bipolar patients ‘ brains are working at a higher metabolic capacity because of some of the inflammation and some of the issues that they have. They have a different genotype, if you will, so they have a different requirement. Autistic children, for example, when you measure blood work in autistic children, they’re going to have lower levels of B12, and they’re going to have homocysteine.

They have these nutrient deficiencies, okay, and that’s not because the parents are malnourishing their kids. That’s not what’s happening. These vitamins and nutrients that we consume, have limited windows of shelf life. They last a certain period of time. So, if you have inflammation, when your body is inflamed, it will go through vitamins at a much higher rate. And so, the same thing with an athlete, or some disorders, or differences, if you will, over time they will burn out. But they don’t have to. You just make sure that that particular system is being reinforced. A child with autism has some sort of inherent mitochondrial insufficiency, so you need to make sure that that mitochondrial insufficiency is supported because they have no reserve capacity. So, if they get an infection, if they get a hit in the head, if they get an adverse reaction to 10 vaccines at once, whatever the heck it is, right? It causes an inflammatory trigger, and that inflammatory trigger doesn’t get resolved; it stays, it perpetuates itself, and it becomes an autoimmune disease. It’s the same thing with people with long-term COVID-19, lots of people with vaccine injuries, lots of people with COVID-19 injuries, but there are lots of people who don’t have those injuries, right? So, what’s the difference between those individuals who somehow were able to tolerate it and those who somehow were not? The difference is their reserve capacity and their ability to adapt to the stress. So, when something has occurred, do they have the reserve capacity to handle that? You know, creating this metabolic or biochemical savings account, if you will.

HOST: Right. So, do you believe the differentiation in reserve capacities can actually determine which disease somebody might be more susceptible to?

DR. GOODENOWE: Absolutely, yeah. So, take the mitochondrial insufficiency, for example. Virtually all women who get multiple sclerosis have mitochondrial insufficiency and children with autism; that’s why we have the 3:1 gender bias. Young girls are basically protected or have additional protection with beta-estradiol because it protects their mitochondrial function. So, the same percentage of boys and girls get exposed to the autism-creating stressor, but girls can have a higher level of tolerance than boys because, technically, beta-estradiol, or estrogen, increases a protein called the monocarboxylic acid transporter, and it allows cells to lactate better. So, this is why premenopausal women have much fewer heart disease issues. If you take a look at the gender biases, the difference between men and women, especially on the cardiovascular side, you’ll see that those lines go back to normal post-menopause. So estrogen is a very highly protective molecule. Then women get adapted to it, their body is used to having it, and then the menopausal process causes them to have quite a dramatic physiological change. They’re adapting to a critical nutrient that they no longer have, and so that’s why, you know, hormone replacement, restoration, or maintenance is quite powerful for individuals. So, yeah, the answer is absolutely correct. Phosphatidylcholine, for example. Take a look at Steve Jobs and Patrick Swayze. Anyone in your world that you found died of pancreatic cancer – I can guarantee you they had a phosphatidylcholine deficiency. That’s Ground Zero on pancreatic cancer and liver cancer diseases, and easily fixable, easily monitored, and so on. Breast cancer and ovarian cancer are very, very clearly mitochondrial-related. What happens with them is that it’s called extramitochondrial ATP production. So, the BRCA genotype is very interesting because even though it affects a small portion of the population, the BRCA1 and BRCA2 genes are some of the most disease-linked genotypes that we have.

HOST: Right, and just for our listeners, the BRCA gene is that breast cancer susceptibility gene, correct?

DR. GOODENOWE: Correct, yeah. What happens when people, when women, have a BRCA mutation, BRCA1 or BRCA2, is that the protein that the gene creates doesn’t function properly. So, it creates a malfunctioning protein, and only about 5% of all breast cancers are caused by BRCA. So…

HOST: It’s that little huh?

DR. GOODENOWE: Yeah, I know it’s interesting, right? You don’t think so; biochemistry contributes to over 90% of cancers. We can predict over 90% of all cancers from biochemical markers alone.

HOST: Things we can control is what you’re saying?

DR. GOODENOWE: Absolutely. Colon cancer, breast cancer, ovarian, the whole nine yards. And I’ve written extensively in print and presented extensively on that.

HOST: That’s good news!

DR. GOODENOWE: Yeah, absolutely. And so, what happens then in cancer? The biochemistry phenotype of cancer is very clear, and its age association is also very clear because our ability to process glucose changes with type 2 diabetes, type concepts, but not just type 2 diabetes. Cancer is caused by impaired mitochondrial ATP production, which forces the cell to create ATP outside the mitochondria, extramitochondrial. So, people hear about the Warburg hypothesis or cancer cells love sugar, for example. Everyone understands, well, it’s not because they love sugar; it’s because they can’t survive without it. They have been trained to become glucose-dependent because their mitochondria can’t provide the ATP that it needs. And since it can’t provide the ATP, it gradually adapts to that situation. So, cancer is, again, it’s an adaptation process. We create the cancer. Cancer comes from a normal cell that can no longer function normally. So, that cancer cell has deviated from its healthy state. It doesn’t want to be a cancer cell, okay? It doesn’t. It has no choice but to become one. And you’re not born with it. So, since you’re not born with cancer, your cells become cancerous. By definition, those cells have deviated from their purpose and, function and health. And so, to put cancer back in the box is actually biochemically pretty straightforward. You need to restore the fasting state. Fasting cells can’t become cancerous. For example, you virtually never hear of cancer in skeletal muscle or the heart, okay? Cells that rely, like 80-90%, on fatty acid metabolism never become cancerous. And so, as we get older, we lose skeletal muscle mass, sarcopenia, you know, muscle wasting gets involved in that. Yeah, and then just statistical probabilities, you have a large group of people, and the cancer rates are still small percentages of the overall population. Cumulatively, they build up, but they’re still a relatively small percentage. And so, that’s because, statistically, now, if you get the right environment, the right susceptibility, then you’re going to get that trigger. And that’s the other thing: all diseases require two components. One is a susceptibility factor, and the other is a trigger factor.

So, back to this bald tire, flat tire analogy. If you have a brand-new tire, your susceptibility to a flat is low. That doesn’t mean it’s impossible; if you hit the right nail, you can blow a brand new tire, but probabilistically, it’s going to be a bald tire that’s more likely to become flat. So, in a bald tire, the trigger (the size of the nail required to cause a flat) is much smaller. And all diseases are like that. And so for autism, for example, you’re dealing with a bunch of children that are running on bald tires, and so just a small trigger can cause it. Whereas children that have a higher level of resilience, they get the exact same trigger, they deal with it, it goes away, and they never get autism. And so that’s why in all diseases, building this reserve capacity is so critical, and what’s so powerful about human biochemistry is that we have all of these studies. Every time I do a study on Parkinson’s or ALS, there’s always going to be a control arm. There’s always a healthy, normal control arm that we use as a comparative. So we know what health is. The medical community has been so focused on diagnosing disease, which is fine; you want that. That’s not a negative thing, but they’ve forgotten that the other side of the coin is just diagnosing deviation from health. We know what healthy systems are supposed to be, so when they deviate from that, we can link those deviations to multiple outcomes.

HOST: You mentioned deviation from health, and we’ve been exploring that a lot in this conversation. What are some basic takeaways people can take from what we’re discussing here? I know there’s not a one-size-fits-all necessarily; we’re different genetically, have different predispositions, and have different environments. But what building blocks would you recommend to somebody out there who just wants to maintain that wellness and prevent disease?

DR. GOODENOWE: That’s a great question, and, you know, it’s actually not that complicated. At Prodrome Science and then at Dr. Goodenowe Research Group, we have a blood test called ProdromeScan, and it’s kind of my list of greatest hits from the tens of thousands of blood samples that we’ve analyzed. And so we talk about what are those core components and what are the key things? One is your membrane structure of the body; what gives you physical three-dimensional structure is membranes. You have 30 trillion cells, and you have about 30 trillion more in your gut. Each one of those three-dimensional constructs, if you will, is covered with a biological membrane. And that biological membrane is not made of plaster and wood, it’s made of actual biological material, and the material is called phospholipids. These phospholipids create a phospholipid bilayer, and it’s critical that you have the well-nutrition of those molecules. The big one is phosphocholine, a critical thing that we don’t measure properly. So, when choline levels get low, reverse cholesterol transport is disrupted, membrane structure is disrupted, and there are lots of things that are associated with that. Plasmalogen levels, which are a type of phospholipid, are like a modifier of your membranes. It’s a critical molecule that your body has to make, 20 to 30% of your brain, 50% of the membrane of your heart, high concentrations in your lungs, and your kidneys; they’re everywhere. But your body makes them, and very significant amounts of it. And what’s happened with COVID, what’s happened with these autoimmunes, is that this chronic inflammation is really depleted people of these plasmalogens, and we’re seeing so much more of that. So you want to make sure you’ve maintained your plasmalogen levels in your body. Then, your fatty acid distributions, people know a little bit about that; there are certain molecules that your gut microbiome makes called gastrointestinal tract acids that are highly linked to inflammation but also to colon cancer and pancreatic cancer. Those are easily screened for breast cancer and ovarian cancer; the risk for those is this fatty acid elongation, which is basically mitochondrial. So your mitochondria are like an engine, it takes in hydrocarbons, and it takes in oxygen, and it burns it, just like the carburetor in your car, your fuel injection, and you get carbon dioxide and water coming out. And the fuel, the actual fuel of the mitochondrial, is a little molecule called acetyl-CoA, a little two-carbon molecule that’s what runs the entire body, and that’s what we use to generate the CO2 and water from.

HOST: Can we take that, that acetyl-CoA?

DR. GOODENOWE: Well, you can’t really take it. Everything goes to it. It funnels down to it. So when you take a fatty acid, so fatty acid beta-oxidation, what it does…

HOST: Like omega 3, 6, 9, is that what you’re saying?

DR. GOODENOWE: Yeah, or saturated fat, like a palmitic acid, which is – so 16 carbons, it just chops it up two at a time and creates these little two-carbon units of glucose.

HOST: So, saturated fat is good, you’re saying?

DR. GOODENOWE: Oh yeah, saturated fat is the cleanest energy of the body. So that’s the most clean-burning fuel. Your body runs on saturated fat. When you eat a meal, this is what your body makes. When your body says, ‘Hey, what am I going to store to eat later?’ it makes palmitic acid, stearic acid, and oleic acid. Those are the three molecules that the human body makes and stores in your fat cells for later. That’s what it likes. That’s human body food, period. All the polyunsaturates, like the Omega-6s and Omega-3s, are just modifiers. We don’t use those as an energy source. We don’t. That’s not fuel for the human body. That is just… we need it for membrane structure and fluidity. It’s like your Omega-3s are critically important, but you’re not using it for energy. So, the cleanest burning energy that creates the least amount of oxidative stress is saturated fat. And the same thing with glucose. Glucose, which is a six-carbon alcohol, gets broken into pyruvate, essentially glycolysis, and pyruvate gets converted to acetyl-CoA. Okay, so both glucose and fat get converted, they get digested to acetyl-CoA, and then the mitochondria burn that. So what happens then, and it’s supposed to burn that, when the mitochondria can’t perform its function, it gets, ‘Oh, I can’t. There’s too much acetyl-CoA. I can’t, I can’t burn all this stuff.’ It leaks out. It’s like a smoking car that you’re following on the road. This acetyl-CoA comes out of the mitochondria, and it goes into fatty acid elongation. It helps support cancer phenotypes and so we can measure that. One of those situations that happen in cancer, which is highly diagnosed we publish this in different populations with breast cancer, is fatty acid elongation rates. So, it’s like you have a messy house, friends are coming over, and you throw all this extra up in your attic. That’s what’s going on in the cell. Like, again, the first law of thermodynamics: once it’s created, you have to deal with it, right? So, whatever comes in, has got to come out.

HOST: Like a spillover of fuel, and then the cancer cells are grabbing onto that fuel. Is that what you’re saying? Wow.

DR. GOODENOWE: You can measure that elongation rate very simply in a simple blood test. So, the other one people know about is your methyl transfer function, which is homocysteine.

HOST: I don’t know what that is. What is that?

DR. GOODENOWE: When people measure the molecule homocysteine, for example, high levels of homocysteine are linked to Alzheimer’s disease and cardiovascular outcomes. So, methyltransferase is a biochemical system that your body uses to add methyl groups. So, SAMe, S-adenosyl-L-methionine, people hear about that. That’s a methyltransferase molecule, and your body uses it to make neurotransmitters. But the big issue is it makes phosphocholine and creatine. Creatine, for your muscles and for your brain, it’s a critical molecule and that’s made by the methyltransferase system. It’s one of the weak links in human biochemistry, so reduced methyltransferase causes all of the neurofibrillary tangles in Alzheimer’s, for example. That controls a bunch of systems in the body. It’s one of the biochemical weak links in human physiology that will decline.

So, people will take methyltransferase support like when you take a B12, methyl folate, maybe people take trimethyl glycine or betaine, for example. Those are all homocysteine recycling molecules. The big value, though, is taking creatine as a supplement and phosphocholine as a supplement. Those reduce the methyltransferase load. So, there are certain nutrients, okay, when we, over the last couple hundred years or so, when people are, you know, scurvy for vitamin C deficiencies, and pellagra, and so on when you have an over-deficiency of a nutrient that your body can’t make, we have these nutrient deficiency diseases,

There are certain molecules that we call non-essential. We call them non-essential because technically, the body can make them, so you won’t die if you don’t get them in your diet, like, if I give you a phosphocholine deficient diet, okay, you’re not going to die, okay, because your body can actually make it. Still, it’s actually stressful for the body to make it.

So some of these essential nutrients that are considered, ‘Oh, you know what, my body can make them, so why should I care to eat them?’ Well, that’s kind of a dumb idea. You want to actually provide high-demand molecules exogenously in your food supply. So, if you take phosphocholine and creatine supplements, your homocysteine levels will be low because what you’ve done is you’ve reduced that load and that demand on your body.

The methyltransferase system is a critical system. The mitochondrial system is very easy to measure. The big molecules for that are your simple B vitamins. We forget these vitamins have been around for a hundred years for a reason, right? Your thiamin, your riboflavin, and good old-fashioned niacin are things that your body uses. So, the basic B vitamins, and then these other nutrients. So when a child is getting breast milk from the mother, it is about 80% whey protein, 20% casein, and then it has plasmalogens in breast milk, which is very interesting. But the whey protein has good levels of what’s called sulphur amino acids. So, the cysteine that we talk about, N-acetylcysteine, is used for glutathione levels. Like, our food supply is basically designed to get most things, and hopefully, if your body is healthy, you can build up reserve capacities of them. But people who are vegetarians or don’t eat enough meat can become deficient in certain sulphur amino acids. So it’s very critical, if you are going to be a strict vegetarian, it’s very important that you take certain supplements that are just really deficient in plant products. Cysteine, sulphur amino acids, is a critical thing. So, in mitochondrial function, we talk about N-acetylcysteine, carnitine, and CoQ10; these are molecules that your mitochondrial function needs.

So, this mitochondrial function I just mentioned about acetyl-CoA leakage is one area. Peroxisomal function: people might not know about that word, but they may have heard it for drugs like fibrates or even if people take DHA to lower their triglycerides. That’s important. So, some of these really simple blood tests are extremely powerful. Fasting triglycerides, okay, always should be under 100, 70 to 80, 70 to 90, 60 to 90 in that range. Whenever your triglycerides, your fasting triglycerides, are over 100, that means your body is just recycling fat. Because your body runs in the fasting state, okay, the human gas tank is all the subcutaneous fat around your body. The only reason we eat at all, the only purpose of eating, is to store fat. That’s what we do. Okay, we eat a meal to store fat and we use that stored fat for energy when we’re not eating, right? And that’s the whole point, just like when you fill your gas tank up with gas at the gas station, you fill it up, you run around town, and you fill it up again. You don’t run around, you don’t fill your gas tank up ten times a day. The human body is not designed that way either. Like, it should have relatively small numbers of meals, and most of the period of time should be in the fasting state. So what happens when your fasting triglycerides get over 100 is that when you’re in the fasting state, your adipose tissue, your subcutaneous fat, is releasing energy for you to survive and live. These fatty acids are being transported to all the cells of your body, and they’re going into the cells of your body to be burned for energy, this whole process. But when they go into your cells, and your cells go, ‘Oh, sorry, I can’t process these fatty acids,’ your cells put them back on triglycerides and send them back to your fat cells. So whenever your fasting triglycerides are over 100, that indicates that your cellular energy is not performing; it has a deviation from health. It’s supposed to be in that 60 to 90 range. If it’s over that, it means that your body’s biochemistry is not working properly. A very, very powerful measure. And that’s why things that lower triglycerides are exercise, resistance training, all these things that are healthy for us do these things.

So, that’s a big valuable system again, easily fixed and monitored, with either lifestyle or diet and certain supplements will help improve that process.

And then cholesterol, you know, cholesterol is a big one. Cholesterol transport, total cholesterol, is one of the most powerful biomarkers of health there is. You want to have your total cholesterol in that 220 to 240 range. As soon as total cholesterol gets under 200, your all-cause mortality starts doubling, and cancer risk goes up. So, you want, because it’s an indicator of health, cholesterol is a really powerful marker of cellular health. And all these people who have all these superagers, what do they have in common? High cholesterol. And high cholesterol in your LDL. It’s remarkable… this obsession we have with lowering cholesterol is just not supported by any epidemiological data whatsoever. Like, we’re not talking about small studies. We’re talking composite studies of 162 countries, tens of millions of patient data sets. Like, this is not even remotely open for discussion. Optimal human cholesterol levels for longevity are somewhere in the 220 to 240 range. And the reason why is it indicates that your cells are healthy.

So, cholesterol is one of the most critical molecules for the human body. High levels of it are in all of our membranes of the body. When you’re measuring blood cholesterol levels, if your cells are unhealthy, for example, when your cells can’t make enough of their own cholesterol – they pull it from the blood supply. That’s what a statin does. A statin will stop your cells from making their own cholesterol, so the only way that the cells can get the cholesterol that they need is that they got to suck it in from the blood supply, so they suck in the LDL cholesterol. So, by blocking your cholesterol manufacturing, you lower LDL. That’s what statins do. But if you have low LDL levels and are not on a statin, that means your cells can’t make enough cholesterol. That means you can’t make enough hormones. It’s a very, very powerful indicator that something is wrong inside your cells. Your cells are not performing in a healthy, functioning way. There’s a drag on your system.

HDL is another big, powerful marker. Like, you want HDL in that 60 to 70 range because that’s what allows your cell to share its cholesterol with each other. That’s reverse cholesterol transport. Because remember, you’ve got a trillion cells. They’re next to each other, and they’re in a symbiotic relationship with each other. So, one healthy cell can make a little extra cholesterol and export it, and the cell next to it gets it back and forth. You have this cholesterol sharing system, especially in the brain, very critical. But if you can’t share the cholesterol, the cholesterol builds up in the membranes. And this is again another really very powerful biomarker of cancers. Like low HDL, low phosphocholine is a high predictor of all cancers. So, keeping your HDL levels up, and the best way to keep HDL levels up, is plasmalogens. Okay, they’re membrane molecules, but when your membranes get deficient in plasmalogens, then your cells can’t export cholesterol properly. This is the other part people think when we measure things. People sometimes take a deterministic approach when, in fact, we’re seeing the opposite. When we’re measuring from the blood, we’re seeing what’s coming out of your cells. And so your HDL levels… HDL is not coming around sucking cholesterol to your cells. That’s not what happens. Your cells are exporting cholesterol, and your body, your HDL system, is adapting to the cholesterol export demands. So if your cells are healthy and exporting more cholesterol, your body will make more HDL to meet the demand. It’s not the other way around. People think, ‘Oh, if I just increase my HDL levels, I’m going to increase cholesterol clearance.’ No, it’s the other way around.

That’s why when you get the phosphocholine deficiencies, so – cholesterol regulation. The other thing with aging that we forget are two other very important biomarkers that are extremely cheap to get in your regular thing I just organize them in a nice report structure, is creatinine. So creatinine is a molecule people measure for kidney function, renal clearance rates, and if you have high levels of creatinine, it indicates you could have renal failure issues, which is fine, works for that. But the more important part is if you have low levels. Low levels of creatinine mean that you are creatine deficient, but it also means you’re in a muscle-wasting space, which means that you’re not making enough creatine for your muscles and your brain. Low creatinine is actually a much more dangerous risk factor than high creatinine. In fact, if you have high creatinine, it says that your kidneys aren’t functioning properly; it’s even more important that you take creatine supplements because your kidneys are responsible for making your creatine. So that’s another very powerful marker: maintain so you don’t end up in sarcopenia.

And the last one I tell people is very easy to measure is uric acid. We use uric acid for gout. That’s what it’s been used for. But really, the more important aspect of uric acid is low levels of uric acid because it indicates if you’re NAD deficient. So, people looking at NAD optimizations. You have, from a biochemical perspective, you know, it sounds like a lot, but it’s actually just some core systems that are what I would consider the high-priority molecules. And if you can get those systems, if you can get your mitochondria to work, your membrane structure working, methyltransferase, cholesterol regulation, if those systems are working, you’re going to be a pretty healthy person.

HOST: That is fantastic. Wow. I hate to say this, but we’re out of time. But I really hope, I mean, we haven’t even scratched the surface of this stuff, and I would love to have you back, Dr. Goodenowe, if you would join us again on a future episode. Just so we can unpack this.

Can you tell people how they can find you and your work?

DR. GOODENOWE: Supplements are available at prodrome.com, and then my research, my clinical trial stuff and our clinics are found at drgoodenowe.com. So, all the educational components and all of our research are done at drgoodenowe.com.

HOST: That’s great. I’ll make sure to include that in the show notes, too. Well, thank you, Dr. Goodenowe. And that’ll do it for this edition of the Natural Man podcast.