Protein and the Gut with David Minkoff, MD

Adapted from episode 78 of The Perfect Stool podcast hosted by Lindsey Parsons, EdD and edited for readability with David Minkoff, MD, who founded LifeWorks Wellness Center in Clearwater, Florida in 1997, which is now one of the largest alternative medical clinics in the U.S. He also founded BodyHealth in 2000, a nutrition company offering a unique range of dietary supplements. Dr. Minkoff has a diverse background as a board certified pediatrician, a Fellow in infectious diseases, an ER physician and as the co-director of a neonatal intensive care unit. He recently wrote the bestselling book The Search for the Perfect Protein: The Key to Solving Weight Loss, Depression, Fatigue, Insomnia, and Osteoporosis and writes two online newsletters each week, The Optimum Health Report and the BodyHealth Fitness Newsletter.

Lindsey: 

So why don’t we get started by talking about how gut health issues relate to protein or can be at the root of protein deficiencies. Because I imagine it goes in both directions, a lack of amino acids can cause gut issues and gut issues can cause protein deficiencies.

David Minkoff, MD:

I think more than any time in history, gut problems are pervasive. Every patient I see has gut issues. And I’m seeing people from very high end professional athletes to people with serious cancer, or Lyme disease or autoimmune disease. 100% of them have got gut issues: they have bad bacteria, they have yeast, many of them have parasites, many of them are on medications that also injure their gut. And they don’t have stomach acid, and they don’t have digestive enzymes. And they don’t digest their proteins, assuming they’re eating enough protein. And so they get protein malnourished. And if you measure amino acid levels in fasting blood, virtually everybody has amino acid deficiencies. And that’s because the proteins that they’re eating aren’t being digested and absorbed. And so they end up in kind of a catch 22. Because the gut, you know, the thing that prevents leaky gut, these special proteins, which hold the cells together, are proteins, and all the enzymes needed to digest food are proteins. And the basement membrane, the thing that keeps the gut, the parts of the gut wall in good separation, are proteins. And so if you get protein malnourished, you’re not going to get those things in their normal condition. And then you get this catch 22 of don’t have enough protein, then can’t make enzymes, so can’t digest the protein. And then the gut is leaky. So these foods go into the body undigested. And then you have allergies and autoimmune things happening. And then added to that, many, many people follow the TV ads that say, you know, if you get heartburn from eating XYZ hoagie, just take a drug to block your stomach from making acid, and you won’t have symptoms, and you’ll be fine. So you add that to the mix. That’s why virtually everybody walking around, at least the ones that come into my office, the first thing that we have to restore is  their gut health and their digestion.

Lindsey: 

Yeah, I was on PPIs for probably 10 or 15 years straight.

David Minkoff, MD:

The PDR clearly says that these drugs can be used for emergency purposes, if someone’s got a bleeding ulcer, or they have severe gastritis. And the drugs could be useful for a couple of weeks. But it’s totally ignored. And all the family doctors and the gastroenterologists put people on them for years and decades.

Lindsey: 

I feel like that’s gotten a little bit better. Like now at least on the package it’s super clear only two weeks, although I guess I do remember it being on the package when I ignored it completely years ago.

David Minkoff, MD:

Yeah. And they’re available over the counter now. So you can go to right, you know, you at any pharmacy and you can buy them. And you don’t even have to go through the doctor. I think last time I looked, there was 25 million prescriptions a month of prescribed acid blockers or proton pump inhibitors. But probably the number of people that are buying these drugs over the counter is double or triple or quadruple that. So it’s pervasive.

Lindsey: 

And a lot of them, what I’m finding is, a lot of them have H. Pylori that’s causing the acid reflux and their gastroenterologists are missing it because they’re only doing a biopsy along with an endoscopy and they’re not doing stool antigen testing, or maybe they’re only doing breath testing.

David Minkoff, MD:

Today, in fact, there was a new patient, and they were having gastritis and they got scoped and the guy said gastritis and the person didn’t have – I don’t know what the gastroenterologist decided – but he didn’t have H. Pylori, and he still had symptoms and he was on his proton pump inhibitor. If he ever tried to cut him off, he couldn’t come off. And then in the office, we found H. pylori, and we’ll treat him and he’ll be fine. And his stomach will get better.

Lindsey: 

 Yeah, it’s easy.

David Minkoff, MD:

Yeah. And we don’t use triple antibiotic therapy because I don’t like that; that makes people worse.

Lindsey: 

What do you use?

David Minkoff, MD:

I use a couple of ounces of aloe with a tablespoon of sovereign silver and mastica and some aged garlic sometimes, and DGL. And one of the keys to it is that the H Pylori can be resident in their gum tissue, and in the partner’s gum tissue. So we have them brushed their teeth twice a day with mastica and have their kissing partners brush their teeth. And then you can sort of end the cycle because if the partner is carrying it, and they’re sharing food or drinks, or they’re kissing, you could treat the one person and they can get reinfected by the other person who doesn’t have any symptoms, but the organism’s living in their in their gums.

Lindsey: 

Are they taking a capsule and opening it up and brushing with it?

David Minkoff, MD:

Yeah. They’re doing their regular teeth brushing. And then they just open up a capsule and brush it in and leave it. And it works. I mean, my success rate for H. pylori is near 100%. They do it for six weeks, and it goes away. And sometimes they’ll get reinfected. But it almost always works and their symptoms go away.

Lindsey: 

That’s great. So back to the protein question, do protein deficiencies or a protein-deficient diet ever lead to gut health problems?

David Minkoff, MD:

Well, yeah, because if people are, and we find this most in people who are vegans or vegetarians, that the quality of proteins that they’re eating, or the quantity of proteins that they’re eating, if it’s fruits and vegetables, have almost no usable protein. So our evolution, we were omnivores; we did include animal proteins, and the animal proteins have the highest quality. And people may not be eating enough, you know, a bagel with coffee for breakfast, or a doughnut, and a salad for lunch, and maybe a couple ounces of meat for dinner is not enough protein. And so people can become protein malnourished, their hair breaks easy, their nails are low quality, they’re tired, their thyroid functions low, their bones start to degenerate, they get osteoporosis, they may have mood or sleep issues. Because these things are all made out of proteins. And it could be generated from the diet and you replenish them with protein or you replenish them with amino acids. And their symptoms all go away and they get better.

Lindsey: 

Yeah, so that sounded like a list of symptoms, but are there some chronic illnesses that have protein deficiency as a possible root cause?

David Minkoff, MD:

Well, almost everybody with any disease, if you check them, they’re protein malnourished. Name a disease, and if I do their serum amino acids, they’re protein malnourished. So we give everybody [amino acids]. You can sort of bypass their digestion, and you can bypass their no enzymes, by giving them this. It’s a product called Perfect Amino*. It’s a mixture of eight essential amino acids, and they replenish their amino acids. And within weeks to a couple of months, they will come back with gee whiz, my digestion is better and my energy is better, and I feel better. And I’ve been going to the gym for a long time trying to get stronger. And now it’s actually working, like I’m getting stronger, and muscles are growing.

Lindsey: 

So what tests do you use with your patients to assess their amino acid status?

David Minkoff, MD:

My favorite test is a Genova. It’s called an ION panel. I love it.

Lindsey: 

Yeah, I like that one.

David Minkoff, MD:

They also do a another one, which is NutrEval, which I don’t like. I don’t think the test is any good. But their ION panel is excellent. I order it on every patient, because you get all the amino acids. And you get all their essential fatty acids, and you get a whole bunch of vitamins and minerals. And then you get organic acids so you can see what kind of infections they have in their gut.

Lindsey: 

Right and the heavy metals.

David Minkoff, MD:

And you get heavy metals. And so it’s a great, great test, my favorite test.

Lindsey: 

Yeah, it’s a great full body test for the money that you’re paying. It’s really an amazing all over what’s going wrong in the body kind of test. So I have found with some of my clients that getting them to take their amino acids can be challenging. Typically, I’m recommending powder forms. Some people have seemed to have bad reactions to them. Like maybe they don’t like the powders or they feel weird after they take them. Any tips on how best to take them and what side effects might happen and how to mitigate that.

David Minkoff, MD:

We make four different flavors of powders. And we also make them in tablets, so they can take the tablets where there’s no flavor, or they can take the powder products called Perfect Amino*. There’s strawberry, there’s berry, there’s mocha, there’s lemon lime, and most people can find one that they like or that’s palatable, and I usually have them throw some greens mix in with it, and it just isn’t bad. And then if they want to put it in with a smoothie, throw some blueberries in there, or some MCT oil or you know, you can doctor it up, and we make a meal shake. It’s got it in there too, which has all that stuff in it with vitamins and minerals. And it really tastes, I think it tastes really good. And very few people have problems with digesting it or stomach upset. There’s a few but it’s in my I mean, I’ve given 1000s of people this product, and very few have trouble. Very few.

Lindsey: 

And what dosage do you typically recommend for someone who is just generally amino deficient, not total collapse of mitochondria deficient, but just generally deficient?

David Minkoff, MD:

Two scoops or 10 tablets. 10 grams

Lindsey: 

At one time?

David Minkoff, MD:

At one time; it works better if you do it at one time. Because that bolus comes in, and then it hits the cell. And then proteins are made right away. It’s in the bloodstream in 23 minutes. It does not spike insulin or a glucose response. So people are fasting, or they can take it and it won’t disturb their fasted state, there’s no, there’s virtually no calories in it. So 10 grams is less than one calorie. So they can get the nutrition from the amino acids, without any sort of disturbance of anything else that they’re doing. There’s also no drug interactions known. So if they are on prescription medication, they can take this safely, without worry that it’ll interfere with the drug or mess with the drug.

Lindsey: 

But it is best on an empty stomach or at least not with other protein foods, right?

David Minkoff, MD:

It works both ways. If you want to get the most for your money, take it on an empty stomach, then in 23 minutes, eat whatever you want. No, it does work with, we have people mix it with other things, and it works fine. So I don’t think you have to be strict with that.

Lindsey: 

Okay, so my understanding is when you get 10 grams of amino acids at once it does stimulate mTOR. So is that kind of dosage not recommended for people who have had cancer?

David Minkoff, MD:

No, we don’t know if it stimulates mTOR. It’s never been studied and measuring mTOR is a tall order. We give it to all cancer patients, I have a practice, it’s 50% cancer patients, usually seriously ill cancer patients, they all get perfect amino between 10 and 20 grams a day, because they need it for their nutrition. The whole immune system is made out of proteins, you know, cytokines and white blood cells and immunoglobulins. These are all proteins. And most of these people, if they’ve been sick, or if they’ve been seeing oncologist and they have been getting chemotherapy or radiation, they’re very protein starved and protein deficient. And their serum level of albumin goes down. And they need proteins very badly. And it does not in any way stimulate cancers or induce cancers or allow the cancers to grow faster. It’s perfectly fine to use that.

Lindsey: 

Okay. And how do amino acids relate to autoimmune health?

David Minkoff, MD:

Well, mostly what I see with autoimmune diseases, they’ve got either a gut that’s too permeable. So that could be from the drugs that they’re taking, or the Roundup that’s in all their food, if they’re not eating organic, or they’re gluten sensitive or dairy sensitive, and they’re eating those foods and they’re causing inflammatory reactions. In the gut wall itself. They get the tight junctions between the enterocytes, between the cells that line the gut break down, and then partially digested or undigested proteins get access to the blood supply. And they go into the intestine, not in a simple amino acid form. But in short protein chains. And the immune system, the biggest part of the immune system is around the small intestine. And those immune cells are sort of our guardians to protect us from foreign things coming in. Now, that could be viruses or bacteria, but it also could be partially digested proteins. And those proteins are foreign. They’re not human. They’re from cows or soybeans or chickens or nuts, whatever people are eating, and the immune system sees those foreign proteins as invaders and makes antibodies to those proteins. And sometimes those proteins look very much like our proteins, like the membranes that line our joints, our skin, our thyroid glands can look kind of like the undigested food from animals or plants, and then the immune system starts an attack against the body, which is what autoimmune disease is. Now sometimes the inciter comes in through a tick bite or an insect bite, or it could be a heavy metal where the surface of the cells look abnormal. And the immune system then doesn’t recognize them and makes reactions, but almost all of it’s gut and for most autoimmune diseases, you have to get their gut in good shape, and then you can get the autoimmune process to turn off the antibodies that the body has been making against itself start to go away.

Lindsey: 

So what that what stool tests do you prefer?

David Minkoff, MD:

I like the DiagnosTechs GI FX 2 or FX 3. It’s very simple. It’s two pages. Like the Genova one, and the Vibrant America one and the

Lindsey: 

GI Map?

David Minkoff, MD:

Can’t stand those tests. They’re too complicated, just confusing, way too many bacteria. Nobody has any idea what all that stuff means. And the DiagnosTechs Test is simple. It gives you a relative level of good bacteria, both gram positive and negatives, it gives you levels of chymotrypsin, it gives you an antibody for H. pylori. There’s a salivary part of it, which gives you antibodies to sIgA total levels, and also to about half a dozen parasites, which actually, like I get parasites on the stool, they find them!

Lindsey: 

It’s PCR I assume.

David Minkoff, MD:

It’s a – I love that test. And a patient can understand it, simple. That’s my favorite one.

Lindsey: 

What was it called?

David Minkoff, MD:

DiagnosTechs GI FX, it’s either 2 or 3. It’s a Seattle lab.

Lindsey: 

Okay, it’s good to know, I haven’t ever looked at that one. Yeah. So do you have any favorite individual amino acids are ones that are particularly pertinent to particular issues?

David Minkoff, MD:

Well, yeah, I mean, you can use amino acids as medications. So someone is hypothyroid. And their tyrosine is low. You might give them extra tyrosine, someone who’s got low serotonin and we measure serotonin levels, or GABA levels, you can use targeted amino acids tryptophan or five hydroxytryptophan or taurine. And they can be very helpful. And they’re almost using like a pharmaceutical, and it can help with mood or sleep. Depending on what the what the person’s issue is. Some people for their gut, glutamine* can be very helpful.

Lindsey: 

What kind of dosage?

David Minkoff, MD:

Five grams.

Lindsey: 

Once a day?

David Minkoff, MD:

Yeah, the powder.

Lindsey: 

Okay. Because I’ve heard claims of needing enormous quantities of glutamine for it to be useful, but . . .

David Minkoff, MD:

That’s because the scoop, it’s easy, it’s easy, and glutamine kind of has a pleasant sort of almost sweet taste. Most amino acids are very bitter. Because you could put a scoop of glutamine underneath your tongue and just let it dissolve. It actually is quite pleasant.

Lindsey: 

Yeah, not like L carnitine.

David Minkoff, MD:

Yeah or methionine, you know, some of them taste horrible.

Lindsey: 

Yeah. So I use freeform amino acids with my clients sometimes. Are the amino acids in Perfect Amino free form, or if not, what’s the difference?

David Minkoff, MD:

Well, the amino acids in Perfect Amino – the only utilizable amino acids are L form. So molecules come with a left hand and a right hand configuration. The human body could not utilize amino acids that are in the right hand form. Most amino acids are that are sold are mixtures. And so you only can utilize half, the L side, the left hand side. So if you’re getting a gram, only 50% of it, only 500 milligrams is going to be L form, and the rest of it isn’t usable. So perfect Amino is all l form amino acids. And if they’re pharmaceutical grade, there’s a lot of companies, Chinese companies, that make crappy amino acids that are full of impurities. And they’re not clean, they’re not pure. So Perfect Amino is – these are pure, these are pharmaceutical grade L form amino acids.

Lindsey: 

I was just going to ask is free form the same as the L form? Is that what that means?

David Minkoff, MD:

I don’t know what free form means. Free form probably means that they’re all there. It’s just amino acids, but there’s probably half right sided. So it’ll say l-tyrosine. Or l-leucine. That’s L for left. The other thing is, like if you look at something like like branched chain amino acids, so these are amino acids that have a structure that has a 90 degree angle, and they’re called branched chains, leucine, isoleucine, and valine. And people have said, well, branched chain amino acids are good for fitness, and they’re good for muscles. Athletes should use branched chain amino acids. But what happens is, if you take those amino acids, you don’t ever build proteins, because if you don’t have the eight essential amino acids there at the same time, you won’t build protein. So the body takes these amino acids and turns them into just calories;  the body utilizes them as carbohydrates. Now you can get effects from single amino acids, as if you’re using a pharmaceutical, but you’re not building protein. You want to build protein, you got to have eight essential amino acids. And the configuration of Perfect Amino is such that the amino acids have to be in a very specific ratio, or the body can’t utilize. And so if you mix up the ratios, like on the on the ION panel, at the end, they give a suggestion of okay, for the amino acid deficiencies that you have, mix, you know, send the pharmacist or, or whoever mixes up your amino acids, this much of this and this, much of that, and this much of that. And that’s what they should take to replenish them. It won’t work, the body can’t use them that way. The way they have to come in is they have to come in in a very carefully balanced form, which is what Perfect Amino is, and then the body will utilize those to make protein.

Lindsey: 

And does the protein we eat come in that perfectly balanced form?

David Minkoff, MD:

No, it doesn’t. So if you look at different foods, you know, if you’re talking to a dietitian, and they’re calculating, you need a gram of protein per kilogram of body weight, or per pound of body weight, depending on who you talk to. So you weigh 120 pounds, you should have 60 grams a day of protein, let’s say, I think you need a little more. But let’s just say that. And they’ll say, Okay, if you have a yogurt, that’s eight grams of protein, and you have a tuna fish sandwich, and that’s 20 grams of protein, and you have a steak, and that’s another 20. And then you have some whey protein, and that’s 20, you get to your 60. But each one of those is not equal in that the body can’t take those proteins and make its own protein with the same efficiency. So this has been worked out, if you eat only whey protein for a day, and then measure, you can measure what percentage of the amino acids that make up whey protein actually get incorporated into the body’s proteins. Because that’s why you’re eating protein, you want to rebuild your own muscles and tendons and ligaments and bone and hormones and all the rest of stuff that they get made out of. And if you take whey protein, only 16% of whey or dairy proteins are usable, they just come in in the wrong combinations, and the body can’t do it. It’s almost like you want to build a car. And the minimum for a car is let’s say, four wheels, and a frame, and a steering wheel and a motor. That’s your basic car, which let’s call that a protein. And if you have a manufacturing facility, where you have no storage space, so if the suppliers don’t send you the exact right things, you have no place to store the excess. So if you get shipped, let’s say 100 wheels, and 25 frames and 25 steering wheels and two motors, you’re only going to get two cars, but now on your lot, you have nowhere to store this stuff. So you have to dump it all. And it’s the same in the body. There’s no storage depot for amino acids or proteins. There are storage depots for carbs and fats. But there’s no storage depot for proteins. So if you eat a protein, and the amino acid balance or mixture in that protein isn’t what the cells actually need, there’s a whole bunch of excess amino acids leftover and those get turned into calories and nitrogen waste. And that’s why we urinate,  mostly to get rid of the nitrogen.

Lindsey: 

Assuming that somebody’s suggestion is repaired and all that, obviously we’re made to get our protein from our foods. So ideally, once you get past the point of needing to supplement, how much and what types of protein should people be eating to get adequate protein?

David Minkoff, MD:

Well, I think what you can do is, we know that if you took 10 grams of perfect amino three times a day, for your average person that would that would fulfill all their protein requirements that they would ever need. Now, that isn’t very interesting. And people like to eat food. So what you have to do, I mean, ideally what the dietitian would say is okay, meat protein, and fish 33% of those amino acids that are in that protein, your body can use, and eggs are the best food, whole eggs, white plus yolk, 48% of the amino acids, they’re utilized. If you look at soy and whey it’s like 16, or 17%. Collagen is actually zero because collagen’s missing tryptophan and you can’t make proteins without tryptophan. So if you tried to live on collagen and lettuce, you couldn’t do it, it wouldn’t go. So these foods are fine. And as long as you’re getting enough of them to meet your daily requirements, you could be okay. You know, if your gut was good, and your digestion was good, what I find with most people is I say just take another 10 grams of Perfect Amino with it every day to make sure that you’ve got enough. If you’re malnourished or you have osteoporosis, you may need more for a while until you build back up.

Lindsey: 

So other than Perfect Aminos,  are there other supplements that you make that you would like to mention?

David Minkoff, MD:

Yeah, we did a study. So I have a practice where most people are semi-nutritionally conscious. So we did a study, there is a machine available, where you can measure levels of what are called carotenoids, or flavonoids. These are the antioxidant chemicals that are in fruits and vegetables and what give fruits and vegetables their color; there’s 1000s of them. So this machine could measure carotenoid levels in the skin. And they correlated with the carotenoid levels in the blood or in the body. And so for fun for a couple of months, everyone that came in, I put had him put their hand over this little sensor and measure their carotenoid levels, and people who had adequate levels of carotenois, cause these are antioxidants, these are what protect us from radiation and heavy metals, and chemical toxins, which we are all exposed to every day. And if you don’t have enough antioxidants in your system, to sort of buffer or neutralize all these things that are coming in, the body gets injured from this stuff. So injury to inside lining of blood vessels, or inside lining of gut, or in the tissues themselves. And it’s manifest with inflammation and pain. So we measured everybody coming in for a couple of months, and what was their level of carotenoids? And above 50 was considered like your adequate, like you got enough, like then if you measured their carotenoid level in their blood, it would be like, oh, this is a good level. And the average that we found from people coming into the clinic was 18. They were all low. And the children that we saw, the average was 12. So as an experiment, we make a product called Perfect Greens, or another one called Perfect Reds. So one scoop, oh and the people who were above 50, were eating 8 to 10 servings a day of vegetables. So very few people eat that much salad or fruits and vegetables; almost nobody because hardly anybody was above 50. We had a few, but most people, the average was 18. So we make a product which is an organic mixture of fruits and vegetables. It’s organic, dehydrated, one scoop equals 10 servings of fruits and vegetables. So I said okay, for the next month, put one scoop in your smoothie, put one scoop on your cereal, put one scoop on whatever you’re eating every day and come back and we’re going to retest your carotenoid levels, and everyone was above 50. So you know, we’re walking around protein malnourished, but we’re also walking around antioxidant malnourished. And if you take one scoop of this stuff, you can put it in the same jar with the same smoothie or the same glass with Perfect Amino and now you get your amino acids and you get your your 10 servings of fruits and vegetables.

Lindsey: 

So do you need the greens and the reds separately?

David Minkoff, MD:

I just alternate, one day do greens . . .

Lindsey: 

Okay. Because it could get a bit overwhelming with your aminos your greens and your reds in one smoothie.

David Minkoff, MD:

Yeah, I mean my wife puts everything in there but I I just have them sitting on the shelf and one day I do one and one day I do the other. Now the other thing that people are deficient in from this ION Panel is many, many people are deficient in Omega 3 oils, EPA, DHA. They’re deficient, they’re not eating fish, and they’re eating a lot of bad oils and the brain and the nervous system are made out of these Omega 3 oils. They’re really important, and most people aren’t taking them. So okay, throw in a couple of capsules. We call it Omega 3 Health, but it’s a distilled product with cold water, deep fish oils with no chemicals, and no heavy metals and no burp when you take the thing. And so everybody ought to take that.

Lindsey: 

How many grams of EPA and DHA are in one capsule?

David Minkoff, MD:

They’re 1200 milligrams each. So if you take three of them, it’s 3600. And I forgot what the balance is. But it works out to be a decent balance.

Lindsey: 

So 3600 of DHA and EPA combined? So more than 1000 per pill?

David Minkoff, MD:

Yeah, I think they’re 1200. [Correction: they are 1200 in two pills]. Okay, I’m going to look at it the thing, but I think that’s what I remember. So sort of everybody gets Perfect Amino, they get reds or greens, whichever one they like better. And if they like both, alternate, they get fish oil. And then we make a multi, which is the best multi on the market, two tablets twice a day. So it’s 16 Whole Food concentrates plus extra CoQ10, methylfolate, good amounts of selenium. I mean, it’s really a good one. And everybody else’s is 12 capsules, and it’s called Body Health Multi Complete, and it’s got 5000 units of vitamin D in it. You know, everybody needs vitamin D. So this is a way to get a whole lot of stuff in a relatively small package.

Lindsey: 

And how many a day?

David Minkoff, MD:

Two in the morning, two at night.

Lindsey: 

I’m looking at it right now. So you know, you mentioned decent amount amounts of selenium. And one thing that I noticed, well, what happened to me was I was taking a multivitamin that had more than the RDA of selenium. And I think something around the amount that yours has, like 200 micrograms, and I started getting headaches, and I started pulling out all the 16 different supplements I was taking till I was down to the multivitamin. And I was like, That’s it. I’ve got too much selenium and I looked up every single side effect for everything that was in it. And finally, that was the one. So I’ve stayed away from higher dose selenium supplements. Am I unusual, or have you heard about this from somebody else?

David Minkoff, MD:

Super rare. In my experience, like most people don’t have enough selenium. Selenium is protective against metal toxicity. And it’s required for making thyroid hormone, it’s required for antiviral activity. So it’s super important. And most people don’t get much. Very few people react to these things. It’s a tablet, and it’s a little bit, I wish we could make it a little bit smaller, but that’s what the complaints are from, the product is maybe a little bit too big. But boy, it’s very rich in B’s, and it’s got you know, methylfolate and 5000 D.

Lindsey: 

Right, and you’ve got the methylated B’s in there.

David Minkoff, MD:

You get the methylated B’s in there, and it’s with P5P. I mean, it’s really a great product, and it’s cheap. If you buy all those things individually, it’ll cost you 130 $140. And so this is a really good mixture. The other thing everybody needs,  magnesium, you know, 80% of the people we do the ION panel on have low RBC, magnesium. So I stick up them on a magnesium. We make a product, which is called Calm. It’s mag citrate. I take a scoop, which is 400 milligrams of magnesium before I go to bed at night, it’s relaxing, helps you sleep. It’s a great laxative. So anybody who’s got slow bowels or they’re constipated, usually there’s a dose that you can work out which is just the right amount so that they have a nice easy bowel movement every day. So that’s on my list. The other one on my list, which I find very frequently deficient is iodine. You know, if they’re eating seaweed or nori a couple times a week, they’re probably okay. But almost nobody or not enough people are and many people are iodine deficient. And that might manifest as low thyroid or cystic breast disease. And so I put everybody on a little bit of iodine.

Lindsey: 

Like 150 milligrams?

David Minkoff, MD:

Usually six milligrams. It’s not a little bit, it’s a good dose. But it’s it’s half of what Japanese people take every day with just their diets. So it’s a product called Ioderal, we don’t make it, it’s half iodine and half iodide. It’s a 12.5 milligram pill, it’s tiny. And I say just take half every day or one every other day. Because I measured  over 500 people for iodine sufficiency. And like 80% of them were iodide deficient. So we’re trying to sort of hit broadly the stuff that really is needed. Those are the things on the list, which I originally give to everybody like these, I just tell people you’re going to take these for the rest of your life.

Lindsey: 

So no, I just I thought 150 stuck in my head. It’s 150 micrograms is the RDA. . . 

David Minkoff, MD:

is the RDA, but it’s way too low.

Lindsey: 

But my understanding, because I have Hashimoto’s, is that too much is also – that it’s a very Goldilocks kind of supplement – that too much is too much as well. It can be can be harmful as well.

David Minkoff, MD:

It can be. If you read any of David Brownstein’s books on iodine. He’s a practitioner in Michigan. His name is David Brownstein. He’s written some incredible books on iodine and what it does and how much you need. And they’re just really excellent. Now there are some people with Hashimoto’s, which you have to watch the iodine. And if they’ve got Hashimotos, I may not put them on any iodine to start. Yes, because sometimes they’ll flare, that is true.

Lindsey: 

And what’s the best way to test iodine?

David Minkoff, MD:

The best way is the urine challenge. So you give somebody iodine, and then you collect their urine and see how much comes out. And if they’ve got enough iodine, they’ll dump it all. If they don’t have enough iodine, most of it won’t come out. I haven’t done that test in a long time. I did about 500 of them over a few years. And virtually everyone needed iodine. I just stopped doing the test because it was a waste of money.

Lindsey: 

And is this because everybody’s moved to sea salt as opposed to iodized salt?

David Minkoff, MD:

Everybody goes, I don’t do iodized salt. I do sea salt.

Lindsey: 

So yeah. Okay. Well, this was all very interesting. Any final thoughts about gut health and any of this?

David Minkoff, MD:

I think you know, the central core of your body is your gut. And if you want to have a good brain, and you want to have good joints, and you want to have good energy, it only can happen if your gut is good. If you are able to, you know you have a functioning gut where you can digest your food, and where you have a mix of bacteria inside which are the right mix for you so that they help you detoxify, they make things that you need. Virtually anyone who isn’t really being careful about their food and eating organic, and supplementing, that a gut test is a sure 500 bucks well spent. And then analysis by someone like yourself or me who’s who’s experienced with this, who can then help the person get their gut fixed is just like, if you want good health, it’s a mandatory thing.

Lindsey: 

Totally agree. Well, I’m going to put a link to your Perfect Aminos and other products you mentioned in the show notes so that people can support the show as they as they look at your products. I really appreciate your time and coming on and sharing with us about this.

David Minkoff, MD:

Yeah, you’re welcome. And the book is called the Search for the Perfect Protein. It describes the whole thing. It was an Amazon bestseller. If they go to our website, which is bodyhealth.com, if they want to download a free PDF copy of it, they can. It’s written for people to give them an understanding about overall body health,  amino acids, and there’s a whole bunch in there about gut health. I’ve just had gazillions of compliments on it because it helps people understand what’s going on.

If you are struggling with gut issues and/or mental health issues, fatigue or other or chronic health problems, I work with clients to uncover the root causes of these issues educate you on how to fix them naturally. So if you want to talk to me about what you’ve been dealing with and see if I think I can help, you can set up a free, 30-minute breakthrough session with me. I can let you know if I think I can help you and tell you about my 5-appointment gut or autoimmune healing program and you can decide it that seems like a good fit for you. Or you can just sign up for a single appointment.

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