Speaker 1:
Welcome to the Dr. Gundry podcast, where Dr. Stephen Gundry shares his groundbreaking research from over 25 years of treating patients with diet and lifestyle changes alone. Dr. Gundry and other wellness experts offer inspiring stories, the latest scientific advancements and practical tips to empower you to take control of your health and live a long, happy life.
Dr. Stephen Gundry:
You know I love supplements. I think the only purpose of food is to get supplements in your mouth. Now, that’s olive oil, but let’s talk about supplements that you really don’t want to waste your money on. First up is Vitamin E. Now, you see vitamin E advertised all over the place. It’s in every grocery store, it’s in every drugstore, and vitamin E is really important. That’s true. The problem is most of the vitamin E that’s available for purchase is the wrong form of vitamin E. There was a very, very famous study years ago that really put the nail in the coffin on Vitamin E. They took a bunch of smokers who are full of what’s called oxidative stress, and oxidative stress from smoking is really one of the main reasons that smoking is so bad for you. Well, vitamin E is considered an antioxidant. Now, that sounds like a good idea if you have oxidative stress, if you’re oxidizing things all the time.
Another way to think about oxidation, if that doesn’t sound familiar, rust is iron that oxidizes, and so that rusty thing on your rusty old nail, that’s the oxidation of iron. An antioxidant would prevent that oxidation, sounds really like a good idea. Vitamin E is an antioxidant, so good idea. Let’s give smokers vitamin E and that’ll prevent all the problems with oxidative stress for smoking. Oops. When they did that and followed smokers, lo and behold, they found that the smokers who were taking vitamin E actually developed more lung cancers than the smokers who weren’t taking vitamin E. For years, it was thought that vitamin E was the problem. Well, vitamin E is an antioxidant, but when it combines with oxygen, it becomes a pro-oxidant. Oops. Now, the good news is if you have vitamin C in your system, vitamin C then takes vitamin E that’s oxidized and reverses that so that it becomes an again.
If you don’t have vitamin C in your system, then the oxidized vitamin E becomes a pro-oxidant and causes the problem. Why is that important? Because at that time of the study, it wasn’t realized that smokers are profoundly deficient in vitamin C. because we’re one of the few animals that don’t make our own vitamin C. It’s not that vitamin E causes cancer, and you still see this on the internet. It was vitamin E and smokers that perpetuated cancer because they didn’t have any vitamin C. Back to vitamin E, most that are available are not the right kind. There’s actually a number of different forms of vitamin E. There are tocotrienols and tocotrienols, and each of them have a specific job, and it’s beyond the scope of today’s lecture to tell you each job. I’ll tell you one. There’s delta forms and gamma forms that may actually be very effective in suppressing cancer cell growth, but that’s not in the vitamin E that you’re taking from the drugstore.
If you’re actually going to take a vitamin E that has any utility, you want to get a mixed vitamin E that says mixed tocopherols and mix tocotrienols. Having said that, there is evidence that those mixtures may not allow the really good guys to shine. Long story short, there’s far better supplements that you can spend your money on than vitamin E.
Second, calcium. First of all, there is no human need to take supplemental calcium in a tablet or supplemental form. The problem with most of these calcium supplements is they are not taken to your bone, which is the reason you are actually taking them. You have to have adequate levels of vitamin D to deliver calcium to your bones. On top of that, you really need adequate levels of vitamin called vitamin K2 to assist vitamin D in taking calcium to your bones so you could swallow all the calcium that you want, but if you’re not having adequate levels of vitamin D, and quite frankly, 80% of my patients in Southern California when they first visit me are vitamin D deficient and fascinatingly, a great number of these people come to me with osteopenia or osteoporosis, which is low bone matrix, low calcium in their bones.
They’re all taking their calcium supplements, but none of them are taking an adequate amount of vitamin D. There’s far better ways to deliver calcium to your bones. Number one, you got to get your vitamin D up. Bare minimum is 5,000 international units a day. The University of California San Diego, which has one of the biggest vitamin D research units in the country, thinks the average American should take 9,600 international units of vitamin D3 a day. That’s basically 10,000 international units a day. In fact, that’s what my wife takes. That’s what I take, that’s what I have most of my patients on. They and I have never seen vitamin D toxicity up to 40,000 international units a day. Never seen it. Both Quest and the Cleveland Heart Lab recommend that a normal vitamin D3 level is anywhere up to 150 nanograms per milliliter. Just this week, almost on a weekly basis, I saw a patient with a vitamin D3 level of 60 nanograms per milliliter whose, well-meaning healthcare professional provider told them that they were vitamin D toxic.
No such thing at that level. In fact, if you read any of my recent books, that vitamin D level of 60 is much too low to be effective. Now, where do you get vitamin K2? Well, I prefer the supplemental form, but vitamin K1 and vitamin K2 are present in green leafy vegetables. As you know, I am a vegetable leafy green predator and I personally think the purpose of salads is to get olive oil and vinegar into your mouth, but it’s a great way of getting vitamin K into your diet. Another great way is eating small fish, whether it’s anchovies, whether it’s sardines, whether it’s mullet. I just got back from Italy and every other day I was served a plate of anchovies or sardines or mullet, and guess what? You eat the whole thing, head and all, bones and all, and it’s a great source of bioavailable calcium.
In fact, a little town south of Naples, the south of Italy called Acciaroli, which I visited, this town has more people over the age of 100 per population of any place in the world. About 30% of this village are centenarians, over 100 years of age. What’s fascinating about these people is that they are fishermen and they eat anchovies throughout the day, supplemented with a lot of olive oil and a lot of rosemary, but that’s another subject. Get these small fish in you and they’re delicious and easy to … Finally, if you’ve been told you have osteopenia or osteoporosis, the cause as you learned in gut check is not your exercise program, is not whether you’re getting enough calcium, but the cause is actually LPSs from leaky gut and there’s study after study showing that it’s the little pieces of shit coming through the leaky gut that’s causing the osteoporosis.
You seal the leaky gut by following the plant paradox program, and we’ve resolved osteopenia and osteoporosis in our patients who we’ve documented that they no longer have leaky gut, so all the calcium in the world is not going to do the job that you think it’s going to do. In fact, there’s some scary evidence, and I don’t want to really scare you, that these forms of calcium rather than going to your bone, can be causing calcification of coronary arteries, but that’s a whole other subject. In other words, don’t waste your money on calcium supplements. Please. How about B12 and folate? As you’ve read in my books, about 50% of human beings carry one or more mutations of what are called the MTHFR genes. Now, that’s a mouthful. I tell my patients the way to remember it is they are the mother effer genes because if you said MTHFR out loud, we’d bleep you from network television.
They are associated with a lot of interesting abnormalities and a lot of people who are told they have the mother effer genes are told that that’s why they’re anxious, that’s why they’re depressed, that’s why they’re suicidal, that’s why they smoke. That’s why they’re addicted to alcohol, that’s why they have suicide densities. It is true that these do associate in families. However, there’s an easy way around this and we can’t spend our lives blaming our mother effer genes for everything that bad happened to us. First of all, what this means is that these genes normally make you make enzymes that attach a methyl group to vitamin B12 and to folic acid and turn them into their active vitamin forms, which are called methyl B12 or methyl folate. You may see methylcobalamin as methyl B12. That’s all well and good. Those are the active forms. If you carry these mutations, you could swallow all the regular B12, all the folic acid in the world.
You could eat rich B12 foods, rich folate foods like green leafy vegetables, and you’ll never make the active forms because you don’t have the enzymes to do it. The great news is you can take methylated B vitamins, methyl B12 and methyl folate. Here’s the catch, many of us to absorb vitamin B12, well, we have to have a receptor in the lower part of our intestines called intrinsic factor. An intrinsic factor basically opens the door, grabs B12, and puts it into your bloodstream. If you don’t have an intrinsic factor, you will not absorb even the right form of B12, and it won’t get into your bloodstream. Now sadly, a number of people don’t have intrinsic factor, and long ago it was called pernicious anemia and people got B12 shots. Well, here’s the great news. You can take methyl B12 and methyl folate as a sublingual tablet and let it dissolve under your tongue.
It will go directly into your bloodstream. Do not pass go, do not need intrinsic factor, and the problem is solved. How do I know how effective it is? Years ago, one of my patients with the mother effer mutations, I put him on sublingual methyl B12 and methyl folate in a tasty little lozenge, and he came back and we measure B12 levels and folate levels in all of our patients. His B12 levels and folates were still lousy and a consequence of that, another chemical in his blood called homocysteine was still elevated. I said, “You’re not taking your B12 and folate.” He says, “Oh, yes, I am every day religiously.” I said, “No, you’re not. He says, “Yes, I am.” I said, you’re putting it under your tongue, right?” He says, and his eyes lit up, he said, “Well, no, it’s so sweet that I sweeten my coffee with it.”
I said, “Well, you can’t do that because you’re swallowing it.” I said, “Do me, humor me. Just put it under your tongue. I’ll see you in three months.” Sure enough, once he started putting it under his tongue, his B12 levels became normal, his folate levels became normal and his homocysteine dropped to normal. That’s the importance of getting the right form of methyl B12 and methylfolate and taking it the correct way. If you’re just swallowing B vitamins, looking for B12 and folic acid, I got news for you. It’s not going to do half of you any good. Now, while we’re on the subject of B vitamins, my good friend Dave Asprey just published a reel about the dangers of Vitamin B6. Now while it’s true that high doses of vitamin B6 have been associated with neuropathy, and I have actually seen one patient for the first time who was on very high dose of vitamin B6 with neuropathy, and when we took away his vitamin B6, that neuropathy cleared.
However, it’s like anything else, the active form of vitamin B6 is called pyridoxal-5-phosphate. That’s a long one. It’s abbreviated P5P. That’s a lot easier. Sometimes you’ll see it as PLP. It’s the same stuff. If you’re looking for the right forms of B vitamins, make sure you’re looking for the active form and good news, a lot of companies make a sublingual tablet with methyl B12, methyl folate, and P5P, and if you see that, that’s the one you’re looking for. You don’t have to worry about vitamin B6 toxicity. Finally, what should you not waste your money on, but what you should spend your money on in terms of vitamin C? I just got a question about this on my social media. Somebody wrote in and said, “Dr. Gundry, I know you’re a big fan of vitamin C, timed release. What do you think about liposomal vitamin C?”
Liposomal vitamin C, like many other forms of liposomal supplements, are more readily absorbed than regular vitamin C. Yes, you will absorb more ascorbic acid in a liposomal form than in a regular form, but quite frankly, that’s not the point of taking vitamin C. If you follow me, you know that vitamin C is one of the few vitamins that we do not manufacture. Almost all other animals manufacture a continuous supply of vitamin C. There are actually five genes that make enzymes to take glucose, yes, sugar and convert it to vitamin C. We have all of those five genes, but the fifth gene in the chain of making enzymes is what’s called a ghost gene. In us, it’s inactive. It’s also inactive in Guinea pigs and new world monkeys. Fun fact. The problem we think is making vitamin C is expensive because it’s taking glucose that your brain might like instead. If you had a lot of vitamin C in your diet from all the fruits and vegetables that we were eating in the jungle, then it would be silly to waste some of that energy in making vitamin C that we were acquiring from the diet.
We think that that’s why it became a turned-off gene. So what? Well, vitamin C is essential to repair the cracks in collagen that occur in our blood vessels and also, in our skin. In fact, you may have noticed that smokers have lots of wrinkles. Getting back to where we started, smokers because of oxidative stress, use up all of their vitamin C, and they don’t have any vitamin C available to repair the cracks in collagen that sunlight causes, and that’s why they have a lot of wrinkles. The same thing we learned in blood vessels. Your blood vessels are constantly flexing, and collagen is kind of the rebar in blood vessels, and when it flexes, it breaks. Normally, vitamin C repairs that rebar. Puts it back together, repairs the collagen. If you don’t have a continuous supply of vitamin C, those cracks appear. Quite frankly, we try to patch those cracks with cholesterol and a plaque.
That’s why in smokers we saw that most of the disease in coronary arteries in smokers was where the bends were, and that is why vitamin C is so essential. How essential is it? Research in rats, we can genetically engineer a rat to have a ghost gene as that fifth gene just like humans. Those rats live only half as long as a rat that makes its own vitamin C. Now, here’s the good news. If you put vitamin C in those rats’ drinking water so that they’re drinking vitamin C throughout the day and night, they live as long as the rats that make their own vitamin C. In fact, the late Bill Sardi, who’s a researcher in vitamin C, showed if you look at that benefit, then if humans were taking continuous vitamin C, they would have the potential to live, based on rat studies, about 250 years.
Sounds fun, so what a hack to just take timed release vitamin C. That’s why, yeah, you could take liposomal vitamin C, you could swallow vitamin C, but what you want is a continuous dose. You can either take 500 milligrams, four times a day, there’s a lot of chewable tablets available, or just by timed release vitamin C. I personally take 1,000 milligrams twice a day. Vitamin C is that important, but an acute dose of vitamin C, sadly, vitamin C is a water-soluble vitamin, and that vitamin C after you take it is gone in about four hours. You have to continuously resupply it, and that’s why timed release vitamin C is where you want to spend your money.
Now, how about joint supplements? Now, joint supplements are not useless, but they’re incredibly misunderstood. There are a number of joint supplements who have been shown in placebo-controlled trials to actually benefit. You may have seen my product called Mighty Flex, which uses a compound that was discovered in a particular breed of cucumber in a placebo-controlled trial in humans, improved joint mobility, improved joint comfort, and improved joint health. That’s just one example.
Many times you go to Costco or another big-box store and see glucosamine and chondroitin sulfate and MSM. These also in placebo-controlled trials work. Here’s the really interesting thing that I wrote about in the Plant Paradox, those compounds work because they bind lectins in your GI tract. As many of you know, lectins and leaky gut are the real underlying cause of arthritis. These compounds work not by getting in your joints, but they work by absorbing lectins that you eat. Just when you see a study saying, “Oh, there was no evidence that MSM or glucosamine sulfate gets into the joint,” who cares? They’re working in your gut and your leaky gut and the lectins were actually the cause of your joint discomfort. That’s the mechanism of action. You always want to look at where are these compounds working? I’m a big fan of these joint supplements, as long as you understand that this particular group isn’t working in your joints, they’re working in your gut.
Five signs of a magnesium deficiency you need to know about. All right, first of all, if you’re not supplementing with magnesium, you absolutely need to be. There are actually thousands of chemical reactions happening in our bodies every day that require magnesium. It’s really one of two essential electrolytes for your heart, your gut and your brain health and your muscle health as well as your mood. What does it do? Well, magnesium controls the movement stability of cell membranes, particularly muscle cell membranes, including in your heart and your gut. The problem is most people really are not getting enough magnesium in their diet, and yet when you go to your doctor, they will more than likely check a magnesium level in your blood and they’ll tell you that it’s absolutely normal. Why? Well, magnesium levels in the blood are kept constant at all costs. The same with the other electrolyte, potassium.
You will suck magnesium out of the inside of cells to always have enough magnesium in your bloodstream. The problem is that doesn’t tell you what your intracellular magnesium is. Now, I got interested in this many, many years ago as a heart surgeon, and we noticed that magnesium levels would plummet after heart surgery and we would actually have to give people intravenous magnesium sulfate, a couple of grams, IV every four to six hours to keep their heart rhythm regulated. Magnesium is incredibly important for keeping skipped heartbeats under control. It’s incredibly important for suppressing atrial fibrillation. As many people find out during the summer, it’s incredibly important for preventing muscle cramps. All of these are because you’ll maintain your blood level of magnesium at the cost of the intracellular level of magnesium where really the rubber meets the road. That’s why I learned very early in my career how many people are profoundly deficient in magnesium.
Your blood level is really a poor indication of your magnesium level and your magnesium stores. What are some indications? Well, one of the most obvious ones is constipation. Your gut wall is a muscle and it’s lots of layers of muscle, and these muscles are very sensitive to magnesium. How sensitive? Well, Milk of Magnesia is concentrated magnesium, and if you will, magnesium in concentrated levels really wakes up the muscles in your gut and of course moves your bowel. Constipation is actually a really good sign, among others, that you have a low magnesium level. Secondly, irritability and low mood. There is actually some pretty good evidence that magnesium helps with mild anxiety and even mild forms of depression. Plus, magnesium helps you get better sleep, which can definitely help your mental health. I joke with my patients when I ask them to take magnesium before they go to bed, that it will absolutely improve their mood.
It will absolutely help with their sleep, and they won’t beat their dog or they won’t beat their husband or wife anymore, and we have a good chuckle. The reason we have a good chuckle is because this irritability and low mood is prevalent in our society, and I submit to you that for a large part of it, magnesium levels being low contribute to this. That’s number two. Now, sleep problems per se. Magnesium is well-known for producing not only a quicker onset of sleep, but a better quality of sleep along with deeper sleep and less tiredness during the day. In fact, studies of older adults also, found that magnesium supplementation helped with them falling asleep faster and it actually protected them against waking up earlier than intended. I can tell you in my practice that particularly older adults have some real issues with not so much going to sleep but waking up at 3:30, 4 o’clock in the morning and not being able to get back to sleep.
Again, studies have shown that this is partially responsible because of low magnesium levels. An insomnia study adults in their sixties actually slept longer, spent less time awake in bed and received lower scores on an insomnia score when taking a magnesium supplement versus a placebo. Now, a number of my patients initially complain of restless leg syndrome, and while this is multifactorial and a lot of it comes from the gut-brain access, research shows that magnesium is really able to help with this, especially if you develop restless legs during pregnancy. Now, magnesium versus melatonin, they both start with M, they sound similar. Melatonin, of course, is what’s known as the sleep hormone, but if you’ve read any of my recent books, you know that melatonin is actually an incredibly important mitochondrial repair hormone that repairs mitochondria and is actually a significant mitochondrial encoupler. I use timed-release melatonin in concert with magnesium in my patients with insomnia and in my patients who have absolute trouble falling asleep, I don’t use immediate-release melatonin.
Yes, it will help put you to sleep, but unfortunately it wears off in a couple hours and you wake up wide awake and that’s not exactly what you want. I mentioned this before, but number four is muscle cramps. Muscle cramps happen, as I mentioned, magnesium and potassium are muscle cell membrane wall stabilizers, and potassium and magnesium actually tell a muscle whether to contract or relax, and I actually in heart surgery use high dose potassium to literally stop the heart during heart surgery where we can work on it, so it depolarizes the membrane and stops contractions. Well, it’s the same way of balancing the amount of potassium and magnesium in a cell and outside of a cell that starts this. If you have muscle cramps when you’re exercising or if you have muscle cramps when you are sleeping, better yet, if you have muscle cramps on a ketogenic diet, a really strong side effect of a ketogenic diet, what you didn’t know is that potassium and magnesium are stored with glycogen, the storage form of sugar in our muscles.
When you go on a ketogenic diet, you not only deplete all the glucose, but you also deplete muscle glycogen. It just so happens that potassium and magnesium leave with the glycogen, which means there’s now no longer any of this protective membrane stabilizing compound in your muscles, and that’s where those uncomfortable cramps come from. If you’re getting nighttime leg cramps, if you’re getting cramps while running, this is a potassium and magnesium deficiency staring you in the face, you absolutely need to supplement with at least magnesium. I prefer a combination of potassium and magnesium supplements, which are readily available.
All right, number five, I alluded to this as well. Heart palpitations. If you are having palpitations, skipped heartbeats, if you’ve been told by your doctor based on a Holter monitor or a bio patch that you have extra beats, that you have extra tickles in your heart, or if you can feel these palpitations, this is absolutely a sign that you’re both magnesium and potassium deficient.
In fact, when I supplement my patients with potassium and magnesium aspartate, which is one of the forms, this is actually my first line of treatment for patients with palpitations and it works remarkably well. How do I know it works? Because for 40 years in the clinic, in the ICU, this is the way we control these extra beats and the oral forms work fine. It’s not an emergency to get them under control like in the ICU, but in my practice in cardiology patients currently, it works just super. That’s five really good signs that you’re magnesium deficient. The good news is, as I mentioned, it’s easy to supplement with. There are plenty of good options for getting these electrolytes into you. Electrolyte drinks, I happen to like a drink called LMNT. It’s spelled L-M-N-T, and I happen to make an electrolyte replacement called Vital Recharge.
Now, an old trick was called Epsom salts, and you would soak your feet or take a bath in Epsom salts. What you were actually doing was soaking in magnesium, and you absorb magnesium extremely well through your skin. A fun fact, some people are very sensitive, particularly women, to oral magnesium products, and you get loose bowels, but we still need to get more magnesium in you. The great trick is I can switch you over to magnesium salts either in a bath with Epsom salts or they’re now what are called magnesium oil sprays. The reason they’re called magnesium oils, they’re not oils, but they feel greasy, but you can just spray them on your tummy, you can spray them on your legs before you go to bed and it really works, but you won’t get the side effect of loose bowels.
Now, magnesium citrate is well known in our hospitals as one of the best ways to induce a bowel movement. If you are really constipated, a bottle of mag citrate is the way to go, and they’re available in every drug store. There are multiple forms of magnesium, and quite frankly, I’m not too worried about which forms are right for each of my patients. There’s magnesium aspartate. There’s magnesium tarate. Tarate now is getting a lot of interesting reviews for its ability to also, help muscle strength and also, to regulate heart rhythm, and that’s available form of magnesium. There’s also magnesium L-threonate. Now, magnesium L-threonate number one is expensive, but number two, it actually has been shown to enter the brain more effectively than other magnesium products. If you’re looking for brain health, magnesium L-threonate is possibly the way to go. Finally, what do I take? I take potassium, magnesium aspartate. There are multiple available on the market. I’m not going to tell you my personal favorites, but I take it twice a day, once in the morning and once at night.
Again, because of my experience, almost everyone listening is deficient in potassium and magnesium. With one proviso, if you’ve been told you have extreme kidney failure, stage four kidney failure, renal failure, then potassium and magnesium are not for you. In fact, I actively limit potassium and magnesium in my patients with stage four renal failure, and I take care of a large number of patients with renal failure. That’s the exception, and you should know whether that is possible with you. All of these things can work. I see certain patients try different magnesium products because different magnesium products work better for them, so try them out. Don’t be afraid of them. They come in tablets, they come in capsules, they come in gel caps. Find one that works for you, but please give magnesium a try, particularly at night. It’s really going to help your sleep and your mood among other things.
Speaker 1:
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