Ep 3: Energy Part 2: Cellular Energy. The easiest biochemistry lesson you'll have :)

In this episode we talk ATP, mitochondria, ageing and the biochemical processes of energy production in the human body. There are so many supplements around that claim to boost energy but how do they work, do they work and are they safe? We promise its not too technical!  

Transcript

Tempo: 120.0

SPEAKER_01 0:07

Hello and welcome to the Pillars of Health. I'm Dr. Nick Krasner and I'm with, as usual, Ben Eshelbee. And Ben, we're here sitting in Formulae in the beautiful Maruchi Dor Cotton Tree.

SPEAKER_00 0:19

We're looking at a uh lovely Maruchi River right now. Um the waves are just rolling in from the from the beach, and uh we're inside the nice air-conditioned office.

SPEAKER_01 0:29

It is outside, you just want to jump in the water.

SPEAKER_00 0:31

That's it. Um, I want to jump in the water from inside too. I'm looking at this water and I'm thinking, why am I why am I inside? It's gorgeous.

SPEAKER_01 0:37

We're so lucky to live where we are. But to do all these things, of course, you need energy. And today we're on our third podcast talking about energy, but we're really going to get to the nuts and bolts of this.

SPEAKER_00 0:47

Yeah, well, it's going to be a little bit of a bit of a science, scientific sort of speak today. So apologies for anyone that gets a bit bamboozled, but we'll try and keep it as simple as we can. But this is going to be a little bit of a biochemistry lecture.

SPEAKER_01 1:01

And I think with this, I think if you understand this, you'll understand why doctors want to do things or uh pharmacists want to do things to get you energy up and certain things that you have in the gym.

SPEAKER_00 1:12

That's right. And there's also lots of uh lots of people marketing various sorts of supplements for energy. Um, and and what we need to do is is I guess educate people on what these are about and what what basis they have.

SPEAKER_01 1:25

Because they're really good but can be really dangerous as well.

SPEAKER_00 1:28

That's exactly right.

SPEAKER_01 1:28

Uh, and like a lot of things, one size doesn't fit all. So, you know, when I think of energy, think of energy in the cell. I mean, we think of the energy of the person. Um, but what's happening in the cell? And what I was taught I did a master's in sports medicine many years ago, and they went through what you use as energy to run the hundred meters. So if you think about uh you saying bolt or something, I think he's about nine seconds. But the main amount of energy is created by these bonds uh between uh phosphate bonds. So we have something called ATP, and you break ATP, which is three bonds, to ADP, which is two bonds, to AMP, which is one bond. And every time you break the bond, it gives energy, and that energy helps the muscles contract.

SPEAKER_00 2:14

I told you it was going to be a bit a little bit biochemical. Keep going, Nick.

SPEAKER_01 2:17

A little, a little bit, a little bit, but hopefully, not too bad. But after after you've used about six seconds, all your ATP is used up, then you've got about two seconds worth of creatine kinase. I'm sure a lot of people have heard of creatine. Then you've got another second or two, and there's no energy left. So the cell has to create this bonds and energy from the sugar that breaks down something called pyruvate through this um little what we call organelle, this thing, a power station in the cell, which we are talking about later called the mitochondria, and it has to break it down and create energy. The thing is that normally with oxygen and when we're sitting around, when you break down sort of one unit of this, it gives you 36 ATPs, 36 batteries. But when you've got no oxygen, it actually only creates two. So it's a very uh so it's it's very, very difficult to keep going in that way. And it also causes poisons in the body. So the 100 meters is a very, very interesting uh run because I imagine trying to keep that pace up for another 10 or 20 metres probably would be really difficult.

SPEAKER_00 3:22

Absolutely. So, what what's your uh opinion on things like from what you've just said, we can see easily where uh creatine fits into the into the equation and why so many people in bodybuilding use it traditionally. But it's sort of gaining a bit of a following for as like an anti-aging type uh product now as well.

SPEAKER_01 3:40

Yeah, I think we need more and more uh research into all of this. But there has been papers on increase decreasing risk of Alzheimer's and things like that. Now, how true that is, I think there were small papers. Um what we do know about creatine is it gives more energy to the cell, not just by it being an energy product itself, but actually in the muscle cells, it holds on to four moles of water. So actually, a lot of people find that when they take the creatine, they find that their muscles bulk up quite quickly. And a lot of that is the water that's held by the creatine. And of course, having water so helpful for all the reactions that are going to happen in the cell.

SPEAKER_00 4:17

I guess one of the other things that um uh especially from a like an inverted commas anti-aging type perspective, um, I guess mitochondrial dysfunction is gaining more and more traction as being one of the key drivers of aging. Would you agree with that?

SPEAKER_01 4:33

Yeah, I would. And it's one way of thinking of medicine. We talk about holistic medicine where we look at the whole body and try and work things out. But I think at the same time, um, you know, when I do integrated medicine, I want to think, what is the individual cell doing? So when we think of the cell and the cell's not working, the main reason the cell doesn't work is because it's tired, it doesn't have enough energy. And when it's got plenty of energy, I mean you can imagine in a city, a lot of people I remember learning the cell is a city, you know, and the mitochondria is a power station. Well, you can imagine if the city, you know, is all run down and awful, you know that there's not a lot of energy or money in that city. Uh whereas if the city had lots of money, lots of energy, it'd probably look beautiful and worked really well.

SPEAKER_00 5:14

Yeah, well, interestingly, one of the things that we can look at when we look at the um uh with the health of a mitochondria, um, and also a lot to do with people's stress levels is is phosphorus. So ATP obviously is adenosine triphosphate. Um, there's a bit of information that suggests that people who have high phosphate levels pumping around in their body, um, they're making a lot of ATP. Uh, and so that means that their body's creating lots of energy and they're probably stressed. However, uh, what happens when people have been under stress for a long amount of time, they go through this slump and people just run out of puff after being stressed. And and the one of the things we notice in these people is often you find that their phosphorus levels in their systems are quite low.

SPEAKER_01 6:01

Yeah, I see that quite a bit, low phosphorus levels, which actually um comes to the the fact that how do you get phosphorus, I mean the old phosphate. It you actually can get it from plants and things, you can get it actually as a supplement. Um, one of the supplements quite a lot of my patients take is P5P, which is the activated form of vitamin B5. And I think we're gonna sort of leap into vitamin B's uh and the importance of them. Um, but no, absolutely, your your phosphate levels are important again with what you described as well. We're gonna keep it to the cell level, to the mitochondria. But a lot of what you describe also will be affecting the adrenal glands uh and the sympathetic nervous system. Uh, but at the but we're gonna stay away from that because it'll get too complicated.

SPEAKER_00 6:45

And I I will I will give you the. All these different symptoms are linked and and different systems are linked, aren't they?

SPEAKER_01 6:51

It is. We're we're a whole machine and stuff and one bit goes. We're like a car. But funny enough, I like watching those car shows, you know, where they take an old car or a car that's bust and been watching Matt Armstrong, it's quite quite amazing what he says. And I'm thinking he thinks and does exactly as I do, the way he does with the car. Yeah. I have the same mental process with the human body.

SPEAKER_00 7:09

Yeah, yeah, that's exactly right. And and everything is linked, and you can't be, I guess as a general practitioner, linking it all together is what you do.

SPEAKER_01 7:17

Well, you are, and things can be really because we get a lot of tired all the time people, and that can be nothing particular to the most awful thing, if you know what I mean. It could be anything. So you really need to start having uh a way of working out what you're looking at.

SPEAKER_00 7:32

Yeah, that's right. So let's get to let's get to things like supplements. So some of the big things at the moment that, or they've been around for a while, is NMN, um NAD supplements, um uh uh nicotinamide supplements, nicotinamide ribazide. Um I guess I guess they're they're very popular at the moment. There's a lot of marketing push behind each one of them. Um essentially what we're looking at is is NAD is the is the basically the active molecule that that drives um various sorts of biochemistry in the in the mitochondria. The problem is it's very unstable, it's very hard to give orally, um, so it needs to be given by an injection, and hence the rise of things like NMN, which which is basically nicotinamide mononucleotide. Um NMN is is derived from nicotinamide, which is vitamin B3. Um nicotinamide we're using in um we've used it in a in a couple different ways clinically. One at the moment is um there's a bit of evidence to sort of suggest that it helps with things like skin cancers. Um but then there's niacin, and and you'd use a bit of niacin, or would it might have used niacin in the past for you know everything from cholesterol to um uh to supplementation. The problem with niacin isn't it gives you a flushing in the face. Nicotinamide doesn't do that. Uh nicotinamide mononucleotide basically converts in the body to NAD. Um, and we'll go into a little bit of biochemistry again, but basically NAD uh picks up a hydrogen atom and two electrons, and what it does is that is ultimately responsible through a whole heap of other reactions for creating the ATP, which is the energy molecule.

SPEAKER_01 9:24

Yeah, I um I've always I always viewed it when I was studying this, and by the way, if there's people who are due biochemistry, medicine are interested. If you look at the Krebs cycle and the electron transport chain, you'll sort of be looking at what we're talking about. I always thought, like, if you break down sugar and fats proteins, it ends up going into pyruvate, and pyruvate then goes into this cycle to get broken down to create the ATP. And the way I look at it is if it all did at once, it's like a nuclear explosion, explode everyone. So it's more like a nuclear reactor. So you have to have something that holds onto the energy to be passed on to make these ATP bonds, and and those are the NAD plus, and you know, and you also need things like magnesium and other things in in the mitochondria to do that. Uh and a lot of the energy cycles are derived from the B, B for Bertie vitamins. Obviously, B B3 is very important. Yeah, that's right. And again, with treating things like cancers and whatever, I think part of the cancer is the cell doesn't have enough energy, it just switches. It takes a lot of energy to keep smart, if you know what I mean, rather than That's it.

SPEAKER_00 10:26

That's it. So so as as mitochondria age, uh they they don't use NAD as effectively. Um they don't make as much um ATP as a result. So what we do is we could use NAD, but remember that that's not really active orally, so it has to be given via an injection, which is a bit of a pain in the neck. So hence the rise of NMN or nicotinamide mononucleotide, which you can take as a capsule. Does this boost NAD levels in the body? Yep, absolutely. Um, but there's also evidence just to say that nicotinamide itself, vitamin B3, can um uh can improve the amount of NAD in the body.

SPEAKER_01 11:07

Absolutely, and that's really important to having a fun food or supplements if you can't get it. The other thing that increases actually mitochondrial numbers and function is exercise. So it's shown that if you do lots of weight training or exercise, actually your numbers of mitochondria increase. So you have so much more energy within your cell, which is why all these things are really important.

SPEAKER_00 11:28

Yeah. So the final thing is with NAD, I guess, moving on from that now what one final thing, NAD turns into NADH, uh, which has got a hydrogen atom. So the the NADH is the is the basically the the precursor for making ATP. Now, why don't we give NADH? You could, and you'd give someone an immediate burst of energy, um, but if you want uh just long-term uh repair and longevity, you need to give NAD, and often you'll see those NAD plus.

SPEAKER_01 11:59

Yeah, and I think that's really important, and I'm sure we'll be doing a talk on this, is we want to be in a low inflammatory state. So obviously, when we're creating more oxidation, that's inflammation that causes lots of harm. So again, I think when we're talking about these supplements, and I'm sure when you speak to your clients, uh, you're also thinking about maybe I should be giving something to help to with antioxidants. And there's lots, probably not going into it today, but there's lots you can do with that.

SPEAKER_00 12:23

Absolutely. Yeah, so you'll it's one of the key key things of and one of the dark sides, I guess, um, of the unaware who are just taking heaps of NMN or or NAD. Um, these things they are responsible by making ATP, it will generate free radicals. It's an oxidation reaction. Now, people take antioxidants to counter the effect of oxidation or or free radicals. Free radicals can damage DNA, they can enhance aging. Um free radicals do have a role in the body, especially for immunity and things like that. But on the whole, when there's too much oxidation happening, uh you start getting accelerated aging. So, yes, you could pump yourself full of NAD, but beware that you could also increase the amount of oxidation and free radicals being generated by your body. So you need to balance that out with a really good potent antioxidant. And commonly, that would be something um like resveratrol.

unknown 13:20

Yeah.

SPEAKER_00 13:21

Yeah.

SPEAKER_01 13:21

Could be good. Tumoric also helps.

SPEAKER_00 13:23

Yeah.

SPEAKER_01 13:24

And actually, I'm quite keen on people looking at iodine levels as well. Iodine can be a very good antioxidant, especially apparently it's the most important antioxidant in the female breast and genital system. So um, but again, these these are things that you know we would look at after how to increase the energy. Of course, we've talked about ATP, but the other thing we mentioned for the runner who has two seconds was of course the creatine, which is is being used more and more. I mean, I I I put I you know, a good smoothie with amino acids and then chuck in, you know, a scoop of creatine. There is evidence that it does help weight loss, it does maybe help cognition. And uh one has to be careful if you take too much, it can cause renal failure. Yeah. But taking the prescribed dose, you should be pretty good.

SPEAKER_00 14:10

That's right. It's it's been taken in pretty high doses with without much problems. Although I have actually seen people.

SPEAKER_01 14:16

But maybe contain, I think, I think years ago, I think like 30 years ago, they overdosed. I think somebody died from kidney.

SPEAKER_00 14:23

Yeah, yeah. I have actually seen someone that had had too much creatine. I I can't remember if it was um uh someone that I was I was talking to in the pharmacy or someone that I just heard from grapevine. But yeah, it does happen.

SPEAKER_01 14:34

So, like everything, it's good it might be really helpful to take, but don't overtake.

SPEAKER_00 14:38

That's it. Don't take too much creatine and NAD. You'll just end up full of water, renal damage, and uh full of free radicals.

SPEAKER_01 14:45

But this is important, and you know, this is often, you know, with patients I get because I get a lot of uh chronic fatigue patients. Yeah. And there's there's lots of causes of the whole thing, but I nearly always get back to mitochondrial function.

SPEAKER_00 14:57

Yeah, yeah. Well, once again, it it's kind of like one of the pillars of aging, yeah. Mitochondrial function. You've got to keep that healthy. Now, one of the other things that um that we can't overlook, you know, my love for the uh all things gut microbiome. Yes. We can't miss out the gut microbiome in all of this. Talk about mitochondria. Mitochondria themselves are once upon a time, they were thought to be just their own little bacterial cell, and they got absorbed basically by a human cell. And then we sort of all well, actually all animals had mitochondria, so the the larger cell absorbed the mitochondria and they started working together. So um, so mitochondria and the gut microbiome kind of speak the same language.

SPEAKER_01 15:39

Absolutely. I mean, as we we were just talking earlier about the mitochondria and the fact that believe it or not, it has its own DNA. And the DNA only comes from the mum. Yep, that's right. And it's not a double helix like in the uh like in in the in the nucleus for the majority of the cell. It's apparently it's a circular uh DNA and it's passed uh fast from generation to generation. In fact, sometimes when people have had mitochondrial problems, um they for their baby they they've used surrogate C mitochondria or DNA to change that. So, yeah, so mitochondria and their DNA is very important. And the gut microbiome, I mean, they'll they'll probably look back in 20 years and go, you thought you knew it, and you knew 1% of what we know.

SPEAKER_00 16:24

That's yeah, absolutely right. So, so as with everything else we talk about with the gut microbiome, the the real chemicals that link the gut microbiome to the human are things called short chain fatty acids. And we might have touched on this in an earlier podcast. Um, but basically we've got uh butyrate, propionate, and acetate are the three main short chain fatty acids. Um and so they these fatty or the short chain fatty acids absolutely communicate with all the cells in the in the colon and and the the mitochondria. Um the other the other interesting one is something called uh urolythin A, and that's found in things like pomegranates and walnuts. Um and and what these what they seem to do um is they basically help wipe out non-functioning mitochondria. So the ones that are causing problems, um they just they induce in the body to to get rid of the bad mitochondria. So you're only left with the good ones. So that that's something that's uh that's fairly new and and starting to to come out in terms of of nutrition.

SPEAKER_01 17:30

Well, I do know like pomegranates are such a superfood, aren't they? Interesting enough, in the temple in Israel, the mitochondria were all over the walls, they that was the food there. And some people believe it wasn't an apple that Adam and Eve out, but the pom pomegranate so just a bit of uselessness. Just as we're coming to the end.

SPEAKER_00 17:49

I've probably had about one pomegranate in my life, but uh I think I I need to increase the uh consumption of them. It could be a lot of hard work, can't you?

SPEAKER_01 17:56

To do that. So, I mean, what do you think our take-home messages for today are?

SPEAKER_00 18:00

I think the thing is we've got to remember that uh the basis of all energy is from uh ATP. Um I guess we need to look after our mitochondria. Um, if we look at mitochondria as just the powerhouses of giving us energy for everything that we do, including aging. Um, if we're going to take supplements and things like that, make sure that we know what we're doing and don't just kind of think that you know a small amount of something is good, so a lot must be better. Um, and look after your gut.

SPEAKER_01 18:32

Absolutely. And again, that's why, you know, people spend a lot of money on illnesses and the supplement, but actually, it's probably worth spending a little bit of money on seeing somebody who knows what we're talking about. I mean, somebody like yourself, you know, new naturopaths and you know, nutritionists and stuff could be very useful. Functional doctors, functional doctors like me. Yeah, exactly. Well, we wish you all loads of energy. This has been me, Dr. Nick, and Ben Eshelby. And we'll see you again very soon on Pillars of Health. Indeed. Speak to you soon, Nick.