Transcript created using AI transcription; errors may occur. Contact Mikki for clarification

00:03
Welcome, hi, I'm Miki and this is Mikkipedia, where I sit down and chat to doctors, professors, athletes, practitioners, and experts in their fields related to health, nutrition, fitness, and wellbeing, and I'm delighted that you're here.

00:24
Hey everyone, it's Mikki here. You're listening to Mikkipedia, and this week I have on the show Dr. Christabelle Yeoh. She's an integrative physician, and she works in the field of mitochondria, energy, metabolic health, and chronic fatigue. Today we discuss the influence of our mitochondria on energy levels, and what the major influences are on the health of our mitochondria.

00:53
We focus on the impact of long COVID on mitochondrial health and what can be done to restore health and mitigate the fatigue symptoms that many people experience. And over the course of the pandemic, but obviously post pandemic, Dr. Yeo in her clinic spends a large amount of her time helping people overcome long COVID complications.

01:18
So we discussed testing that she also recommends people do and what tests can show us about our mitochondrial health. And we go in depth into some of the strategies that she recommends people do. Now, just on the whole fatigue aspect, though we sort of focus on long COVID, prior to COVID, Dr. Yeo worked a lot with people just on chronic fatigue as a rule. So any sort of fatigue related.

01:47
conditions could be enhanced through some of the strategies that we discussed today on the show. Dr. Christabel Yeo has had over two decades of experience in clinical care, most of which has investigated the root causes of chronic disease. Dr. Yeo is passionate about sharing her knowledge on the interconnectedness of human metabolism, biology and behavior. It dedicates her practice to working with patients with complex chronic conditions.

02:14
neuroimmune mediated or chronic inflammatory illness. And she helps address the chronic conditions that can be related to adverse factors in her patient's lifestyle, nutrition and environment to help optimize their overall function and wellbeing. And I have listened to Dr. Yeoh presentations at several conferences over the last few years and she is so knowledgeable.

02:39
Dr. Yeoh graduated from medicine at the University of London in 1999 and obtained her membership with the Royal College of Physicians in the UK. She also has a master's degree in nutrition from King's College in London and after practicing hospital medicine she worked as a general physician with an interest in nutritional and environmental medicine. She was a director and past president at the Australasian College of Nutritional and Environmental

03:08
and is active on the teaching faculty there. And I have included links to where you can find Dr. Yeo at her clinic, Next Practice Health, and you can see them in the show notes. Just before we crack on into the interview, a reminder that the best way to support the podcast is to hit the subscribe button on your favourite podcast listening platform. That increases the visibility of the podcast out there and amongst the literally thousands of other podcasts.

03:36
so more people get the opportunity to learn from the guests that I have on the show. All right, team, please enjoy the conversation I have with Dr. Christabel Yeo.

03:48
So, Christabelle, thank you so much for taking the time with me this afternoon to chat about your work. I really enjoyed your conference presentations at ACHNM, and I've heard you speak before on mitochondrial dysfunction. I found your talk really instructive with regards to long COVID and fatigue, and it's stuff that I am seeing a lot of clients with.

04:15
would love to do a bit of a deeper dive into that and fatigue in general this afternoon. So thank you so much. Absolutely, Miki. My pleasure. Can we first start, Christa, because obviously you're a doctor, but the way that you practice medicine I feel must be quite different to the usual sort of GP type doctor, if you like. How did you get into the sort of functional medicine and become interested in mitochondrial

04:46
Well, I've been in practice almost 20 years, so it would be too long a story. But I started my journey, well, I left hospital medicine when I was a gastroenterology trainee because I figured that I couldn't do very much for my patients in 10 minutes. And that's where I was practicing in the hospitals in London. And I...

05:12
I decided to get a nutrition master's degree, clinical nutrition. And then I just worked in private practice dealing with various chronic fatigue and chronic disease states, largely using nutrition and environmental medicine. So my training is more in actually environmental medicine where you are instructed much more than you would be in any medical degree on the effects of

05:42
molecules like toxic molecules, toxins, and so on and how they impact our biochemistry, detox pathways, immune pathways, cellular health, all that sort of stuff. So that's where I started. And then because my patient cohort was mostly a chronic fatigue cohort, then you just have to learn all the relevant things. So of course, mitochondria come in pretty quickly.

06:07
Yeah, for sure. And Christabelle, how was it for you when you, you know, obviously, you go through medical degree and you learn all the things to then start learning information that, that was any of it at odds with what you learned in your medical degree and or actually was it just, was it just entirely different learning for you? It's just an entirely different learning. Yeah, nothing at odds in what you learn and

06:35
medical school, I mean, all of that is still relevant because if you see acute medicine cases you need to still apply or what you learned like in pharmacology and so on. But this just goes even further because you can bring in all the lifestyle and other environmental medicine methods of depuration, depurification, detoxification and so on. Yeah, and that just becomes more relevant as you get more.

07:05
more into chronic disease, not acute medicine. Yeah, for sure. And obviously, I want to get your insights into the mitochondria, what they do, the dysfunction, etc. But first, just in terms of fatigue in general, you know, fatigue has been very much in my mind over the last few years with regards to long COVID vaccine injuries and things like that.

07:32
Yet, of course, for many years, you know, for decades before there have been people suffering from fatigue. And I remember my uncle actually, he was in bed for several months. I remember when I was like 40 years ago with what was just sort of like ME, I think it was called. But no one really, it's not that no one took notice, but it was almost dismissed as something. What are some, do you see any major?

07:58
misconceptions out there about fatigue in general? There's probably a few ways to see that or answer that question. So let's take it from the perspective of the medical profession and how they see fatigue. So if someone goes to their GP frequently and just says, I'm tired all the time, I'm tired, I wake up, I don't have refreshing sleep, I'm tired, then it's...

08:26
because medical diagnostics and basic blood tests don't quickly find you any information once you know they're not iron deficient and they're not anemic and so on, then the doctor's quite likely and quite quickly readily to think that is, oh, you need a holiday, you are stressed, it's psychological. So I think that would be the biggest misconception on the medical perception of fatigue.

08:56
And then maybe from the public perspective or the person experiencing the fatigue, there could be different ways to feel fatigue too. So you drill down on what kind of tiredness the person has of the brain, of the body, different states of energy through different times of the day and so on. But maybe just generally speaking, a misconception might be that.

09:22
They just might need to exercise more or eat more, perhaps for more energy or, you know, tired so eat again, can't think so eat again, tired eat again. So that's probably, as you would see it in your work, the biggest misinterpretation of our body, thinking you're tired and you might just need more food. Yeah. Whereas actually with the type of work you do, it's more about the inability to utilise

09:50
fuel effectively at that mitochondrial level. I mean, it's way more than that, but that's the thing I immediately think about when I'm thinking about mitochondria. So, for people who are unfamiliar, can you briefly explain the role of mitochondria in our cells? It feels like a huge topic and obviously we don't have days to do a really massive, massive deep dive, but mitochondria, what are they and what do they do?

10:19
So I would say the word on the street is that the mitochondria make you energy. And that's what everyone thinks of or knows if they know that word. So yes, mitochondria make you energy. And then the classic description is the mitochondria are the powerhouse of the cells. So if you Google it, that's the first thing you see, I think. I'm sure I've used that. Yeah. And so in the last 10 years or so, I've been

10:49
Whenever I speak about mitochondria, I like to remind people, and this perspective is just a repositioning of where the mitochondria sits in our biology, is that the mitochondria is not just there to pump your energy. That wasn't the mitochondria's first priority. Oh, let's just make John heaps of energy, you know, pump, pump, pump. But that's not what it's primarily doing. The mitochondria actually.

11:18
have much greater relationships and extensive networks into our biology that's much more than we even think about. So in the context of the work I do and where people have got post-infection states of fatigue, what was really exciting to learn when Dr. Robert Navio started to write about this, I think 10, 15 years ago, was that the mitochondria.

11:48
first are there to fight new viruses and fight infections. So the mitochondria are the first port of call, the first steps in innate immunity. So innate immunity would be the first response of our immune system. The adaptive is the learnt response. Yeah, so the mitochondria have to face the outside world, the viruses and

12:16
eons ago when we first evolved, the main kind of attackers and scary things in the outside world were viruses and pathogens that kind of were going to steal resources from you or eat you. Today's world is different because the toxins entered the space. So toxins actually then mess around with that process.

12:45
The original process of mitochondrial metabolism is first steps in innate immunity. And then the second step is it wants to use oxygen. So it's an aerobic obligate thing, like it has to use oxygen. And then if it looks after that first, and then it will think, okay, I've got all this extra spring in my step, I will generate more ATP.

13:13
But if that oxygen utility isn't there, it's a bit like if you pull back a spring or it's an oxygen using capacity. And I showed this slide on some of Navio's work with using oxygen is like how deep is that sink or how deep is that spring to spring back or how shallow is it? You can imagine if a spring is very shallow, it doesn't have much power to power.

13:43
Yeah, so if that using oxygen is really efficient, then you spring well into making energy. Christabel, with that in mind, before we get on to the post infection or sort of injury and sort of side of things with mitochondria, like as we age, in your view, should we expect some sort of mitochondrial dysfunction the older we get because things don't work as well or our exposure to other?

14:12
things in the environment, drain our, I don't know if drain our resources is quite the right term, but impact on that mitochondrial function. Yeah, absolutely. The mitochondrial theory of aging is probably the theory of aging that I subscribe to most because there's various theories of aging, you know, with telomere shortening and various other ideas around aging, free radicals and so on.

14:40
the mitochondrial theory of aging in senescence is probably what I think is the most amenable theory. And so as we grow older, definitely we age because the mitochondria are subject to wear and tear, which looks like basically oxidative stress, pathogens stealing your resources, toxins using up your fuel.

15:11
And yes, so as you rightly said, demanding demand and resource. But we're probably aging faster than we should. And then you use the word mitochondrial dysfunction. So I guess it's just a question of definition, because we all think aging is normal. We can't reverse it. But then when does normal become a disease, and when is dysfunction a disorder, and how much dysfunction are you happy with,

15:41
you know, yeah, it moves into longevity medicine. Yeah, for sure. And is that something that you also do a lot of work in? I can, but most of my patients come much more with difficult chronic diseases. But longevity medicine absolutely, you know, dovetails right into chronic disease because what I've learned from longevity medicine

16:11
regenerative medicine, that's what I think they like to call it more regenerative medicine. It's the same longevity theories and techniques to try and reverse a chronic arthritis that's really hard to reverse and you're using regenerative techniques to do them. So the regenerative medicine space, and some don't like it being called anti-aging medicine, but that's how it was called initially.

16:41
is where things were much more novel and people were trying things and it was more cutting edge and that's how science progresses. It has to be controversial to some initially, it has to be cutting edge, it has to be shocking, it has to be unacceptable to others and that's how it progresses gradually. But in the last 20 years I've been working through this field that's...

17:10
probably where I've learned the most cutting edge things is from the regenerative space because we can take that and apply to chronic disease, but it's those things that help longevity. Yeah, they're on a scale, right, of like optimal health versus not optimal health, I suppose. I think that raises such a good point about that, when do we view aging as...

17:38
accelerated and what is an acceptable rate of aging, I suppose, because if we are in an environment as we are, when it's very foreign to us as humans, if you consider evolution, like the amount of time we've spent in this type of industrial, I don't know, I can't recall actually what age we're supposed to be in now. It's probably not industrial.

18:04
There you go. Is there a current age of AI? Yeah, there you go. What to your mind, what would be acceptable? I think it's such an interesting question because I was at a conference a couple of weeks ago and someone did a presentation on anti-aging and there were just all of these factors which were all seemed almost insurmountable to me that we could actually apply them without several hundreds of thousands of dollars.

18:33
What do you think, Christabel? Is that something you think about? I don't know. I don't think of it exactly as that way because I just think of it as how we as individuals want to live our individual lives to then progress our micro communities. And then if people have got greater aspirations than that, great. But it has to start with...

19:03
us and the immediate people around us and then the community around and then go ahead and save the world. So I just think of it's what a person wants. So I see the people who want to get better and who don't feel well and who know something is wrong, even if all their blood tests were supposedly normal. And so that's what I would then just call a dysfunction.

19:30
Yeah, no, that makes total sense. Like if you feel really good, have really good energy and you've got this sort of sense of everything is right with you, then that's great. But if that's not the case and your energy is poor and you feel like you should be feeling better and not, then I suppose that's a really good sign that things are amiss. Can we talk a little bit then, Christabel, about fatigue and about

19:58
some of the signs and symptoms that you see in and around it. And obviously, actually, my first question is long COVID. Are we seeing things different with long COVID than we would with any other infection that you can see? Or is it, or is sort of post-infection fatigue actually quite normal, but we've never had a spotlight on it before? Post-infection fatigue for certain viruses is quite common.

20:26
Common doesn't necessarily mean normal, because normal has been changing over the years, like how they keep changing our blood test parameters, lower and lower or higher and higher, because the whole populace is changing. So common after certain neurotropic viruses is the case, like Epstein-Barr virus.

20:52
herpes simplex virus and so on, other viruses that gravitate to the nervous system. So that's common, but I won't say it's normal, but because I would say it happens because there's some other immune dysregulation that couldn't fix it up fast enough. So then what's unusual with COVID is that it is an extra punch or two. So it is a neurotropic virus that does gravitate very much to the nervous system.

21:21
But what is different about it is that apart from the fact that it's a man-made virus, so who knows how, whether nature would have eventually come to this kind of virus anyway, I don't know. But what's extra with this virus is that the spike protein is extravascularly injurious.

21:51
mechanisms which I think we'll come to probably in long COVID that you don't see as much in a post EBV viral fatigue or post Lyme viral fatigue because that's another big one tick-borne illnesses and other infections that can be quite stuck in the system. COVID I think has got an extra punch or two. Okay. And

22:18
Across the last three years, has the level of post-COVID, post-virus fatigue changed with the different variants? Because I know obviously that the symptoms have sort of changed and potentially the severity appears to have changed. Has the long outcome also changed? Or is it, or has it not really? From what I'm hearing, I don't think it's

22:48
statistically backing me what I'm saying or fully researched because we're still in the evolution of it. Obviously, what's changed is the acute presentation. But what we're seeing is irrespective of the acute presentation, the people who are going to get the tail end problem is there because they already have some other vulnerabilities in the system. It's not so much because of how acute

23:18
COVID that isn't that bad. I mean, it's not fun like a bad flu or thereabouts, but that the post-COVID fatigue is unexpectedly bad. Yeah, and you actually mentioned it and that was gonna be my next question. Who in your clinic have you seen as being most...

23:43
vulnerable or most at risk of developing long COVID. Have they been people who have already have this like an immune sort of challenge or another sort of virus underlying? Is that who you see? So we expected to see worse in those patients. Those are the immune challenge underlying issue. And for my patient cohort, that is the post-Lyme-like illness.

24:11
Lyme disease, vector-borne illness type of patients who haven't recovered from that and then got COVID. So they're already not well and then they got COVID on top. So expectedly, I thought they would be quite bad and that's what we do see. And then in some, but not all, who have had chronic fatigue syndrome before, because I guess they've got

24:41
some degree of vulnerability. And the logic, common sense to that is just how well have they looked after themselves and how ready were they when they got the COVID. So those were expected scenarios. Then the unexpected scenarios that we're seeing would be in the fit exercising group of people, especially youngish people.

25:10
teenagers, early 20s. And that's just, I think that's actually just my particular cohort. Cause I think if you talk to other ME, CFS doctors, they might see some other people. But certain young people have got significant neuro dysregulation. So self-regulation issues, combined with very poor mitochondrial health, which

25:40
I think we'll go into in a bit. Like they're just doing everything wrong from the mitochondrial perspective, eating at the wrong time, sleeping at the wrong time in front of blue light and screens the whole time. So they really have a weakened system there. So those are the surprising ones that I'm seeing. But before they used to wake up at four or five to go rowing, you know, three, four times a week and perhaps...

26:08
exercise a lot because they can and they're young and they're fit but don't feel properly. Yes. Yeah. Yeah. So is that just like if you're thinking about other obviously than the other sort of lifestyle behaviors and stuff like is it like the added stress on their immune system because of all of their training that's then making them more vulnerable in that post infection state? Yeah. You might know a group of people called the post

26:38
training syndrome or the, oh sorry, overtraining syndrome. Yes. Yeah. So it's a cohort of ME-CFS, but they were athletes and trained a lot and then got hit by something and fell straight into ME-CFS. Yeah. So it's a bit reminiscent of that really. Yeah. And Christabel, what about the population of people who, you know, when we, when with

27:05
COVID, it was looking at the research and hearing some colleagues talk about who they saw as being sort of the most severe cases, like people with metabolic syndrome, people with obesity, inflammation. Are these people potentially also at risk of this post-infection or are you not seeing that? Because I imagine they've already got a level of mitochondrial dysfunction.

27:30
that might be progressively worse than say someone else who is fitter and not as much. Yeah, so I'm pretty sure that that cohort is pretty big and everywhere. It's just that I probably have a bit more of a niche practice with complex chronic fatigue cases. So those don't tend to be typical.

27:53
classically already diabetic and have bad metabolic syndrome or, you know, a 45 year old overweight man kind of thing. But I'm sure out there that that's exactly who's getting very tired, but maybe they're not getting full blown MECFS. Yeah. Okay. And then before we sort of move on into some of the sort of practical elements of it.

28:19
I believe you talked about vaccine injury at the ACM conference. What is the role with the mitochondria in potential vaccine injury? Is it the same as what you've just described? I had presented a case, that's where that vaccine injury was. I presented the case study, I think, on the second day of the conference, and it was a teenager who actually I can't remember the case now.

28:48
I presented so many cases. Sorry. I know. That's fine. Yeah, because yeah, we're definitely seeing, I am seeing a fair bit of post vaccine symptoms and injuries and then sometimes they settle down and then sometimes they haven't settled and then the person gets COVID and then it's just all starts all over again. So then you don't know what's vaccine, what's COVID. It's both.

29:16
What I did present in my talk was the numerous papers of how spike protein continues mitochondrial dysfunction and is behind the myocarditis and is behind the endothelial inflammation and the spike protein is behind a number of the core pathophysiological mechanisms that keep the disorder going.

29:45
Yeah. How long did it take you to figure out the link, you and your colleagues, like, actually, there's something going on here with long COVID and with vaccine injury, which is very similar to what you would have already seen with those chronic, complex fatigue cases in your clinic. Was it quite obvious early on for you, Christabel? We already knew to expect it.

30:15
because it's not just about COVID and COVID vaccines. Already before COVID, there's a significant cohort of people who get injured by vaccines, which would be the type of patients that come to our environmental medicine clinics because of the immune dysregulation that they have that other people don't recognize, but that we do recognize. So small number of people.

30:45
definitely have problems with the HPV vaccine or the flu vaccine or different vaccines. So we knew that there would be a group of people that would have a higher chance of problem. And then a group of people that we already treat would be those with Marcell disorder, Marcell activation syndrome. And I can't remember which vaccine it was, perhaps

31:14
did have it on their documentation right there in the second page or something, that that vaccine should be contraindicated in mast cell disorder. So when we saw it's like, okay, I've got a huge population of patients in mast cell disorder, we could be in for trouble. Yeah, yeah. So interesting. So, Christopher, how does like, I want to talk through some of the number of the lifestyle factors that...

31:43
that do improve mitochondrial dysfunction, of course. How do you diagnose mitochondrial dysfunction? How do you know what you're dealing with? Particularly if, I mean, obviously in your clinic, you'll have a range of tests, I imagine, that sort of determine it. But what about for people who don't have access to clinics like yours or something like that? Like what are some sort of signs and symptoms? I mean, they're probably fairly obvious, but it'd be quite good just to sort of run through some of them. Okay.

32:10
First, I would just say that mitochondrial dysfunction is probably not just this rare thing over there and that it is a continuum. I would go so far as to say that most of us would have a degree of it if you want to consider aging and toxins and we're all strung out with various other things and then the mitochondria a bit under the weather.

32:37
So just, yeah, we would all have a degree of mitochondrial imperfections. And then it's only if you use the word mitochondrial disease, then that's different. That sits in the world of geneticists, pediatricians, metabolic specialists. So we're not talking about that. But if that was the case, that's what doctors.

33:07
NGPs would see very abnormal blood test markers, usually around lactate dehydrogenase, creatine kinase, liver enzyme markers. There's no one marker that's just, oh, that's mitochondrial. It's just a combination where you can see that aerobic and anaerobic metabolism is slowed down and acidic. You might see high lactic acid. You might see high...

33:36
pyruvate. So things like that, that's what then would make someone suspect that there's a true mitochondrial disease and then you get sent off to geneticists and they have all their own special ways of testing. So we're not really talking about that group of people. So we'll leave that on the side. So then for people who are just fatigued and wondering, well, how much mitochondrial dysfunction do I have?

34:04
then actually this is very hard to quantify. And I can tell you of very highly specialized labs in other countries and so on that I have used before and I have experimented with and because I practiced in England and I had access to European tests or I could, I can send tests overseas here too. It's just that's pretty impractical for most people if the test is going to cost a thousand dollars a test, let's say.

34:33
But because I've done, I have had years of doing tests like that, testing out various things, going to conferences where people talk about all these things. I can tell you that there are tests out there, but for your average GP in person, just thinking about chronic fatigue and how much mitochondrial dysfunction it is, it probably falls into two camps. One would be just...

35:01
Because mitochondria dictate metabolism. One would be, is there a very visible metabolic issue that you can see on blood tests? And any doctor can do this. Blood glucose, insulin, HbA1c, leptin, or oral glucose tolerance tests with insulins. So that's all doable. And that's the very visible face of mitochondrial dysfunction. Yeah, nice.

35:30
And then the much less visible, invisible faces of it is kind of all under the tip of the iceberg. So then that's where functional medicine doctors have various other tools that are quite easy to do, but not that cheap. So for example, a urine organic acid test, which is about $400, $300, $400, that shows quite a number of mitochondrial markers. And that's...

35:58
probably what most naturopaths, nutritionists, functional medicine doctors would do. Yeah, yeah. And I'm kind of going in reverse order to what you asked me because now let's come to the symptoms. Yes, that's fine. So symptoms, the common symptoms would be brain fog and post-exertional malaise. So exercising and then feeling exhausted. Feeling ill. Yeah, okay. Yeah, feeling ill from the exertion.

36:26
And that exertion could be a varying degree of exertions and that malaise could be a varying degree of malaise. So the technical term is PEM, post-exertional malaise. Sometimes that malaise is such bad vomiting and needing to lie down for like one whole day or two days. And then sometimes it's muscle pain and nausea. Okay.

36:54
People who does the sort of level of malaise related all to someone's cardiovascular fitness or does it seem unrelated to that? Because I actually imagine that someone who is fitter might push themselves harder, which might actually end up with more malaise rather than an unfit person. Is there a relationship there? So the exertion is an exertion for that person. So if someone is normally a, you know, runs.

37:23
two, three Ks every day, but then they like sprint up the stairs at home and then they realize that, you know, their legs are unusually heavy. So that's not really a terrible malaise, but they know something's up there. It's like, how come that's not right? But maybe someone who doesn't exercise at all, but then they might just struggle to, I don't know, go out, hang the laundry, walk their dog.

37:52
Yeah. Do normal sort of activities of daily living. Yeah. What about POTS, Christabel? Is that all part of it as well? Yeah. So it's a continuum spectrum. So POTS is really bad post-exertional malaise, but it's where you can actually diagnose a problem with the heart rate when a person is upright. So, because obviously if we feel really sick, tired, vomiting, dizzy,

38:23
But sometimes we really absolutely need to lie down because the body actually can't even tolerate a vertical stance with gravity. Yeah. So that's POTS. Okay. So then, you did such a great job of sort of breaking down some of the steps that you take with your cohort to sort of get them on the path to sort of feeling better. Are we able to run through these and how they help?

38:51
I mean, I know I'm talking about mitochondria because it's sort of at the heart of it, but how they help the long COVID fatigue and stuff that people experience. Okay. So, yeah, we'll talk about this mitochondrial support steps. Yes. And as you said, long COVID, but this does apply to everyone, even if they don't have long COVID. But let's say they're really tired from the flu last month.

39:20
Yeah. Yeah. Yeah. So this would apply equally well. Or someone maybe who's a lot sicker, they've got Parkinson's disease and they have that awful fatigue as Parkinson's patients do. So this applies across the board. So starting with nutrition, I don't know if you heard in my talk, I said, well, because I've been talking about nutrition for, you know, like two decades. Yeah. I just made it a bit of a joke as to saying.

39:49
I don't care what you eat, but I care what time you eat it. So I do care what people eat, but I'm really trying to now drive home the emphasis on what time they eat. Yes. Can we talk about that, that chronic nutrition? Why is it so important? Yeah. So because the mitochondria, these things inside our cells actually evolved from nature and they are like...

40:16
They were these tiny bacteria that got into our cells, or what eventually was going to become a very complex organism cells. The whole idea is that mitochondria have evolved with nature and the things that have helped us evolve over nature is all the forces of nature. So that is sunlight and light.

40:46
And also magnetism, so the magnetic fields from the earth, but I didn't really talk about that so much in the talk. And then also, which I didn't go into as well, the cold. Yeah. So from a food perspective, it is, and the research is coming out in this area, which is awesome. That what time we eat really has a major impact on our oxidative.

41:14
So our oxidative phosphorylation, the kind of energy processes inside the mitochondrial matrix and membranes that is affected by what time we eat and how late we sleep and things like that. So if we're eating in the middle of the night, then we're just telling our body that it's daytime, whereas at night we should be recovering and regenerating the system.

41:44
And is there a, because I have done a bit of reading around time restricted eating and intermittent fasting and things like that. So if, so what is your practical sort of recommendation for people with that eating window? Yeah, it would be to eat when the sun is up and stop when the sun is down. Just that's a really generic rule. That's really easy.

42:13
to understand. But then some people also have to shorten the window even more because of either trying to achieve more fat burning capacity or other reasons. But then I would say then it's better to eat early and finish early. So I prefer that people would eat breakfast at you know, seven, eight or nine and then finish eating at two, three or four. Yeah.

42:41
Because I know it was quite popular in the previous years to go the other way. Start eating at 2 p.m. and then finish dinner at 8 or something. So that is not that easy to do that for some people's social patterns. But I think that that's the more efficient way for the mitochondria to rest and recover because if we want to do a longer intermittent fast for...

43:11
stimulating mitophagy, then it should be to skip dinner and then have a good breakfast. Yeah. And so mitophagy, so this is the purpose of it to stimulate that. What is mitophagy? So mitophagy is, well, it comes, it's a similar word to auto-autophagy or other people say

43:41
So they regenerate themselves, decide which cell needs to go, which cell to keep, eat up, clean up, throw out the rubbish. And just like that's what our body does with cancer cells. It does autophagy and chews up the dead degenerative and cancer cells, the bad, bad cells. So mitophagy does the same thing except the mitochondria do that to themselves.

44:12
mitochondria decide themselves because there's several hundred in each cell. Let's say if it's a muscle cell and then there's more if it's a nerve and less if it's something else. So each mitochondria decide for itself, what state am I in? What's the degree of disrepair here? Do I need to crumble and make myself die and clean up the mess? Or do I can I?

44:39
keep going or do I join with other mitochondria, such as mitochondrial fission and fusion? Shall I go and join my neighbor over there because I'm dying off and I'll give them the few resources I have left. So the mitochondria decide all that on their own. Somehow it's just like, wow. But they do that to recover themselves and to keep the cell healthy. So it's like they are

45:09
They're kind of altruistic. They like jumping to save the sinking ship. So they go, oh, goodness, the cell I'm in, we're not going well. We need to jump off and save our resources. We'll kill ourselves and the others can survive. That's what mitophagy is. And fasting supports that process and is essential for that. Okay, that's awesome. And then, Krista Bell, of course, ketogenic diets, similar.

45:37
of health benefits to fasting. Is that something else that you would recommend to a motivated patient? Ketogenic diet is definitely helpful for a lot of reasons. And if a motivated patient can do that, it's really great. But it's also sometimes quite hard to do if a patient's got quite a heavy infection load. So the difficult patients that we see who

46:05
struggle with that would have maybe they still have a lot of active fungal issues, active Borrelia, Lyme, other infections because the viral load, the infection load keeps them in anaerobic metabolism and they feel as if they just need to eat. It's really hard not to eat carbs and really hard to have all the long gaps as well. So in the end, even though

46:35
get the ketones up to help the brain inflammation, to help the microglial activation, to do all the regenerative things that they do. Sometimes it is quite difficult for a patient and then you just have to do the best you can and the best you can therefore be eating when the sun is up and having tons of protein and enough good fats and then do what carbs you need to do like to get by.

47:02
Yeah, okay. And then what about ketogenic, also ketones? Have you explored the use of them with any of your patients, Christabel? I haven't used like beta hydroxybutyrate supplements as a ketone supplement consistently because of our supply issues here. They kind of go up on and off in the Australian supply issue in the community. So I know in the US you can

47:33
I haven't done that, especially if you try and stick to TGA approved products. But what I would use all the time is MCT oil, which is pretty helpful. Yeah, for sure. And what about, and I know like the, obviously the eating window, the sun up to sundown is important.

48:00
those kind of recommendations? Do you make recommendations around greens powders for people who don't want to eat? What are your thoughts around stuff like that? If I'm thinking mitochondria, I don't even think any of that. Amazing. Good to know. Good to hear. It maybe is a blind spot of mine because for sure the polyphenols and other plant substances would help the microbiome and then that helps.

48:28
goes back. There's a lot of mitochondrial microbiome crosstalks for sure. But that just isn't my big emphasis. And also probably because a lot of my patients already eat quite well. They're already mostly what you would call paleo. They mostly already just do meat and vegetables. Yeah. So you just get them to double down on that stuff then in the meat particularly? Enough protein. Yeah. Yeah. Yeah. And

48:57
What about supplements, Christabel? What do you see is important there? The key supplements I would focus on would be some of the nutrients for oxidative phosphorylation and the electron transport chain. Primarily, ubiquinol. I do also like B1, Benfotiamine.

49:25
especially the fat soluble version of B1 and B3 niacinamide, but more often I'd use nicotinamide riboside or nicotinamide adenosine dinucleotide. And then I would often be using carnitine as well. For that fatty acid transport? Yeah. What kind of amounts would you suggest with that?

49:55
acetal alkanitine. Yeah. Because if I look like people often ask me about that and I do you know Dom Dagostino? Yes. Yeah. He said to me on a podcast that he uses three to four grams a day. And then if someone goes and buys them off the shelf, they often buy the capsules, which has like 550 milliliters. Yeah, like terrible, like quite small, but obviously your amounts are sort of in the gram realm that Dom talks about too. Yeah. I usually like a minimum of one gram.

50:24
gram and sometimes I do two. Yeah, nice. Your ubiquinol, is that like, you must be familiar with MitoQ? Are you familiar with that? And is that like, because there's a lot of research that they suggest it's the best type of sort of product because of the bioavailability, but is that, is that that's not? So MitoQ, like the company that makes ubiquinol? Yes.

50:53
Yeah, I didn't know that necessarily, but ubiquinol would be the not ubedo-carinone, but an activated form of co-Q10. Yeah, so definitely use ubiquinol, not ubedo-carinone. Yeah, it's funny because when you're so exposed to one brand and you're like, that's the best, that's the best, that's the best. And then so many people like so expensive.

51:23
to hear of other successful practitioners using alternative and very successful, successfully using other options for people who might not be able to do the MiliQ route, I suppose. I mean, if you look through the, there's some good papers with showing all the different vitamins that do all these different things for the whole energy pathway, you could end up on a lot of supplements, you know, like.

51:51
glutathione, vitamin C, vitamin E, ALA, NAC, zinc, selenium, molybdenum, magnesium, B1, B2, B6, B12, like all of those. And so I do think, yes, they all play a role, but what I wanted to say about supplements is first I would come back to the redox state of the mitochondria before pushing the biochemical state. Okay. So don't tend to load people with a lot of supplements.

52:20
like all those things I just said, but I'll tend to just pick a few, but then really try and get them to push the redox state support. The redox state support would be hydration, electrolytes, what's your pH, trying to use light and water and magnetism more to balance that redox. Yeah. Now, when you mentioned magnetism, are you talking about grounding? Yes. Yeah. Yeah. I've heard like...

52:49
Are you familiar with Dr. Mike Twyman? I think his name is. I don't know that name. He's interesting. He talks about quantum medicine. I believe that's what he talks about. But he often, he is very sort of in the circadian sort of biology grounding. Totally. Yeah, yeah. Space. And he's talked about that before. So is grounding, Christabel, literally going outside bare feet?

53:18
in grass, on sand, that kind of thing? Almost, because nowadays you have to choose your spot. Yes. Yeah. So you can't do it on like the grassy bit in between Westfield and high rise shopping centers and stuff. But yes, basically all the quantum theories, biophysics is what we're talking about. That's what feeds the redox state of the mitochondria. Yeah. And because I...

53:47
I've learned a lot over the years and listened a lot to Dr. Jack Cruz, who is a big quantum guy. So that's where I learned this information. So the way you can ground yourself, whether it's in the sea, lakes, rivers, volcanic areas, swim in cenotes, you know, in New Zealand, you would have a lot of volcanic.

54:13
Auckland is like volcanoes. Yeah, totally. Yeah. And where there is an interference of dirty electricity, of man-made grids and wiring, then that's where you get the best kind of grounding. Yeah. Yeah. And like what kind of timeframe are we talking in terms of, you know, how long would you need to do something like that for? I have not.

54:38
really read that that's very research-based as to how long x number of minutes on y number of days. But in our community who talks about this a lot, you know, everyone will do grounding a little bit every day. Yeah, okay. Yeah, just because it's a bit of a reset. We live in such an electrified world.

55:02
If you can just reset every day, that's what helps. But also the other answer to your question does depend on how sick a person is. Yeah. So the sicker the person, and this is what I said in my talks, the sicker the person, the more we need to leverage what nature can do. And so we see those sickest people who leave where they used to live or grew up because there was no light, no grounding, no...

55:29
decent air, it was industrialized, like how are they going to get better? They leave it and go and live in somewhere where they can integrate their whole life into nature, watch the sunrise, walk on the beach, have a swim, get in the cold water or yeah, by the mountains, rivers, lakes, wherever it may be.

55:52
and then that's where they get well and you see that all the time. Yeah, yeah. Yeah. It makes perfect sense. Like, you know, like it's, it feels like common sense to me. Now this will be probably, I've seen grounding mats. Is that cheating or is that actually legit? It's not that it's cheating. It's just where you plugging it into. Yeah. So if you are, live in a high rise building and you plug it into your PowerPoint and then it's going down and how is.

56:21
wiring of that whole building and how well is it earthed or not earthed. That's the conundrum there when we live in dense areas. But you can work with building biologists to measure these things. So you can measure the dirty electricity environment and all sorts of measures you can try. But if you live in fairly rural areas, just your house and a decent garden around,

56:51
then you can stick a copper wire down or a grounding rod down with your bed sheet or your grounding mat or whatever. That's pretty fun. Yeah. Okay. And you've mentioned cold water a couple of times. And in fact, like I love jumping in the ocean in winter or like cold showers or whatever. What kind of, and is that because of the potential for that mitochondrial biogenesis? Is that?

57:20
Yes. What we see there. Yeah. Absolutely. So mitochondrial biogenesis, I mean, when you look in all the usual textbooks and papers on mitochondria, we all know that exercise is the only way to create new mitochondria. So we have to exercise. Okay, let's exercise. But some people can't exercise. And actually now there's more information on cold thermogenesis, CT.

57:48
CT is a really efficient way to create new mitochondria. Yeah, and mitochondria are basically like batteries in the end. And if you are a physicist and know about semiconductor physics and all of that, which is what I've learned through Jack Cruz, then the cold makes the battery basically more efficient, like your semiconductors will work faster. Yeah, yeah.

58:18
What kind of recommendations do you make to your patients, Christabel? People have to start where they can because most people don't like the cold, especially if someone's got dysautonomia and they're quite weak and debilitated. It's not a welcome recommendation. It's easier to just do grounding, light, sunlight, things like that first.

58:46
start with just a face plunge. Oh, nice. Yeah. Yeah. So the face plunge is probably more efficient than just trying to do a cold blast shower because everyone hates that. And then how long are you in there anyway? And it's awful. Yeah. But a face plunge is acceptable to most people. And it's even more efficient because of all the neural reflexes in the face and there's a diving reflex in the face. And

59:15
And a submersion is more impactful than just a shower. Yeah, so if you get a little bucket, like just a little thing that you can just stick your head in, your face in. And then if you need to start to hold your breath longer and longer, you just use a snorkel. Then you can start to keep your face in there 30, 60, 90 seconds, two minutes, three minutes. But it might just be.

59:44
10 seconds to start with. Yeah. So basically you meet people where they're at with regards to it. And what you do for everything, you know, like, yeah, because you have to. Is there a place for sauna, Christabel? Just to finish off in the cold, but a good rule of thumb is as people get more used to the cold, for people who like to go in the sea or do an ice tub or have an ice bath at home, then it's one minute per degree.

01:00:13
So, if people have worked to being able to get to 15 degrees, then you stay 15 minutes. Yeah, that's such a good rule of thumb. Thank you. It's quite a lot because if it's five degrees, it's five minutes. Oh my God, I can't do that. I'm too tropical. I haven't trained myself enough yet to get to that degree. You can have it up, Christabel.

01:00:42
that's a good rule to follow. Yeah, that's great. And sauna, is that something which is useful at all or not really to the same extent? So sauna, not for the same mitochondrial biogenesis reason. Sauna for the infrared light. Yes, for the light, as we said earlier. So that could just be a red light for the biomodulation panel. Doesn't have to be a sauna. But if it's a red light,

01:01:11
sauna and these days they put them all in together, the heat and the near and the fine for red, then great for the mitochondria. But from the heat perspective, that's not so much mitochondrial biogenesis, but it is good for detox. So then reducing the toxic load of course is really important eventually for the mitochondria. But where people have got

01:01:37
pots and they're quite weak and they're tachycardic and they have dysautonomia. They don't do heat very well either. They faint, get dizzy. So then we just start with red light panels. Yeah. Yeah, that makes sense. Christabel, what have you been seeing over the last year or two in terms of success rates with your clientele, with your protocols? Because I know I talked to a lot of people who just appear to have been sick for a long period of time.

01:02:07
not necessarily hopeless, but really do feel a little bit of despair that they're never going to get back to how they were. So do you get good success? So we have a very motivated patient community and I'm sure that helps a lot because they're searching for answers and giving them a lot of information and they're motivated to do these things.

01:02:34
not everyone's going to be motivated to see the sunrise, not eat after dark, go in the cold. You're asking a lot of your patients, take 10, 20 supplements, don't eat this, don't eat that. It's not easy. It's a tough journey to take for our patients. But when they take it, they do well. It's just a constant step-by-step progression.

01:03:02
They discover something, they put it in place, they learn from it. Like I haven't talked about blood sugar management and that's more basic stuff that pretty, you know, a lot of your listeners will know. But like I get people to track and we do continuous glucose monitors because they have to learn and see for themselves on their body. And then they take all that into account. So when, yeah, when people do all of this, that's definitely really...

01:03:31
positive steps. And of course, it's not that it's just all that only there are some patients out there that are really quite sick. And then we do, I do refer people into much more alternative and outside the box therapies are not available in this country, for example. Yeah. So people go overseas for different treatments and that's sometimes we have to do that as well. And when we do all of that, it does work.

01:04:00
Yeah, for sure. Do you see, Christabel, just to finish up, like is there, like, can you see in the future more mainstream type clinics adopting some of the things that you're doing in your clinic, which you've been learning about for years? Uh, mainstream, so when you say mainstream to me, that's a seven to 10 minute bulk billing. Okay. Yeah.

01:04:28
public medicine, don't pay anything, doctor, you just can't do any of this. Yeah, that's it. It needs, it's time, it's coaching, it's showing people the relationship of their bodies to their food, to their nature, to their environment, to the light, to everything they do, how they sleep, how they think, everything. So that takes time. So the other thing I didn't say is that, the other reason that we are quite successful, I feel,

01:04:58
coaches and in groups. And so we take time to keep on with this information. I run like free patient webinars every month for my patients. You know, people just log on and they learn a little thing and they just like, yeah. So it's how do you do that in 10 minute conventional mainstream medicine? You just can't. Yeah. But lifestyle medicine and other doctors who've got

01:05:27
more time in their clinics are and more motivation to work with teams, to work with a nutritionist, work with a coach, refer to an exercise physiologist, work with a chiropractor. They're usually much better at these things as well. Yeah. Yeah. Yeah, for sure. I think that's the willingness to do that. Yeah. No, that's awesome. Christabel, do you take patients right now? Is your clinic full? Like what's the...

01:05:55
So we take patients all the time. They just go in kind of set intakes. Yeah, nice. So like I'll have an intake of new patients maybe three times a year. But we just do it in a group just so then we can deliver all the information and education as a group. But the one-on-one appointments with me are one-on-one. It's just the group goes through together. So yeah. Yeah.

01:06:24
It's a good efficient way of sharing the common information, yet also you're able to individualize it with your one-on-ones. Yeah. Amazing. Christabel, thank you so much for your time this afternoon. Where can people sort of find out more about you and some of your information and your resources? I've seen a few YouTube podcasty type things that you've done online. It's all a bit random what's on the internet and YouTube and podcasts, because I've done

01:06:54
various ones all over and I haven't, I don't put them in one place, but my clinic website is Next Practice GenBiome. So that's G-E-N-B-I-O-M-E and that was like the generation biome and genes and biome. That's awesome. It's so good. We'll definitely put links up too.

01:07:21
to where people can find you and a little bit more about your clinic in the show notes. Thank you so much, Christabel. Really appreciate your time. You're very welcome. It was fun.

01:07:43
So hopefully you got a lot out of that conversation. And if you know of anyone who is experiencing chronic fatigue or long COVID related complications, please do pass on this podcast episode two because I think it could be really valuable. Next week on the show, I speak to Dr. Guillaume Millet, all around ultra distance running and exercise physiology. Super interesting.

01:08:13
So make sure you tune in to that. Until then though, you can find me over on Facebook @mikkiwillidennutrition, Instagram, Twitter, and threads @mikkiwilliden. Head to my website, mikkiwilliden.com, and catch up with me there. All right, team, you have a great week. See you soon.