Key Biomarkers & Diet: Your Path To Longevity

Russell M. Jaffe, MD, PhD, CCN

Thanks for having me.

Joel Kahn, MD, FACC

Thank you, sir. Let us dive in and let us try and hit three right now. Let us talk about homocysteine. I do not think anybody today or on this summit is touching much on homocysteine. Tell us what it is and how it happens to be elevated. It is a simple blood test. Everybody should have at least once. Why is it one of the top eight predictive biomarkers of health?

Russell M. Jaffe, MD, PhD, CCN

Kilmer Macaulay in the 1960s and 70s documented that not only was plasma homocysteine accurately done, which means promptly predicting atherosclerosis, myocardial infarction, and stroke, but it also predicted all causes of morbidity and mortality, all the things that cause disability and death. But it has to be properly done. Most tests are easy to do incorrectly, you have to just follow the rules. Plasma homocysteine is properly done.

Joel Kahn, MD, FACC

Can Quest Lab Corp at your local hospital?

Russell M. Jaffe, MD, PhD, CCN

Yes. For example, Quest Laboratories will not process a specimen for homocysteine or plasma homocysteine if it is been more than 20 minutes from the time the blood work was drawn until it was spun.

Joel Kahn, MD, FACC

Hopefully, today there are.

Russell M. Jaffe, MD, PhD, CCN

There are today, many mobile phlebotomists carry with them a little centrifuge that allows them to spin the specimen quickly and properly.

Joel Kahn, MD, FACC

We have the luxury in my clinic of a phlebotomist and a centrifuge, and I think she reached that goal. That was not a goal I was aware of previously.

Russell M. Jaffe, MD, PhD, CCN

Yes, but I want you and everyone to be aware of how to properly do the tests so that the results mean something for the person, the individual, not a statistic.

Joel Kahn, MD, FACC

Okay, that is good. As you have to do it properly. Now, I know there has been a buzz. I will just throw this out. There is a very influential business coach, kind of like Tony Robbins. He had probably liked that comparison with Gary Brecka. He has been all over the Web lately, with no medical degrees, and he has helped counsel some people. He has read a lot and knows your homocysteine, but you must know your MTHFR gene status. Now their available blood tests are 23 and Me, and others. I think you do not completely agree on the topic of you must know your MTHFR, for those who are listening, that is a gene test that you can get done and your sixth, seventh, seventh SNPs, and your 1298-SNPs and find out what your parents gave you, which can influence your homocysteine. Do you care about that or not so much?

Russell M. Jaffe, MD, PhD, CCN

I will quote Dr. Eric Lander, a great advisor to the President of Science and Head of the Broad Institute at MIT and Harvard, and a geneticist. He says if you want to be confused today, do genomic tests. Because people assume that genomic tests are black and white, yes, no, on, off, when they are part of a matrix, part of a symphony, or part of a ballet. He goes on and on. But I will stop at the point where the people who advocate these genomic tests do not understand them, period. Say Eric Lander and many, many others, including Jimmy Watson.

Joel Kahn, MD, FACC

Okay.

Russell M. Jaffe, MD, PhD, CCN

But on the other side, the true markers of lifestyle, epigenetics, these eight tests—not 8000 tests, just eight tests—turn out to cover all of lifestyle, all of the things you can do something about, all of the epigenetics, which is at least 92% of your lifetime health.

Joel Kahn, MD, FACC

Now that is 92% lifestyle. What is the homocysteine level you will be pleased with when you get the results back?

Russell M. Jaffe, MD, PhD, CCN

Less than six.

Joel Kahn, MD, FACC

Less than six. That is a tough bar for people listening. 

Russell M. Jaffe, MD, PhD, CCN

Well, wait. We get better and then get better, and then we get better. I do not know, but I can tell you that the best outcome goes value for plasma homocysteine is less than six, and fortuitously, mine has been so since I have behaved. Well, I am curious. I was young; I was young and immortal, and then I would do whatever. But anyway, for a certain period—decades now—I have walked my talk; I have preached less and practiced more. I believe that the reason my dad lived to be 90—taking no prescription medicines but many supplements, exercising, and laughing a lot—is something attainable by almost everyone. I have been in cardiovascular research and medicine for 50 years, going back to the NHL being the Heart, Lung, and Blood Institute with Don Frei and Bob Maley. Bob mainly coined the term lipoproteins. Don Frei is not the guy who showed those bifurcation points. Atherosclerosis is more likely to be aggressive, and I showed that changes in platelet blood clotting function predicted atherosclerosis years of decades ahead.

Joel Kahn, MD, FACC

Okay, so less than six, but get better before you get perfect. Do you attribute a reasonable amount of your super-low homocysteine to proper supplementation?

Russell M. Jaffe, MD, PhD, CCN

Well, first you. Yes, I do think that a safer, bioavailable, and proper supplementation sufficient to meet certain personal individual needs is essential in the 21st century.

Joel Kahn, MD, FACC

I will go back to the online self-appointed health guru, but his audience is in the millions. 

Russell M. Jaffe, MD, PhD, CCN

Okay, go ahead.

Joel Kahn, MD, FACC

He was going on and on about how I brought down a client, very well-known client, and how they followed a homocysteine with trimethyl glycine, TMG. Do you think that is enough? That is the only thing he mentioned. Do you think that was?

Russell M. Jaffe, MD, PhD, CCN

TMG is one of the 40 nutrients and meaningful amounts that we have incorporated in our PERQUE Life Guard Tabsule. That is a novel delivery system that we pioneered. We have had TMG in our products since 1987. Roughly, and the idea.

Joel Kahn, MD, FACC

Right now, I am not surprised.

Russell M. Jaffe, MD, PhD, CCN

You did not surprise me? You pleased me to point out that we have long been ahead of the curve.

Joel Kahn, MD, FACC

All right. But do you think TMG is enough for most people? Is it going to be common?

Russell M. Jaffe, MD, PhD, CCN

No, well, TMG has a very interesting molecule. Trimethyl glycine. It is just glycine. Glycine, an amino acid, is the simplest amino acid. But if you put three methyls, trimethyl glycine, and you have a methylating substrate, something that wants to be methylated. If your methylation is low, that is a good thing. What I want is balance in nature. I want to use nature’s form of nutrients in balanced amounts for my metabolism to go correctly. 

Joel Kahn, MD, FACC

Okay. I think your question is very important. Do not assume that nature or natural products are magic bullets or drug-like; they are not. I will go on and on about why nature’s form is safer, more bioavailable, and more effective. We know enough today what the supplementation is that is necessary for an individual based on these predictive biomarkers and some self-assessment. We want people to know that they can save their lives and add decades of quality to their lives. Okay, well, first, say good time. I bring up one other thing because of this too. You can learn from so many different people. This morning, a patient emailed me, Did you ever check my homocysteine? Here is an interesting article. Of course, every patient I practice with gets their homocysteine checked, and hopefully, within 20 minutes it is spun down. However, the article was about lowering blood pressure with lowered homocysteine, and elevated homocysteine can contribute to hypertension in general and potentially refractory high blood pressure.

Russell M. Jaffe, MD, PhD, CCN

No, no. We know this is true.

Joel Kahn, MD, FACC

I found literature that I had previously been unaware of.

Russell M. Jaffe, MD, PhD, CCN

Low level. It is called low-level DIC, Disseminated intravascular coagulation. This was pioneered by Dan Dakin and myself in the 1970s, and many others have documented it since. The fact that, in essence, if your homocysteine goes up the edge of the blood barriers, like the blood-thyroid barrier, the blood-brain barrier, and the blood-kidney barrier, there are a whole bunch of barriers in the body that need to be renewed continuously. Otherwise, you slip down a slippery slope into survival and do not thrive. I want everyone to have enough good nutrition. It begins in the cooking pot. That is what Beatrice Trauma Hunter taught me and many others. I want you to have a wide variety of whole foods that you can digest, assimilate, and eliminate without an immune burden. 

Joel Kahn, MD, FACC

Good. Just for the sake of educational expansion, let us go to hemoglobin A1C, I think the audience has heard of it. A three-month blood sugar average is based on your hemoglobin being sugar-coated like Dunkin Donuts. It is not a very good thing to eat, and it is not a very good thing to happen to your red blood cells. But talk to us about why everybody should know that number and why it’s a predictive biomarker for lifetime health.

Russell M. Jaffe, MD, PhD, CCN

Well, interesting is that Dr. Paul Gallop in 1967 was interested in connective tissue cross-links, and then he got interested in sugars, stuck to protein, and then he developed the hemoglobin A1C test, 1960 to 76, and he used to come over and play the organ at Carl’s house because they were friends and they were both mentors of mine. Let me jump to the conclusion. If you keep your hemoglobin A1C less than 5%, you have a better than 99% chance of living the next 10 years.

Joel Kahn, MD, FACC

Okay. Less than 5%. Another high bar.

Russell M. Jaffe, MD, PhD, CCN

No, you can see many ads on cable that say you can lower your hemoglobin A1C to seven. Not good enough.

Joel Kahn, MD, FACC

A lot of primary care doctors, and even endocrinologists, are okay with that, of course. We are talking now usually about type 2 diabetes.

Russell M. Jaffe, MD, PhD, CCN

Now 90% are type 2. a little bit more than that today. It used to be called adult diabetes, except that too many kids now have type 2 diabetes. Yes. This is something that we studied with two different outcomes: six-month community-based studies, one on type 1 diabetes and one on type 2 diabetes, showing that our lifestyle epigenetic management program is better than the best standard of care today.

Joel Kahn, MD, FACC

Okay. Any thoughts about why it is such a powerful predictive biomarker? Your hemoglobin A1C, what are the pathologies that result from leaving it high?

Russell M. Jaffe, MD, PhD, CCN

When is there more sugar than is needed? There is a little bit of sugar that is needed in proteins. They are called glycoproteins. When extra sugar needs to get stuck onto a protein to prevent it from gumming up metabolism and killing you, because that is what would happen, your hemoglobin A1C, your fructose amine, and your glycosylated proteins all go. Now, Paul Gallop was smart enough to realize that it had to be a very simple measurement. Hemoglobin A1C is very easy to measure accurately in serum. It has been done on every socioeconomic, every ethnic, and every geographic group. It is an all-cause morbidity and mortality marker, and you can promise to get to lesson five. 

Joel Kahn, MD, FACC

If we were to go over to the PERQUE site since we are allowed to talk about the brilliant products we make, where would we find that?

Russell M. Jaffe, MD, PhD, CCN

Well, no. My suggestion for many people is to go to BetterLabTestsNow.com. This is a consumer portal that brings together our work on all sides in the service of consumers who want to be healthier.

Joel Kahn, MD, FACC

BetterLabTestsNow.com

Russell M. Jaffe, MD, PhD, CCN

Better Lab Tests Now

Joel Kahn, MD, FACC

BetterLabTestsNow. I am sorry.

Russell M. Jaffe, MD, PhD, CCN

I apologize for the long name, but it is BetterLabTestsNow.com. As of right now, dot com.

Joel Kahn, MD, FACC

Okay. I am sure a lot of people, after the lecture, 

Russell M. Jaffe, MD, PhD, CCN

Do not go away. 

Joel Kahn, MD, FACC

Exactly. You have plenty of time to go over it thereafter. Let us tackle one more because we have some important goals. Let us talk for a minute about one that has created a lot of interest, which is high-sensitivity C-reactive protein. What is it? Is there any particular education you want to give us about how to test for it? What the heck can we do about it? What is perfect now?

Russell M. Jaffe, MD, PhD, CCN

Well, high-sensitivity C-reactive protein is the measure of inflammation, which is a repair deficit. This was put on the map by MacFadyen and Ridker with the help of Mass General and Harvard, etc., and I have known about it for 25 years. There are many measures of inflammation, different phases, and different times, and they are all interesting. But the one that has stood the test of time is HS-CRP, not the old-fashioned CRP. High-sensitivity CRP (HS-CRP) It should be less than 0.5, less than 0.5, which means you can do repair and defense on your behalf.

Joel Kahn, MD, FACC

What is an optimal level since it is a predictor?

Russell M. Jaffe, MD, PhD, CCN

The next best outcome goal value is less than point five.

Joel Kahn, MD, FACC

Okay. Give us your brilliance. There are some things people can do that might help bring it down.

Russell M. Jaffe, MD, PhD, CCN

Well, the most important thing is to eat foods you can digest, assimilate, and eliminate without an immune burden. That means doing a cell culture test to find out what food sensitivities you might have. If you cannot do that, I would just recommend a wide variety of organic or biodynamic whole foods in a wide variety of ways. If certain foods make you feel worse or you think, well, maybe you avoid them, but I can tell you that history, food, diaries, and so forth are very unrevealing in the long run, whereas cell culture is very revealing in the short and long run.

Joel Kahn, MD, FACC

Any prescription options to lower high-sensitivity C-reactive protein.

Russell M. Jaffe, MD, PhD, CCN

Thanks for asking, yes. About antioxidants in general. That means nature’s ascorbate. That means polyphenol looks like quercetin and dihydrates in soluble OPC. That means buffering minerals like magnesium and choline citrate to enhance and triple the uptake of magnesium. Because magnesium is an antioxidant that protects essential fats like EPA and DHEA, omega-3 essential fats are in transit, in transport, and in LDL transit. I understand that the Fredrickson diet-heart hypothesis still dominates conventional care. It has been wrong for decades, and the physiologic approach, what we are talking about using personalized epigenetic lifestyle markers, saves a million lives a year at a minimum if it were nationally applied. 

Joel Kahn, MD, FACC

That would be profound. 

Russell M. Jaffe, MD, PhD, CCN

A trillion dollars could be invested in speeding the transition from the current sick care model to a proactive prevention model.

Joel Kahn, MD, FACC

Yes. We do not have a very proactive prevention model yet.

Russell M. Jaffe, MD, PhD, CCN

Not yet. I am a grieving optimist, like Thomas Jefferson.

Joel Kahn, MD, FACC

Well, I think we have covered three of eight. This has been an excellent introduction. Everybody can go and learn more. I did what I asked the audience not to do. I went over to BetterLabTestsNow.com. After this lecture, and this interview, please go over there. I find it very interesting. There is a lot under the education tab and a lot about how you can order the biomarkers for the lab tests. There is a section under delayed allergy tests called the LRA. This is a lot of stuff. I think there is a free downloadable e-book, so people do not want to miss that by any means. Thank you for that shout-out. It looks like a great resource. I am going to sign up for the free downloadable e-book too and learn here with everybody. Dr. Jaffe, do not go anywhere. We are going to say goodbye and thank you to our general audience and stay on for a couple of minutes with our premium audience. We will see you in a minute, Dr. Jaffe, okay?  Welcome back, everybody. We are still with Dr. Russell Jaffe, who is coming to us from Vienna, Virginia. A busy man who does a lot on social media is fun to follow on social media. A very lively Instagram Live, so be sure to check that all out. What is your Instagram handle, Doc?

Russell M. Jaffe, MD, PhD, CCN

Dr. Russell Jaffe.

Joel Kahn, MD, FACC

That is easy. Well, let us turn. We have been talking about predictive biomarkers for lifetime health. A lot of these we have already discussed are; cardiovascular health, homocysteine, hemoglobin A1C, and C-reactive protein. But it has to be the high-sensitivity C-reactive protein. One that you talk about that, as a cardiologist, I may or may not previously have spent much attention on, which you just mentioned in the earlier section, was the proper kind of food allergy testing, delayed allergy tests you call LRA. But I know there have been several publications just recently linking common food allergies from a huge database, particularly dairy, egg, and wheat, to impaired cardiovascular outcomes. Now, you have been all over this for a long time. Tell us what an LRA is, and tell us why somebody listening might want to go over to Better Lab Tests Now and arrange that panel. Take it away.

Russell M. Jaffe, MD, PhD, CCN

Yes, LRA means Lymphocyte Response Assay. Lymphocytes are white blood cells that carry immune memory. They come in a variety of flavors and kinds. But when you are ex vivo, which means just as it happens inside the body, when you measure these cell responses, especially the T cells, but including the immune complexes and differentiating the good from the bad antibodies, you learn a lot about what people should be eating and drinking. Then we combine that with an HAQ which is a little acronym for our Health Appraisal questionnaire. We ask people to fill out a ten- or 15-minute questionnaire that gives us enough information to make recommendations. In addition to the food-sensitive tests, we also ask what you should avoid, what you can eat, and what supplements you should take to repair. What activities, mental and physical, would most likely promote your healing response? We are way upstream in the predictive arena, and we personalize these interpretations, especially the LRA because we get results that way.

Joel Kahn, MD, FACC

Wow. Okay. Tell us, technically, what is another blood test?

Russell M. Jaffe, MD, PhD, CCN

Yes, this is a whole blood test. We have to send the kit because you have to use the correct needle. There is been preparation for four days. You cannot do some things for two days. You cannot do some things because these are living cells that get to us, and we process them ex vivo. We process them just as they react in the body. Now, that is an art that we perfected in the early 80s. We have over 100,000 cases in our database. We have over 30 million cell cultures done, and we have the most precise cell culture in the world.

Joel Kahn, MD, FACC

That is a statement. You are testing for not only food allergies but also additives, preservatives, food coloring, mold, environmental chemicals, toxic materials, and even reactions to medications, herbs, hairs, and feathers, right? 

Russell M. Jaffe, MD, PhD, CCN

Absolutely. We purify all of those antigens ourselves to make sure they are what they are supposed to be. We have been doing this with a novel microtiter plate that allows us to do a one-step enzyme-amplified procedure. 1983, 84. We are now very confident that our outcome studies in fibromyalgia, type 1 diabetes, and type 2 diabetes, and our case studies in many autoimmune self-attacking conditions in many cardiovascular risk conditions, in many conditions where atherosclerosis, myocardial infarction, or stroke is a concern. We have without doubt scientifically the evidence that our recommendations are better than the current standard of care.

Joel Kahn, MD, FACC

I am going to read a recommendation on your website. Better Lab Tests Now become about this test because a lot of people will relate, and this is the quote: For six months, I had hives all over my body. I was taking antihistamines and getting little to no relief. When I had the LRA by ELISA/ACT done, I discovered that, after adding several ingredients to my fruit smoothies, I was having them 1–2 times per day. As soon as I removed these items from my diet, I started getting better. Within weeks, my hives were gone. Thank you for giving me relief, end of quote. Again, you might say, but what about a Cardiovascular Summit? I knew I was close to the mark, but just recently there was a journal article entitled IGE, The Common Food Allergens is associated with cardiovascular mortality. I mean, that is what we are talking about here. Maybe untested it is eliminating the food allergy from the diet, and we will have lower cardiovascular mortality. That was not; this was an observational study. But again, milk was very high up here, along with shrimp, peanuts, eggs, and wheat. That may not be. Is that an optimal way, or not optimal?

Russell M. Jaffe, MD, PhD, CCN

In essence, what we suggest is that you be comprehensive today and personalized tomorrow. This means that statistically, it is true that type 2 diabetics are more likely than type 1 diabetics and non-diabetics to have a hypersensitivity to cow dairy. If cow dairy is in a tack and you are sitting on it, I recommend removing that tack. But what about the other tacks you are sitting on? That is why I recommend a comprehensive LRA cell culture to determine what is going on in your immune defense and repair system and tune it up.

Joel Kahn, MD, FACC

Well. This has certainly been fascinating and has big implications. I do not hear many people speaking this language and have been supported for years. But this new, large, well-done study in the Journal of Allergy and Clinical Immunology is pretty highly regarded. We have learned a lot. We have only gotten through four of the eight, but we will leave it for everybody else to do some self-study. One good resource would be BetterLabTestsNow.com. Where is another website that you post on?

Russell M. Jaffe, MD, PhD, CCN

Well, we do have a website called drrusselljaffe.com. We have a YouTube channel called Dr. Russell Jaffe. I want folks to know that if they go to their BetterLabTestsNow.com and enter the code JAFFE20, they will get a substantial incentive reduction to make them want to have the tests.

Joel Kahn, MD, FACC

JAFFE20.

Russell M. Jaffe, MD, PhD, CCN

JAFFE20 is the code.

Joel Kahn, MD, FACC

JAFFE20. That is very kind of you because I am sure many people are going to list this and go right on over and do that. Fantastic. Thank you, doctor. Thank you, audience.

Russell M. Jaffe, MD, PhD, CCN

Thank you, Joel. I want everyone to understand how many lives you can favorably influence and how many lives you can save through this summit. Thank you very much for doing it.

Joel Kahn, MD, FACC

Everybody’s doing their part. We are trying to do ours. Thank you so much.