Root Causes of Aging & Resetting Metabolism for Lifetime Health

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s great to be here. I was honored that you even asked me to talk with you, so this is great.

Sanjeev Goel, M.D.

So I’ve heard you talk so many times at A4M and it’s been such a wealth of information. I know your background is in pharmacy, is that right? Like you first started as a pharmacist?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, and I still consider myself, I’m a clinical pharmacist. I mean, all the other things I’ve studied from homeopathic medicine to clinical nutrition, master’s in theology, I mean, everything else I’ve studied, I think just adds on to my basic construct of everything we do whether it’s meditation, we take a nutrient, we eat it’s all information that affects our receptors. And I’m grateful that I went through pharmacy back in the stone ages. So we actually had to do a lot of receptor confirmation work and really understand what’s affecting our body, what’s signaling things to happen, and so still a pharmacist at heart.

Sanjeev Goel, M.D.

Yeah, I think that’s like the real pharmacist. I mean, we think of pharmacists to dispensing medications but you really take it to another level of understanding how these compounds are working in the body, which they don’t train, they don’t teach us in medical school very well. So I really, I think-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

– Yeah, well, I’m glad you appreciate that, yes. I always try to get that across to folks, It’s like, “Look, we’re the guys that…” Back when I went through school, we had to go through every body system. So if it was neurology, we had to learn all the drugs, all the receptors related to neurology, if it was cardiology, nephrology, if it was anything related to the liver or anything on the endocrine system, we had to basically had to learn how every one of the receptors and hormones are working and interfacing, what the negative feedback loops are, so how our body’s really trying to maintain control. 

And that’s in the end, and I was fortunate to go through the University of Cincinnati, College of Pharmacy Program, and John Uri Lloyd was the founder of it. And so we had this rich botanical medicine history because he started Lloyd Specifics Pharmaceuticals which is a part of the Eclectic Medical Movement, which the other word for the Eclectic Medical Movement is the whatever works movement. So I try to honor that tradition and we studied pharmacognosy. I mean, I had classes in plant medicine and had to learn how to extract plants and it was all part of my pharmacy training. So, I’m just grateful I went through pharmacy school during that period of time.

Sanjeev Goel, M.D.

Yeah, I definitely wanna make sure we talk about plant medicine because I don’t think we have any other speakers who could speak to that expertise like you can. But maybe just tell us a little bit about your thinking, how it’s changed, ’cause I think even over 10 years, how you’re addressing like antiageing strategies has changed and our understanding has changed, and I think you are at the forefront of that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Honestly, I started teaching the American Academy of Anti-aging Medicine, I mean, 17 years ago at this point, really, almost at the gestation of it. And I think if I had to think of the one concept that continues to evolve and I think we get a deeper understanding is this process of metabolic inflammation. Back when I wrote the book “Cracking the Metabolic Code” in 2002 it was kind of this notion of, you know what? Our whole body is working together and creating these signals that lead us either towards a path of being well as we age and then the other path is towards chronic disease. And so, I really believe people deserve vitality at every stage in life. I don’t care whether you’re a six year old suffering from eczema or asthma, or you’re an 80 year old that’s suffering from poor kidney function. 

We should strive to kinda help people become their best version of themselves no matter what their challenges. And so I think the biggest thing, and I’m telling you, man I wake up every morning and I’ve got the next three years planned out, what I need to be looking at. I mean, one of the most exciting things for me is all the epigenetics and the omics revolution and really understanding the impact of what really affects our DNA and the way we blueprint that next version of us in healthy cells. And it turns out now we’re really starting to learn that yeah, diet and exercise really do matter just like the notion of mind, body medicine and trying to keep our nervous system intact. 

So not allowing stress to overwhelm us, but I think that this new concept of testing for biological age versus chronological age, and then what we can do about it, and I think that’s where the 10 years is gonna take us when we start to incorporate things like artificial intelligence and the looking at all these different genes that are being turned on or genes that we’re keeping turned off, so that we promote a healthier body for a longer period of life. And so that concept, that’s now in the literature called metaflammation and inflammaging. I think that we had a notion of that 15 years ago, 10 years ago, I think it’s now becoming an incredibly refined concept so that people can really begin to grasp, oh, when I’m doing things that turn on my inflammation chemistry that’s actually causing me to age. 

And I think that’s the biggest concept for me, and then it’s, well, what are the strategies? whether you look at peptides or obviously there’s popularity now with stem cells or really exciting things like plasmapheresis, which is really on the cutting-edge, all of these constructs are there to help us bring our body back into what I call whole body metabolism balance, right? How things are working together and being unified so that you can… I like it when people just come in and they’re in my office and I say, hi, how you doing? And they just say, “I’m doing great.” I like it when they’re not having to think about, well you know what, my knee, geez, I’m still reacting to this food, wow, I still have this allergy. 

I love it when we get to where people just get to that concept of, I feel well and now I can move forward. And I think this concept of where we’re moving is just continuing refining our strategies that allow us to really personalize what I call performance health. I mean, that’s what we’re doing with the Pro Football Hall of Fame Performance Health Centers is we’re really looking at how do we get people, whether you’re a teacher, an executive, a housewife, a stay-at-home dad for that matter, whatever it is, that does not just have to be an athlete have performance health.

Sanjeev Goel, M.D.

So this inflammaging, so just maybe for the viewers to understand exactly, what exactly is happening there. Like I understand there’s something called inflammasomes or these little pockets, the balls of inflammation. Maybe you could just kind of just teach us a little bit about that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, well, the first thing and you have to understand, well what causes inflammation? So I remember I laid a chart out back in 2005, that you probably have seen maybe 20 times or more in my talks where I said, the big drivers of inflammation are obviously we do have genetics, they do play a role, we can’t deny that that matters. And then there’s, well, what type of diet have I eaten through my life? So diet, so for example, depending on your gene type, you may not be able to tolerate saturated fat. So, your neploids is 344 it’s called, you may take in too much saturated fat and that could trigger your body to release inflammasomes and also inflammatory cytokines. And you can think of all of those things as forest fires that are getting out of control in your body. And basically your body is built and then there’s other things. 

So before I get to what your body does to defend against that, there’s other things like environmental toxicity. So what do you think of, and this was in my 2005 pictogram, things like toxic metals, organic pollutants, biotoxins, mold, all of those types of environmental burdens that we can be exposed to, plastics, for example, any of that stuff can start to trigger inflammation, stress can trigger inflammation, you could get an infection. You could be deficient in nutrients like omega-3 fatty acids, or one of my favorite, magnesium, which could make your body be in a position where it can’t turn the inflammation off. 

‘Cause inflammation is actually good, your body is incredibly smart and it made us so that we’re able to create inflammation when we need it, in order to repair, but here’s the key, when you get under chronic inflammation your body doesn’t turn off the inflammatory cycle in your body. So all those compounds like inflammasomes, which by the way, one of the big things that help with inflammasones is a process called autophagy. And one of the best ways to help manage your inflammatory chemistry, time-restricted eating, fasting, or I utilize and I make no bones about this, I’m on the advisory board for L-Nutra, and Dr. Longo is just fantastic work on fasting mimicry or using a fasting mimic diet where you’re eating a certain prescribed amount of food that mimics the metabolic effect of fasting. 

And so one of the biggest problems I see for people is they eat too much, they eat too often, they pick the wrong foods, they get stressed out, they don’t move enough and then they don’t get enough sleep. So once we start there that starts to get the ball rolling on inflammation. Now, when you don’t turn the inflammation off and get your body back into balance, there’s a lot of things that start to happen, your insulin receptors don’t function the way they should. So blood sugar start to go up and people become insulin resistant. 50% of the U.S. population as adults are either insulin resistant or diabetic today. And that’s a big number.

Sanjeev Goel, M.D.

Isn’t everybody having chronic inflammation like this is what it basically sounds like to me, that nobody’s doing or very few maybe like yourself, but very few people are able to maintain a low level of inflammation.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, I have to admit for me at my age, at 60, I don’t ache and even though I lifted a lot and was a competitive bodybuilder, and was a scholarship athlete, I think a lot of the tactics that I learned from when I started in the practice in 1986. So I actually started doing this work full-time in 1986, I think those strategies have really paid off for me. And I took a test called the TrueAge Diagnostics Test and actually lectured for them this last Sunday. And it was interesting ’cause if you look at my genes, they’re terrible. 

So, you would look at my genes and go, “Uh-oh you are not gonna live long, my friend.” But then when they did the TrueAge test on me, I still remember that when they were interpreting it, and they said, “You know what? You’re at the 95th percentile of aging, you’re aging incredibly well.” And I think it’s important for people to keep in mind and I agree with you, I think a lot of people are in that inflammaging process, especially here in the U.S. And I think that we need to start to think of aging as a disease that literally if we can suspend this inflammatory chemistry, that’s going on as long as possible and help our body to repair and stay on that inflammation on, repair, turn inflammation off. If we can stay there, now we have the opportunity to really have a health span and perform at our best late into our life. 

And it goes everywhere from cognitive function to energy to managing your weight, to reducing a lot of the chronic degenerative diseases that really affect us. And I don’t think it’s so much that, oh I’ve got this magic peptide that everybody should take or I’ve got this magic nutrient that was picked by Tibetan monks and eaten by an African lemur and whatever, you know what I mean? There was none of that going on, I’m sorry. 

We can use all these tools, but we still have to empower ourselves to say, “I wanna age gracefully, I’m gonna take the steps to reduce that inflammatory process.” And I think that’s the important thing for people is that my message this next decade is going to be a message of empowerment for people. I think I’ve done that, at least when I get up and lecture I try to empower practitioners to help people but I really wanna get that message out in general, that we have to start to empower our patients and we have to empower ourselves and we have to start to look at aging differently so that we can say, “Hey, I got this, I got this under control, I’m gonna live the life I can.”

Sanjeev Goel, M.D.

Do you think that like people are listening to this and think, “Oh, I’ve kind of abused my body for like 20 years and is it too late?” Like how reversible is this by, let’s say you making these changes now? Have you seen these, like with people you’re working with and what can you tell them about that?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, first of all I’m gonna say it’s never too late. I mean, I’ve worked on 80-year-olds and changed their lives. I regularly work on 50 and 60-year-olds that think that oh man, I’m not thinking clearly, I think I’ve got early dementia, geez, I have energy problems, I can’t lose weight. And when I had my clinic in Ohio, we had the LaValle Metabolic Institute and we were averaging about 300 and 400 patients a week that we were doing personalized health programs on. And so I would say that I’ve probably seen more patients than most in this area of precision health, personally overseeing them. 

And even now I’m still in practice a couple days a week and it still never ceases to amaze me, the power of creating a good plan, one that’s organized and steps people through their rejuvenation process. And then watching them blossom back to the vitality they deserve, and it literally changes everything about them. It changes the way they view their relationships, it changes their work and it changes their enthusiasm for the selections they’re making about the foods that they’re eating. And so, yes, I would say I don’t care if you’ve abused your body for 50 years, I think you can take that first step and you’re going to see a difference.

Sanjeev Goel, M.D.

Right, so maybe let’s take in these categories, you kinda mentioned these categories of how we can attack the aging process in us. So you mentioned diet and you mentioned fasting mimicking diet ProLon which I just recommended to a client of mine. So I’m quite familiar with it, but maybe just the sense of how does fasting make an impact on aging? I think you’ve mentioned a little bit about that, and then your thoughts about keto versus paleo versus vegan, I would love to hear a little bit of your thoughts on that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Sure, so first of all, with fasting, the most important aspect of fasting, in my opinion, especially in this modern world, is it gives people digestive rest because people eat all day long. They snack, they nibble, they never really create a rest phase for cells to repair, they’re always working. Every time you eat you gotta release enzymes, every time you eat then your blood sugar goes up, you have a cortisol response. And so it’s important to understand that when we fast, we get digestive rest, that’s one. 

Secondly, it turns off nutrient sensing, and why that’s important is when you turn off nutrient sensing in your body, what happens is you turn on the process of autophagy. Now, you can say autophagy is just it’s the vacuum cleaner for your cells. basically you’re eating up waste proteins out of your cells that are actually either damaging your cells or creating misinformation. And so turning on autophagy is really important because autophagy is actually the signal, that counters inflammasome activity. So if you read up on inflammasomes, what it talks about is that when you’re inducing autophagy, the inflammasome activity goes down and when inflammasome activity goes down you’re turning off inflammatory signal. So that’s the first piece about fasting that’s so important. 

I think the second one is that they’ve showed that there’s some stem cell renewal. By about day three with fasting, you get stem cell removal, so you’re getting these beautiful cells that are able to go out and repair and create new vital tissue for you. And so that’s the second piece that’s important. And you have to remember when I’m turning off inflammation, that means that I’m going to create more efficiency and how my cells are working, so a big one for that is how your insulin receptors work. So insulin receptors of course, are responsible for taking glucose into your cell and either making glycogen and storing it in your muscle or utilizing it for energy. And so those are the three key areas that I think fasting can help people, there are others, but that’s I think the three big highlight, top line, of where it really has value.

Sanjeev Goel, M.D.

So when does the autophagy begin? Like if someone’s doing intermittent fasting, does autophagy begin after 12 hours? Or like what’s your thoughts on that?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, that’s a really good question. And I would say that I don’t have a good answer for that yet, I’ve looked around in the literature, it’s sparse, there’s some notion that it might begin at 14 hours. A lot of people were doing 16:8, 16 hours of fasting, eight hours of eating. I have to be honest, people doing 16:8 coming to me, they’re doing it seven days a week, they actually, after a few months they’re not doing so well, their energy isn’t as good. I start to see changes in their lipid profiles and their cortisol sometimes it’s going up because some people if they don’t good sympathetic and parasympathetic nervous system balance, they can go to using cortisol as a way to generate energy for them. 

So I like 16:8 a couple of days a week, and then I’m more favorable towards a 12 to 14 hour fasting window with 12 to 10 hours of eating on a day in and day out basis. And this is once again, I’m not saying I’m the all out authority on this, I would just say that clinically because I see an awful lot of people, I actually also see athletes and all five Major League sports, plus tennis, plus… I mean, a lot of athletes that are trying to do those types of things, it’s not working for them as well. And so that’s why I think it’s important.

Sanjeev Goel, M.D.

Do you think that the meal that they should begin late? Like what’s the evidence showing that they begin late or is it that they should end early? ‘Cause I think that they’re on weight loss…

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Great question. So there’s a couple of ways to view this. So fasted training, for example, has been shown in the morning to induce growth hormone and improved free fatty acid metabolism. So that means you get burn fat better, basically. However, if you looked at, there are some studies coming out of Japan that were showing that a morning meal was actually very important for cardio metabolic health, that there was a reduced incidence of cardiovascular disease when people ate breakfast. So to me now I look back at tradition, I can’t help it. I come from an Italian family and my grandma would say, “Jimmy, eat a good breakfast, eat a good lunch, sit around at dinner with your family at 5:30, finish your evening meal by six. And maybe if you’re a good little boy, Jimmy, we’re gonna give you a little snack around maybe seven if you’re lucky and that’s gonna be it for you.” And I kinda think that we’ve taken time restricted eating and it’s really just the traditional way that people have eaten food for generations, not overeating food, having a plan set of time between meals and in general cultures would have that last meal relatively early, maybe unless you’re in France, right? 

Or Persian, a lot of times I find when I’m working with, because I got a lot of Persian clients, they like to eat their meal around 8:00 p.m. but I would also say that a lot of Persians have diabetes. So it could be the rice, it could be eating late, it could be a combination of the two. So I think maybe what I try to get people to do is identify what makes you feel best, and then we mark that against their lab parameters. How do your labs look at the way you’re eating and what does it show? Because that comes to the question of what just asked me, do you think ketogenic, do you think paleo, do you think vegan, do you think plant-forward, pescatarian. We developed a diet plan, gosh, I’ve been using the same diet plan since 1986, actually, which is what I call a modified low carb, antiinflammatory low allergen diet, where we’re looking at the data that shows that helping people maintain their weight, at least here in North America is on an average of about a 22% carbohydrate diet and not up to 40%. 

Now, because everybody says eat a Mediterranean diet well, I agree that eat a lot of plants, eat more fish, I get that, but we’re not walking up and down 300 flights of steps and going and walking to get our fresh food each day and ending our day at 5:00 p.m., we’re in a different culture. so I think we have to look at diet as more prescriptive, what’s gonna work? I think, look, I use ketogenic diets on people, if I’ve got cancer patients, the only thing I’d say I vary is I try to get more fiber into them, I get the cows dairy out on them, but at the same time there are some people that do very well on a ketogenic diet, and there are some people that their lipids go crazy, their triglycerides go crazy, they don’t do as well on a ketogenic diet. And I’ve always prescribed to that notion that maybe one way of eating isn’t right for everyone let’s understand that sliding scale of carbohydrates, fats and proteins for an individual as a way to fuel them and a way to reduce systemic inflammation. Here’s the common theme, whether it’s paleo, whether it’s a plant-forward, whether it’s vegan and look a lot of vegan cultures have high rates of diabetes too. 

So I’m not so sure that eating an all plant diet when people are becoming very reactive to things like pea protein ’cause all of this beyond meat stuff is very rich and high lectin plant proteins, and I’m finding when I test them for food allergies even their immune compliment food allergies, like C3 BD they’re getting reactive to things like peas and legumes because they’re overdoing them. And then the way we process them, they are powderized now, instead of being eaten as a whole food. 

So now we grind them up and the surface area when you drink them or you eat them is much greater, when it is being presented to your small intestine. So, I wish I could give you the clear thing of oh yes, everyone should be paleo, or everyone should be keto. I honestly feel like I have some people do very well on an all plant-based diet, and sometimes we do that for their first six months. And then we reintroduce protein and look I track things like B12 and iron and carnitine and CoQ10 because when you go plant-based those are the nutrients that start to go south. And when they go south, that’s your mitochondrial energy that’s being affected when CoQ10 and carnitine are being downregulated from your diet.

Sanjeev Goel, M.D.

Okay, wow, I have so many questions, but I’m gonna try to move it a little forward-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I’m sorry.

Sanjeev Goel, M.D.

About, no, no, it’s all good, it’s so interesting. So it looks like if we wanna have to benefit stem cell renewal, we need to go more than two and a half days or something like that. Is that correct like people should do these longer more intensive fasting periods?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, if you’re gonna fast and I recommend people fast under supervision these days because of so many people are just glycemic. If you are going to fast and you’re gonna look for stem cell renewal, you’re looking at that in the third day, right? Third to fifth day is where you’re really gonna get the big benefit. Autophagy will start kicking in at the end of the day two. Now, if you’re looking fasting mimic diet, fasting mimic diet, and we have to be very careful about claims being made on fasting mimic diet but certainly there are improvements in your metabolism when using the fasting mimic diet, that we see people have less hunger afterwards, that they feel more satisfied, they feel more in control, they lose fat versus just losing lean muscle. 

A lot of people, when they do just calorie restricted diets they don’t realize that 30% of their weight loss is lean mass and lean mass is our currency of aging, right? I mean, the more we hold onto our lean mass the better we’re gonna age. We’re gonna be more stable, so as we age we have to worry about falls, and so the more lean mass we retain as we age the healthier we’re gonna age.

Sanjeev Goel, M.D.

That’s very interesting. Maybe let’s just move right into exercise, ’cause you’re talking about lean mass and so on. And so I did the TrueAge and I’ve had a couple of people I went and talked to Ryan Smith about that. Some athletes, people who had trained a lot and their TrueAge was actually higher. And I want to get your thoughts about that. Like how much is too much exercise? It sounds like it might be causing inflammation. what type of, if you train with all these athletes, what are you telling them and what can people do?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, you know what, athletes have a career. An athlete is being paid to perform and their penance, their sacrifice is their body, right? Because I just talked with a tennis player two days ago, I did my first interview with them, trains five and a half hours a day. And so the reality is this, there’s a lot of times people go into the gym, and look, I developed the programs for Life Time Fitness that affected a quarter of a million people. So, I mean, I’m pretty familiar with it, and I work with a lot of professional athletes and collegiate athletes and high school athletes for that matter. 

But it’s not all we do, I mean, that’s probably 20% of the practice the others autoimmunity and metabolic syndrome and colitis and all that other good stuff. But with athletes in particular, it’s not about how much you train, it’s how well you repair. And so being able to make sure they’re getting a good sleep that they’re using a wearable device, looking at their REM sleep, looking at their deep sleep, understanding the impact of eating late, are they drinking alcohol? What are they doing that impacts how they can repair? 

The second piece about repair is nutrient replenishment, everything from electrolytes to amino acids, to making sure that antiinflammatory compounds are on board that can help them to turn that inflammation switch off. Because in general, the longer you train in the course of your day, the more inflammation you’re going to trigger, and the less of your ability to turn that inflammation will be off, I mean, you’re not gonna be able to get that to correct. And so I find a lot of people they simply overtrain so they don’t see the value in walking, it’s boring. 

Well, it turns out if you look at walking, walking, it helps with interleukins or cytokines to become more imbalanced. It helps with your neurochemicals, it’s really efficient in helping balancing your nervous system. When I start to do things that excite me, I’m doing interval training, I’m doing high intensity training. I’m doing interval high intensity training, right? The harder we push, the more we trigger, do I think it’s bad? No, I mean, I’m a avid exerciser. I would say that as I’ve aged, how I trained when I am 20 is way different than how I train today at age 60. 

Today at age 60 I’m doing more walking, some jogging, some assault bike, I train with weights three days a week, I used to train a lot, to the point I was competitive. Do I think I had benefit from that? Because when I was young, I put on a lot of lean mass and I’ve been able to retain a lot of that mass as I’ve aged. So I do think there were benefits to that but I think some athletes, even though they look healthy because they train a lot, they mirror the blood chemistries a lot of my metabolic syndrome folks.

Sanjeev Goel, M.D.

I mean, you see some of these people look like they burned out, like they were super athletes but then by the age of like 60, they’re like, lost like a lot of fitness and health. So I’m just-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I tell them bright stars burn fast. It’s really about using exercise as another strategy to maintain your longevity. If you’re not a professional athlete, there’s no reason to train at high intensity all the time. Now, if you’re passionate about, I wanna do a marathon I wanna compete as an Ironman, well, that’s kind of taking it to a different level of you’re committing to a event and you’re committing to athleticism that isn’t necessarily making you super fit. It is in the moment, but over a long period of time, it may not be. And so what I always show is when you look at a lot of folks that have for example, done a lot of distance work over the years, their skin almost takes on a little bit of a leathery and high oxidative stress look, unfortunately. They’re lean, but I don’t necessarily see vibrance in them, I see weariness. And I know I’ll probably get attacked for saying this but I think the literature is on my side. 

And I mean, I work with the head of the NHL Strength Coaches Association. I’ve taught researchers that work on special forces troops and we’re all looking at this state of readiness, resiliency, so what we’re really looking at today, these are the terms resiliency, durability, readiness. all right, those are the, those are the terms and allostasis, the ability to handle a stress load and recover from it. And so if we start to think about it in terms of resiliency, durability, allostasis, I think it starts to make more sense for us to think about as we’re aging, “Hey, I’m still sore, maybe I should kinda do something restorative today instead of getting after it again.” It’s really creating that balance with your exercise.

Sanjeev Goel, M.D.

Okay, so maybe let me pivot ’cause we have in the next 20 minutes or 15 minutes, what’s your thoughts about, I mean, growth hormone I get a lot of clients coming to me and saying they are taking growth hormone. And so I won’t mind your thoughts about how does that contribute to aging or how much is it reversing aging? ‘Cause there was that study I think that showed these patients who were getting growth hormone, they had an epigenetic age reduction of a couple of years, but then I’m concerned at how do we-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, that’s a good question. I mean, in that study, they actually they used metformin and DHEA to counterbalance the effect of growth hormones impact on insulin resistance and increasing the risk of developing type 2 diabetes. And once again, metformin, I think while interesting, I don’t think we should put it in our water yet. Growth hormone, I mean, metformin affects your microbiome. I mean, it’s known, I mean it affects the microbiome and so there are some people that they look at epigenetically that metformin might not be the best thing for. If you read into that study a little bit further, they also talked about these variances in the application. Do I think growth hormone makes sense? 

Well, whether it makes sense or not very difficult to do in the U.S. because it’s hard to acquire and I think that’s where peptides kind of shine. I’ve had a lot of obviously, helped found the International Peptide Society, I’m not doing anything with them anymore but that was one of my initial advancing. And I think that’s the next undiscovered country for us is I like the concept of peptides ’cause it helps us to release our own growth hormone. We make plenty of growth hormone as we age, we just don’t release it as well. And so I kinda like the concept of trying to have endogenous growth hormone be released instead of being dependent on growth hormone say from the time you’re 45, which a lot of people were getting on it in their mid 40s and I think it’s just like testosterone replacement at an early age. 

Why not try to get your body to make it if possible? And so I’m always in favor of endogenous concepts and thought processes for hormones before we resort to the exogenous or external sources of them. Do I think there’s probably a role for growth hormone? I think Feje’s work and Sinclair’s work on aging, I think that it should be noted that, hey, look it did reverse the epigenetic clock and we have to continue to investigate its application. I think one of the big things that we miss, when I developed, for example the algorithms for the Metabolic Code platform, it’s really looking at all of the interactions of how you feel? What your blood tests show? What your wearable data is telling us? What your biometrics are? So where is your heart rate? If your resting heart rate is above 62, you’re sympathetic dominant, it’s that simple. 

If your blood pressure is going up, you’re 130 over 90 or you’re 130 over 89, you’re trending towards sympathetic dominance. And when you have sympathetic dominance, you’re gonna make more inflammatory cytokines. So I think that as we look at this concept of, hey, growth hormone or not, growth hormone will not erase or eradicate, ignoring things like blood pressure, heart rate, proper diet, where are my blood chemistries at? How am I feeling? What type of sleep am I getting? And sure, well, probably placate some of it. You’ll look leaner and I always say to people pretty on the outside doesn’t mean pretty on the inside, so it won’t .

Sanjeev Goel, M.D.

It couldn’t contribute to aging? Like it couldn’t contribute to aging ’cause it’s constant stimulation of IGF-1, and I’m just concerned about that, and people are maybe taking them, and taking big doses.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I think your point is well taken, and I kinda agree with you. I’m not a big advocate at this time for growth hormone because I think there is some thought that excessive IGF-1, especially, back in the early 2000s, I wrote a book, a chapter in a book called Diabetes and Cancer: Epidemiologic Links and Molecular Evidence. And it was the outlining of how people go from being insulin resistant and diabetic to developing cancer at the cellular level. I mean, it was, I mean, you read a page of this thing and you fall asleep, I mean, it was deep. There was top researchers and they asked me to do the simple chapter, but this is what’s interesting is excessive IGF-1 signaling, combined with insulin resistance, that is the fire of cancer cells. And so it’s not just, “Oh, hey, I’m gonna raise my IGF-1.” Where’s your blood sugar at? Where’s your fasting insulin at? Where’s your postprandial insulin at? Are you really managing those aspects of it, because as I said, if you just add growth hormone in and think that’s it, you could be causing problems, and I totally agree with you on that.

Sanjeev Goel, M.D.

And so let’s talk about the peptides like CJC and Ipamorelin and such, like the studies, how much of an increase of growth hormone are we seeing? Like let’s say if you were to compare, let’s say getting a deep night’s sleep, exercising, and taking CJC, how comparable are these? Do people have like as dramatic an effect let’s say from taking growth hormone? Like these peptides what are they-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I can only give you my clinical experience because as you know the human trials on most peptides, unless you’re looking at some of the peptides that are on the market as drugs like insulin or liraglutide, or thymosin alpha-1, so certainly there’s a fair amount of research on those. But the research is good, it’s there, it’s evolving, but I would say that as you get older you could exercise and eat right and get a good night’s sleep and you still might not release enough growth hormone. And what I’ve seen with people that have utilized ipamorelin or tesamorelin or sermorelin or any of the peptides that are geared at growth hormone release, is that they do improve their quality of sleep, so they report, “Hey, I’m sleeping deeper and better.” 

They ate less, it varies, now I’m not gonna say this across the board because I’ve seen this vary, some people get a dramatic fat loss where they improve their lean mass and reduce their fat. Some people not so much, but I would say that that’s the area where it warrants study because I think that at least clinically what I’ve seen and I’ve interviewed a lot of people that have taken peptides and I’ve seen that in general, people were pretty happy with the results of them and want to continue to be on them. 

And once again this is an area of, I would say, it’s an undiscovered country because, we’ve got the FDA wanting to be responsible and regulate things appropriately, right? We always have to keep that in mind. And then we have a lot of these peptides that are being sold not for human use that people are taking, which may not actually be safe. There was one study that showed that up to 88% of those compounds either were not at label claim or had adulterated materials in them. So, yeah, I think it’s gonna be interesting to see how the government legislates peptides over the next decade. And I do think they’re important therapy of compounds, and of course now you’ve got almost 200 peptides in drug trials right now. So obviously Big Pharma thinks they’re important, they’ve been approved in certain applications. So I think we’re gonna see, I’m hoping we see that people were able to utilize these types of things to support their innate release of growth hormone because everything I’ve seen says, “Hey, they think it works.”

Sanjeev Goel, M.D.

So what’s exciting? Like you must have a supplement regimen, so what are the things that you think are kind of the mainstays of what people should be thinking about if they’re gonna supplement with plant medicines or other nutraceuticals, like what would be on the top list?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I think, yeah, first of all thinking of the adaptogens are incredibly important, whatever culture you look at over the last 5,000 years of written history on botanical medicine, culturally adaptogens are the most important herb in every culture. So whether it’s ginseng or cordyceps or ashwagandha schisandra, all of these agents are incredibly important. And the reason they’re important is they help our body adapt to stress, that’s why they’re called adaptogens. And so since the beginning of medicine, we’ve identified that managing stress is incredibly important. And in the modern world, of course, people wait till they are incredibly anxious, and Xanax and Prozac have become our new adaptogens.

And I think that’s tragic ’cause I would rather people be resilient and stay resilient than frazzle their nervous system to the point of anxiety, panic, and depression. And so adaptogens, ashwagandha, , I love cordyceps, so cordyceps sinensis, which is in the Chinese medicine materia medica helps to oxygenate tissues, helps protect the kidneys, helps the liver to detoxify. So it’s really I think, an important adaptogen. Then you can get into something like curcumin, the big thing on curcumin is what does it absorb? So a lot of pills people take me not absorb and I’m working on a project with a German company actually a German drug company that has figured out how to nanotise their curcumin to the point where it’s superior to IV curcumin, but has a longer half-life and superior bioavailability.

So I think that as we apply modern biopharmaceutics there I go with my pharmacy background, again, we apply delivery, we apply how we can get that plant medicine to absorb. I think that we’re gonna see exciting evolution in the application of plant medicine. So things like green tea, why is green tea and curcumin and quercetin so important? because they help us to regulate something called the sirtuins. And why sirtuins are important is they help our body to keep our mitochondria within the cells firing and keeping them healthy. So as mitochondria get ragged and they break down, you hear about mitophagy, the mitochondria breakdown. And what we really wanna do is promote our mitochondria staying renewed and being able to generate energy so that our cells can perform all their functions. 

So when you look at green tea and quercetin, curcumin decreasing inflammation, upregulating the signals that help our mitochondria stay strong, I think that’s important. I’ll tell you another one I think is important is nicotinamide riboside. As we age, we lose the ability to generate NAD in our cells because we’re not efficient with niacin or niacinamide anymore and nicotinamide riboside goes through something called the salvage pathway of your cell and that triggers up-regulating NAD. And why is NAD important? Because it helps our body go through our transport cycle for making energy. And so I think nicotinamide riboside is a biggie, just as CoQ10 is important. And then it starts to get into, well what’s your issue, because if we read about an herb and say, wow, I could use that, I could use that, I could use that, I mean, you only ended up taking 50 things and I’ve kind of gotten away from that. I mean, I try to get people to eat right, try to get them to exercise, try to get them to sleep do a little bit of deep breathing to reset their nervous system and then I want them to take targeted nutrients. 

Where is your metabolism broke? And that was why we developed the Metabolic Code platform was to try to get people to say, here is where you’re the most broke. You need to use berberine because your tight junctions in your gut are broken down and you’ve got gut permeability problems. So we need to repair that, so berberine is really good, cat’s claw is really good. Are you having issues with hormones? I’ve had great results using standardized fenugreek extract and eurycoma to stimulate testosterone for men and women without having to resort to a replacement in many cases. 

So I think once we get past the adaptogens, and a lot of the plant foods like curcumin, like medicinal mushrooms that have what I call a pleiotropic effect on your body, they’re working in multiple good ways to help your body stay in balance, keep your immune system attacking, keep your thymus gland functioning, so you’re making good T-killer cells to go out there and fight the good fight. I mean, I think, once we get past those, I mean, everybody should be on magnesium, I could tell you right now, I know it’s boring, at the same time I find very few people have enough magnesium in their body. And I measured the red blood cell magnesium, and usually it’s under 5.6, it’s usually in the fours and you’re just not gonna operate as efficiently when you don’t have essential vitamins, minerals and amino acids in your body.

Sanjeev Goel, M.D.

I think this is very interesting, the way you’re saying this because I’ve always thought and I think people come to say, “Look, I take all these supplements, but I don’t even know they’re making a difference.” But we’re really moving to precision medicines, what you’re doing with the Metabolic Code, I think that’s the key message, I think you want the viewers understands that we can now kind of do more targeted recommendations about what’s best for them. I mean, through the blood tests and other testing.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s exactly it. Like, that’s why I liked the epigenetic tests. What I’m doing, ’cause like you said, you saw these athletes I’m sure they were doing things but yet they had accelerated aging. So, where am I broke? Let’s fix that before we worry about how I enhance myself. It’s no different than rebuilding a classic car or an old home, start at the foundation, work your way up. Where’s the foundation? Well, it’s different than everyone. Some people their foundation is the gut immune brain access where they’ve got food allergies, and they’re reactive and they’re making a lot of histamine and their brain’s foggy and they’re not thinking clearly. And some people it’s in their energy where it’s the relationship between adrenals, thyroid, and pancreas. So blood glucose, cortisol and thyroid hormones ’cause when that’s out of balance you gain weight and you feel sluggish. 

So, I really think it’s important for people, and I know it’s been my passion as I watch this last, 35 plus years of practice is trying to get them to understand what do you need to fix? And then what are the nutrients that are right for you? And then let’s verify. Verify by is your blood pressure down? Is your heart rate better? Are your symptom scores better? And lastly, what are your labs look like? And now what’s your epigenetics look like and the promise of omics and really showing that we’re turning off activated genes that should be turned off. I like to look at it as this process that we should be putting people through to show them, and we also have to remember everybody isn’t ready to grasp it all at once, sometimes we have to start simple with folks. I’m the type of person and I’m sure you are too, if you gave me eight things to do and you’d said, “Jim, I just worked you up and these are the eight things I need you to do in order to get better.” I don’t want you to tell me, just start with the first two, I’m gonna say, give me all the details on all eight and I’m gonna do all eight and I’m gonna ask you about the next two. 

But everybody’s not there, everybody isn’t have that Spartan kind of mentality. And we really have to be careful about precision medicine and precision health, in my opinion, because if we hand people a big basket of tasks and what they’re really used to is a sedentary lifestyle and kind of eating whatever they wanted, and not getting enough sleep, we’re not doing them a service by saying, “Hey, this is your plan and you need to do it.” We have to meet them halfway. And I think for people it’s incredibly important as practitioners that we understand even with precision medicine and precision health, and it’s fantastic targeting that we’re gonna be able to do, the best program is the program that a person can follow.

Sanjeev Goel, M.D.

Yeah, wow, that’s really powerful. How would you, as the last question, how do you describe now this whole version of medicine? You mentioned precision medicine, I’m kind of leaning towards that, but like what’s your thoughts about what is this new medicine? How can people understand? It’s not necessarily always antiaging it’s not integrative, like what exactly is it? This new paradigm?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

When you think of precision health and precision medicine, and it’s a term in medicine, precision medicine is a bonafide term, right? It’s really about identifying in individuals, the actions that are needed to repair and renew their chemistry. And so whether that action is I need you to do some deep breathing, I need you to eat better. We’re going to do these tests, you need this MRI in order to find out what’s wrong. It’s identifying the proper tests, the proper procedures, the proper diet, lifestyle, and really creating an approach that is solely focused on solving the problems at hand first.

And then you target, how do I stay well, after I deal with those problems at hand? And that’s how I view precision medicine. It’s not just about, oh I wanna do things in order to live longer, right away, it’s targeting the areas that you need for your repair. And that means good traditional medicine, that means the application of antiaging strategies, the application of diet theory, the application of exercise theory, behavior modification. All of these things kind of are tools in that toolkit that allow a person to start to get a sense of where they’re broke. And honestly, that’s how I talk to people, I always try to get in sync with them on understanding here’s where you’re broke and what it will take to fix it, let’s talk about what you’re able to do now.

Sanjeev Goel, M.D.

Perfect, thank you so much, I think this is a great hour for our listeners, I really appreciate it. And I wanna talk to you about some other stuff offline, but so many more questions but I really appreciate your time, Jim.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, it was great, thanks for having me, this was a blast. I’m so appreciative of you really working on like bringing awareness of this type of health out to people, it’s fantastic.

Sanjeev Goel, M.D.

Yeah, and where should people go if they wanna learn more about you and the work you’re doing and about Metabolic Code, where should they go?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

So they can go to jimlavalle.com if they wanna kind of see all the books that I’ve written, I’ve written 22 books and 18 eating books and two more books coming out this year. And then they can go to metaboliccode.com if they’re interested in looking at kind of what I think is a very advanced way of being able to evaluate a person and at the same time make it fairly simple for them to understand where they need to start.

Sanjeev Goel, M.D.

Awesome, okay, great, have a great day.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

All right thank you.

Sanjeev Goel, M.D.

Talk soon, okay.