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EP132 The One About The Four Big Causes Of Non-Alcoholic Fatty Liver Disease

Transcript Of Today's Podcast

Dr. Martin, Jr: Hello, my name is Dr. Martin, Junior.

Dr. Martin, Sr: I'm Dr. Martin, Senior.

Dr. Martin, Jr: This is the Doctor is in podcast, and this is episode 132. Today we're going to talk about [00:00:30] a condition that affects, some estimate as high as a third of adults in North America, which is just crazy to think about. However, when you look at the rapid growth in diabetes and stuff like that, you can see how that makes sense. Of course we're talking about fatty liver, right? Or fatty liver disease. It's one of those things that ...

Dr. Martin, Sr: Talking about non-alcoholic fatty liver.

Dr. Martin, Jr: Yeah, and that's the thing, right? At one point fatty [00:01:00] liver disease was strongly associated with alcohol. It was a problem that plagued people that drank excessive alcohol. Now that's not the case anymore. Non-alcoholic fatty liver disease has overtaken by a large margin, when it comes to the diagnosis of liver problems. It's such a common issue, and it really is a silent epidemic and a silent killer, because ... You know? We had talked about this before in newsletters and in [00:01:30] previous podcasts, that if you were to reverse engineer type 2 diabetes ... Type 2 diabetes is a disease of insulin resistance. You and I have talked about that many times. It's not a disease of high blood sugar. That's a symptom. One of the problems with the current management of type 2 diabetes is it's treated as a disease of high blood sugar, so a lot of the mechanisms and a lot of the treatments that they use in place, is to simply lower and manage your blood sugar, [00:02:00] than when it really is a disease of high insulin.

Now it's funny, you and I did a presentation not too long ago. We did an online webinar, and we had a ton of people on there. It was a lot of fun, and we were talking about lowering insulin. Then in the questions, one of the ladies that was on the presentation typed into the question box, and it was like a light went on. She was a type 2 diabetic, and we were talking about just the mechanisms of having high circulating insulin, [00:02:30] and she kind of just all of a sudden typed in ... It wasn't even a question, just kind of like, "Why if insulin is elevated, if it's a problem of high circulating insulin, am I taking insulin to treat type 2 diabetes?" Our answer to that was, "Well exactly." It's treated to be managed, and it's treated to be made worse in a lot of ways, right? Anyways, that's kind of off topic, but if you were to reverse engineer type 2 diabetes and go all the way back to the beginning, one of the first steps that happens [00:03:00] is an accumulation of fat in the liver. That starts off a process, right?

Maybe we should even go back one step before that, just to give an overall, a real good picture of what's actually going on, because you and I, we can kind of simply give a real simple explanation without getting into too much, because it can ...

Dr. Martin, Sr: We don't have to get into the weeds.

Dr. Martin, Jr: Yeah, because it can get bogged down in a sense, right? I mean every time you eat anything, it's eventually [00:03:30] broken down into glucose. I mean some things break down a lot quicker, some things break down a lot slower. That's where the concept of the glycemic index came from. Foods that break down very quickly into glucose, quickly raise your blood sugar, and slower foods that take to break down, slowly raise your blood sugar, but eventually they all break down into ...

Dr. Martin, Sr: They all get there.

Dr. Martin, Jr: That's right, they all get there. You and I say this all the time, but glucose, blood sugar is very, very toxic. [00:04:00] It's a really toxic problem, which is why it's really tightly regulated. Your body regulates very tightly blood glucose. You have three hormones basically that will bring up your blood sugar levels, and you have one that brings it down, right? Of course we're talking about insulin. Insulin does a few things, and it lowers your blood sugar levels. Now it's interesting, because when you eat any food and it's broken down into glucose, [00:04:30] glucose is a fast acting fuel. You either burn it off right away, or you throw it into storage. You have to throw it into storage. There are three places that you can store that glucose, right? You either burn it off, or because you can't leave it in your blood, because it's toxic ... You don't want high blood sugar, because that could be dangerous. You don't want low blood sugar, because that could be dangerous, so your body has to get rid of that high blood sugar, so it has to store [00:05:00] it.

The three places of course, one is your muscles. Muscles can store anywhere between ... Depending on the person, the amount of muscles they have, but let's just say 500 grams of glycogen. Glucose is converted into glycogen and then stored in your muscles. I mean that's one place, but what happens if your muscles are full already? A lot of us have full glycogen storage of our muscles, because we're not exercising, we're not burning that off, right?

Dr. Martin, Sr: Yeah, yeah. We're not making more [00:05:30] room to be stored. That's why, just as a little side point that you and I talk about it all the time, we always talk about, "Well what's the best exercise?" Hey, go for a walk. You've talked about that. That'll lower your blood sugar by a half, just by going out after a meal.

Dr. Martin, Jr: Yeah, there was one study that shows that 90 seconds of walking every 30 minutes of sitting will cut your blood glucose levels in half. I mean move around, right? Go for a walk.

Dr. Martin, Sr: Even [00:06:00] after a meal, go for a walk.

Dr. Martin, Jr: Yes. At night time, that's what they say. A long brisk walk after a meal at night time lowers blood glucose.

Dr. Martin, Sr: But, if you want storage for muscle and you want to put that glycogen into your muscles, you better have muscles. A lot of people ... Look, we're not saying not to do aerobics or whatever. A lot of people spend a lot of time doing aerobics, and we're not saying not, but we're talking because we're food scientists, we're [00:06:30] always talking about food and the reality of the people and how we eat today. You want a place to store that glycogen, and your muscles is a great place, but you've got to have, and that's why we talk about resistance, weight, weight lifting exercises.

Dr. Martin, Jr: That's one of the dangerous side effects of like a sarcopenia, right? Muscle wasting. It lowers your metabolism, it affects your insulin sensitivity. There's a lot of ...

Dr. Martin, Sr: There can be very unhealthy [00:07:00] skinny people. Very unhealthy.

Dr. Martin, Jr: Oh yeah, and that's a problem. They don't tend to get the same warnings that somebody else may get as well, which is dangerous. Yeah, so getting back, you're absolutely right. I mean if you want to be able to store more glucose into your muscles, you've got to have more muscles to do that. The best type of exercises as well, also will burn that glycogen in your muscles. High intensity interval training. You want to burn the glycogen out of your muscles, but you don't want to go [00:07:30] so long that you're actually breaking down muscles to fuel the ... Right? Because that's one of the problems of long cardio, is it becomes catabolic, meaning it starts to break down protein in order to get the energy from protein, because protein is a source of energy.

Dr. Martin, Sr: It'll go right after it in your muscles if [crosstalk 00:07:46].

Dr. Martin, Jr: Yeah, it'll eat it away. It'll kind of go at it a little bit. If you are going to be a long cardio person, you have to be consuming a ton of protein just to be able to do that. That's one of the things that happens, right? You can't use that glucose for energy right away, so you throw it into your muscles. When [00:08:00] your muscles are full, another storage unit for glucose is your liver. The liver stores about 100 grams depending, I mean plus or minus, whatever, but it is a small storage spot for your glucose you're not using.

Dr. Martin, Sr: Think of it as a suitcase.

Dr. Martin, Jr: That's right, and that's what we're going to talk about, exactly what happens with the liver, is that it gets full of glycogen, and it's like a suitcase so your body tries to pack more in there and it starts to put fat around [00:08:30] it. I always kind of give the example of family going away on a trip in a minivan and they pack the van full, and the dad realizes we've got three more suitcases, so then they go in the ...

Dr. Martin, Sr: They go on the roof.

Dr. Martin, Jr: They go on the roof and they tie it around, and that's kind of what happens to your liver. The liver gets full.

Dr. Martin, Sr: That's a great analogy, because it's really true.

Dr. Martin, Jr: Yeah, the liver gets full and then the body starts to strap on more fat and it gets fatty liver. Then of course, the third option ... Once your [00:09:00] liver is so full, you can always make more fat cells, so that's a third place where fat gets stored. Not fat, it's glucose.

Dr. Martin, Sr: I love this, just an aside, because you said this to me one time and I have never got it out of my mind, because it's something that when you talk about being tightly regulated blood sugar and how your body just will not allow sugar in your blood stream ... It's interesting, because [00:09:30] in the office we do a urine test. I always tell them, "Well you know what? Urine is so much more accurate in terms of diabetes, because if you're spilling over, just think of it, your body is so protective of your blood stream of sugar, you're going to start peeing out your sugar." I mean when you ... They don't do that much anymore, you know? Like in my day, my old days, blood sugar wasn't as [00:10:00] important as was your sugar in the urine. The old fashioned doctor used to smell the urine and know that a patient was ...

Dr. Martin, Jr: Yeah, it smelled sweet.

Dr. Martin, Sr: It smelled sweet, right? You could smell that sugar. Anyway, I mean the point I'm trying to make is when ... You said this and I've never forgot it, is that because the body is so tightly ... It regulates your blood sugar so much, it will do anything to throw it into your muscle. Muscles are full, throw it into your liver, but like you said, [00:10:30] the other thing, and this is what's happening in the world today if you look at it, like you see it. It's a visible experiment that we see in society. What is that? People are so much bigger today. Think about it, right?

Dr. Martin, Jr: Oh, yeah.

Dr. Martin, Sr: I mean you've got to be my age, probably born in the 50's, grew up in the 50's and 60's. People were tiny. You look at Hollywood. They were just little people, just very tiny around the waist. [00:11:00] I think of my mom and my dad might have been a little bit bigger, but my mom was tiny. Everybody ... Nobody was big in my class. I mean if you were big, you were tall. You were not ... Tall, I was 6 feet when I got to high school, and I was tall, but nobody was really big.

Dr. Martin, Jr: No, and that would be an interesting podcast, because there's a bunch of reasons for that.

Dr. Martin, Sr: Well, when you think of it ... Just coming back to the point you made. People get bigger because of the inexhaustible [00:11:30] amount of fat, that if you can't store it in your muscle, you can't store it in your liver, the body will do anything it can to keep you away from diabetes.

Dr. Martin, Jr: Well, my theory on that, exactly what you just said ...

Dr. Martin, Sr: I like that. That's what I'm trying ...

Dr. Martin, Jr: Yeah, my theory on that is that obesity is your body's way of protecting itself against diabetes, because it doesn't want to have an abnormal blood sugar issue.

Dr. Martin, Sr: It is very dangerous, like you said, for a lot of reasons.

Dr. Martin, Jr: The body will continually store [00:12:00] the glucose into a form that can be stored in fat cells, right? I look at obesity as a protection against diabetes, but eventually it catches up anyway. The body can only find out ...

Dr. Martin, Sr: When you think of diabetes being a problem with insulin, then you already are diabetic.

Dr. Martin, Jr: Yes.

Dr. Martin, Sr: You just don't get the diagnosis, because the diagnosis is looking at the wrong thing. It's looking at sugar in the blood stream.

Dr. Martin, Jr: I kind of look at type 2 diabetes diagnosis as that's your like in stage 3 already. You've had [00:12:30] diabetes for a long time, but now your blood sugar levels can't be regulated anymore normally, so now ...

Dr. Martin, Sr: We should write a book about this.

Dr. Martin, Jr: Well, because it is an ...

Dr. Martin, Sr: Stage 3 ...

Dr. Martin, Jr: Yeah, because it is interesting.

Dr. Martin, Sr: Type 3 diabetes ... I know they named the brain, Alzheimer's type 3, but we've got to think about it. I like that, because you rarely ever see the science of that where people are thinking outside the box and looking at ... People are already diabetic.

Dr. Martin, Jr: They are for a long period of time, and like I said, I think when you finally [00:13:00] get diagnosed with type 2 diabetes, you've had diabetes for a long time, but now your blood sugar levels just cannot be maintained by storing fat in cells or fat in your liver, or fat wherever it can. I mean that's what ends up happening.

Going back to fatty liver, one of the things that happens along that way is some people do not have the same ability to make fat cells as somebody else does. Some people have an amazing ability [00:13:30] to make fat cells, and that's an amazing ability the body has to protect itself from diabetes, so they make more fat. Some people that don't have that same ability to store fat, or store glucose in fat cells, they pack it even more in their liver, which means from an appearance thing, they're thinner, but they have fatty liver.

Dr. Martin, Sr: Yeah, and I see that in the office all the time.

Dr. Martin, Jr: That's what happens, right? You have a third of the population or more that has fatty liver. Some of them are thin, some of them are bigger. It doesn't matter. [00:14:00] The liver is now full, it's like the minivan that has the luggage on top, it's packed there. What's interesting, and this is what I find interesting as well, there's really only two things that can happen once you have fatty liver. You have two things that really happen. One, is that the fat then will kind of circulate in the blood flow as triglycerides.

Dr. Martin, Sr: Very dangerous.

Dr. Martin, Jr: That's right, because then high triglycerides is an indicator that you and I take seriously, because that is [00:14:30] really telling you your body is insulin resistant, you're packing fat in your liver.

Dr. Martin, Sr: You've got fatty liver.

Dr. Martin, Jr: Yes.

Dr. Martin, Sr: You might not get the diagnosis, but if your triglycerides are high, and especially women, very, very dangerous for them to have high triglycerides. The doctors want to talk about cholesterol, and we say, "Cholesterol schmolesterol." I mean, cholesterol is part of ... If you've got real bad numbers in cholesterol, it's part of metabolic syndrome, but that's ...

Dr. Martin, Jr: Not by itself though, right?

Dr. Martin, Sr: Yeah, never by itself. It's [00:15:00] not an issue.

Dr. Martin, Jr: That's the thing. High blood pressure, high triglycerides ... I mean there's a whole bunch of ...

Dr. Martin, Sr: Fatty liver.

Dr. Martin, Jr: Oh yeah, and that's the thing. Like I said, a fatty liver, the fat can go away as triglycerides start circulating, or it can stay in the liver and cause a lot of problems. You and I have kind of talked about four factors that drive fatty liver that we see today. The amount of fatty liver. There's kind of four factors. Of course, the underlying big reason is high [00:15:30] circulating insulin, right? These people are insulin resistant, and as a result of having insulin resistance, they have high circulating insulin. The reason of course, is because the body is ignoring the insulin and it's not responding to it, so the body makes more insulin in order to get the same job done. They have high circulating insulin, and that causes more fat storage and more fat storage around the liver, so that's one [00:16:00] of the problems ... I mean that is the problem when it comes to fatty liver.

Aside from that, there are really ... That's the fourth one, but aside from that, there are really three other driving factors that we see, that's kind of caused a lot of this that we are ... Why is it such a common problem today? One is that you and I kind of call the other drinking problem, right? It used to be alcohol that was the driving force for fatty liver. Now it's the other drinking problem, which is high fructose [00:16:30] corn syrup.

Dr. Martin, Sr: It sounds like a great word, but you know? It's interesting, because they discovered high fructose corn syrup in the 70's, and I like to give this a little bit of a history, because you can understand ... Again, if you go back far enough and you watch what the food industry did, they literally hired scientists to lie. Remember they said George Bush lied about W ...

Dr. Martin, Jr: Yeah, it's like big tobacco.

Dr. Martin, Sr: Yeah, George Bush lied and people died, right? I mean that was sort of an expression. [00:17:00] Well, the food industry lied, because first of all, they said that fat makes you fat and so we're going to take the fat out of all foods, and eggs give you cholesterol and meat is no good for you, because we want you to eat our foods, right? Look, I don't blame them. They're in business and they did their thing. What they discovered though, and I don't think they ever fully understood the danger of this, and that was high fructose corn syrup. They put it in everything. It was very inexpensive, it tastes fabulous, [00:17:30] but folks, don't be fooled for one minute. It's not a healthy sugar.

Dr. Martin, Jr: No, and I hate the word as well, because high fructose, right? Of course people think of fructose, and fructose is the fruit sugar, and it's like well ... They kind of tied the two together, but high fructose corn syrup is really an unbound form of fructose, which makes it cheaper, but it's also processed differently.

Dr. Martin, Sr: It's like Monopoly, don't go past go. Your body doesn't metabolize [00:18:00] this sugar properly.

Dr. Martin, Jr: No, and it's interesting that it is actually ... High fructose corn syrup is metabolized very similar to alcohol is.

Dr. Martin, Sr: Yeah, right to the liver.

Dr. Martin, Jr: Yeah, the liver has to do its work, and one of the things is you hear of a beer belly that adults get when they drink alcohol and it's fat around that liver. Then you see kids today, they have those sugar bellies, which is very similar, but it's like the nonalcoholic version of a sugar belly that these kids are getting. As adults, it's not just kids that are eating high fructose corn syrup. [00:18:30] I mean adults, that's a big part of their diet now days.

Dr. Martin, Sr: Well, it's in cereal, right? It's in fruit drinks, it's in soft drinks, it's in ... You name it. Ketchup. I mean they put it in everything, because it's so inexpensive for them.

Dr. Martin, Jr: People drink a lot of soda.

Dr. Martin, Sr: It tastes good, right? I mean as far as taste, it's a very, very sweet ... It's very cheap for them.

Dr. Martin, Jr: Yeah, it costs nothing. It increases their margins. I mean people drink a lot of these high [00:19:00] fructose corn syrup drinks, right? I mean that's what they drink.

Dr. Martin, Sr: Right off to the liver. Just metabolizes in the liver like alcohol does.

Dr. Martin, Jr: Yeah, and it causes ... Yeah, so not only does high circulating insulin cause fatty liver, drinking high fructose corn ... Especially drinking it, consuming it, yes absolutely. I'll tell you, there's nothing ...

Dr. Martin, Sr: Worse than drinking it.

Dr. Martin, Jr: Drinking your sugar, right? I mean it's metabolized so much faster, it really kills your blood sugar levels. It creates a lot more insulin. It really messes you up. Just remember that [00:19:30] high fructose corn syrup is metabolized in the liver, which will cause some liver issues. That's one of the reasons. One big cause today driving the amount of fatty liver has to do with high fructose corn syrup. The second reason is lack of movement. I mean think about this for a second. You have so much energy to burn. Let's just say you're active. You burn off that immediate glucose that's sitting there in your blood supply. Then you need more energy, so you have [00:20:00] to start tapping into stuff. You have to start tapping into glycogen in your muscles. You start to burn that off. Then you start to burn off your liver glycogen, so what's happening is, it's that analogy of driving again. Imagine packing your minivan full of luggage, driving somewhere and then not emptying it out, but adding more stuff to it. That's what's happening today. Rather than getting to a location, emptying it out and then repacking it up and emptying it, and that's what [00:20:30] you should be doing. Exercise does that.

Another thing that's interesting, is you basically wake up in the morning normally in a fasted state. Not everybody in a sense, because some people are eating way too long, but that overnight fast can drain your liver glycogen to a certain extent, which is another reason why you want to kind of stop eating a little earlier at night in a sense, drain out that liver glycogen.

Dr. Martin, Sr: It doesn't only reset your pancreas. We've often talked about that, intermittent fasting. [00:21:00] You stop it a little earlier at night and then don't eat for quite a while. You're giving that liver a good chance to empty itself out too, right?

Dr. Martin, Jr: Which is very important. Then lack of exercise never empties out your glycogen, especially your liver glycogen. It just gets packed full and full. Activity, and there's a lot of research that shows the effect that exercise has on fatty liver. It's so good for it, right? I mean it really is a protective mechanism that you have when it comes to fatty liver. [00:21:30] That's the second reason. The first was over consumption of high fructose corn syrup. The second was a lack of movement, and the third has to do with really environmental toxins. You think about it for a second, your liver is your detoxifying organ, and I heard somebody say this. I can't remember who it was, because it was fascinating, but he kind of equated us now, our bodies are rent free storage units for chemicals. That's what's happening today, because every [00:22:00] time they do a study now where they check the urine of people, there's folates everywhere, there's BPA everywhere. I mean we're loaded ...

Dr. Martin, Sr: Heavy metals.

Dr. Martin, Jr: Heavy metal. We're loaded with chemicals.

Dr. Martin, Sr: Mercury. We just talked about high fructose corn syrup. One of the biggest issues in that is a lot of mercury in high fructose corn syrup.

Dr. Martin, Jr: We're just an absolute storage unit for chemicals now days. Everybody is. If you live on planet Earth, you are ...

Dr. Martin, Sr: They've seen that in the placenta, you know?

Dr. Martin, Jr: Yes, how many chemicals? I can't remember that study exactly, but in a placenta [00:22:30] how many chemicals were in it.

Dr. Martin, Sr: Oh yeah, yeah. I remember Wendy Mesley, she would CBC ... This is years ago. I'm talking about in the 90's, I think she did this little thing on CBC and it might have been Marketplace or whatever they're called, and she could not get over ... They analyzed the chemicals in the placenta. It was incredible the amount, right?

Dr. Martin, Jr: We're a storage unit of chemicals. I like that term. We're a storage unit of chemicals.

Dr. Martin, Sr: I don't care where you go folks, [00:23:00] I mean, you know?

Dr. Martin, Jr: That's the reality.

Dr. Martin, Sr: I told you about that story about a patient that came in and said they were moving to Costa Rica, her and her husband. They're leaving and they were going to be on a little island like it was almost like a movie that you would make, that they were leaving everything and going to the ... I said, "You know what? You're less than 1.1% of the universe can" ... I don't know if it's Costa Rica, it's great there and probably not a lot of pollution. I said, "Well [00:23:30] okay, what about the rest of us? We can't do that?"

Dr. Martin, Jr: No, and if they drank bottled water, they've tested it from all around the world, right? I mean at the end ...

Dr. Martin, Sr: Yeah, there's plastic there too, isn't there?

Dr. Martin, Jr: That's right. You're breathing plastic. It's in the ... I mean the reality is we are, like the guy said, a storage unit of chemicals.

Dr. Martin, Sr: Not paying rent.

Dr. Martin, Jr: The unfortunate thing ... That's right, rent free. They're a tenant you can't get rid of, and they're a tenant that didn't ask you, right? I mean it's terrible. One of the side effects of that is an overworked liver. The liver is constantly trying to [00:24:00] detoxify your body. It is overworked, overstressed. That fatigues the liver, and again accelerates the process of fatty liver. Now imagine, you have a fatty liver already and we live as a storage unit for chemicals. Your body can detoxify even less than before, and it kind of becomes this circle of faster ... I mean your body just breaks down even faster, because it can't detoxify properly, and then they've shown that as that happens, your levels of glutathione decrease, [00:24:30] which is your body's master antioxidant. It's like a sticky compound that sticks to junk and gets rid of it. That decreases, and everything just compounds from thereafter. When you have fatty liver disease, it can really accelerate your time on Earth, to end faster. It can go a lot faster, because you're not detoxifying, and there's all these other things that happen. Fatty liver is a ...

Dr. Martin, Sr: The inflammation that would go up in your body, right?

Dr. Martin, Jr: Tons. It's [00:25:00] a serious problem. That is what's going on out there. I guess we're kind of already out of time, but we could talk really quickly about a couple of remedies. One obviously would be getting your insulin low. That would be first and foremost. You get your insulin low, research has shown this over and over again. You can ...

Dr. Martin, Sr: It doesn't take long. It's amazing.

Dr. Martin, Jr: No, there's studies showing how fast you can get rid of fatty liver, if you do the right things you can get rid of it. You want to keep your insulin low. Something [00:25:30] else I find interesting is kind of like a catch 22, that came about as a result of the crappy guidelines that North America has been living under with low fat, for the longest time. Eggs, and you still see some people ... Eggs are cholesterol fatty foods, and you don't want to eat eggs, but ...

Dr. Martin, Sr: Yeah, no saturated fat.

Dr. Martin, Jr: ... One of the big contributing factors to fatty liver is a choline deficiency, which is found in eggs. You need choline. Your liver needs it. It's kind of a funny thing. It's like a double whammy. You decrease [00:26:00] the amount of eggs you're eating, so chances are you're filling that up with crappy sugar filled foods. I mean it's just a kind of round and round you go. I mean definitely exercise as well. Eating low glycemic ... Not glycemic. I don't like low glycemic necessarily, but low insulin foods coupled with exercise, awesome for lowering fatty liver. Nutrient-wise, there's a few that you like for fatty liver. [00:26:30] I guess we have just a minute or so. Anything you want to ... What would you recommend?

Dr. Martin, Sr: I mean I always say that you want to be anything that ... I even talked about [inaudible 00:26:41]. I always loved Navitol, because it elevates your glutathione, right? I mean if glutathione is like velcro in your blood stream, it really does make a difference there. We always like milk thistle too, and probiotic. Again, these are all ...

Dr. Martin, Jr: Yeah, probiotics is key for fatty liver. It sounds funny. That [00:27:00] was one of our top recommendations for fatty liver, because probiotics ... Your liver needs probiotics, but also probiotics are kind of a precursor to glutathione production, so you need that. It plays a massive role in that, so you need that as well. I mean there are a lot of things you can do for that, but the key again would be keeping your insulin low, exercising, and then probiotics and even a good antioxidant like our Navitol would be our recommendation. Again, we're out of time. We want to thank you for listening. If you have any questions, you can email [00:27:30] us at info@martinclinic.com. You can also go to our website. If you don't get our newsletter, sign up for our newsletters at martinclinic.com. Every Thursday morning you do a Facebook live.

Dr. Martin, Sr: Upside down sometimes.

Dr. Martin, Jr: Yeah. No, I know. We still ... Your grandkids ... We get ... They get such a kick out of the upside down grandpa who starts off the Facebook live, but I mean that's only 50% of the time, so it's not too bad. You can join you every Thursday morning for that, and it's awesome. You get a lot of viewers on there asking a ton of questions, [00:28:00] so you can do that. Again, thank you for listening and have a great day.