Jay Feldman 0:12
Welcome to Episode 57 of the energy balance podcast, where we teach you how to live without constant hunger and cravings, fatigue, brain fog, poor sleep and other low energy symptoms by maximizing your cellular energy. I'm Jay Feldman. I'm a health coach and independent health researcher, and joining me again today is my good friend Mike Fave. Mike and I have been studying health and nutrition together for a long time now, and Mike also draws on his experiences from working within the healthcare industry. Today's episode will be part two of our series discussing tissue oxygenation, cellular swelling, pH balance and other related topics. In part one, if you missed it, we discussed the role of carbon dioxide in our metabolism, and if you haven't listened to that episode, I'd highly recommend you go back and do that, because that information is vital for understanding what we'll be discussing today, which has to do more specifically, with glycolysis, lactate and pH balance. And I do want to mention that this series that we're doing right now is a little bit more heavy on the physiology and biochemistry side, and so if that's not up your alley, if that's not your cup of tea, then I'd highly recommend going back and listening through episodes one through seven of the podcast where we took some time to build a foundation as far as the bioenergetic view of health goes. In today's episode, specifically, we'll be talking about why lactate is not a harmless byproduct of glycolysis. We'll be talking about how lactate drives cellular swelling and prevents proper mineral balance, oxygenation and pH balance. We'll also be talking about misconceptions surrounding pH balance and the idea that alkalinity is healthy and that we just want to be more alkaline. We'll be talking about why we want ourselves to actually be acidic instead of alkaline, and what we can do to help maintain a proper pH balance throughout our bodies. To check out these show notes for today's episode, head over to Jay Feldman wellness.com/podcast where you can take a look at the studies and articles and anything else that we referenced throughout today's episode, and if you are struggling with any low energy symptoms, whether those are symptoms that we've discussed throughout this series, like high blood pressure or heart failure or edema, or any other low energy symptoms, whether that's chronic cravings and hunger, low energy or fatigue, chronic pain, weight gain, digestive symptoms like bloating or inflammation, brain fog, poor sleep or insomnia or any hormonal imbalances. Then head over to Jay Feldman wellness.com/energy where you can sign up for a free energy balance mini course, where I'll explain how these different symptoms and conditions are really caused by a lack of energy, and what you can do to maximize your cellular energy and resolve these symptoms and various chronic health conditions. So again, to sign up for that free energy balance mini course, head over to Jay Feldman wellness.com/energy, and with that, let's get started. So the contrasting side, the opposite side, of the efficient glucose metabolism that provides a lot of carbon dioxide would be basically two, two other components that we talked about last time. So one was the fat oxidation side, and sometimes that goes on on its own. But there's also the glycolysis side, which is basically when, instead of glucose being completely metabolized, as far as it could to produce the maximum amount of ATP and go through the eventually go through the Kreb cycle and electron transport chain. Instead, it basically gets stopped after that first part, which is called glycolysis. And when that happens, instead of getting basically, you end up with pyruvate, is the end product of glycolysis. And then, instead of getting shunted towards the Krebs cycle as acetyl CoA, it gets converted to lactate. And so that's that main break that we see. And not coincidentally, a lot of regulation happens at that pyruvate dehydrogenase enzyme, which is that conversion from pyruvate to acetyl CoA. And then same goes on with pyruvate to lactate, which is called lactate dehydrogenase. That's the enzyme for that one, and basically, when things are not functioning well, when we don't have a lot of CO two, when things are getting stopped up at the electron transport chain, leading to lower levels of energy and a lower NAD 10 ADH ratio, that's going to impair the conversion from pyruvate to acetyl CoA, and another factor there is, is b1, which is also involved in that, in that conversion. So when those things are happening, then what you see is that pyruvate getting converted to lactate, and that in the same way that we've talked about these kind of this cohesive system. That all works together, that has several mechanisms that all work to either slow down respiration or speed it up, or improve the metabolic state of the cell, or decrease it. The conversion from pyruvate to lactate is one of those backup bank mechanisms that works on the slowing downside, the slowing of metabolism, the slowing of energy production, and it has a few effects that do that. And again, all of this makes sense, where we need to have this backup pathway available for any time when we have extremely high energy demands. So normally, people talk about this in terms of exercise, where when you have very high intensity exercise, you'll first run on what's called the phosphocreatine system, but then after that, you'll be using glycolysis to provide energy and as kind of that primary backup mechanism to produce energy. And it's very quick, but it can't be sustained for very long. We only have a couple minutes where we can continue with that anaerobic glycolysis. Sometimes I call it anaerobic glycolysis, which basically means that the oxygen is not being used because the electron transport chain isn't functioning there. So we end up with just that first glycolysis point. But we're very limited on the limited on the amount of time that we can do that, and that's because it comes at such a cost to run through just glycolysis to lactate, and not go the full route, and it requires a huge amount of stimulus to force that to happen, considering that cost. And again, it's a good thing that this is there so that we can deal with those major energy demands when we have them, but we don't want this to be something that we're running through on a regular basis. And again, there are a few different kind of breaking mechanisms that lactate has that kind of contribute to that, but I don't know if there's anything you want to add before we dig into those Mike?

Mike 6:50
No, that's there's like a few, like for vitamin when you said b1 you meant it was like, just to clarify, nothing really to add to the system. But it was like vitamin d1 which is also thymine is important for private dehydrogenase, in case somebody didn't know what that was. And the phosphocreatine system, I want to reiterate, reiterate, is specifically within the musculature. As far as I understand, it's it's main, mainly occurs in the muscles. And it's like, it's very anaerobic glycolysis, which is running glycolysis because you don't have the oxygen or without oxygen present, is very different than the metabolism that occurs with aerobic glycolysis, which is something I don't know we might touch on today, but we might touch at another point, or if anyone's heard it in the repeat sphere, those are two very different things. But besides that, yeah, that's pretty good summary. Overall,

Jay Feldman 7:44
yeah. I mean, by aerobic glycolysis, isn't that just the same process, just in the presence of oxygen, because there's some something blocking the chain, or is there something else you're talking about?

Mike 7:52
Well, aerobic glycolysis is, is the like, that's supposedly the cancer metabolism. And so I don't want people to confuse, like, what happens with muscles under intense muscular activity intensity being just defined here as moving large amounts of weight, is more is a natural process. It's something that's supposed to go on. It's something that your body has that system in place for a reason, whereas aerobic glycolysis is more like a pathological condition because of damage at the electron transport chain.

Jay Feldman 8:27
Yeah, but it's the same like biochemical processes. It's just in different contexts where the reason why we, why you, it's called anaerobic glycolysis, is because the basically, they're talking about oxygen delivery being the main limiting factor that's preventing the full glucose oxidation, even though it isn't really, because, well, it's part of it. But anyway, with aerobic glycolysis, basically it's you have enough oxygen available. The oxygen is not a limiting factor, but you're still running through glycolysis. But again, it's kind of relative, right? Because if you're not producing a lot of CO two, for various reasons that we talked about, then are you really in an aerobic state when the cell can't take up oxygen? And how different is that from an anaerobic, glycolytic state? It's, I mean, in many ways, it's just kind of, I mean, it's all contextual, right, but the nomenclature isn't quite as clear, but it's the same problem and so, so I guess what the real difference is here is that with the anaerobic glycolysis that we're talking about, or that's typically talked about, is it's not pathologic, because it's induced by these large energy demands, whereas the aerobic glycolysis that's typically talked about is pathologic, because what it's saying is that There's problems with glucose metabolism that are preventing the glucose from being fully oxidized and causing it to just just being run through the glycolysis part?

Mike 9:49
Yep, I just wanted to clarify that, because there's a lot of talk about aerobic glycolysis and it is different. It's not the same, not the same pathway. Yeah.

Jay Feldman 10:01
Yeah, yeah. Well, same pathway, just, just different context, yeah, yeah. And so that's, that's a that's something helpful to consider, but it is. It's also important to even consider it in terms of the anaerobic glycolysis, glycolysis and, like, how short lived that is. Like, you know, you really can't run on that system very long, and that's because it comes at this huge cost, whereby cost where basically what's happening is you're because you have such high demands you can't keep up, like you can't really keep up with them fast enough. And so you begin..

Mike 10:35
it's like a metabolic bottle bottleneck, essentially, right?

Jay Feldman 10:39
Yeah. You end up with, yeah, exactly. You end up with a bottleneck. And when you're converting that pyruvate to lactate, what you end up doing is helping to resolve the NAD to NADH ratio. So as I mentioned, that tends to be the main break of the system is that having a low NAD to NADH ratio, and when you convert the pyruvate to lactate, you convert NADH to NAD. So it's a way to create NAD plus and help to fix that ratio. But it comes basically at the cost of diverting the pyruvate to lactate instead of allowing it to fully be oxidized and produce ATP or more ATP, yeah, and the and, as we kind of talked about before, that's creating a debt. And they actually call this oxygen debt even though, and again, this is they call this oxygen debt in the context of exercise, even though it's not directly related to oxygen. It's kind of indirect, yeah, but they they do that because what happens is that buildup of lactate then has to be it then leaves the cell and has to be converted back to glucose at the liver. So what your base the cell is basically borrowing energy from the liver, and then the liver is paying by converting that lactate to glucose and losing its own NAD and exchanging your friend ADH, and also losing some ATP in the process as well. And then that glucose ends up getting sent back out to to the cells, to be picked back up. And that's called the Corey cycle.

Mike 12:04
Yeah. And I want to, like, zero in closer to what you're talking about, specifically at the cell with the NAD to NADH ratio. Here it's so essentially what happens is the the glucose molecule, when it becomes acetyl, when it goes to pyruvate, you have, like a split it's like a fork Road, essentially. And in certain conditions, you can take the road to become acetyl CoA and go through the Krebs cycle. And in the Krebs cycle, you're creating or you're taking the electrons, or you're taking the energy from glucose, and you're storing them in NAD, and that becomes NADH, becomes reduced. You're adding electrons. Electrons are negative, so that's why you're calling you're saying it's reduced. And then the cell, or the mitochondria, takes that energy, that stored energy, and releases it through the electron transport chain. When with what happens with glycolysis? Or what happened, what induces glycolysis, what makes you essentially go down to that other path is that that path, the for the first path in the fork Road, gets blocked, and it's like there's only one way to go, and it you get forced down into that glycolytic pathway. And essentially, what's happening is your your body doesn't have enough of those molecules that NAD to store the energy from glucose. And when you don't have enough of those molecules, it's like, you don't have the carriers, right? You don't have the buckets to hold the water in. You don't have however you want it. You don't have a wheelbarrow to put the rocks in. So your body's like, Okay, we need to open up more wheelbarrows. We need to get more buckets to store this water, water being the energy year or or rocks being the energy here. And essentially it starts to just dump the rocks. And with glycolysis, little you'll dump the rocks without bringing them to where they really need to go. You're you'll waste the water without bringing it to where it really needs to go, and you'll free up the buckets. But that comes with, like with the loss of the energy, because when you when you oxidize through cell respiration. What is it like? In total? It comes out to be like 32 ATP, roughly. But when you start doing, when you start going through the lactic acid, what do you get? Like, net to ATP, it's like significantly less ATP, significantly less energy generated. But the the point here is essentially, now you have a NAD. You've just freed up the NAD, but in doing so, you've also you've also wasted energy. You've wasted potential energy at the cell, because you could have created more energy with that, with that glucose molecule. And even worse than that is now you've created this mediator, lactate that has to go to the liver and use the the livers energy supply, or stores use the energy liver energy stores to then convert it back to glucose. So now you're just, it's like a it's like a double negative, almost. So it solves, like a little problem at the. Cellular level, where it frees up your buckets, it frees up your NAD and then, but it you lose potential energy at the cellular level, and then you actually directly lose energy at the at the liver level. And that's because in order for the liver to process lactate back into glucose, it requires ATP, so it's kind of, it's not a good state to be running in. It's, it's like a and this is why it can't, you can't run it extensively. This is why you only have a certain period of time to do this. Because it's not meant to be a long term option. It's meant to be a, like a short term Band Aid solution, quick we're gonna particularly in muscular energy. It's like it gives you a very rapid and quick production of energy. It's like a very quick burst, and then you get you essentially are burning out of your supply. You've gone through everything very fast, whereas when you go through cell respiration, each molecule of glucose is producing a significant amount of ATP, but it's just doing at a slightly lower rate, yeah, yeah. And without, it's also doing it without basically wasting energy at the liver, and you're getting the full amount of energy that you could have gotten at the cell. So it's just overall, like, it's just a way better place to be. Yeah, go ahead,

Jay Feldman 16:21
Yeah. And it's without react, racking up that debt, and that let that debt comes at, you know, at the cost of the liver. But, you know, again, there's, as you were kind of describing earlier, this isn't pathological in the short term, where you do end up at the very end, like after the Corey cycle, you end up back with the same glucose, back at the cell. You just kind of borrowed the the ATP and the NAD and NADH from the liver. And then eventually, if things are fine, that muscle cell could then use the glucose and run it all the way through respiration, if it's at if it's in a better state. But the real problem comes about is that is when we are not efficiently converting like glucose all the way through, through the Krebs cycle, and through the electron transport chain, at a high percentage, and a lot of it is getting diverted to lactate, even when there isn't that huge demand. Then all of a sudden, it's, it gets worse than debt, because it's, it's like, on every dollar, you're losing 50 cents or more 80 cents, you know, it's like, you're just stuck at an inefficiency. It's like, you know, you have an engine and three of the cylinders aren't running and so and it's a sign that things are wrong. And as we talked about these things all like our bodies aren't, are meant to recognize that as a sign this? Well, it is. I mean, when we say it's pathological, I guess all that we're really saying there is that it's associated with a state of lower health, but it's something that our bodies are actually dealt like, like a not built, but used to dealing with and adapting to in times of stress which we don't want, we don't want to be creating that stress. But it's, it's a way, like it's a signal that our body uses to further depress its metabolism, just like stress hormones, and just like low CO two and a low and a D to NADH ratio.

Mike 18:04
Well, it has to depress this metabolism, because if you continue to run at that level, you you can't it's you don't want to have a lot of time, even if you put it in terms of, like, the bank account, right? Like you're you have $1 you're giving $1 to lose five, right? You're like, trading $1 for five. It's like, there's only so long that you can do that, because you're starting to tap into your own resources. And so eventually, like, it's a, basically a trigger for a break. It, like, starts putting the break on the entire system. It's like, whoa. We're really, we're we're losing the we're losing energy here, boys, we need to, we need to slow it down for a second, see, like, figure out what's going on, and then it starts. That's when you start, and this is where the idea of, like, hormones overlaying on the system come in. That's where you start elevating those adaptive hormones and start activating all these backup pathways just to make it through. So you start lowering metabolism. Well, we'll we can lower a little bit over here, we can lower a little bit over here. We can divert energy. Over here we need more energy while we can pull it from our tissues. And then that's where you start seeing, okay, adrenaline elevates. You start increasing fatty acid oxidation. You start liberating protein from your muscle tissue to create more glucose supply. And like after you depleted your your liver glycogen, or lowered your liver glycogen, and then when all that starts to come in, it's like the snowball. It's like, if you imagine a mountain on top, you have a little snowball. You can go down. One side, you can go down the other one side is like having your metabolism working appropriately. The other side is like working on all these backup pathways. When you start going down the backup pathway road, you the snowball starts to continue to get larger as it goes down the hill or the mountain or whatever it is. And then essentially you, and this is something I think that's important when people want to when people want to rebuild their health, or they want to get themselves back into a good state. It's you got to roll that snowball back up the hill and push it over the other side, and you have to kind of undo and, like unengrain these pathways that you've been hammering and hammering and hammering and concepts that go in there, like upregulation and down regulation of receptors and whatever else, whether or not as receptors or not. It's essentially the cell, the cell that your tissues, your body, start when they start getting ingrained into these into the system, the signals start becoming less potent, right? So it's like, if you're in a if you're in a pretty healthy state, and you're, you're, you're, you know, you're not excessively stressed. When you elevate that those stress hormones, and you have the release of adrenaline, or you have a release of cortisol, you feel it. You really feel it, because it's like you're changing from you're all the way up here, and then you start hitting the stress hormones, and then you feel this change. You're like, oh, like, there's a there's a larger gap, at least subjectively. And then when you're hitting the stress pathway consistently, you don't, you know, you may not necessarily feel the changes as much, because you have that stuff present consistently. Your body's consistently used to dealing with this, like you have another stress and then this is like, oh, okay, but at a certain point, and this is where you start talking about, like, Han Selig general adaptation syndrome, where it's like, at first you have, at first you have, like, an alarm. It's like, oh, we have a problem. And when you're in that healthy say, Oh, you get the alarm, then you have resistance to it, where your body's like, biting it and essentially, and that's where you start to you can deal with for a little while that problem, right? You can continue to deal with it. You can continue to be like, hitting that those backup pathways, and you're sort of like, I could deal with this whatever, and you're not as sensitive. And then a certain point you hit fatigue, and that's where you start. People just like, are pooped out. They're done. It's just like they're completely exhausted. They like, they can't do anything. And any little stress sets them off, like, any little thing tips them over the edge. It's like there's nowhere else for the snowball to go. It's at the bottom of the mountain, and it's just sitting on top of you, and it's huge, and it's like it's rolling a little bit closer, so it's and so the reason I bring that up is I want to make it immediately applicable, because these systems running in aerobic glycolysis, or, like, starting to really hammer glycolysis. And this is outside of the context necessarily, of of, like, bodybuilding and exercise and whatnot. I mean, at some point, like, too much of that can can also be like a huge meta, uh, metabolic burden on the body. So it's important to point that out. But this is like, I think our context here is more like in chronically negative health states, where you've continually hammered these pathways, continually moved into these backup systems, and now you gotta, you gotta reverse that. And this is basically we're getting into the mechanics of why these backup systems are such a problem. And you can break it down into into these empirical terms, like where you're literally comparing ratios of the different, the different molecules, or the different, for example, NAD to NADH, or what happens with lactate at the liver. There's like these pathways have been mapped out to describe this process in like, very empirical or objective terms, but the subjective side of that is essentially what I was trying to just describe.

Jay Feldman 23:29
yeah, yeah, and that. And, you know, even to be more specific, that might be something that someone experiences when they aren't able to tolerate exercise very well, and they tend towards fatigue, or they get a lot of achiness, or that they're, as you were saying, they're very susceptible to stress. Anything that's small can set them off. There's much less available for energy reserves, and for any like in the state, there's much less available as far as energy availability. And then anything extra is going to require a stress stimulus in order to increase the production of energy. So you are going to be a lot more susceptible to stress. Susceptible to stress the as you were saying, also, though sometimes when you're in such a chronically stressed state, you don't even notice that something is requiring stress because you're already there. So it can kind of depend. But I think on the extreme side, you tend to see like fatigue as one of those main things. But at the same time you mentioned the Warburg effect, which is basically the description of this, a description of being in this glycolytic state despite having oxygen available, which obviously isn't the bottleneck at that point, there's other bottlenecks farther up that are blocking the conversion from energy or food to energy. And Warburg effect is was studied as a way to describe what happens in cancer and leading into cancer. So there's kind of another potential application. There another place like there's, there's some really interesting research that I've referenced in the past in terms of weight gain and obesity, where they talk about that being a major factor that leads to constant hunger, because your food is not getting converted all the way down. You're not getting the ATP. And. ATP is not available to shut off your hunger signals and say you've got enough energy, because you don't have enough energy. And so that leads to continuously eating and eating because you're not actually using the food effectively. So definitely a lot of direct real world applications here, in addition to some of the like other pathological states that we'll be discussing. But another thing I wanted to mention, too is some of those other physiological effects of of lactate. And one is in contrast with what we described, as far as the production of CO two, where the CO two can end up taking sodium and calcium out of the cell by converting to bicarbonate and then sodium bicarbonate or calcium bicarbonate, and lactate does not have that ability where it doesn't have that same effect. Again, this is based on some things that right P to talk about, yeah, has talked about, I haven't seen direct research with it, but again, it's not really the way that research is conducted. It's not really looking at these sorts of things, but it makes sense biochemically and physiologically that lactate wouldn't have that same D swelling effect and that same reduction in sodium and calcium intracellularly. So that's one component to consider, and then, and so another thing too, and we'll dig into this in more detail, as far as the pH balance, is that that'll leave the cell being more basic and make relatively the blood being more acidic. And we'll talk about why that's not ideal also. So that's one thing, and then another thing as well is that, and this is, this was a pretty interesting one to see in the research, is that in the same way that carbon dioxide can bind with hemoglobin to lead to the release of oxygen and increase oxygenation at the cell, lactate can do the same thing, and that makes a lot of sense, because when there is a lot of lactate present, oxygenation is going to help relieve that lactic acidosis type state and bring back proper respiration and energy production. So it's like a really important feature, that backup mechanism, kind of like nitric oxide being the backup vasodilator. Again, these things come at a cost, but they still have these backup ways of, kind of having the same effects. And so lactic acid can, or lactate can bind with hemoglobin and lead to the dissociation of hemoglobin and oxygen, which allows for the cell to pick up the oxygen. But the problem is that, and again, this is something that repeat has talked about. I've not seen direct research on it, but if anybody has any, you know, yeah, but it definitely, again, makes sense biochemically and physiologically, where at the lungs, when? So when the hemoglobin typically comes back to the lungs, it's bound with the carbon dioxide, and then the carbon dioxide is released, and the oxygen is picked up by the hemoglobin, and the carbon dioxide leaves as as vapor. It's vaporized, and so we have an easy exchange there, but when the lactate is bound with hemoglobin, and would end up back at the lung to exchange with oxygen, lactate doesn't. We don't just breathe out lactate. So at first you would have that switch. You would have the hemoglobin, pick up the oxygen and let go of the lactate, because you have the opposite pH balance there, and you have the excess, you have the excess oxygen relative to the hemoglobin bound with lactate, like the hemoglobin doesn't have much oxygen, and so that puts it on the other side of that curve and allows it to take up oxygen. But because of the lactate isn't just released into the air, the lactate would accumulate. And so that would make it harder for the hemoglobin to drop off lactate and pick up oxygen. It would end up kind of going against the gradient. So because of that excess lactate, and excess lactate bound with hemoglobin would potentially decrease the uptake of oxygen at the lungs, which would be a problem if you want to be getting oxygen anywhere else in the body and and while there isn't direct research on this, there is evidence around it where, and we'll dig into this situation of altitude sickness, where we know that lactic acidosis occurs there, and we know that there's impaired oxygen uptake. Same thing happens with hyperventilation, so And same with any like state of edema, where, again, in all these situations, you'd see excess lactate and you see problems taking up oxygen. So even though there's maybe not something directly that I've seen looking at that, it would definitely make sense, both physiologically and in these applications.

Mike 29:23
Yeah, and I think you see it in a ton of other pathological states, where, for example, things like sepsis or acute respiratory distress syndrome are all one of the markers that they check for all these things is your lactate level. They're essentially trying to see, okay, what's going on with at the cell and all it's it's all coming down to that energy failure. So even if, even if, Pete's because you covered, like, quite a few things there, but even if Pete's, Pete's theories on how things with lactate, as far as, like pulling pulling protons out of the cell and. It when making the cell more alkaline, and then also changing, in doing so, changing the the balance of sodium, potassium and calcium magnesium between intracellular and extracellular in the cell, like even if that doesn't necessarily pan out the exact way that he describes the just the the idea behind the energy metabolism basically failing or having the because that's essentially what happens. What's happening is you have, like a an energy metabolism failure. When that starts to happen, and you start to move towards towards lactic acid fermentation at the cellular level, you those processes are going to curve, whether or not it's from lactate or not, just based on the idea of Ling's Cardinal absorbance and structured water, etc. And so as any you're basically the current theories don't fully describe all this stuff and such a like, I don't know it such an exact way, right? Like, there's still, there's a couple gaps here and there with some of them, but it they still generally trend towards understanding things in a similar fashion, where essentially in states of endotoxemia and whatnot, when you have the energetic failure, you it's characterized by it can be characterized by higher states of lactate. And then essentially you start to see, like all the other issues that come with that, which is you have massive amount of swelling. You have massive amount of shifting of fluids so that you basically go into shock. There's nothing, there's nothing in the in the vasculature, and you have, like, all these adaptive systems, like pouring in to fix the problem. You have massive blood vessel constriction, just like changes in your respiration, trying to blow off CO two. And it's not because CO in a lot of these states, it's not that CO two is the problem. It's it's that like with sepsis or ARDS, like you're trapping CO two at the lungs so you're not able to get the oxygen in and allow the bore effect to work. So basically, whether or not Pete's theories on exactly how this works make is is like exactly how it goes. Just the metabolic aspect itself still describes the same problems and and basically the same the things are happening, whether if it's directly from lactate or not like it still comes down to what's going on metabolically, and shifting towards that lactic acid metabolism is still always a problem. The other thing I wanted to clarify here is, when you go move towards lactic acid fermentation, just essentially the mitochondria creates gradients with protons. So if you're gonna, if you're gonna go through cell respiration, and you're gonna produce x x number of ATP. The way the mitochondria does this is by creating a proton gradient. When that doesn't happen and you start to move towards lactic acid fermentation, you start to shift cellular pH. And so the reason I want to address this is you've glanced over a little bit. I just wanted to clarify it a little more. But all these idea about, like, alkalizing the body and whatnot, as far as, like, what happens at the cell, if you're if the cell is oxidizing appropriately, you're probably going to be slightly acidic inside the cell. And then you'll like, so it's the acid and base stuff, like these theories on, oh, you ought to be at more alkaline, whatever, so you got to eat more vegetables and stuff like that. Like, it's not like there's some basis there is, but it's that's not the key point. The key point, and this goes even with the hydration aspect. The key point for hydrating a cell, and the key point for making sure that the cell has the correct pH, is making sure that's energy metabolism is right, because the energy and metabolism will allow the cell to hold on to water, and it'll allow the cell and the right way, right. You don't want a water log cell. We talked about this in the last one, but it allow the cell to hydrate appropriately, and it will also allow the cell to take up the correct minerals, so it has the cell will have the correct pH, and the cell will have the correct intracellular and extracellular mineral balance. And so it's not about, oh, you need to, like, you need to eat vegetables, because when you burn them, they produce an alkaline ash. Or you need to eat meat, because when you burn it, it produces an alkaline ash. It or produces an acidic ash. What you want to be looking at more is the cell respiring correctly. And when you're starting to move towards something like lactic acid, like moving towards a shift towards lactic acid production, that's and you start to not have the proton gradient be created, and not have and have lactate pull protons from the cell. And you have the cells start being more alkaline, you start actually having problems. So those are the key areas that we want to focus in on. It comes down to metabolism, pretty much every single time. And for most diseases, even like the most severe forms, where you see things like ARDS or sepsis, though the markers that they are looking at are those, are lactate, are. Are less hap and the consequences coming from the damage the metabolism in these pathologic states are essentially rapid consequences that you see people take lifetimes to develop, like chronically. So when you see somebody who has just gone into like global and sepsis and they're super edematous, that's those states are similar. When you have, like, the energetic failure of heart failure, and people start to become edematous, like, it's the same idea. It's the same concept, just on a different time scale, based on what's going on.

Jay Feldman 35:34
Yeah, yeah, absolutely. And I'm, I'm glad that you brought up the pH balance. I mean, all the, all of that was, was really great. I mean, super helpful context. But I wanted to talk a little bit about the pH balance, and you know, in terms of metabolism, and then what you know, you know, in contrast to what a lot of people are told, or what a lot of people say there, because it does directly pertain to CO two and lactate in a few ways. One of them, of course, is just like it's well recognized that things like lactic acidosis are a problem that, or is a problem that can potentially happen, as you mentioned, like during sepsis or during various degenerative states, or various like critically ill people, or in critically ill, like health situations, there is an association with lactate so that's definitely an issue. We'll be talking later on about respiratory alkalosis, which is basically what happens during altitude sickness and hyperventilation and during some other like illness states as well. And part of the reason why I think it's valuable to bring that up, and then also to talk a little bit about the pH balance between the cellular environment and the extracellular environment is just because there's a ton of there's a ton of misconceptions. There a lot of, like, misinformation that's kind of thrown about as if it's truth, just about, I don't know, the general idea is basically that, like, acidity is bad and alkalinity is good, and it's just, it's one of those weird impositions of morality that people have made on some, you know, kind of health situation, and we've talked about that in terms of, like, different diets, but acidity and alkalinity. There's no like, inherent good or bad there. And as we've kind of talked about it, or alluded to, and we'll talk about more like, more specifically, we actually want the cell to be relatively acidic. That's actually, like, a sign of a healthy cell, and an alkaline cell is very unhealthy cells. So, and a lot of times people are talking about it too, as far as, like, the blood or as far as foods that are eaten. I know you mentioned that, like, you kind of alluded to it quickly, as far as the ash of the food, yeah, and yeah. And that's like, where a lot of this, like a lot of people talk about acid base, basically, are saying that you want to be eating alkaline foods, and that's determined based on the ash of the food. And all that that really is representing is mostly the mineral content of the food, other than phosphate. So phosphate would be like, on the acidic side, but all the other minerals, magnesium, potassium, calcium, sodium are all we're all create an alkaline ash. And so it's basically just saying that those foods would be the beneficial foods, or healthy foods, and that tends to be like fruits and vegetables and dairy, and then meat and grains have more phosphate so they would be on the acidic side. But there, I mean, we've talked about, like, the issues with grains and a lot of phosphate is not ideal.

Mike 38:30
And I think that, like, the basis for this came from people like, oh, plant based diets are better. And it's like, this was, like, a rationalization around it. I don't think that people were like, Oh, let me burn this food and see what like, if the ash is acid or alkaline, and base my whole diet off of that. Like, it's a little bit arbitrary, um, it's kind of like ridiculous. And go ahead, finish what you're saying before I get off on a tangent. I

Jay Feldman 38:56
mean, that's kind of where I was going to, like, it is virtually nothing to do with what's actually going on physiologically, whether the food is acid, acidic or alkaline, and then also what's going on internally. I mean, acidity and alkalinity can be termed determined by all sorts of physiological processes that have to do with how quickly you breathe, or, like what's going on inside the respiring cell, or how much sodium you're taking in, and also all of the balance between all those things and all the different minerals. And we'll dig into, I guess you can go ahead and off on your attention. Then we'll talk about what's actually going on physiologically that would affect pH balance.

Mike 39:32
This is, it is. And what I'm going to say is, is tangential, but I'm kind of getting annoyed, because consistently we go not, and it's not, not with you. It like with this, this idea of, like, it has to be either or, right? I'm either carnivore or I'm vegan, I'm either acid or I'm alkaline, and it's just everything is split. And then there's only two options. And then people are forced into this idea of, I have to choose either one, where it's I don't think any. Thing comes to that there's not like, a black and white like that, where it's like, oh, I'm carnivore and that's it. Or, oh I'm, I'm, I'm vegan, that's it. I'm protrutarian, whatever it is. Or, oh I'm, I'm plant based, oh, I'm paleo, whatever these things are, like, it doesn't have to be like, like, all these things aren't mutually well, they some of them are mutually exclusive, but it doesn't have to be that way, right? You don't have to just eat plants to be healthy. You don't have to just eat meat to be healthy. Like, there's def, there's a combination to things that makes the most sense. And so, like, there's a everything that you do has a pro and a con. There's not, most times there's not one thing where it's like, there's all Pro and zero con, right? A lot of things. Like, even with meat, even though we are we, we are pro eating meat. We're a pro whatever, like, and it's not be, not an ideologic basis, just like a, like, a physiologic basis, there is value to meat. There are still problems with meat. Like, there's in Well, while we're sitting here, we're not, we're saying there's not a like, we don't see the point in creating a whole diet based off the idea of acid and alkaline, understanding acidity and alkalinity, like actually understanding it. Besides, I'm just going to burn some steak and all its acid, like really understanding it in terms of what's going on at the cell and how metabolism integrates with that. That's important, and it is a metric that can be important. But I don't what we're saying is that, or at least what I'm saying is that I don't think that that's a determinant. And then I don't think that making decisions where you're put, where you're given two choices as the only option, like, there's always more than two options, first of all, and then second of all, they don't have to be like, it doesn't have to be like. You have to choose between this one or that one, right? There's there's combination and and I think we've seen that like in the different spheres, with people jumping all over, oh, I'm I'm a vegan, oh, now I'm carnivore. And then after a little while, it's like, now I like, No, I'm not vegan and I'm not carnivore. I'm sort of just doing whatever works for me. Like, there's been a lot of people like doing 180s on their stuff, and like having to adjust over time, because nothing is ever just black or white, vegan or carnivore, acid or alkaline, there's like the acidity in alkalinity is okay, where, where are you acid? Are we talking inside the cell? Were you in the mitochondria? Are we out of the cell? Are we in the small intestine? Are we in the stomach? Are are you talking about in the colon? Like It, it's, it's contextual. You want an acidic stomach. Acidic stomach. I don't if you came and told me, Oh, I want, you want your stomach to be alkaline, like there's no basis for that. You want your cell to be alkaline, like it. That doesn't mean anything. So like that it. I think it's important to get away from the idea of this or that and more of what makes sense. That's really the question that that we want to get to because it's not, we're not just trashing on or any like, oh, acid, alkaline and just straight BS. It's like, no, there's value to it. But within the perspective, oh, I have to be one or the other. And then whatever food, whatever foods, Ash i Burn, is like what I am doesn't seem to have much basis in reality. It's like what, let's get close to reality, and let's stay away from a dogma. And you can have principles, or you can have, like, generalized understandings for a period of time, but you have to be open to understanding at the same time that you could be wrong and that, I mean the people who've walked from doing the different diets, or, like, even in my own experience, it's like sometimes I thought something, and then eventually I realized that it wasn't 100% right and had to adjust. And so now, very careful about saying this is it, and I know I think both of us have had experiences like that, so it's like, let's find out what's right, and let's just get away from this or that.

Jay Feldman 43:33
Yeah. And I think what you're getting at also is that is the dogmatism leads to kind of blindness when evaluating these things. And, you know, when you ask somebody, like, who is, you know, believing those, those asset based type things about, you know, like, kind of, why does that matter, and what's actually going on? Like, there's, there's not much there, it's a very surface level kind of concept based on, you know, some sort of imposed belief system that isn't is pretty separated from the physiology, and that same thing can happen, whether it's a carnivore argument or paleo argument or a repeat argument. I mean, there's the problem comes from the dogmatic faith based kind of blindness, as opposed to, as you're saying, Look, you know, finding the nuance, recognizing that not everything is necessarily right, and when you recognize that, you can then question those concepts and dig in deeper and understand them further. So, yeah, yeah.

Mike 44:32
I just, I just see it consistently, like on multiple forums, on Facebook and on Instagrams, people's Twitters, like everybody just, and I know for marketing, that's what sells, but that's not reality. There's not just, like, I don't know carnivore XYZ, or plant based so and so, like, just, that's where the nuance comes in. And you can start getting to that nuance when you stop, when you stop just focusing completely on. Like, on a dogma. And I say that as somebody who, at one point was ingrained in Dogma, and had hurt myself from being ingrained to the dogma to some extent, and had to just take it, like, take a gut check and be like, Wow, I'm really in a bad place, and it's because of what I'm doing to myself. And like, maybe I'm wrong. And like, it is really painful, like that cognitive dissonance. Dissonance does suck it. It's, it's, it's, like, psychologically painful, but afterwards you like, oh, I learned something right? You like, and then eventually the principle there of, like, avoiding the dogma sort of comes out. So I just, I want to talk, I wanted to preface that, because I see a lot of that going on where and then, like a lot of people, like arguing over certain things, um, from those perspectives of either or where it's like, there's, there's not an either or conversation.

Jay Feldman 45:52
Yeah, yeah. I mean that not to, I mean, obviously this is a decent, you know, decently far tangent from what you're talking about. But, yeah, just just all of this. But, yeah, I mean, in a time like now, just seeing what, and I know you're not on social media all that much, somewhat, but, like, there's rarely a conversation or a post on, you know, Facebook or or Instagram that does not just, I don't know, spiral into, like, some sort of argument and some sort of personal attack and some sort of, like, political divisiveness, or nutritional divisiveness or..

Mike 46:30
Or racial divisiveness now too, like, just like, Yeah, any, any category, it doesn't matter like, what it is like, it just, oh, we have this New Category, like, men versus women, Paleo versus vegan, Republican versus Democrat. Like, everything is like, black or white. It's like every two sides to everything in an argument.

Jay Feldman 46:49
Yeah, but that's, that's like a much larger problem and and obviously something that is beyond the scope of this episode. But, yeah.

Mike 46:56
I didn't want to get too far. I just wanted to basically, like cover that it doesn't we're not trying to crap on things for the sake of crapping on them because we're peat herians or anything like that, which I think we've been called before. It's more like we're trying to figure out what's right. And there's times we've been wrong, and there's times where we've been right, and we're still continuing to figure that out. And part of figuring that out is avoiding the either or conversations. It's well, what makes sense, like what? What makes sense out of these two situations? What can I take and that works? And what can I throw away? That not working for me right now?

Jay Feldman 47:33
Yeah, yeah. And obviously we take a lot from, like, Ray Pete's ideas and concepts, and yeah, definitely inspired by a lot of this work. But I think what, just to clarify the point you're getting at is that there's no like, there's the goal is, is to, is for that to be just an input that we then filter through our own experiences and, yeah, and questions and learnings and and build on, you know, build on it from there. So, yeah, are you ready to to move back to some of the more specifics of pH balance?

Mike 48:10
Yeah, yeah. I didn't need to go that far off tan into a tangent.

Jay Feldman 48:13
No, no, that's good. That's cool. So when it comes to the actual acidity and alkalinity physiologically that I do think is worth talking about, again, as a representation, kind of like when we talk about hormones, they're a reflection of what's going on. And so acidity and alkalinity can be as well. When we're looking at the intracellular environment, meaning inside the cell, we want it to be relatively acidic, because that's a reflection that glucose metabolism. Complete glucose metabolism is happening. There's a lot of CO two production, and so a lot of structuring of the cell, a lot of energy, and that's going to lead to the exclusion of sodium and calcium, which are the main uh minerals and electrolytes that would and ions that would make the intracellular, intracellular environment basic, and they do basically when the cell contracts and uses its energy and ends up in the low energy state sodium and calcium influx, and that causes an alkaline state. So in the high energy resting state that has allowed CO two production and ATV, ATP production, that's going to be relatively acidic, because it's going to exclude the sodium and calcium and also, and again, we talked about some of the mechanisms for that part of those, or potentially one of those being the CO two, actually combining with the sodium and calcium and taking it out. So that's, yeah, that would be kind of the first part. And then the contrast to that would be the extracellular environment being slightly alkaline, and that's because it would have that higher concentration of the sodium and calcium. And so in contrast to that side, when you have inefficient metabolism going on and you have a lot of lactate production, that's going to allow those, uh. Those ions to enter the cell of sodium and calcium. But also, again, we talked about this potential mechanism where the lactate would take protons out of the cell, and that would make the cell more basic and make the extracellular environment more acidic. So yeah, I mean, those are kind of just the basics on the cellular, intracellular, extracellular side, as far as acidity and alkalinity goes, which is probably contrasting to what's generally said as far as everything wanting to be alkaline. The other interesting thing too, when you're talking about alkalinity and acidity, is there's always some contrast. Everything is there's always a movement of gradients of different ions. And so if something is more alkaline, relatively, something else has to be more acidic. So it's kind of a, just a funny side note.

Mike 50:45
yeah, it is, it all is relative, like, it's so, and that's, again, that's what, like, how acidic are you talking that's why the context matters. With that, it's not just, oh, I eat vegetables some alkaline, or I eat this, so I'm acidic, there's like, there's much more depth to that.

Jay Feldman 51:03
Right, right. Yeah. And it just...

Mike 51:07
Basically, our point is that it largely stems on metabolism.

Jay Feldman 51:12
yeah, so, and then, and then the other huge component has to do with the, you know, in the blood, has to do with the CO two and, oh, two concentrations. And same thing at the lungs, if you want to dig into that a little bit.

Mike 51:22
Yeah, so there, well, there's actually two places where that, where that happens, essentially. So the one that works the fastest is from the lungs. And essentially, your lungs can control how much CO two you have in your bloodstream by increasing or decreasing respiration. When you have high amounts of CO two, you will increase respiration to blow off the CO two, or at least, that's the idea. And so basically, your your nerve, it's like, it's more, it's like a more complex system, but there's an area within your bloodstream. What's it? I think it's like, By the by, I think there's an air sensors by the medulla and somewhere by the heart that basically look at the different concentrations within the blood of the different gasses, and then they basically refer to your nervous system. And your nervous system can control your breathing rate. So in like different path pathologic disorders, there's different breathing patterns, like there's something called Kuz mall respirations, where, essentially, you're breathing rapidly. And it's not really a good sign. Basically, it's showing like a metabolic issue, because your body is trying to excessively blow off the CO two that you have in your bloodstream. And it could be from whatever, like it's it's your perfusion problems. Whatever is getting the CO two is getting trapped. There's, they're basically not getting oxygen. There's, there's different, um, there's like, different respiratory patterns like that that you would know in the hospital. And all comes down to this stuff. So your lungs, can your lungs, control your your acidity or your alkalinity, by blowing off CO two, and then the next piece that that controls it, and it takes a little bit longer than the lungs, because you can change your breathing rate right now, but is your is your kidneys, and your kidneys can control the excretion or the or retention of bicarbonate, and that can adjust. And so there's also a relationship with bicarbonate and some of the different molecules, like or, or ions like potassium, with the red blood cells and carbon dioxide. And there's like exchanges there. So there's like a whole system of of regulation around maintaining pH, and you can have different compensation patterns. You can have it at the lung, or the main two that we look at is at the lung or at the kidney. And essentially the first one, and one of the largest ones to act is is at the lungs, and that's by blowing off CO two. So essentially, the more CO two you blow off, the less, the less carbonic acid you'll have in your bloodstream. And it can it'll basically increase your pH. It'll break, make you making me learn alkaline. Yeah, so those are the that's the main regulation, and that's something that's really important to keep in mind. There is that the ability of oxygen to unload or load onto hemoglobin is dependent upon these pH concentrations. So the pH at the cell and the pH at the lungs are both, are both different, and you, the body wants to maintain this polarity of the PHS at the different areas so that it the enzyme can work effectively. And that's why there's all these comprehensive systems built and ingrained into the body with multiple layers of control to maintain things within that tight regulatory range, so that you you don't go out of that. Because if you go out of that, things, things start to not work. And I mean that goes with pretty much everything. It even goes with like temperature, like at certain temperatures, the enzymes in your body do not function. Well, if you go too high, you can start to denature, completely eliminate function. You go too low, everything starts to slow down. So everything has tight, tight set limits and multiple layers that function around me making sure everything works well.

Is the primary one first...

Jay Feldman 55:52
Right, right

Mike 55:52
And then when you lose that, because I think this research came out of looking at people with COPD where they were because they basically trap CO two, because their lungs, their lungs aren't able they're not elastic anymore, so it doesn't recoil. But essentially, they lose that control, or that regulation via carbon dioxide, and or at least the idea was, they lost the regulation based on carbon dioxide, and they start to judge by oxygen. And so at least within nursing or medicine, or whatever, for a long period of time, there was an idea that you weren't supposed to give them any excessive amounts of oxygen, because you lower their respiratory drive, because now they're regulating off oxygen, off oxygen concentrations in the blood. I think, I think what we want to get to here is everything comes down to making sure that metabolism at the cell is is going well. As far as cell respiration, the Krebs cycle, electron transport chain, make sure everything is functioning there and you're producing CO two at the cellular level. And I think that's the main the main point, if your metabolism and whatnot is functioning well at the cellular level. You don't have to worry about alkaline and acid and whatnot. You don't have to worry about potassium, magnesium, calcium, yada yada yada. Because essentially, if that system is working right, it'll take care of everything else. And that's because everything is integrated. And so really you want to be producing CO two at the cell. That's the goal. Produce CO two at the cell. And if you're doing that, then you're not, you're not doing lactic acid fermentation, you're not, you're and depending on the amount, you're not doing as much beta oxidation. And then you're when your cell respiration is functioning appropriately. You're producing adequate amounts of ATP with that CO two, then you have your Cardinal absorbance. That'll determine what your electrolyte balance is going to be, intracellularly versus extracellularly, and it's going to allow basically make sure that the cells in correct structuring of water so it amplifies your hydration. And just basically go from there. That's that's really the central point of everything going on. You need to drive that, even if you don't understand all those specific pathways and the core recycle and yada yada yada. The most important point is to make sure that that's working, and to basically the and it comes down to being as simple as you need to supply the things that the cell needs, to make sure that that's working appropriately, and you need to remove the blocks. And that's, that's really what it comes down to. So, and we've talked about this kind of ad nauseam that you essentially want to basically get, get rid of blocks like endotoxin, polyunsaturated fats, toxic heavy metals, whatever else. Make sure that your nutrients, both macro and micro, are dialed in, and that you're not over taxing the system, right? Because there's a limit to how much energy you can produce the next period of time. So like, running a 5k every day would be a bad idea. That's kind of the idea. And then at the most basic level, that's what you want to do, is you want to optimize metabolism at the cell, but as you go up another layer above that, then you start seeing what's happening with with hormones, and then above that, you have neurotransmitters, and you have the immune system, and then you have digestion and whatnot. So you want it like there's concentric they're like a series of concentric search circles. And each layer you basically have, you have the primary goal that you have in the center, and you understand each layer going from there, and you basically, you build it out. But the primary goal is making sure that metabolism is functioning well, the cell. And that's, I mean, that's the basis, and that's why, when people ask Dr Pete all these questions, and like, he based, at least from what I hear from him, it's like everything he can. He like continues to point people down that direction, and like, he continues to say things like, the basic protective effect of like, the basic protection of the cell is making sure that your metabolism is is functioning correctly, is or is, like, our basic protective factor, something along those lines. I don't know the exact quote, but. So don't like don't quote me on it, but you continually hear him, and that's basically what he says. And when you start looking at the research, if you're interested in that, you start basically seeing the same thing, especially from the context of structured water, the bore effect, Gilbert Ling's hypothesis, the association induction hypothesis. And you basically just go out from there, and you can start to fill in the different blanks on how to how exactly to make those things work. And the other thing is, your body will tell you. Your body can tell you, to some extent, how you're feeling, what's going on, how what's going on metabolically. If you're cold all the time and you're not producing heat, probably not a good sign, right? If you're, I don't know if you're having gut issues, if you're dealing with chronic infections, if you're any of these symptoms are indicating that this, this, this energetic issue, is what's going on. So that's the that's the core problem. And then you have to figure out what the root of that is. That's really what it comes down to, what do you have? Something going on your gut? Do you have something? Do you have a series of deficiencies, whatever it is? Do you have toxic exposure? Do you have an excessive amount of stress on your system? Like, are you, have you not been eating enough? Like, those are all the things to start really looking at and dialing in with from this context. So that's, that's what I think, like, where things comes down where, where things come down to.

Jay Feldman 1:01:25
Yeah, yeah, and yeah, the carbon dioxide is just a big point of that and and we'll talk about some of those details too, about maybe some other options for improving carbon or increasing carbon dioxide. And when it comes to pH balance also refer to the episodes where we've talked about mineral balance in terms of especially sodium and water, because those inks are are involved as well. Yeah, but I think that's a pretty good summation for now. Yeah. All right. I hope you enjoyed that episode. I did want to add in really quick, something that we had missed as far as the alkaline acid ash diet is that sulfur is another element that is a major contributor to an acidic ash. And sulfur is found in a lot of amino acids found in various animal sources of protein, like meat and milk, contributing to their acidity. So just wanted to mention that I know there's a few others that we didn't touch on. I mean, it's, it's not particularly relevant as we as we mentioned that whole perspective. But just wanted to mention that in part three of this series, we'll be digging into the real world applications for a lot of the concepts that we've been discussing. And these are applications like altitude sickness, hyperventilation in relation to panic attacks and anxiety, and also various respiratory illnesses, including covid 19. So we'll be discussing those different situations and how they relate to these different aspects of metabolism. And of course, carbon dioxide in particular, and lactate and that whole situation, if you did enjoy today's episode, then please leave a like or comment. If you're watching on YouTube and if you're listening elsewhere, please leave a review or a five star rating on iTunes. All of those things really do a lot to help support the podcast and are very much appreciated. To check out these show notes for today's episode, head over to Jay Feldman wellness.com/podcast where you can take a look at the studies and articles and anything else that we referenced throughout today's episode, and if you are dealing with any low energy symptoms, whether they are directly related to some of the symptoms we've talked about today and throughout the series, like high blood pressure or other cardiovascular issues or edema in various capacities, or if it's various other low energy symptoms, like chronic cravings and hunger, fatigue, chronic pain, weight gain, digestive symptoms like bloating or inflammation, brain fog, poor sleep, hormonal imbalances or low libido, or any other related issues there or any chronic health conditions, whether those are autoimmune issues or diabetes or heart disease or any other of those chronic health conditions. Then head over to Jay Feldman wellness.com/energy, where you can sign up for a free energy balance mini course, where I'll explain how these different symptoms and conditions really come down to a lack of energy. And I'll also walk you through the main things that you can do, as far as your diet and lifestyle are concerned, to maximize your cellular energy and resolve these symptoms and conditions. So to sign up for that free energy balance mini course, head over to Jay Feldman wellness.com/energy, and with that, I'll see you in the next steps.