Optimizing Mitochondrial Health: Autophagy, Mitophagy, and Biogenesis

foreign everyone I will just wait another few seconds just to to allow people to log

in before we start tonight's webinar so good evening everyone and thank you for joining us tonight for this bent

webinar my name is Alma ahmadich I will be your host this evening um before we start the tonight's

preparation just a little bit of housekeeping um the webinar will be recorded and it

will be available from the band website it will last for about an hour and we will have about 10 minutes at the end

for Q a so if you do have any questions as we go along please start them in the in the chat box and we will run through

them at the end of the presentation our presenter this evening is Jillian Crowder so Jillian is a nutritional

therapist and a naturopath she has been a senior member of the Academy of nutritional medicine since 2010 and

she's the director of research Jillian specializes in complex multi-system disorders and she finds it mitochondrial

dysfunction very often under underlines today's chronic diseases so this is the last part of the three-part series the

recording and presentation slides from the previous webinars part one and part two is available from the band's website

and you can find it under science and education section in part one Jillian talked about providing targeted micro uh

micronutrients for mitochondrial support and function in part two she talked to us about reducing

um oxidative stress in mitochondria and tonight in part three we will learn about my top 50 Dylan will discuss the

efficacy of calorie restriction and herbal extracts for metal mitophagy as well as specific dietary components and

nutrients that help to generate new healthy mitochondria so it is my pleasure to introduce you or presenter

for tonight Jillian please welcome thank you very much indeed Alma and thank you bent for giving me this

opportunity and thank you everybody who's here so um I'll just begin right away

um it falls into two sections really the presentation tonight what is autophagy and mitophagy and the second section is

mitobiogenesis in other words the generation of new healthy mitochondria so um to begin with what is autophagy

and mitophagy and I'm using the I think American pronunciation of it um you'll often hear the term autophagy

as well and metaphagia so um it is um something that's only really been

understood for about 50 years so that's relatively recent and when it was first um discovered as a mechanism within our

cells it was understood to be um triggered to maintain cellular energy balance under nutrition deprived

conditions as this article describes um so in times of starvation it's actually

um a an environmentally um well you could say um

over time you know it's developed in order to allow us to degrade ourselves into lipids glycogen and

protein to Keep Us Alive in the absence of nutrients and um later it was also discovered to

be a process that intelligently removes damaged and harmful components of the cells to

both degrade them and get rid of them but also to recycle the parts that can still be used

so as this article goes on to say it provides biosynthetic materials for ongoing cellular needs

so interestingly the Nobel Prize for Research into this was only awarded in 2016 which is very recently

to the Japanese biologist Professor yoshinori on Sumi and so lots and lots to read up on that

if you're interested he discovered how cells really do recycle and renew their content

and interesting and very very important is that you need a phagism as well as an isosome for this to occur

the phagosome often also called an automatism engulfs the parts of the cells that need to be

degraded but it must merge with Eliza Zone for that to happen and the Liza Zone

then as the word lies implies then degrades the parts of of the cell that are no longer needed and um ensures that

they are um removed

if the lysosome and phagosome cannot merge then autophagy cannot take place and

um that's something very serious because then the cells become crowded with these dysfunctional parts that no longer need

it but cannot be exited from the cell so what's mitophagy that's a selective autophagy it's a subset of it and

actually you can see here from this lovely um image from the

um article that's referenced below that the cell is able to remove via the phagosomes and lysosomes

um every part of the cell that it needs to whether the

peroxisomes the ribosomes the endoplasmic reticulum the nuclei

um you've got um virophagy here removing viruses

xenophagy removing contaminants in the cells poisons so um it's an excellent process if it

works well now um mitophagy you can see here from this

image um is uh set up to clear mitochondrial debris and it is

useful to think of mitophagy as being the first step before autophagy though of course we're not able to uh sequence

this perfectly but um as mentioned below it is best to activate motophagy first

as radical autophagy risks clearing indwelling mitochondria that's mitochondria that are within the cell

that may still be functional and of course Within cardiac cells you may have up to 10 000

mitochondria within cells in the substantial Negra in those axons you may have up to 2 million

so just radically clearing cells without worrying about their organelles within them can be problematic

though I will be talking about how intelligent the mitochondria and cells are and the crosstalk between them and

their ability to work out what needs to be cleared first so we don't have to be um hugely uh concerned that we're doing

things in the right order order so here you can see the mitochondrial fission that's not the fusion but the vision the

division of them and how the damaged mitochondria are isolated within this um autophagism and then the lysosome joins

and then they are degraded and any healthy parts that can continue to be used are generally merged with others in

Fusion rather than fission and then continue to operate as this article here describes healthy

mitochondrial fragments are reused so what are the reasons for stimulating this

well um when the mitochondria are fragmented or not intact and there are ways of suspecting that or even finding

that out when the cells have been invaded by a virus or a bacteria

and of course this should really be one aspect of detoxification from anything that may have contaminated

the cells whether medication residues or heavy metals or other contaminants

so it's an appropriate mechanism to use in most forms of mitochondrial dysfunction

one um really important aspect that has been intensively researched over the last few

years is that viruses can actually really disrupt this process this is a an article that shows how sarskov 2 for

example localizes to the mitochondria hijacks it and actually

um prevents it from replicating in an intact manner it as it describes at the

bottom evades host cell immunity and facilitates virus replication and covid-19 disease once it enters the host

cell so this like many viruses is able to disrupt the healthy function of

mitochondria and actually it can down regulate mitophagy it leads to lysosomal dysfunction

so as this article describes we observe that mitophagy was inhibited mitochondrial homeostasis is disrupted

by sarskov-2 in the virus cell confrontation and there are many articles out there

talking about sarskov-2 and mitophagy impairment and interestingly over again the last

three years where this became evident it's been Unearthed that this actually is the case with other viruses too

herpes viruses also block autophagic flush flux for example this one here describes how the Epstein Barr virus

that's glandular fever blocks this flux and appropriates the autophagic Machinery to enhance viral replication

and the human cytomegalovirus does that as well these articles

um all referenced at the bottom of the pages can obviously be accessed in full to to read about this

enteroviruses which are not DNA viruses like herpes viruses but RNA viruses also do the same

and hijack metaphagic flux to enhance viral replication so they're also clever and unfortunately enhance their own

replication by disabling the ability of the cells to discard

mitochondria that cannot work which actually um or cannot fully function which are

responsible for innate immunity which is what we need to get rid of viruses in particular but also bacterial pathogens

they do the same this article here for example autophagy a story of bacteria interfering with the

host cell degradation machinery and even streptococcus can do that this article has a very telling title

and so we need to think of pediatric Auto Neuropsychiatric disorder

pandas and pans this one is associated with streptococcal infections but pans which

is the same Neuropsychiatric disorder that's not associated strictly with

streptococcus but with other central nervous systems Associated viruses and bacteria that one I'm sure if we go on

digging we'll see that that one is also um um associated with

the the disabling of the autophagic Machinery in our cells so very very important really a few

cautions um it can be detrimental to stimulate motophagy if the patient doesn't have

enough mitochondria and this is something that you can measure this is an example of a patient who only had two

mitochondria in each cell and obviously in a case like that it would not be appropriate to begin

pruning the mitochondria and um giving the patient a really really perhaps serious

um additional uh sense of fatigue and um perhaps organ dysfunction as a result I have noticed also

um that with fluoroquinolones that's ciprofloxacin levofloxacin that family of

antibiotics because they impair mitochondrial DNA replication by inhibiting

II which that article there describes um in patients who've suffered from fluoroquinolone poisoning it is also not

a good idea to certainly begin with um mitophagy and autophagy until you've certain that they've begun to

generate uh healthy mitochondria again which we'll be talking about in the second half

so um what are supportive agents and initiatives for this well

there are many many articles out there luckily that have investigated um phytochemicals that stimulate

metaphogy as well as initiatives which we'll be talking about so these two here are just magnificent

articles with lots of um references tables with um different phytochemicals mentioned and

of course you can obtain a lot of these phytochemicals from Foods as well though the issue is whether you contain

sufficient quantities of them to really stimulate the cells without obtaining too high a quantity of um

of carbohydrates too because most of them are in either fruits or vegetables so um that

first one effects of plant and animal natural projects on mitophagy contains

a longerness than just this but it actually has references many many studies that indicate how these work and

um you'll know I'm sure all of these that are mentioned

on the first page of that table Resveratrol berberine question sulfurofen and others

that are a bit less familiar to us and the ones that have the strongest effects

um I would suggest anyway are indicated by those

that act on the greatest number of Pathways and again they're listed in this long very detailed article with

their exact function how the pathway is stimulated with each individual phytochemical

and how they manage to stimulate mitophagy so the two with the greatest number of Pathways in this particular

article are Resveratrol and cocumin they aren't the only ones of course there are many others for example urine

a which is the active extract from pomegranates is um very well able to stimulate

motophagy and in fact there are well-powered randomized controlled trials on this

um this particular one I have actually included in the listing in nutrition evidence on the bank website and gone

into the conclusions of that study and how effective it does appear to be um the title of this one urine within a

improves muscle strength exercise performance and biomarkers of mitochondrial health in a randomized

trial in middle-aged adults and um it does explain the extensive testing and the Baseline and then the

two months later it was you know I think a four-month study and so um it was

um 88 participants so that's well over the 26 I think that a study needs to be to begin to be well powered

so that would be very worth reading and there are actually um

sources of that available in the UK not just in the states where the ifm and others have become very very interested

in this and are really profounding it and this next study um

also uh was a randomized clinical trial and explains um how it increased muscle endurance and

mitochondrial Health this time in older adults and um explains here at the bottom here

we showed that uralism a improved mitophagy and mitochondrial respiration in primary chondrocytes from joints of

both healthy donors and um older adult patients so that perhaps a little bit surprising

though I do remember seeing a webinar by Dr Kiran Krishnan a name I'm sure you will be familiar with where he spoke

about exactly this and it's benefits for the mitochondria due to its ability to clear the unhealthy ones and leave

healthy ones to replicate so um mythology modulating phytochemicals are even

linked to specific disorders in the Magnificent articles that are out there here

non-alcoholic fatty liver disease so various ones are mentioned some that we will know and others that we won't

um quercetin acabia saponin D I've got some lovely pictures of it over here on the right

because it will probably be one that we're not that familiar with and probably wouldn't want to

um actually introduce unless we're working together with a herbalist or you know someone who was very familiar with

it or of course if we can find a source of it that is already sort of pre-dosed to make it safe for us to

utilize but um it grows in East Asia and is increasingly being studied it's called a novel Forest crop so I suspect

it would fall under a novel food here in the UK and in Europe but um quercetin is another one where the um qualities are

all outlined here in great detail and um that it increases mitochondrial membrane potential is is very important

because actually this is something by which the mitochondria themselves can detect whether to

um go into mitophagy or not they actually use their voltage gradient to detect that we are electrical beings

really I mean the only I always think it's so strange that the only sort of a component that hops along the electron

transport chain is exactly what it says on the tin electrons and so um it is so fascinating to remember that it is the

um voltage gradient between those two membranes of the mitochondria the tiny little things you only have you know

they're so small so minuscule that uh huge amounts are still only now being discovered but it is that um

membrane potential that determines whether they will destroy themselves give the signals to

the cell that the time is ready for them to sort of be recycled so it's interesting when you see that a plant

extract can actually do that um melatonin even though it's difficult for us to use that here in the UK but um

there we are and um cyan and three owed leukocyte that's um an extract from the red blue and the purple or hued plants

um both vegetables and um fruits um

going on to the next page we have stimulators from um some of the same plants and some other

ones like scatellaria which is Chinese skull cap I'm sure you'll have heard of that

very often used as an antiviral as well and come to think of it these antivirals have a lot of their properties due to

their ability to trigger this cellular and mitochondrial recycling um in almost every antiviral that you

hear of if you start looking up the metophagy and autophagy properties of it you'll see that they're strong

and um Resveratrol is mentioned there as well so this is a set of phytochemicals that can be used in

obesity diabetes related conditions like retinopathy and vascular disease and

atherosclerosis and spermidine is another um excellent

polyamine that can induce metophagy and autophagy it is um an extract of wheat germ but also of

sprouted buckwheat and so if your patients are a little hesitant to include wheat germ extract in their

protocols even though that does not contain gluten nevertheless you could then suggest that

they go for sprouted buckwheat extract instead and spermidine is an excellent autophagic and metaphagic agent which is

used in anti-aging medicine has been for many many years and as sort of really come into its own over

the last few years do you I think partly to how helpful it is being in covet related conditions including long

covid so this article describes some of the food or at least on this page I've

described some of the foods that are natural sources of it though again the difficulty would be

obtaining high enough levels of it really um to to Really sort of trigger that

effect in your patients certainly initially when patients are perhaps feeling

breadfully um fatigued and unable to really go out and Source their own

ingredients and cook for themselves so um mitophagy in neurogenerative disease is

the topic of this article here and it describes the effect of various compounds on mitophagy and

neurodegenerative pathologies and um uralism a is mentioned in this article

specifically as well as spermidine that they are being introduced into medical practice and this is an article from

March 2023 so you can see that this um really is is progressing in Leaps and Bounds this um

um science and I just wrote the word microbiome here to remind us of how important and

useful it is here to see that the microbiota in the intestine are linked so closely to this

um and maintaining mitochondrial quality in the brain obviously it's it's not just about giving phytochemicals to

induce our own cells to understand how they should turn over and renew themselves our mitochondria have a

bacterial origin and all the bacteria in our microbiome respond to these signals as well

so there are specific bacteria like acamancia for example which go hand in hand with cell renewal and that would be

a topic I think of another um talk or or investigation that we could

do together but definitely our microbiota um need to be looked at from this lens

as well so mitophagy agents that have effects on the nervous system and these do include

human studies listed here are uralism a and Resveratrol quercetin and spermidine

so those are agents that we've already mentioned and of course

you can find nutrients or nutraceuticals that include a number of these together and if your

patient is suffering from the virus at the same time then perhaps it's suitable too

choose nutraceuticals that are also antiviral knowing that they'll help with mitophagy

too but um if your patient is someone who doesn't

respond well to synergistic mixes and prefers single agents then it's possible to get

all of these individually to and often it's useful to introduce a liposomal component so that they go through the

cell wall directly into the cell more efficiently and also through the blood-brain barrier

so initiatives sorry about that sis jumping a little bit initiatives that are also very

helpful to induce um this cell turnover uh

fasting and exercise so I'll just mention a few words about both calorie restriction drives autophagy as

well as prolonging life and health span this article here which is an excellent review

describes that and um you can see here for example how it talks about a number of the

nutrients that we've just talked about but also calorie restriction and how that drives the um Pathways that help

with the initiation of autophagy and interestingly ampk which is I'm sure a pathway that you've already heard about

numerous times that's amp activated protein kinase that helps to drive autophagy and the opposite in a sense

the mtor mechanistic target of rampromycin complex I don't know why that has such a terribly complex name

but that one if you can um kind of halt it put a stop to it as here indicated by the red will initiate

autophagy as well so you can go down very very interesting rabbit holes if you'd like to by putting in

ampk and mitophagy or autophagy and the same with mtor and you'll find that the kinds of substances the the

nutraceuticals the initiatives that come up a full broadly into the two categories

you don't really want to pursue anything that drives mtor and you do want to pursue initiatives that drive ampk

the next article um is actually from the same study

um I believe apologies I may be a little bit um out of sync there but it it was a

randomized controlled trial and this one showed impressive metal metabolite enrichment from intermittent fasting

so this was called the interfast study and it shows that four weeks of strict alternate day fasting that means fasting

on one day and not on the next obviously improved markers of General Health in healthy middle-aged humans while leading

to a 37 calorie reduction on average and the metabolites that it enriched are fascinating if you can see here the

mitochondrial inner membrane was strengthened caspase activation a very important mitochondria sorry an

antioxidant enzyme glycogen metabolism and so on so um

fasting is available in many different forms um whether intermittent fasting or

alternate day fasting I'd just like to mention that it's um good to be a little cautious about

um strict fasting in pre-menopausal women in particular for various reasons here it just

explains in this article that alternate fasting alternate day fasting may not suit women as well as men because it

appeared in this particular study to increase their glucose while their insulin response was unchanged and um so

it may adversely affect glucose tolerance in non-abuse women though it didn't seem to have the same effect on

them and likewise intermittent fasting and

pre-menopausal females appears to um trigger a hormonal pathway that um

can shut down their reproductive Pathways or their reproductive um

um sort of signals at least for the time that they're fasting so rigorously you'll know of amenorrhea

um being or appearing to at least be correlated with strict fasting and this seems to be connected to the hypothalamo

pituitary ovarian axis at least in this article here I'm sure there will be others that contradict

that but um for example um Dr Bean as he's called you may have

heard of Dr mabin Syed who does a lot of um um sort of really concise

um but very well evidenced um podcasts and videos he works together with the Frontline Critical Care

um covert Alliance and he has put together some very good um videos on

how to time intermittent fasting for for women who are pre-menopausal so so as to just exclude any risk of of this

happening which doesn't mean they shouldn't do it but just you know sliding into it gliding into it very

carefully and extending the hours very gradually and I'm doing various testing tests to ensure that it's safe

this was a further study on on what sounds on the face of it rather worrying nutritional infertility linked to

intermittent fasting and dietary restriction but this was on rodents not on human beings it would probably not be

very safe to do this on on women likewise this one here that evidence that a three to six month

alternate day fasting schedule seemed to cause a reduction in ovary size and irregular reproductive Cycles again only

in rodents it remains to be seen whether that would be the case in human beings but probably an inadvisable study

so exercise is also an excellent way of um turning over your cells and your mitochondria because obviously in a

sense causing slight lesions in the muscle which rigorous exercise will do does need those cells to require repair

and sometimes they need to be renewed so this study which was in 33 participants so again well powered showed that

regular endurance exercise promoted fishing mitophagy and oxidative phosphorylation in human skeletal muscle

and equally in the next study um

oh sorry I thought we had a further study there but um exercise is also excellent for what

we'll be talking about next which is mitobiogenesis the creation of new healthy mitochondria because obviously

in um giving the signal to yourselves that you need them that will call mitochondria

into action otherwise they're dormant and the more you need them the more they'll begin to replicate and answer

the call to action so I just wanted to mention that there are many means by which mitochondria and

autophagy actually cross-talk it is a very new field of study because this is so difficult to identify you know what's

going on in these tiny little creatures and the cells but several lines of evidence suggest a powerful

mitochondrial influence on autophagy and this again is due to the voltage dependent

um signals that they exchange with both the nucleus and and and with each other as well

so it's the mitochondrial insult is not too severe than metaphagic degradation can rescue

the cell and prevent cell death now I'll go on to the second section which is metabiogenesis

and um this is the growth of new mitochondria and the

division of pre-existing mitochondria this is triggered by PGC one alpha which I did go into I

think in a bit more detail in the previous talk I can never quite remember what exactly that stands for and I have

it written here but um I think it's on another page it's a very very long term it fills one entire

line but PGC one alpha triggers um biogenesis of the mitochondria and you can see that via the fission and

fusion activities um it can create new mitochondria with the assistance of two very important

enzymes part in and pink that we'll know also from um for example Parkinson's disease where these two

become dysfunctional unfortunately um mitochondrial

biogenesis is hugely important and is going on all the time in our cells cautions are that it's best not to drive

metabiogenesis if the mitochondrial numbers are already high this for example shows a cell that

shouldn't have more than about 250 mitochondria in it and it has well over a thousand and that suggests that the

cell is trying to counteract the lack of energy overall by increasing the number of mitochondria and continuing to drive

that further is probably not a good idea because they won't be intact they'll be to a certain extent dysfunctional and

that's why it's picking up this lack of energy and driving further replication so

um if many of the mitochondria are not intact um as well

um that may not be a good idea I'll just um that's very complicated number to

understand I mean we can as therapists that's a bit like the measuring the number of um

um bacteria in our microbiome zero five means to the power of five so what's uh a regulator that indicates

that mitobiogenesis is happening it's pgc1 Alpha um that's Central in regulating

mitobiogenesis and quality control of the mitochondria and there are many ways that you can

drive pgc1 Alpha in fact um oh here we have it peroxisome proliferator activated receptor Gamma co-activator

One Alpha and um so uh

pqq for example is able to stimulate motorbiogenesis this is a nice article that describes how it does that and um

States very clearly that pqq influences the activity of this important pathway which is a major mechanism for

regulating mitochondrial biogenesis Resveratrol can also do the same thing and you'll remember that we saw that in

the mythology autophagy section so because the mitochondria as the orchestrators of ourselves really do

have this huge intelligence um together with the cell and all the other organelles they are to a large

extent able to work out themselves what's needed so giving them a trigger like Resveratrol will

um you know you can rely on the fact that um at least some of these phytochemicals

will be able to distinguish between what's needed so giving Resveratrol is an excellent idea especially in the

neuro neurological conditions that we saw earlier and if mitochondrial biogenesis is needed

um rather than metaphorically um it will support that this was a cohort with 38 subjects and

eight weeks of ecgc interestingly the extract of um green tea

and Resveratrol supplementation increased mitochondrial capacity as well as stimulating fat oxidation

and this was a randomized controlled trial this is another one that I have in the

collection of articles in the nutrition evidence section that I've linked to below

I don't know quite what happened there sorry will I find it again

I will but somehow must have clicked off the topologies so here we are

going back to it again so we were here there are many peer-reviewed scientific

articles on Resveratrol as a PGC one alpha activator and this is just a small extract of

what's out there I'll just make that larger again and

um this is a selection of articles that evidence ECGs the ecgc and L-Carnitine as activators of this um meta biogenesis

um support and this here

um describes the sorry my screen is jumping a bit

describes the B3 um vitamins in the niacin form particularly

but also nicotinamide riboside they have the ability to support this as well in the cells and quercetin

and alpha lipoic acid that's perhaps the strongest candidate of all in the listing of articles that I've found this

was a randomized control trial that explains how um it has a synergistic effect and actually

supports um nitric oxide situin which is one of these Pathways involved in this as well

as pgc1 Alpha this actually had four groups of 25 subjects so it was a hundred people in all

and um the evidence for alpha lipoic acid um is is really huge particularly in the r

form and that's one of the antonymers there's the r and The L4 and the r alpha lipoic

acid there it is more expensive is is more effective so Cyanogen which is um from the red blue and purple huge fruits

in particular um is excellent listed here are particularly

grapes bilberry blackberry blueberry Cherry choke Brewery and so on so um there are

nutraceuticals that include the extracts of those they're of course having a you know good helping of those a day will

also be um a wonderful addition to your diet and echolonia Carver which is a brown

seaweed um that has superb antioxidant properties

too is also um helpful for um the growth of new mitochondria

and cocoa mean of course which is high up in all the categories and we've seen that in the first presentation I gave as

a mitochondrial fuel in the second as an antioxidant and now also as a

trigger for both mitophagy and the biogenesis of pneumitochondria so exercise two mediates the same

for very obvious reasons that if you as I mentioned before give your muscles give your cells the the message

that they're needed then the mitochondria will um hopefully at least begin to

um strengthen though of course that needs to be you

know very carefully aligned to what else is going on with the patient we talked the first time I think about the cell

danger response and if your cells have gone into either or the mitochondria have gone into protective mode because

there is something serious going on in the cytosol that needs dealing with whether it's a virus a bacteria a heavy

metal or a contaminant and even very serious uh sort of trauma can can also Drive the mitochondria into the same

physiological response then um we'll all know of cases where just suggesting to patients that they

begin exercising is just not helpful but very very gentle movement of the muscles even if you're lying in bed will help to

increase mitochondrial function and numbers so even photobiomodulation appears to

have its role in this especially near infrared light um this is one article of several not a

lot yet further research is needed here but this um quotation on the right our data

indicates that near infrared light Alters mitochondrial biogenesis signaling and may represent a

mechanistic link to clinical benefits so there are various different ways of accessing that for your patients they

can even use home devices so that's all I'll cover today it's obviously a vast area I'd just like to

point out that I'm sure you know where the two previous webinars are so grateful to band for sort of

categorizing all this so wonderfully these are in the metabolism section of advanced e-learning and there are many

many other resources that you can use to find out more about the mitochondria if you're interested and I'm always happy

to you know talk more about them if anybody wishes but thank you so so much again

for spending your time this evening listening to this and um there you go

thank you this is brilliant and thank you so much for um the whole series you've taken a lot

of time to create and to present um to band members so we're all very grateful and appreciative very much so

there are a few there are a few questions um also just a couple of comments so

when you were talking about women in Perry um perimenopause so there's a common

saying that it explains why women are struggling to lose weight fasting because you know why it has different

effects on men and women but if it raises um their instrument

um the question is what is there an optimal length of time to fast for autophagy and motophagy

I think that hugely depends really on the patient's um Constitution and on you know what condition you're dealing with

obviously if it's um uh you know anorexia amenorrhea I don't know you know there are so many different factors

that you need to add to the mix there are um

entire sort of books Wonderful webinars by Specialists on that and whether you choose alternate day fasting or

um intermittent fasting or you know a fasting Retreat I know there are magnificent uh you know groups running

Retreats even here in the UK where you can be very well sort of monitored but um it really depends I think on how

serious the patient's condition is and I would add um from sort of my recent research into

this would probably depend a little bit on on the numbers of the mitochondrial numbers they have and how much they're

able to tolerate I I wouldn't want to put a patient through fasting or certainly you know rigorous fasting

whose mitochondria were very scarce thank you and do you know if any Studies have been done on urolithin with chronic

fatigue syndrome from I guess from pomegranates extract well

um the um studies that I showed there were done by a group who admittedly and I'm

Inventus is very appropriately mentioned that in the nutrition evidence as well were done by a group that has um

subsequently produced a supplement to support patients with uralithin a and I mean that's the problem is that

pharmaceutical companies aren't really going to put huge amounts of money into studying this

when they um can't make any money out of it because nutritional supplements are generally unpatentable so um I suppose

we could look at that set of studies and see um I will you know do that I know that

that one was done on joints and on muscles and you know looking at those sort of easier to classify

um conditions as I'm sure you'll all agree chronic fatigue me you know is is a bit difficult to Define because it can

be driven by so many different different underlying conditions so so I'll check and then let you know

okay um great so um

can you do something to think um can you pop into the chats the doctor mentioned with regards to the YouTube

videos for women on intermittent fasting what's his name out Dr um

I'll put that into the video he's called doctor in interestingly you know they just sort of abbreviate his

name and stop to Bean and he does b-e-a-n okay you'll find him okay he

um puts out something called long story short every week and you can also find him under

f l c c dot net the front line covert Critical Care Alliance um have actually because he's a member

got an entire section with all of his uh lovely videos there uh brilliant I think that includes all

of our questions um we'll just look once again there are a couple of comments uh yeah I do

apologize it's a very complex area I've tried to make it as sort of simple as I can but I I I hope what when I mentioned

that it's fascinating when you begin looking into all these supplements that you're maybe giving your patients

you begin to find that they're often working on these exact Pathways it's done particularly the antivirals when I

began to look into them one by one they all or most of them have this property so um you know it's a bit of a sort of

you know hidden Miracle there yes amazing um so I I'm just checking through so

they're just a couple of comments um um

so they would want to comment is this is one of the reasons why many women got um many women got pregnant in the

concentration camp during the war I'm not sure really why

um oh sorry all the way around it's one of the reasons not many women I apologize

which makes sense of course because if um with the fasting and the effects on the women exactly sorry Heather I've

just read that I've made a mistake um the fascinating subject didn't thank you so much for sharing

um it's it's it is an amazing subject the whole mitochondria um mitophagy things that we can do to

improve our mitochondrial functions so thank you for sharing with us and you did mention somebody else had a couple

of questions in the past they're welcome to contact you um if they do have any yes my email is

at the end of the presentation and you're very very welcome to just send your questions in because

um I'm sorry I know from the last couple of presentations I didn't always answer them all thank you very much for you

know putting on this series uh I was delighted to be involved and thank you everybody for taking the time

Julian thank you once again and thank you to everyone who attended um these presentations and as I said and

as Dylan mentioned they are available from the signs um my education section on the band

webinar so thank you everyone have a lovely evening and bye-bye and we will catch up in the next few days thank you

thank you very much