Dr Chandler Marrs
This week our resident health experts Elliot Overton and Doug DiPasquale interview Dr. Chandler Marrs on the essential roles of vitamin B1 (thiamine), mitochondrial bioenergetics, and how to stay healthy in our toxic modern world.

Dr. Chandler Marrs is a researcher and writer who holds a PhD in experimental psychology/neuroendocrinology, where the research focus was on female hormones and women's health. She co-authored the book "Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition", and is also the founder of the health website and online journal "Hormones Matter".

In her time as a writer she has written well over 200 articles, and her research has gradually moved over to medication-adverse events, the mitochondria, and examining the roles of nutrition in mitochondrial function.

When she is not busy at work, Dr Marrs is involved in competitive powerlifting and is also a self-proclaimed long-time jock!

Here's where you can find Dr. Marrs:
Her website: http://www.hormonesmatter.com/
Facebook: https://www.facebook.com/chandler.marrs
Old Ladies Lift: https://oldladieslift.com/
YT Channel: https://www.youtube.com/channel/UCopTDVMrTYb6K3UvucQ7P_g

For other health-related news and more, you can find us on:
♥Twitter: https://twitter.com/objecthealth
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Running Time: 01:08:47

Download: MP3 - 62.6 MB

Here's the transcript of the show:

Elliot: Hello everybody and welcome to this week's edition of Objective: Health. I'm going to be your host today. My name is Elliot and joining me in the virtual studio is my co-host Doug.

Doug: Hello.

Elliot: This week we have a very special guest. This week I am pleased to announce that we have the co-author of the book Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition. This is Dr. Chandler Marrs. Dr. Chandler Marrs is a researcher and writer and she's the founder of the health website or journal Hormones Matter. She has a PhD in experimental psychology and a background in research in neuroendocrinology and women's health. She has written well over 200 articles and gradually moved over to researching medication adverse event research. She has a particular interest in the mitochondria and how nutrition impacts mitochondrial functioning. When she's away from her work, she is a long-time jock, a competitive power lifter and a part-time athlete.

So Chandler Marrs, thank you very much for coming on the show. It's an absolutely pleasure to have you on.

Doug: Yeah, welcome.

Chandler: Thank you Elliot. Thanks guys.

Elliot: Just reading that out, that's an impressive bio right there and it seems like you have a great deal of knowledge spanning across many different topics. You said that you had your PhD in experimental psychology. What led you to that point? What led you to want to study that subject? But then also, what led you from that point to actually go on to do all the things that you've achieved since then?

Chandler: Well it's been a rather circuitous route. To get the PhD in the area of neuroendocrinology, I was very impacted I guess you will, by the case of Andrea Yates. You may or may not remember this. It was 10 or 15 years ago. She had post-partum psychosis. They treated her very negligently and each time she had a child she became psychotic and they would send her home to take care of her children, psychotic. Ultimately she became so bad that she killed all five of her children. It was a horrible case.

At the time I had three-year-old twins. That means that was 21 years ago because they are now 24. So I remember watching that on the news coverage and thinking "How in the world could they 1) let a woman who was floridly psychotic take care of children because taking care of young children, regardless of whether you're psychotic or not, is very difficult and then 2) what was the precipitating factor. If you understand being a woman and having hormones and cycling hormones you understand that during pregnancy your hormones are exponentially greater than they are at any other time in your life and then you give birth to children and they crash.

Well all of those chemicals interact with your brain chemistry. So it's conceivable that that simple change in hormones from pregnancy to post-partum in some women could initiate psychosis as well as a variety of other symptoms so I wanted to study it. It was a long and winding route but I did. I measured hormones in women who were late term pregnancy, measured them in immediate post-partum and then across the post-partum year and did psych assessments. I found the hormone patterns that would precipitate psychosis and I thought sincerely that that was the direction I was going to go in.

But then the economy crashed in 2009 and I'm here in Las Vegas and I had young children and I lost my job so I had to come up with another way to begin attacking this problem and Hormones Matter was born and it was more of a statement than anything else. It was Hormones Matter Damn It! because people weren't paying attention to these things. Then as we evolved, as women began telling their stories and as we started looking at the medications that they were given, I ultimately found my way to the mitochondria and nutrition and to Dr. Lonsdale and the book that you mentioned and everything else we've done.

Elliot: I am a massive fan. I've read that book last year and I will say that that book is one of the best books I've ever read. I continually am back and forth, picking it up, back and forth and I think both of you did such a fantastic job on that book. Since then I've come across your website and I think it's just such a fantastic resource, hormonesmatter.com, especially in the technical details. You've got the technical articles but also the individual experience of people who go through really terrible things.

But the main reason I wanted to ask you onto the show was really because you co-authored the book on thiamine and I think that thiamine in nutrition-related fields is such an under-acknowledged topic. It seems like a nutrient of such importance and that no one is really talking about it other than you guys.

So would you be able to quickly just explain in a basic way for our listeners, what is thiamine?

Chandler: Well thank you for the complement on the book. I'm very proud of it. I go back and read it regularly and sometimes I'm in awe and say, "Wow! I wrote that!" [laughter] So I'm very excited about the book. It's got a little bit of a scary title and a scary cover but that was the publisher. We didn't have much say on that.

What is thiamine? Thiamine is vitamin B1. It's very simple. It's a B vitamin, one of many B vitamins that we need. It comes in pork, a lot of meat products. You can get it in brown rice. You can get it in a variety of things and it's disabled by things like coffee and tea and raw fish and other things. Why it's not viewed as important is because there's this presumption that we solved it because most of the cases historically evolved in states of malnutrition, not necessary the high calorie malnutrition that we have now, but malnutrition. The thought was that once you start fortifying foods with this that you will have solved the problem and so no one even addresses it.

So why is thiamine important? The interesting thing about thiamine is that it is at every entry point and around every portion of the cycle. It's a cofactor in how we convert food and the enzymes that convert food into ATP. I'm old. When I studied mitochondria we memorized the various components but the presumption was that as long as there were sufficient calories, it didn't matter what those calories came from or what they were composed of, the mitochondria were these magical black boxes that would somehow produce ATP and they would go on doing this indefinitely. Not a thought was given and frankly I never gave a thought to it until I met Dr. Lonsdale and until we did all this medication research that was damaging the mitochondria.

So the presumption was that you really just need your basic macronutrients - carbohydrates, proteins, fats, etc., and the mitochondria will take care of everything. What is ignored is that to get from those macronutrients to ATP you actually need functional enzymes and you need micronutrients - vitamins and minerals at each step and there's 22 of them you need. Thiamine happens to be the most important because of its geographic position, if you will, and because of it's great limiting step along the various pathways.

No matter what other deficiency you may or may not have, if you do not address thiamine you will never heal. It's not the only vitamin you need, but it's the one you absolutely must address before you deal with everything else. I think that's the most difficult thing for people to realize and why folks will go on these things with folate and B12 and this, that and the other thing, forgetting entirely that that's so much further down the pathway than thiamine. So they wonder why they don't heal and they seem to think, "Well it must not be the nutrients. It's not the vitamins. I've done the vitamin thing and it's not working." But they haven't done the right ones yet.

Elliot: I think you wrote this down in the book actually, the thing that helped me to understand it was that it's almost like the entry point.

Chandler: Yes.

Elliot: It's the entry point. It's like the initial step and if you can't get through that initial step then what good is providing a bunch of nutrients?

Chandler: Exactly. I think of it like a factory. You have all these raw materials and the raw materials are the macronutrients that have to be converted into the product, which is ATP. At each point in the factory the machinery in the factory needs things to get from point A to point B to point C, to get all the way to ATP. So if you overload the raw materials it doesn't matter if they can't get in the door and then if they can't get through the different processing phases, you're not going to do anything. You're going to end up with the same amount of ATP you always do which is usually diminished.

The problem we have - and this is why the title says High Calorie Malnutrition - is because in today's society what we eat, the western diet, is predominantly processed sugars and processed fats, but processed sugars. So we have all of these calories, all of these raw materials sitting here but none of the substrates that power the enzymes to move it through the factory, so everything backs up. Frankly, it actually does back up. It turns into fat and we store it for potential energy use later. So it's a situation in which until you get that door open and until you get those different machines working, nothing's going to change.

Elliot: Okay, so you mentioned some of the foods it's in. It's in whole foods.

Chandler: Pretty much.

Elliot: Like the grains as well. What part of the grain is it in? Is it in the husk of the grain?

Chandler: In the rice it's in the brown rice, the outside, the husk. The story - this is Dr. Londsdale's part because he's historically been involved with this - is that the Japanese, when they began polishing the rice is when they began seeing the thiamine deficiency. Of course they did not know what it was at that point but they realized at some point later that they needed the meats, they needed the different nutrients. They needed additional foods to get thiamine. They couldn't just eat white rice. One of the things I will say as an aside, as an athlete and as a lifter and cross-fit and all of that, one of the key foods these days that all of the athletes just absolutely love is white rice. They live on white rice and I cringe every time because they have these high carbohydrate pre-workout drinks that are basically caffeine and sugar and then they'll have a protein and white rice. It's just a mess.

Elliot: So essentially when we're removing that husk, we're taking out the micronutrients but we're keeping the macronutrients.

Chandler: Yes. And we're making it pretty and easier to digest so to speak, because it is quicker to some extent. But we've derailed our metabolism in the long run.

Elliot: Okay, so what happens when this goes on for too long? For instance, if thiamine is so important and people are low for whatever reason in our modern world, because we have this chronic influx of sugar, refined carbohydrates, refined grains, all of these things, how can this manifest in the human body? What kind of things might you see?

Chandler: Well the cardinal symptom is fatigue and as you see increasing fatigue or fatigue that is just unremitting, you automatically go to the mitochondria and you automatically should be going to thiamine. Why we don't do this I've never figured out. But that should be your first thought. But it manifests because it derails mitochondria because mitochondria produce the energy for all cellular function. It's going to derail and manifest in these bizarre ways based upon the individual's genetic background, their environmental exposures, their history, all of these things. It's not going to be a very systematic, 'this exactly is thiamine deficiency' until it gets far enough along and you can see the classic symptoms.

Initially it's going to be just weird symptoms. Maybe you have gastrointestinal symptoms, you have weakness, you have fatigue, you have some memory fuzziness, sometimes neuropathies. A lot of just weird stuff will happen. If you look at the genetic disorders, even the genetic mitochondrial disorders, even though someone or family members may have similar genetic risk and genetic pictures, the genotypic expression, the phenotypes are going to be different, when they express it, how they express it because it's so variable relative to the environment and the diet and everything else that in some ways it's both the most difficult thing to diagnose but the easiest because if you see something that doesn't fit any one diagnostic category, you should be thinking mitochondria and you should be thinking thiamine. That's just the way it should be but it's not. We like things in boxes.

Doug: Well that makes me think that maybe there's a lot of misdiagnosing going on out there with a lot of the disorders that people are having. The first thing I'm thinking of is fibromyalgia or chronic fatigue or something like that. Those things could very well be thiamine deficiency.

Chandler: They most inevitably are, 99 to 100% because thiamine deficiency can be the cause or the consequence of derailed mitochondria and there have been studies on folks who have done high dose thiamine who have fibromyalgia, chronic fatigue and it's wonderful. They do significantly better.

Doug: Interesting.

Chandler: Most of their symptoms improve pretty quickly. It's just that folks are reticent to take it. In fact if you read through some of the comments on some of our posts about these topics, you'll see folks who will say that they've had 10 or 15 years of x, y, z symptomology. They stumbled upon the research, they started taking thiamine and lo and behold, they can walk again, they can think, their energy levels are up, their gastrointestinal issues have resolved. It doesn't happen overnight. If it took you 10 or 15 years worth of ill health to get there it's going to take a little time to put things back together but the stories are pretty remarkable once people find it.

The problem is that most will not consider it until it's the absolute last resort. They will try everything else but thiamine and it's painful to watch frankly.

Elliot: As I said at the start of this interview, no one talks about this. All of the natural health experts like honestly, when I came across your book, it was like a complete breath of fresh air. I studied nutrition. I learned all about the vitamins and the minerals and everything, but we had very little education on thiamine. But then actually reading through the functions, how it's just so important for every single cell but particularly in the nervous system and whatnot...

Chandler: Exactly.

Elliot: ...you would think that if there was any kind of neurological dysfunction then someone might actually think to use thiamine, but they don't! So reading through some of the case studies absolutely blew me away. You said some of the people who read your comment on hormones on the website that they've seen benefits. Are there any particular kind of cases that you can recall that particularly stood out to you, that you know of? Any stories where someone's taken thiamine and they've seen really good benefits?

Chandler: Well there's a lot of them. There are a number of them. There's one that's ongoing right now. In fact she just emailed me today, someone who has MS and has a variety of other conditions, has been suffering for years. She was unable to walk, her balance was horrible. Her eyesight had been becoming problematic and a whole host of other things. She texted me this morning. She's taking two grams of allithiamine a day which is a huge dose. But she says she feels fantastic for the first time in her life. She was starting to get better at one gram, which is again, an enormous dose and this was about a month-and-a-half ago she had texted me. She said "I'm up to one gram and the ataxia, the memory difficulties, the balance, all of these things are starting to resolve." She texted me this morning. She's up to two grams and she says she feels like a new person.

So that's just remarkable but it's not uncommon. Again, you read through the comments and you see this happen with various manifestations of the deficiency. A lot of them are so different from each other you think that this can't possibly be the same vitamin affecting all of these things and it is because of its position and it's role in the mitochondria and because the mitochondria are responsible not only for energy production which is certainly the predominant function of them, but they are responsible for steroidogenesis, they're responsible for calcium management, they're responsible for potassium management. They signal and manage immune function and inflammatory responses. They are central to health and disease. Period! And if they are not working up to speed, if they are just marginally inefficient, then they set off these adaptive cascades that are meant to be short-term, that are meant to keep you alive but if they continue on and you continue in this deficit for long enough, the balance between healthy and unhealthy gets skewed and you get death spirals in the mitochondria and your illnesses get work and so on and so forth.

But really, all you need to do is start feeding the mitochondria and they will start unwinding all of those adaptive mechanisms over time. I'm going to anthropomorphize this. They want you to live! Their job is to keep you alive and they will do whatever it takes to keep you alive despite whatever you may do to them.

Elliot: So if you were to tell a conventional medical doctor that you were taking two grams of thiamine...

Chandler: They'd think you were crazy! [laughter]

Elliot: You do touch upon this in your book. I'm fascinated by this concept. If someone is chronically deficient and the functions which rely on thiamine start to become down-regulated, almost like the body starts to adapt to a lower availability of this nutrient, things start to slow down, you speak in your book about how high doses are sometimes needed to kick-start those functions back again. Just a standard RDA dose is not going to work.

Chandler: Oh certainly not! The RDA is just meant to keep you alive, bare minimum survival. It's not meant to keep you healthy. It's to keep you breathing for the most part. The dosing is interesting. Dr. Lonsdale goes into this a bit in the book. You do need a higher dose to kick-start but you also risk, with folks who have been chronically or severely deficient, what he terms a paradoxical reaction. They get worse. Things start to kick into gear, particularly those who have had predominantly cardiac symptoms. That's where you have some problems, where you get heart palpitations, you get increased heart rate, you get irregularities in heart rhythm, things that can be someone not only troubling but can be somewhat dangerous.

So ideally if you were to go the high dose route immediately you would be doing so under the care of a physician who understood what was going to happen and could help you manage it. Now that doesn't happen. So folks have to navigate this on their own. We tell them to titrate up slowly over time so that they can withstand and modulate some of those potential reactions. Typically, if they're going to happen they happen pretty immediately and then they last for a long time. So it is a struggle that they have to go through but if they make it through a week or so of dosing just at the simple 50 mg TTFD and don't have any problems, then they go up to 100 and they don't have any problems, then we're going to - knock on wood - likely be okay. That doesn't necessitate that you always are, but it's a good indicator.

But if they start having a reaction pretty quickly then you know you're going to have a couple of weeks to a couple of months of struggle while they get up to the speed they need and it's going to be difficult. They're going to feel horrible. Some of them do feel horrible. Some don't.

Elliot: You just mentioned TTFD. Just for the listeners who don't know, there are multiple different types of thiamine, right?

Chandler: Certainly.

Elliot: So would you be able to briefly explain that for people who don't know?

Chandler: The standard thiamine that you would get in a supermarket or in a vitamin is thiamine hydrochloride. That's the same kind that you would get if you were to do IV thiamine. It is great if that's all you can get, that's what you've got to do. But if you have transporter issues, meaning the transporters that will take the thiamine into the cell or if you're severely deficient or if you have other issues, a version of it is TTFD. The brand names are allithiamine or lipothiamine. Lipothiamine has alpha lipoic acid with it because you need that in one of the subunits of the enzyme, it doesn't matter.

But that's a form of thiamine that will cross the cell wall of the mitochondria without the transporters. They call it a fat soluble but it's a water soluble vitamin so it's technically not fat soluble. It's just not as transporter-dependent as the HCL. So you have that. You have benfotiamine which is a different derivative and I can't remember the abbreviation of it, but it is great for some instances. It works really well on the periphery but does not cross the blood brain barrier and if you have a lot of neurological symptoms then you're going to want the TTFD version to get across the blood brain barrier. I think those are the three main ones. They all have different brands but those are the major ones.

Having said that though, there is work with benfotiamine in children with Down's syndrome. They've got a lot of neurological issues and with the benfotiamine, even though perhaps it doesn't cross the blood brain barrier, they do see improvement in the neurological performance. By what mechanism, I don't know but folks have been using that. There are colleagues of mine that use that with children primarily because it tastes better. The allithiamine and the lipothiamine apparently taste horrid if you open up the capsule and try to put it in a smoothie or something for a kid. They need to develop sublingual and other types of delivery methods for children and they haven't.

Doug: You mentioned using intravenous thiamine. So thiamine HCL is the form that you would find the intravenous stuff in. Does that mean that the intravenous would not be as good as TTFD?

Chandler: Well intravenous would be better just in general. The format is because you're bypassing the liver and other things and it's going directly. Now one of the things that Dr. Lonsdale recommends is doing other nutrients with the thiamine. You can do the thiamine alone and you often will need more thiamine. But doing a cocktail of the full compliment because generally if folks are thiamine deficient they've got a lot of other deficiencies going on too.

Doug: Sure.

Chandler: I like the idea of doing IV if we could get more folks to do IV, more practitioners to offer that and to have it not be a boutique specialty, high cost endeavour. I think that that would be a great way to go for some of these individuals who have absorption issues even with the TTFD and who need everything.

Doug: I do have a friends who's a medical doctor and she requested that I ask you this. She's in Europe and can only find intramuscular injectable stuff and she wanted to know if that would be appropriate for doing intravenously. Do you know?

Chandler: From what I understand, the intramuscular hurts like crazy but it has been used a lot with, again, MS patients. I know a physician who uses it with his MS patients quite a bit but it is very painful from what I understand so I don't know. IV would be great if you could do it, intramuscularly if you can't. Most of the research is with MS patients.

Doug: Okay.

Elliot: There's also the althea cream? I had a couple of clients who used that and they say it absolutely stinks.

Chandler: Okay, I haven't used it. I actually just heard of the cream today. There was a discussion where they were looking for something and someone mentioned it. Apparently there's one for post-alcohol, for hangovers too. I don't know much about that, whether it stinks or not. Irrelevant, but how much of it is absorbed because thiamine is water soluble. The TTFD is water soluble even though they call it fat soluble but it's a different mechanism so I don't think that that would apply to a skin-based application. Most of the skin-based applications work best with fat soluble steroids. You can do steroids in a patch or anything like that. I don't know the kinetics of that and how well it works.

Elliot: Okay. You were saying before how in our modern world we have our modern diets, the way that we're eating now has changed so drastically. We destroy our food. This is a clear factor which predisposes someone to easily run through their thiamine source because thiamine's water soluble, right?

Chandler: Yes.

Elliot: So you can run through it fairly quickly and produce a deficit. But what other kind of things might predispose one to actually being low in this vital nutrient?

Chandler: Well medications. All pharmaceuticals attack the mitochondria by some mechanism or another. All pharmaceuticals leach some vitamins and minerals. They vary between pharmaceuticals. So the more pharmaceutically based your lifestyle is, the more likely that you are going to have difficulty, not only with mitochondrial function - because you can have severe damage, but with nutrient status - so it becomes kind of a cyclical thing. You have poor nutrition. You get pharmaceuticals which damage the mitochondria which sucks out more nutrients which gives you more symptoms so you think you need more medications and you just keep going. It's a great business model. It's not particularly effective for health.

Some of the key ones that everybody's on, metformin. Metformin is a thiamine analogue in a way that when metformin is present thiamine can't get in.

Doug: Wow!

Chandler: You have type II diabetics - and type I diabetics - who are 70% thiamine deficient. A huge number of diabetics have thiamine problems. Then you give them metformin and metformin not only takes the thiamine and blocks it from entering the cell, but it also depletes CoQ10, damages the electron transporter chain, reduces ATP, at least in rats, by something like 48%. So it's this drug that basically makes you worse. But it does lower your blood sugar. It allows you to eat cake. It doesn't help you to become healthy, as much as the advocates of metformin think it's a wonder drug.

Doug: Yeah. It's generally thought of as harmless too. I see people write about that all the time. "Oh yeah, there's no side effects. It's actually a really, really safe drug."

Chandler: Nooooo. It's not. You end up with a lot of fatigue, neuromuscular issues are big, memory, fogginess. I can tell you a personal story on metformin. My mom who's 70-something at this point - all her life had been on a gazillion medications like any person and I gradually got her off all of these medications and she was healthy for a couple of years, did great, exercised, let her diet go a little bit. The doctor put her back on metformin which she had previously been on for probably 20 years but had been off it for three or four years at this point. Within three weeks she was walking into walls and couldn't stand up and just fell apart. And she wouldn't listen to me. Parents don't.

So we got her back off. We got her thiamine levels back up and she was fine. She couldn't walk straight! She lost all ability to manage. She had the drunk man walk and was very fuzzy and weak and everything. It took three weeks. Now why it took three weeks this time and she'd been on it 20 years before and didn't have that particular issue, I don't know. But it was noticeable. A lot of people, the first time they get on it they'll mention that and maybe they adapt to it over time.

Thiamine stores are interesting in that we have two weeks of absolute stores, meaning if we completely eliminated it from our diet and had no thiamine whatsoever for two weeks, that's how long it would take. But nobody's like that. Things wax and wane. You have good days where you eat well and you have bad days. So symptoms wax and wane with that, but over time it all catches up.

Elliot: Aside from the medications - I probably know what you're going to say - many of the other chemicals that we come into contact with, I know in the book you spoke about glyphosate but there's also many of the petrochemicals that they're spraying on the food?

Chandler: Well certainly. It's not a good situation and that's actually what my next book is about. It's called Not Quite Fatal and it's this presumption we have that so long as something doesn't kill us immediately that it is safe and that's how we view all of these chemicals that we spray on our food and we tout the economic benefits, etc., etc. But none of them really kill us immediately. They institute small changes that accrue over time and that make us very, very sick eventually and they make our offspring sick.

So certainly organic, but the regulations on organic are changing, at least in the US because of our current administration so they're unwinding a lot of those things, but what the overuse of those agrochemicals has done to the food is depleted the soils of minerals, so the soils are basically sterile at this point and depleted the foods that grow in them of necessary vitamins and minerals. If you eat lots of fruits and vegetables but they're conventionally grown, you're not likely to get the nutrients that you need because they're grown in depleted soils and they're sprayed with all these toxins which becomes a net deficit in energy because you don't get the nutrients and then you have to deal with all the toxicants on top of it.

It behoves people who are ill - it would be great if everybody did it so they didn't get ill - but if you are ill, to eat absolutely as cleanly as humanly possible in today's environment, to rebuild your body.

Elliot: That brings me on to the next question actually. So from what I gather, eating a diet high in sugar is probably not a good idea.

Chandler: No.

Elliot: But there's lots of other diets that are high in refined sugar. What kind of diet or dietary template - it may be completely individual - but is there any particular dietary template that you would think is beneficial for maintaining or providing our body with thiamine?

Chandler: Well certainly more protein because that's one of your major sources. I see that particularly in women. We've been scared off of protein since time immemorial because protein makes you fat so women tend to not eat anything but low calorie carbohydrate-based stuff. So that's one of the things when I'm dealing with folks who are ill, is the most difficult thing to get them to consider, to actually eat protein, lots of it! Fat is the second one. We need fats. Again, women will not eat fats to save their lives! Then fruits and vegetables, primarily vegetables. You'll have a lot of people who will eat fruits only and think that that's sufficient. It's not. Those are still carbohydrates. They're better carbohydrates certainly than sugars and processed foods but vegetables are better for you.

So those are the key things and whole foods. You eliminate all processed foods to the extent that it's humanly possible and eat food. It's not rocket science. I was chatting with someone who has recovered but had a relapse because she took a supplement that ended up making her worse. Everybody's looking for that supplement, this magic pill and it's natural, it's human nature. You're not quite fully recovered. You think 'if I take this it'll expedite things'. It doesn't. But we were chatting about this and now that she has gotten back on track and she's got her thiamine doses up and she'd needing to start exercising and moving. Take it slow. You have to build a base with everything you do. This is not something that you go out there and you go a full on workout. It's not something that you can fix immediately. You have to build your body's capacity up over time just like you do with the nutrients. You build things up over time so that systems can unwind. She commented. She said "You're just entirely too practical."

That's all that it is. People think that it's very complicated but it's really not. If you become ill it took you time to get there. It doesn't happen overnight and it's going to take you time to recover and you just have to do it. You have to go through each of the steps, whatever they are for you. You have to eat. You have to move. You have to do this, but it's not going to happen overnight and you just have to plod through until eventually you look back two or three months previous and you realize how much improvement you have. You may not notice it day-to-day but you look back over time and you'll see it. So that's the gist. Eat real food and move.

Elliot: Okay. When you Google thiamine in food it'll talk about coffee, it'll talk about these other kinds of things...

Chandler: Are anti-thiamine.

Elliot: ...yeah, which potentially inhibit it, which are like anti-thiamine, which prevent our body from absorbing it. How significant do you think that is?

Chandler: If you're someone who is already thiamine insufficient and you're drinking 4-6 cups of coffee or tea a day, I think that it would behoove you not only to get your thiamine up but to start dropping the coffee down and at the very least drop the coffee down or space out the thiamine ingestion with the thiamine ingestion so that the thiamine has already been absorbed, digested, done it's thing before you drink your coffee. And try to do it that way. Yes, I think it becomes significant, coffee and alcohol. That's the other thing. Folks drink. They like to drink. Well, that's not going to help your thiamine status and if you are serious about getting better, you have to eliminate some of these things.

Now you don't have to go cold turkey but you need to start bringing it down and being smart and practical about how you do it. Ultimately if you can get down to a lot less coffee then you'll probably feel better. And if you get your thiamine up you probably won't need the coffee.

Doug: Interesting.

Elliot: How long would you say it takes - and I appreciate that this is probably highly individual - but if someone is severely thiamine deficient or is on the cusp of a serious illness, let's say, how long might it take for someone to build up their stores again to start activating these systems and whatnot?

Chandler: Well it could happen immediately, not that they will resolve everything, but if they can get IV thiamine and be under a doctor's care in the event that they have some additional symptoms, you can start seeing improvement immediately. In fact people who do get IV who are hospitalized with Wernickes or these others, they get improvement almost immediately. It doesn't resolve everything but you start to see improvement and over time you unwind everything else. But if you're doing it on your own and you have to titrate up slowly, it could take you a while. It could take months before everything starts to even out and settle down because you can't take that high dose to kick everything into gear.

Elliot: If I was being devil's advocate and say "Well we're human beings and we evolved on planet earth, we evolved to eat the food, we didn't evolve to eat supplements so why can't we get all of our nutrients from food?"

Chandler: Well we didn't evolve to eat atrazine or glyphosate, all of the other chemicals. That's the gist of it.

Doug: Good point.

Chandler: If we didn't have all of that we probably wouldn't need this.

Elliot: Yeah, that makes so much sense.

Chandler: Unfortunately.

Doug: How prevalent do you think thiamine deficiency is? How many people just walking around out there on the streets probably have thiamine deficiency at this point?

Chandler: Or thiamine insufficiency.

Doug: Sure.

Chandler: I would say most of them frankly.

Doug: Really?

Chandler: If you look at the data on diabetics, I don't know what percentage of the population is type I or type II diabetics, but they're 70 or 80% right there of all diabetics. If they're on any medications, women are on birth control. If they're on birth control their thiamine and a variety of other B vitamin deficiencies. If they eat the typical diet they're likely thiamine deficient. Really, if anyone is on any medication chronically, they're deficient because of what the different medications do to the mitochondria. They may have a sufficient diet but the damaged mitochondria require more for it to perform the same functions. So it's not say thiamine deficiency in the strictest sense. It's a need for more.

That's why you see people with such high doses because the damage is so bad and it's not necessarily that they're so deficient that it will come up on the different lab tests but that the systems don't work. So even though they're taking this, they're only absorbing and being able to utilize a certain amount of it and they have to overcome all the other stuff going on in the mitochondria to kick it into gear.

Doug: And will taking high doses over time up-regulate those things so that they'll...

Chandler: Yes. That's the thing. Mitochondria are born and die regularly so you want a proportion of healthy to damaged that is favourable. Generally people have the opposite. The damaged is higher than the healthy. That takes time to rebalance and re-regulate and once you give the mitochondria what they need then they start reproducing in more healthy ways because they've unwound all the other symptoms. So it's complicated but in a way it's very intuitive and logical.

Elliot: We're placed under so much stress in our modern world that it kind of makes sense. You have to counter-balance that with something.

Chandler: Yes.

Elliot: There's one interesting thing I'd just like to clarify. I think in the book there was a study - I actually went and read this study afterwards - and it was talking about how you need the thiamine for one of the enzymes which activates vitamin B6 to be used, pyridoxal kinase.

Chandler: Yeah.

Elliot: There's a research study saying that thiamine deficiency actually down-regulated that enzyme which you need to basically make use of vitamin B6. So a thiamine deficiency can have downstream effects on how you're processing everything else. It's bizarre.

Chandler: It is. It goes to the point that everything's connected and our compartmentalized approach to medicine hopefully will go by the wayside at some point. Illnesses are not discrete and they're not limited to the particular body compartment that you happen to be specialized in. The body talks to itself at every level from the largest organ down to the smallest microorganism. Everything is talking and so to the extent that one system is off, everything else is going to have some sort of reaction to it. It may not be something noticeable, at least not initially, but over time as those things accrue you're going to start to see breaks in the system and disease.

Elliot: That is something that you and Dr. Lonsdale really exquisitely present in the book, I think towards the end, is this whole kind of new paradigm which is being taken on by a lot of the researchers, kind of relating to this bioenergetic model. You talk about how we need biological living energy to perform everything, to perform all of our functions and if any step of that process becomes blocked, then it's going to have numerous downstream effects. So although we've asked you a bunch of things about thiamine, I know that you know a bunch of things about another lot of things. You cover so much on your Hormones Matter website, so what else is going wrong? What would you like to talk about? What do you think is, other than thiamine because thiamine is a problem, but what else?

Chandler: I think you framed it really well. People ask me about specific symptoms all the time and if thiamine or something else will help a specific symptom and my answer is always yes it will. But to reframe the conversation, the reason you have these symptoms is because something's not working somewhere and that's your individual expression of that weakness.

Everything that I have learned about medication reactions has been that it lands in the mitochondria but that you can have different medications end up with the same damage and different medications that have entirely different mechanisms of action that shouldn't be able to damage in a similar pattern to each other, end up doing damage. For example, thyroid. Thyroid gets damaged. Whenever there is a medication adverse event or adverse reaction, it doesn't matter what medication it is, the thyroid is like the canary in the coal mine. It is always damaged. It almost always ends up in Hashimoto's if it persists long enough.

Every now and again you get Graves with the hyperthyroid but it's a 95-to-5% breakdown. But the thyroid, no matter what medication, if someone experiences an adverse reaction, the first thing they need to do is look at the damage to their thyroid, rule it out, take care of that. Now it just so happens that the mitochondria in the thyroid have very tight reciprocal relationships so if you heal one, you heal the other. But it's that crossing of boundaries that I think has been the most enlightening in my work. We saw this in every medication that I studied. The thyroid was damaged. We ended up at the mitochondria as being the causative agent but it just gets us away from this discrete mechanisms of action, away from the pharmacology as I was taught.

Pharmacology is wonderful and cool and I love all the mechanisms but you've got to realize that if you block or increase something artificially, which is what a medication does, that it's going to have effects everywhere because all systems are conserved. It's been an interesting learning process, to come from a traditional background, perhaps not as traditional because hormones in the brain is not necessarily what everybody studies, but a traditional chemistry pharmacology background, all the way to where I am now where I use that understanding to map systems and stuff but I don't hold to that anymore because I understand what the mitochondria do and that everything talks to everything else and it's all connected and there's no discrete nosological distinctions between each disease. That I think has been the most important thing that I've learned in doing this.

Doug: Very interesting.

Elliot: It reminds me of the way that human beings throughout the various traditional healing methods, whether it be naturopathic, philosophy, Ayurveda, traditional Chinese medicine, rather than compartmentalizing the body, the separate parts and approaching everything mechanistically so to speak, actually there's this underlying communication that's going on and a lot of the stuff that you're publishing on your website is actually showing the research is completely in support of that and we got it wrong!

Chandler: We did.

Elliot: Medicine got it wrong! I think you and the other editors, and there's many other different websites that do similar things, is gradually tearing it down because people are starting to see that there's so many holes in the narrative, it's got to change at some point.

Chandler: I agree and one of the things with regard to say "natural medicine", whether we're talking about ancient medicine or any of that, is they understood that there was a connectivity of the body itself but that there were ecosystems among ecosystems. So the other flaw I think in western thought is that somehow we're separate from the environment we live in and that we can adjust to the environment and it's somehow magically not going to affect us. It's this insane amount of compartmentalization and boundaries. I think if we're to evolve and survive all of the chemistry that is hanging out in the environment right now and we're pouring into our bodies, we've got to get those experts from the different fields looking at the totality of the different ecosystems and talking to each other.

I do work sometimes on bugs and bacteria. It's not something I ever thought I would be interested in. I was not interested in any of that. I was human, human, human. I had no interest whatsoever in anything else but again, things evolve and you realize that the expression of disease processes in other species and other organisms is, though a little bit different, is very similar to us. So you've got to start looking at the patterns across different ecosystems.

Elliot: Just one more question on my end Chandler. You were talking about medications before and it's just come to my mind - I didn't want to forget - essentially, if someone was taking a medication, if they're taking a medication that they don't necessarily have any choice about, perhaps they've got some kind of condition which they require to take it long-term and we know that it's probably depleting thiamine, I know that you can't give any medical advice on this show but what are your thoughts on supplementing with thiamine just as a precaution?

Chandler: I agree you should. I think you need to compensate, particularly if you know that everybody's deficient. So yes, I would say yes. You need to supplement with that and probably a number of other nutrients and optimize their health nutrition as much as you can, that foundation, so perhaps even if they have to take the medication chronically, perhaps the dosage can change or perhaps they will feel better on it because that's ultimately what you want. You want to live a life and feel healthy. You do not want to feel fatigued and run down and have all of these pains, so you want to be healthy.

So to the extent that you can help them with that by maximizing their nutrition and reducing any other toxic exposures, I think that's a win.

Elliot: Yeah, that really makes sense the way that you just put it. You said that you're writing a book but have you got anything else coming up in the future, like any events or anything that you'd like to share with the listeners? Anything that's going on for you?

Chandler: No, nothing exciting. I'm deep in the trenches of research. I'm actually writing two books right now. One is the one I mentioned called Not Quite Fatal and it's medical ethics, toxicology, kind of a hard look at all that we've done to ourselves and the environment and the reasons why we've allowed it to happen. The other has a working title of How to Heal from Almost Anything and is more of a broad based approach of health and healing after living a life that lands you in some sort of illness. Hopefully it will be a less intense guidebook than the thiamine book, although I think the thiamine book is written for an educated lay audience. That was my goal. But the title and some of the chemistry's a little scary so I'm hoping to tamp that down a little bit and make it a little bit more accessible.

Elliot: That sounds fantastic. When are you hoping to have...

Chandler: Oh [laughter].

Elliot: We'd like to get you on the show.

Chandler: Like now! [laughter] I'm still in the beginning chapters so we've got at least a year if not more.

Elliot: And where can our listeners find you? You do a lot of writing for Hormones Matter, yes?

Chandler: So Hormones Matter is my site. That's the best way to find me and then certainly on Facebook you can find me there. We have a private Facebook group called Understanding Mitochondrial Nutrients if you'd like to look into that and that's primarily research. We basically do what the group says. We look at the different nutrients, how they act and who needs what, when, where and how. Then on the personal side, on the power lifting side, I have a website called oldladieslift and a similar private group on Facebook with that too for all the women who are older and lifting heavy weights.

Doug: That's great.

Elliot: Fantastic. There's also a YouTube channel for that one, yes?

Chandler: Yes. We added the YouTube channel. That was just a fun project I did because I'm lifting and in any given meet there aren't that many older women and I thought there's got to be more of us around the world. We have about 1,400 now in the group and a lot of 60, 70 year old women who are just lifting phenomenal amounts of weight and it blows me away. It's a lot of fun.

Elliot: For the listeners, I would definitely recommend checking that out because it's phenomenal. It's really impressive, like serious!

Chandler: Yeah, we want to change the paradigm there too. You guys are young so you don't know this, but women of my age group in the US in particular, grew up before and were athletes or attempted to be athletes, before legislation called Title IX came into being that said they had to let women into equal number of sports in high school and colleges. Prior to that there was nothing. So women were not allowed in gyms and on different teams and this and that until that legislation. But all of us grew up before that and a lot of us have come to this power lifting sport in particular, as old ladies, as 40, 50, 60 year olds and starting from zero. I thought 'there's got to be some other people doing this' and apparently it's a very popular thing. It's quite impressive that these women who have lived a life and had their children, some of them have grandchildren, come and start doing power lifting and are squatting 300 pounds or dead lifting 300 pounds. It's like wow!

So we're going to change that. You're told you can't build strength as an older women. Well, that's just not true.

Doug: Apparently not. Squatting 300 pounds! My god!

Chandler: I know. Right?

Doug: It's very impressive.

Chandler: I can't squat 300. I can dead lift but my squatting is a little less. But anyway, that's just a fun project but it's kind of part of my overall philosophy that you have to eat well but you also have to move. You have to do something. You cannot be inactive because you use it or lose it frankly, and muscle loss is a huge factor in illness. So maybe we'll spur some change in that area too.

Elliot: Well Chandler, it has been absolutely amazing having you on.

Chandler: Thank you.

Elliot: It has been an honour. I really wish you the best in writing your new books. I think the work that you're doing is absolutely fantastic on Hormones Matter. There's loads of people who see so much benefit from the articles that you guys post. Your book is fantastic. For the technically minded, I will say, probably for the layman they might find it a bit difficult but I would say that even if you are a layman without any education I think you should still buy the book because even for those who don't have technical knowledge in biology, most of the book is still completely understandable and quite frankly, you can skip over the technical parts.

Chandler: Oh yeah, certainly.

Elliot: Many people do that.

Chandler: We had hoped to do that. We needed to give sufficient research for physicians and researchers and back everything up. That's why we have so many case studies in the book too is for the lay person. We tried really, really hard to make it accessible and to tell the story that someone who needed to treat themselves or needed to learn this and convince their physician to look at it, could read. And that was the goal.

Elliot: I think you did an exquisite job of that. Thanks again for coming on the show. I really wish you the best of luck with everything and it's been a pleasure to have you on.

Chandler: Well thank you very much. I enjoyed it.

Doug: Thanks very much. This was great.