20. "Survival of the fittest" AFTER 50!

As we age past our reproductive years, Mother Nature stops taking care of us. We discuss a recent article by Dr. Bruce Ames of the University of California, Berkeley, who's one of the first and most distinguished anti-aging scientists--still productive in his 90's! We uncover some of his secrets as we discuss why, as we age, certain supplements become even more important to our healthy survival. Some of our most valuable nutrients are in fact likely to be depleted with normal aging and there is an overlooked strategy to consider, choosing specific foods and supplements helpful for a long and healthy survival--long after our reproductive years!  Join us for this episode, and enjoy!

Dawn Lemanne, MD
Oregon Integrative Oncology
Leave no stone unturned.

Deborah Gordon, MD
Northwest Wellness and Memory Center
Building Healthy Brains

Chapters

• 2:41 Bruce Ames' article for discussion
• 33:20 Osteoporosis risk increases with more pregnancies
• 39:54 The supplement to the main article
• 56:19 Blue Zones real or a record-keeping error?

Transcript

[00:00:00.000] - Dr. Lemanne               
Yes. The purpose of a human being is to create an ovum or sperm that then combines and creates another human being, which will go on to do the same.

 [00:00:09.270] - Dr. Gordon
And thereby another human being. Now, we may not think of that as the individual meaning of our unique lives, but this is how nature works. We keep life going. So once we've reproduced, and as we've talked about in discussions of menopause, for women, When we stopped doing that in our 40s or maybe as late as 50. How do we rely on what we know about nature to stay alive for as long as we might want to after that?

 [00:00:44.290] - Dr. Lemanne
You have found your way to the Lemanne-Gordon podcast where Docs Talk Shop. Happy eavesdropping. I I'm Dr. Dawn Lemanne. I treat cancer patients.

 [00:01:03.090] - Dr. Gordon
I'm Dr. Deborah Gordon. I work with aging patients.

 [00:01:06.900] - Dr. Lemanne
We've been in practice a long time.

[00:01:08.050] - Dr. Gordon
A very long time.

[00:01:10.880] - Dr. Lemanne
We learn so much talking to each other.

 [00:01:12.680] - Dr. Gordon
We do. What if we let people listen in?

 [00:01:21.370] - Dr. Lemanne
Good old Mother Nature. As we age past our reproductive years, Mother Nature stops taking care of us. Dr. Gordon reports that unhappy fact means you had better increase your intake of several vitamins, especially, get this, queuine and ergothioneine. Yes, in this episode, Dr. Gordon introduces some strange sounding, but vital nutrients I'd never heard of. Join us as we discuss a recent article by Dr. Bruce Ames of the University of California, Berkeley, who's one of the first and most distinguished anti-aging scientists, and he's still alive at We discuss why, as we age, certain supplements become even more important to our healthy survival. Dr. Gordon explains why valuable nutrients are likely to be depleted with normal aging and the role of intentional replacement with specific foods and
supplements. Enjoy this episode.

 [00:02:24.820] - Dr. Gordon
The question is, are we going to talk about evolution, survival of the fittest, antagonistic pleotrophy, early versus late menopause, vitamin triage, or Bruce Ames? What do you think?

 [00:02:41.630] - Dr. Lemanne
I think we should talk about... Well, I don't know. You sent me this article and I'm still reeling. I've never heard of this article. I certainly heard of Bruce Ames. But the article that you sent me, you expanded my vocabulary this week, Deborah. I I had to learn. I learned about new vitamins that I'd never heard of, and I didn't know how to pronounce them. I had to go to YouTube and find out how to pronounce some of these vitamins. So for our audience, the article that Deborah sent me, and she's referring to, is an article by Bruce Ames, who's probably the the OG, the original gangster of longevity research, although it wasn't called that when he was working. And the article lists several, about 10, I think, nutrients that are rather obscure. Some of them, some of them aren't. Some of them are very obscure. Vitamin D, magnesium made the list. But queuine, And PQQ. Now, I've heard of PQQ, but only a little bit. And ergothioneine. All of these things that Bruce Ames, who is one of the pre-eminent thinkers in the longevity space, in my opinion, things are really important and things we ought to pay attention to in terms of making sure that we encounter those in our daily life, in our diet, and other ways for healthy aging. How did you hear about this article, Deborah?

 [00:04:12.350] - Dr. Gordon
It came across my radar somehow. I don't know. But you know what? So I'm going to... I thought Bruce Ames' original work decades ago, and I think he did most of his work at UC Berkeley, or somewhere in California.

 [00:04:31.810] - Dr. Lemanne
That's our alma mater, go Bears.

 [00:04:33.920] - Dr. Gordon
Yes, was determining how you would identify if a substance is carcinogenic. Isn't the Ames Protocol devised by him as a test for taking environmental toxins, purported toxins, and determining whether or not they are carcinogenic?

 [00:04:57.450] - Dr. Lemanne
Any toxin, including things from food.

 [00:05:00.300] - Dr. Gordon
Yes.

 [00:05:02.230] - Dr. Lemanne
So the Ames Test uses bacteria, I believe, and looks for double-stranded DNA breaks when particular substances are introduced into the bacterial culture. And it was the first simple and easy test for DNA damage. And that's why it became really, really important and popular and widely used to determine if something might be carcinogenic. It doesn't prove that something's carcinogenic, but it does prove that it can cause DNA damage, which we can then extrapolate may lead to carcinogenesis, cancer-causing.

 [00:05:39.780] - Dr. Gordon
And I think he became a little bit of an angel and a target because I can't remember what the substance was, but I remember at some point eons ago, Bruce Ames reports that this substance you're worried about in your water or air is UNlikely to be hazardous, as often as he found things that were LIKELY to be hazardous. So he had a very objective way of categorizing things, not an answer that sometimes may be an environmentalist wanted to say, but I don't want this dumping into my water. Well, it's not causing cancer.

[00:06:20.960] - Dr. Lemanne
Yeah, I think he became somewhat controversial and talked about how ordinary things, fruits and vegetables, can cause cancer. They contain cancer-causing chemicals. And it's just a natural part of life that we encounter these things. And we have mechanisms to deal with toxins to a certain extent. So, yeah, it's a really interesting and nuanced mind that he had.

 [00:06:53.410] - Dr. Gordon
And I think- I think, is he no longer still alive?

 [00:06:56.560] - Dr. Lemanne
He is alive. I looked him up. He's 95. I shouldn't have said was, is. I should say is. His mind is.

[00:07:04.420] - Dr. GordonYeah. And he's in his mid-90s now. And this article was published just a few years ago. I'm not sure. So this article that we're talking about, which we'll put a link to in the notes, but it’s   Prolonging healthy aging, longevity vitamins and proteins by Bruce Ames. And I began reading it and it resonated in my mind with a lot of thoughts that that I've garnered from my meager understanding of evolution through being involved in the paleo-world. How do we determine how evolution happened and how did we get to be who we are? And survival of the fittest only carries us so far in life. And if you want to prolong healthy aging, you have to have some attention, like Bruce Ames gives in this article, to longevity vitamins, because we learn from evolution that frankly, evolution just really protects us to have babies, and after that, we're inconsequential.

 [00:08:11.720] - Dr. LemanneYes. So it's not really survival of the fittest, it's survival In terms of longevity.  Longevity exactly isn't accounted for in survival of the fittest, only survival of the “earliest and best at reproduction”.

 [00:08:30.100] - Dr. Gordon
I'm trying to come up with a word that is like fittest. So it starts with an F and ends with an E-S-T, and I can't think of one, actually. But fecund and fertile both start with Fs, and that's what evolution selects for more than fitness itself.

 [00:08:49.110] - Dr. Lemanne
That's the only thing that it selects for. I would argue. It selects for reproduction. And you know, one of the interesting things about that in my line of work is that certain genes, when mutated, such as BRCA1 and BRCA2, the reason that they persist in various populations is because they increase the damaged genes, increase fertility. So BRCA1, on the East Coast, they call it BRACA, and on the West Coast, we call it BRICA. Mutations. People who carry those have, on average, more children, both males and females, produce more children than people who have the normal version of those genes. So there you have a gene that absolutely selects for shorter lifespan, but more children.

 [00:09:38.100] - Dr. Gordon
And what level of amplification does it do? Because what we're talking about, these two genes increase a woman's risk, maybe a man's risk, too, of having breast cancer. By what factor?

 [00:09:50.550] - Dr. Lemanne
So I would have to look, and it depends on where in the gene the mutation occurs. So these genes are thousands of base pairs long, and you can have deactivating, damaging mutations anywhere along those 4,000 or so genes. And don't hold me to the exactly 4,000, but they're long. And they can be broken in different places. It's like having a car. You could have a flat tire or a bad radiator, or the steering might not work. Any So all those things are going to deactivate your car. Same with the BRCA gene mutations. And where the deactivation or damage in those genes occurs also has something to do with the penetrants or the actual expression of this damage as increase in cancer risk.

 [00:10:34.690] - Dr. Gordon
So the common parlance where people say, as I myself have said, Oh, my mother had breast cancer, but she didn't have the BRCA gene…or Yes, she had the BRCA gene, I have the BRCA gene. But really, it's a question of variants or mutations in the long part of our chromosome that is labeled in all of us, the BRCA gene. Is that right?

 [00:10:54.900] - Dr. Lemanne
Sort of. A gene is defined as a stretch of DNA that basically defines usually one protein. Now, there's some variants in that. You can have what's called alternative splicing and make two different proteins in certain genes. But basically a gene, one gene, one protein. Okay. So if you have, and you're supposed to have a certain amount of this gene being made, and we need the amount being made by two sets, one from the father and one from the mother. If one of those is broken or mutated and not working, we only have half the dose of that protein. Normal BRCA1 or 2 protein. And that's not enough to keep us healthy throughout our entire life. And so that increases the risk of cancer early in life.

 [00:11:46.400] - Dr. Gordon
But it increases fertility.

 [00:11:50.560] - Dr. Lemanne
It's thought. No one knows why. But it's thought that perhaps this gene makes people more attractive to the opposite sex, the broken gene, for some reason. We don't understand that. I'm not saying that that's necessarily true, but that's one of the hypotheses. I think that's got to be tested and looked at. Maybe it's true, maybe it's not. But that's an interesting idea.

 [00:12:17.460] - Dr. Gordon
So this is just making me think about another gene, and we're going to get to the longevity vitamins. I do want to get there. But there's a gene that is very common in the MTHFR, Methyline Tethrahydropholase-reductase, I guess, region. And it's the particular base pair that is referred to as C677T. And I know its disadvantage is not a cancer, but is heart disease or miscarriage. And it's interesting thinking along the lines every disadvantage must also have an advantage.

 [00:13:03.990] - Dr. Lemanne
If it persists in the population.

[00:13:05.820] - Dr. Gordon
Well, this is very persistent. A good percentage of the population has it. Most of its effects are later in life, increased risk of dementia, increased risk of heart disease. But early in life, it's an increased risk of miscarriage, which makes me think about, and I'm going to go out on a limb and hypothesize what the benefit of this gene is. And what do you think it is? To have this variant. So when you have this gene, you can't properly do the methionine homocysteine cycle in your metabolism very well. You cannot apply methyl groups very well, which means you never have the risk of being overly methylated.

 [00:13:53.880] - Dr. Lemanne
So you're always going around a little bit under methylated if you have this particular variant.

 [00:13:58.200] - Dr. Gordon
If you have this variant. And one of the hazards of being overly methylated is anxiety, the nocebo effect where everything affects you badly, and some adverse profiles of neurotransmitters. So it's more that you're avoiding the risk of having too much methyl. I can't really think of a benefit other than that to being undermethylated, but I'm going to look for it.

 [00:14:31.110] - Dr. Lemanne
Have you noticed that in your practice? Have you noticed that patients who have this particular variant are less anxious?

 [00:14:37.850] - Dr. Gordon
Do you think I'm less anxious?

 [00:14:40.550] - Dr. Lemanne
Than...

[00:14:41.350] - Dr. Gordon
The average bear? I do think I'm less anxious than the average bear.

 [00:14:45.270] - Dr. Lemanne
You know, I think you might be. I agree. I would agree. Yeah.

 [00:14:49.300] - Dr. Gordon
I can think of a few other people and I would... Women, because I've talked to women who are having trouble with miscarriage and suggested They probably have this gene, and we've checked for it, and they did. And those couple that I'm thinking of are on the less anxious side. But I'm going to look up and see what other benefits might be conferred. And somebody is raising their hand right now in our audience, and please let me know if you know the answer, what's the benefit to being a little under-methylated? So we'll find it.

 [00:15:25.700] - Dr. Lemanne
It's an interesting hypothesis, and a hypothesis can be tested. So Interesting.

 
[00:15:31.030] - Dr. Gordon
And the most famous example of a gene that cuts both ways is the gene for sickle cell disease. Yes.

 [00:15:40.060] - Dr. Lemanne
Isn't that pretty clear?

 [00:15:42.300] - Dr. Gordon
It is pretty clear.

 [00:15:43.390] - Dr. Lemanne
And that's- If you have half a dose, you get one sickling gene from one parent. You are resistant to malaria, but you get two. And yes, you're resistant to malaria, but boy, are you sick your entire life with repeated sickling episodes that are just It's truly devastating.

 [00:16:02.320] - Dr. Gordon
And so that's the prime example in the concept that is so hard to spell out and write, but it's very interesting conceptually, which is antagonistic pleotrophy, which is- You want to explain that for me and our audience? I had to look it up because I only had an idea in my mind what it is. But the idea that there's a gene that can have an effect in an organism that can have antagonistic effects, one that's promoting life and vigor and one that's detracting from it. And so sickle cells the perfect advantage, where if you sickle, you're very sickly to the point of death. But if you don't sickle, you're really sick to malaria.

 [00:16:51.400] - Dr. Lemanne
People with one allele of the sickle hemoglobin can sickle. So if they go up in an airplane, if they exercise too hard, et cetera, if they get ill, they certainly will sickle and they'll have a sickle crisis, but they don't have it as often or as people who have two who got a gene from both parents.

 [00:17:12.170] - Dr. Gordon
And we've discussed this concept, antagonistic pleotrophy, in other talks about the APOE4 gene and the risk of Alzheimer's disease.

 [00:17:24.210] - Dr. Lemanne
Now, APOE4 people are smarter than others in early life, right?

 [00:17:27.610] - Dr. Gordon
That is right. They are smarter than others in early life. They have a greater inflammatory response, which there's another... So inflammation up to a point is a really good thing. You're out on a walk in the desert and you stub your toe and you're not going to be back in health care access for three or four days, it's good to have a good inflammatory response.

 [00:17:53.790] - Dr. Lemanne
Or never because you're a caveman.

 [00:17:55.520] - Dr. Gordon
Exactly, yeah. Yes. So cave people days, those who had a better inflammatory response, that was great when they were young. It's just not so handy when you're older and maybe getting a little bit of insulin resistance, a little bit of vascular disease, then having a greater tendency to inflammation can push you over the top and into an early grave. They did a study of older women somewhere in Western Europe. I was reading about it. And And they distinguish them with how prominent their inflammatory response was. And those who had the stronger inflammatory response died sooner in this cohort of admittedly already older folks. But things going wrong in your '70s, '80s, and '90s, that's why the COVID outcomes are harder for older people and why it's recommended that even though I think of myself as really fit and vigorous and healthy, I am technically still in that age group that's at risk for hospitalization. So if I get COVID, I'm still supposed to take Paxlovid, which is hard to do because it's really just going to protect me from going in a hospital where I've never had to be except to give birth. So age and inflammation, bad when you're older, but maybe very protective when you're younger and coming upon hazards just in the routine of your daily life, that it'd be better if you could heal yourself.

 [00:19:33.950] - Dr. Gordon
So APOE4 does that. Apoe4 also is really good at harvesting fat from the meal they eat and storing it, which is very advantageous if you have to survive periods of absence of food or fasting, but not so beneficial in our food abundant environment, because then you pick up too many foods and put Too many of them in your mouth. And you've, as an APOE4, held on to the fat, preferentially.

 [00:20:06.460] - Dr. Lemanne
Well, the trade offs we could go on and on. We can get pretty deep, like life equals death.

 [00:20:14.790] - Dr. Gordon
Or we could talk about vitamins.

 [00:20:18.490] - Dr. Lemanne
Let's talk about this paper, Deborah. This is such a fantastic paper. So the name of the paper I'll tell our audience is called Prolonging Healthy Aging: Longevity, Vitamins, and Proteins by Bruce Ames. And it was published in PNAS.

 [00:20:38.290] - Dr. Gordon
Proceedings of the National Academy of Sciences.

 [00:20:41.900] - Dr. Lemanne
Yeah, in 2018. And we'll put a link to it in our show notes. And yeah, I was just so delighted to review this paper in preparation for this, although it was a difficult paper read for me. I mean, not just because there were a lot of new vitamins.

 [00:21:06.500] - Dr. Gordon
A lot of new vitamins. And nothing about it is rocket science, but it is new applications of concepts And it's fascinating how to just follow it through, left foot, right foot, left foot, right foot. And he makes the best... People say, oh, I eat a lot of good, healthy foods. Why do I need to take vitamins? And I'm just going to have handouts of this paper and just hand it to them. But he makes the point that based on what we were talking about earlier, which is that we are created as living beings on this planet to reproduce our genetics, that my genes get passed on to somebody else and my genes survive way longer than I do as a being.

 [00:22:06.090] - Dr. Lemanne
Yes. The purpose of a human being is to create an ovum or sperm that then combines and creates another human being, which will go on to do the same.

 [00:22:15.320] - Dr. Gordon
And thereby another human being. Now, we may not think of that as the individual meaning of our unique lives, but this is how nature works. We keep life going. So So once we've reproduced, and as we've talked about in discussions of menopause, for women, we stopped doing that in our 40s or maybe as late as 50. How do we rely on what we know about nature to stay alive for as long as we might want to after that? And what Ames talks about in this paper is there's a lot of vitamins that you look at them, and if there's not enough, your body is going to just spend the whole amount to keep you going through your reproductive fitness years. And if you're out of that nutrient after that, well, You're either just out of luck or you have to go to the supplement counter and replace it. Or he gives plenty of food options, too.

 [00:23:24.330] - Dr. Lemanne
So let me see if I understand what you're saying. So if you're going through life and you're in your reproductive years and you do not have enough of a particular nutrient, your body will use that nutrient in the service of reproduction at the expense of any longevity activities.

 [00:23:44.830] - Dr. Gordon
Yes. I think of spending your- Is that what you're saying? Yeah, that you go to your ATM and instead of leaving some money in your- You can either buy food or pay the electric bill. But also, if you have something in reserve at your bank and you say, no, no, hook my ATM, my debit card up to my reserve account as well, because I'm going to live life for today and I don't really care about next year.

 [00:24:11.970] - Dr. Lemanne
Isn't it like you only have enough me in the account to do one of two things. You can't do both. That's how I think of it. Okay. Does that make sense? Am I thinking about that correctly? I have $20 worth of bills and I have only $10 in my bank account. I'm going to use it to keep Body and Soul together today, and I'm not going to put any in savings for retirement.

 [00:24:35.080] - Dr. Gordon
That's right. That's right. Does that make sense? That's a very good way of saying it. Yes. And so if you want to live during your retirement years, You have to find some way of fueling that. And what we're talking about today, which is much more interesting to me than the money part of it, we're thinking about what supplements might be particularly needed for me as an an older person that I might have run through completely when I was younger. And if I don't pay attention to either eating these foods or taking these supplements, he's outlined the ways that my body will pay the price for not having them. And I like that, that he gave, Okay, vitamin D is really good when you're young. It really helps you interact with magnesium and calcium and build yourself strong bones and keep you from having a bunch of more resistance to infectious disease. That's great. And vitamin D levels tend to go down as you get older. Wait, wait. Vitamin D also predicts against cardiovascular disease, dementia, diabetes, and can't I have some? Sorry, you used it all up to stay healthy bones, uninfected through your early years.

 [00:25:59.290] - Dr. Gordon
You can't rely on living on the planet to have enough D to get through your later years, you're going to have to supplement with vitamin D.

 [00:26:09.040] - Dr. Lemanne
D is an interesting one. So the body makes vitamin D. We can make it if we are exposed to the sun and if we have the right chemical set up when we're in the sun. For instance, we're getting the sun on the skin that has the sabaceous glands, not so much on the distal arms and legs, doesn't make vitamin D, but the central part of the body where the skin is oily. So the upper torso, front and back, and the face, etc. Those areas when exposed to the sun will produce vitamin D. It's really hard to get vitamin D from food. And food is a pretty difficult source unless you're eating Arctic animal's liver, things like that. Seriously, cod liver oil. That's why in By the way, mothers would give that to their children because there's not a lot of sun there. And the cod liver, the fish liver, the fish stores vitamin D in the liver. So do we, by the way. So, yeah, it's hard to get vitamin D except by supplementation for most of us.

 [00:27:16.140] - Dr. Gordon
Yeah. I want to say something else about the skin, though. Because we don't go in the sun. Well, no, I've just thought of something else because, of course, where we live at a northernmost latitude, the sun doesn't come through at a proper angle except in the high sun summer months.

 [00:27:31.260] - Dr. Lemanne
10:00 AM to 2:00 PM between April and October. Outside of those, you cannot get vitamin D. You can sit in the sun all you want. There's some exceptions. If you're at high altitude, there's less atmospheric interference with the...

 [00:27:44.180] - Dr. Gordon
But I just learned something from you, which is that if I would better absorb vitamin D from my oil skin-rich central torso, well, I can tell you my central torso is not the oil skin rich area that it was 20 years ago. That's right. So skin dries out as you get older. And I thought it was because I had less melanin in my skin because I can no longer really get a tan the way I used to. But it really probably has to do with the degree of dryness in my skin, not my ability to tan or not, as to whether I'm absorbing vitamin D.

 [00:28:26.260] - Dr. Lemanne
So we do know that vitamin D, it's difficult for And then I use a little bit of water in the water to get a little bit of water in the skin to make vitamin D. So yes, supplementation is really important. And how do you do that? I actually measure my patient's blood several times a year. And then supplement, I like to have a level of around 50 It's more between 50 and 70 for certain diseases like prostate cancer, certain lymphomas. I'll go up to 100 blood levels of vitamin D3. But yeah, I use supplements. It usually takes about 4,000 units a day to get the levels to 50 for most people.

 [00:29:02.120] - Dr. Gordon
Yeah. I do like to test a couple of times a year, and I shoot for those same levels. I tend to find it takes between more closely approximated as 5,000 international units a day. But I sent out a newsletter this week from my office and I said, I am just guessing for most people it's 5,000 units. But if I move to Los Los Angeles and start practicing there, I almost put in, please hospitalize me. There's something very wrong. But if I were to suddenly move to Los Angeles, I would not assume that their dose would be 5,000 international units a day. I mean, really, don't you think if you practice in the Southern part of the United States, it probably wouldn't be 4,000 either.

 [00:29:48.580] - Dr. Lemanne
It depends how much people go outdoor. So a lot of people live an entirely indoor lifestyle, no matter where they live, if they live in a place of beautiful climate. You grew up in Southern California, I did. Yeah, I grew up in Southern California.

 [00:30:02.640] - Dr. Gordon
Yeah. Out in the sun, I bet I had a really great vitamin D level when I was young. Yeah.

 [00:30:09.220] - Dr. Lemanne
All those backyard swimming pools and everything. Yeah.

 [00:30:11.600] - Dr. Gordon
Out at the beach surfing, weren't you, Dr. Lemanne?

 [00:30:15.010] - Dr. Lemanne
I did when I was young. Yes. So, yeah, I think, vitamin D supplementation is really important, and it's probably more important in people who work and live indoors. And their only outdoor exposure is going from their car to their house and then the car to the office and back and forth. That's it. And that's a really difficult situation for most Americans. People with dark skin also are almost all of us are very, very deficient in vitamin D in this country. I think in this article, Bruce Ames talks about that. And It's something that one wants to think about if you're taking care of people with someone, a patient with a darker complexion, please. So Bruce Ames says, Almost all dark skinned people residing in northern latitudes are Particularly deficient. And he's talking about vitamin D.

 [00:31:18.030] - Dr. Gordon
Vitamin D?

 [00:31:18.740] - Dr. Lemanne
Yeah. And he starts his paragraph on vitamin D about that.

 [00:31:23.290] - Dr. Gordon
So vitamin D is inseparable and intrinsically related to vitamin K, which is another longevity variable vitamin. And he talks about this a little bit more in the supplemental information than the article itself. But vitamin K, I think most people might hear about it because they have an aunt who's on a blood thinner who can't take vitamin K or eat green salads because it has vitamin K. So vitamin K has blood clotting capacities. It helps us not bleed extraneuously. But there's other aspects of other isomers of vitamin K that tell vitamin D or tell the body... So vitamin D helps us absorb calcium, which is beneficial most famously for our bones, but for a lot of other mechanisms in our body as well. And vitamin K tells our body what to do with the calcium, tells it not to just litter up of tendons and arteries with calcium, but instead to put it in your bones or put it in if they need it as an enzyme, helping some process somewhere. But vitamin D without vitamin K, I think of as hazardous and only modestly as effective as it could be. And vitamin K is another one of those vitamins that does get used up, probably because we build and are more avidly repairing our skeleton throughout our fertile years of our life.

 [00:33:03.690] - Dr. Gordon
And for women, sometimes they're sacrificing the D and the K that they have to build a new skeleton for a little being inside of them. Did you know that you can almost exactly predict the degree of a woman's osteoporosis by how many full term pregnancies she's had?

 [00:33:21.770] - Dr. Lemanne
You know, I did. I'll tell you a secret. I flunked obstetrics. The first two or three times I took it in med school. So I've taken obstetrics many, many times.

 [00:33:35.140] - Dr. Gordon
You've never flunked anything. I don't believe you.

 [00:33:38.850] - Dr. Lemanne
And there was a reason I got a really bad case of influenza. Anyway, you're not going to hear a lot of stuff.

 [00:33:47.130] - Dr. Gordon
Okay, I believe that.

 [00:33:48.570] - Dr. Lemanne
But I hate obstetrics. I could never do it. I admire people like you who've done so much obstetrics and I've delivered so... I still have my little logbook. I've delivered 156 babies.

 [00:34:04.100] - Dr. GordonYou've delivered more than I have.

Dr. Lemanne
Really? Yeah. That's because I kept flunking obstetrics and I had to repeat it. Oh, actually, I didn't keep a logbook in school, but I still don't think I did 156.

 [00:34:16.760] - Dr. Lemanne
Oh, my gosh. And I couldn't wait to get out of there. And Deborah, even though I've done all that work in obstetrics, I did not know that you could detect the loss of bone density, and it correlates with the number of pregnancies.

 [00:34:35.620] - Dr. Gordon
Full term pregnancy. Because the woman doesn't really calcify the skeleton until pretty late in the pregnancy, thank goodness. It can't have this little thing swimming around in your abdomen that swims very agilely making bones.

 [00:34:52.940] - Dr. Lemanne
So does the first baby get the best bones? Yes. Okay. All right. So So if you're the first born, you're going to have less trouble with osteopenia and osteoporosis than your later born siblings?

 [00:35:07.500] - Dr. Gordon
All other things being equal, yes. But of course, then there's so much about... Maybe the second kid feels so neglected that they're running around climbing trees and climbing mountains and throwing footballs and running races. So maybe they have better bonds.

 [00:35:22.810] - Dr. Lemanne
You mentioned something else that I want to go back to. You said calcification of the arteries. With a lack of vitamin K. So are you saying then that vitamin K deficiency leads to arteriosclerosis?

 [00:35:40.300] - Dr. Gordon
Yes, can contribute to it.

 [00:35:43.320] - Dr. Lemanne
Well, one of the things that we were taught when we were in medical school was that a high fat diet caused that disease. But let's tell our audience, why don't you tell our audience where we get vitamin K from?

 [00:35:55.720] - Dr. Gordon
Well, where do we get vitamin K from? We get it... Oh, cheese is my favorite source of vitamin K. Dairy fat, right? High fat dairy food.

 [00:36:03.810] - Dr. Lemanne
Yeah. And I think other, fats from other ruminants. So like fatty steak and things like that. So a low fat diet is actually implicated in hardening of the arteries. In other words, let me say that again, eating a low fat diet, avoiding animal fats, like dairy fats and things like that, eating skim milk instead of full fat milk may predispose you to hardening of the arteries. The very thing eating a low fat is purported to help you prevent.

 [00:36:33.380] - Dr. Gordon
But thankfully, because there are populations in the world thinking of Asia or people with really severe milk allergies who don't eat dairy, there's another really great source of similar vitamin Ks in non-dairy food that's completely zero fat.

 [00:36:57.580] - Dr. Lemanne
Nattokinase?

 [00:36:59.170] - Dr. Gordon
Natto. Well, that would be- Is that said? Yeah, nattoquinase. But that isn't what I was thinking of. I've never had it. I take it in a supplement. But sauerkraut and kimchi. Okay. Do you like those?

 [00:37:13.850] - Dr. Lemanne
No.

 [00:37:14.920] - Dr. Gordon
So any fermented foods.

 [00:37:17.910] - Dr. Lemanne
I mean, I get it. I don't hate them. If they're there on my plate and I'm at somebody's house for dinner, to be polite, I'll probably just shove it over to the side and make a space in it. So it looks like I eat it.

 [00:37:29.280] - Dr. Gordon
And move it around. Play with it.

 [00:37:31.220] - Dr. Lemanne
I probably won't eat it.

 [00:37:32.500] - Dr. Gordon
But fermented foods are another great source of vitamin K2, as well as a couple of tablespoons of sauerkraut or kimchi. And you've run out of your probiotic pill that you take, you don't need it anymore. Just eat a little bit of fermented food.

 [00:37:49.490] - Dr. Lemanne
I want to go back to... I'm going to get off sauerkraut, please. Okay. Vitamin D deficiency. I'm reading the supplement that in this article, this wonderful article. And he says, Bruce Ames, Deficiency of vitamin D is associated with increased risk of cancer incidence and risk of mortality. And that is And then he goes on to say, An estimate has been made that doubling the mean concentration of vitamin D in the population would reduce the mortality rate by about 20 % and increase life expectancy by two years.

 [00:38:28.640] - Dr. Gordon
Just doing that.

 [00:38:31.520] - Dr. Lemanne
Yeah.

 [00:38:32.040] - Dr. Gordon
Just doing that. And if you draw a lab for somebody and it's at some random hospital that they go to and you get the report from that hospital, the hospital will provide what they consider to be an adequate level of vitamin D. So they'll say, they draw your patient's vitamin D, they tell you what it is, and they say, we consider if it's low, if it's less than, what's What's the lowest number you've ever seen there?

 [00:39:02.060] - Dr. Lemanne
Oh, something? I've been seeing it in the single digits, vitamin D.

 [00:39:05.760] - Dr. Gordon
Not their level, but what the hospital considers as normal.

 [00:39:08.590] - Dr. Lemanne
Oh, oh, yeah. Something like high teens, 18, 20? Yes.

 [00:39:13.010] - Dr. Gordon
That is lethal.

 [00:39:17.390] - Dr. Lemanne
Over decades, yes.

 [00:39:19.650] - Dr. Gordon
That is ridiculous. So I think the US nutrition data citation says a level of 30 is fine, but there's plenty of data that Bruce Ames puts in this article and that you and I have seen in various places showing that levels of 40 or 50 up to 70 are associated with reduced risk of of fill in the blanks, not everything, but there's a lot of different diseases that are reduced by having levels higher than 18.

 [00:39:54.220] - Dr. Lemanne
So I'm reading more in the supplement here by Bruce Ames, and he says, The rate of decay of brain function in humans is faster in individuals with lower vitamin D levels. Executive function improvement, as measured by visual memory, was more effective with supplementation of 4,000 units a day as compared to 400 units daily. Do you remember when tests of vitamin D research, when we were in med school and then beyond, they would use 400 units as the intervention? Yes. It's nothing. Even now- It takes 10 times more than that to move the needle.

 [00:40:30.460] - Dr. Gordon
The recommendation for somebody over the age of 40 in the United States is 800 international units a day.

 [00:40:37.760] - Dr. Lemanne
Yeah.

 [00:40:38.250] - Dr. Gordon
There's still a fear of- Vitamin D toxicity? Yeah.

 [00:40:42.390] - Dr. Lemanne
And I don't think you see. I think it's established that you don't really see vitamin D toxicity until you get levels of 300 or more. Oh, my goodness. Okay. So I think that's a fear that needs to be tempered by reality. And the way to get 300 in your bloodstream is something like a million units a day supplementation for several months. Then you might get a level of 300 or so. So I think I reassure my patients, they'll come in with a level of 100 or 105 or something like that. Oh, my goodness, it's above the norm. It's like, relax, it'll be fine. We'll just take you off for a couple of days and then start it up again. Maybe if we were on 5,000, we'll go to 4,000 or whatever. We'll just... Something like that. But As long as you're keeping track of things, nothing is going to happen.

 [00:41:35.230] - Dr. Gordon
You know, another practice in the conventional vitamin D world is to give tens of thousands of units once a week.

 [00:41:43.630] - Dr. Lemanne
We talked about that at our last episode or a recent episode. You know in that, giving a big dose intermittently actually increases the risk of falls and fracture in elderly women. So I don't recommend that. I recommend Daily moderate dosing to keep the level where we want it.

 [00:42:03.000] - Dr. Gordon
As I do. The way like it would be natural to get sun. If you're a young, healthy person living before the age of supplementation and you're getting vitamin D in a natural way, you wouldn't put yourself on a spit for 24 hours once a week.

 [00:42:19.440] - Dr. Lemanne
I've had friends who do that.

 [00:42:21.680] - Dr. Gordon
Those days.

 [00:42:23.070] - Dr. Lemanne
The tinfoil, tanning bed and all that.

 [00:42:27.430] - Dr. Gordon
Well, what were some of your other favorite supplements from this wonderful article by a doctor? He's not a medical doctor. I'm sure he's a PhD. He's not a medical doctor. He's a PhD, right.

 [00:42:36.570] - Dr. Lemanne
I liked ergothianine. That was really an interesting new vitamin, he calls it. And it comes from fungi. Yeah. And it comes from very specific mushrooms. And the button mushrooms are not it.

 [00:42:56.810] - Dr. Gordon
So wait, wait. Yeah.

 [00:43:00.150] - Dr. Lemanne
So I was really interested in that. And it's an antioxidant. It's found in oyster mushrooms in high amounts. And it's found in porcini mushrooms.

 [00:43:15.710] - Dr. Gordon
Oh, that's a pretty good one to cook with.

 [00:43:18.310] - Dr. Lemanne
Yeah, I'm not really familiar with that. He called it something else, King Bolit or something like that.

 [00:43:23.450] - Dr. Gordon
I didn't know what that was, but I- I looked it up.

 [00:43:25.990] - Dr. Lemanne
It's called porcini. I've heard of that, or porcini.

 [00:43:29.030] - Dr. Gordon
Yeah, and I'm pretty sure they I have that at our local store. I'm going to pick it up this weekend. Yeah, see if I can cook with it. Because it does come packaged as a supplement or as a vitamin. But when you can get it from food- I I so recommend food.

 [00:43:46.530] - Dr. Lemanne
We hope that what's on the label of our vitamins and supplements is truly what's in the little pill, but not always. And so I worry a little bit about that, not extremely, but it's a concern. And so I do recommend getting it from food. And I've been making an effort to eat mushrooms several times a week now. And I have been enjoying oyster mushrooms, but I'll try the king bolitus. That's what he calls them. Okay. And he says, there's more than 100 milligrams per kilogram in the wet weight of oyster and king bolitus or porcini mushrooms. And compare that to 0.5 milligrams per kilogram, 20 times less in the white button mushrooms. And that includes white button mushrooms. And I think it's the brown caps with the small and the light, the cramina and the portabello. Yeah. They're all, I think, the same species. So they may... He doesn't talk about that.

 [00:44:49.850] - Dr. Gordon
Not be your best source.

 [00:44:50.660] - Dr. Lemanne
Might not be the best source.

  [00:44:51.660] - Dr. Gordon
But it doesn't mean... Didn't he say... I mean, it's richest in the ones that you talk about. But did he mention that it is in other Are they in the white button mushrooms as well?

 [00:45:01.110] - Dr. Lemanne
Yes, but at really low amounts. So 20 times less. 100 milligrams per kilogram compared to 0.5, half a milligram per kilogram.

 [00:45:09.060] - Dr. Gordon
Yeah, that's quite a big difference.

 [00:45:11.320] - Dr. Lemanne
And then moderate, he says, levels are in one kilogram per kilogram. So twice as much as in the white mushrooms, but only 10 times. I don't know, 100 times less. 200 times. My arithmetic is wrong. It's 200 times less in the white button mushrooms as compared to the oyster and porcini mushrooms. And 100 times less in beef, pork, lamb, and chicken. And then Oat brand, black turtle bean. I don't know what that is. Is that a lima bean? I don't know. A red kidney bean, he says, contained three milligrams per kilogram compared to one milligram per kilogram for beef, pork, and lamb. So there's some foods that contain it, but the best source is definitely these special mushrooms.

 [00:45:54.480] - Dr. Gordon
In the mushrooms. So my favorite supplement from this list is- 

Can I tell our audience what it does? Oh, yes. Oh, please do. Oh, yes.

 [00:46:08.320] - Dr. Lemanne
So I'm just looking at this article you sent me in it and this blew me away, Deborah. So it's found at millimolar levels. That's a lot. That's high concentration. That's a lot. That's like glucose and things and fats are in our blood. It's found at millimolar levels in the brain, bone marrow, the lens and cornea of the eye, and in red blood cells. And it plays a significant role, he says, as an antioxidant. And its lack is thought to be implicated in coronary vascular disease. It's found in people with rheumatoid arthritis, apparently collected on purpose in the red blood cells, likely in an attempt to decrease inflammation and oxidation from that inflammation. It's found in high Concentration is in mitochondria, where it's thought to be an antioxidant. And he mentions the evolution, which you were talking about earlier. He says the transporter for ergothianine appears to have been selected for in the European transition from hunter-gatherer to agricultural societies. So that's really interesting. So as we went away from picking mushrooms and killing ruminants and started growing plants to eat, we needed more ergothianine. And so people who had more of this tended to survive and reproduce.

 [00:47:45.440] - Dr. Lemanne
There's our natural selection happening there in Europe. So that's really interesting. And it also suggests that some of us, we may differ in the amounts of this that we need, although Ames doesn't talk about that in here, but that comes to mind. And he talks about it being associated with Crohn's disease.

 [00:48:04.120] - Dr. Gordon
That when you can't properly process your ergothianine, that's associated with Crohn's disease. Yeah. And it looks like, I think experimentally, they took it out of some species, and those guys didn't do so well. They took out the transporter.

 [00:48:24.000] - Dr. Lemanne
Yes. Yes.

 [00:48:25.600] - Dr. Gordon
So, yeah. And have you actually... Have you seen it? I think it It is available as a supplement. Have you seen it as a supplement?

 [00:48:32.740] - Dr. Lemanne
Deborah, I was not aware of it until you gave me this article as a supplement. But I had noticed. I had noticed that there's an influencer, anti-aging influencer named Bryan Johnson. I believe that's his name. And he has a program that he puts forth that he's following to slow and reverse aging that he calls the blueprint. And The Blueprint diet is heavy in mushrooms. His main meal, a A large portion of it every single day contains mushrooms. There's a picture of it. I can see it in my mind now. It looks like it was the button mushroom. So maybe he ought to switch to the... If that's true, if those are buttoned mushrooms, maybe he needs to switch to the oyster mushrooms or porcini to get more of this. But yes, I was aware of that. And he purports to have developed his diet with essential nutrients and micronutrients in mind to result in slowest aging and reversal of aging. Yeah, but I was not aware of ergothianine.

 [00:49:38.830] - Dr. Gordon
Nor was I before I read this. I had to look again and I vaguely remember I saw it as a supplement, but don't remember. But now I'm going to look for oyster and porcini mushrooms or porcini, however you pronounce it. What I was trying to interrupt you with was my favorite of all these-I'm not very interruptible, am I? Well, thankfully, because you have a lot more to say. So in that case, it was a good thing. My favorite in these, and I had to keep searching on YouTube until I found someone who pronounces it the way I do, which is Tourine, because-How are other ways of pronouncing it? Taurine.

 [00:50:22.050] - Dr. Lemanne
Oh, East Coast, West Coast. Okay. Maybe. Yeah, yeah.

 [00:50:26.130] - Dr. Gordon
On the West Coast, I'm Dawn, and on the East Coast, I'm Dwan. Dwan.

 [00:50:33.000] - Dr. Lemanne
So maybe that's Tourine, Taurine

 [00:50:36.160] - Dr. Gordon
Thourine. Well, my birth sign is Taurus. Oh, there you go.

 [00:50:41.350] - Dr. Lemanne
You have the authority then.

 [00:50:43.450] - Dr. Gordon
It seems to be that it should be. They should be pronounced the same. But I'm pretty aware of Thaurine before I read this. I know that it's a longevity darling from a lot of points of view, a life extension I was focused on it recently. Rhonda Patrick talked about it recently. This is all from Bruce Ames' article six years ago. But what I learned from this article of his, say you are a 70 kilogram human. 70 grams of your body is taurine. One one-thousandth of your body, 70 grams in 70 kilograms is taurine. That's amazingly abundant. That's a lot, isn't it? That is a lot of taurine. And I know it because I know of it because there's a lot of taurine and heart muscle. And for my cats and dogs are very dependent on taurine. And the less attention you pay to what you feed them, the more likely they are to have some heart disease. So we've recently...

 [00:51:59.020] - Dr. Lemanne
If you don't make sure that they get taurine. Taurine.

 [00:52:01.320] - Dr. Gordon
So we lately, and of course, the best food source of taurine, and in this article, he actually ascribes it to fish. But I would say it's to the... You know how I love- You're going to say something really weird that the rest of us don't eat, like heart or something. Exactly. I would say heart. But what you can do for your cat is you can buy a tray of chicken hearts from the butcher, which is just in our grocery store, and we freeze them and we pop a thawed chicken heart in our cat's food every day. I will bring some over for your cat, Dawn.

 [00:52:37.610] - Dr. Lemanne
We have some.

[00:52:38.800] - Dr. Gordon
Oh, there you go.

 [00:52:39.830] - Dr. Lemanne
We have chicken heart, but do you grind it up?

 [00:52:41.960] - Dr. Gordon
No, we slice it and she loves it. And sometimes we give it.

 [00:52:46.030] - Dr. Lemanne
You do slice it up, though. Yeah. And it's raw.

 [00:52:48.340] - Dr. Gordon
Yeah, raw. And she gets it. We get it from dark poultry, fish, eggs. We also can get it from ruminants. How I have used it historically in my practice, magnesium torate. So torine is active in so many different processes in the body, but it's very active in muscle. It's particularly active in the muscle of the heart. So if somebody's heart needs a little magnesium, because it's so magnesium, which is also in this article of his, magnesium is a calming mineral. If you want to get a calming influence to a maybe tending to go too fast, too irritably heart, magnesium torate is a supplement I've used for that purpose for eons and only recently have realized, oh, taurine in and of itself has a lot of value. People take it to help them with sleep. What he describes is a lot more the research that's been done to reduce the risk of ischemic heart disease, diabetes, dementia, and that it is one of those supplements that if you're just going about living your life and somebody's measuring your blood, it goes markedly down with age. And if you want to have a longer life without cardiovascular disease, brain dysfunction, diabetes and stuff, Taurine would be a good supplement to add in.

 [00:54:26.160] - Dr. Lemanne
And the dose that you recommend now, we've talked about this, and I think it's pretty high. We're talking in several grams a day.

 [00:54:34.380] - Dr. Gordon
It's somewhere between one and three grams. So what I like to do for this, as I do for glycine, because both of those amino acids can be in doses from zero to four or 5,000 milligrams. Well, which one is it, Dr. Gordon? I like to do a nutritional test that evaluates-Oh, there's a test for this. It's not a regular blood test. It's a urine test that looks for the function of different nutrients in your body by their metabolites evidenced in the urine, not by their levels in your blood. And they give a list of the amino acids and suggested supplementation So you're going through the trash here? Yeah, I'm not. Thankfully, the lab is, but yes.

 [00:55:21.460] - Dr. Lemanne
To see what the packaging is and what that person has been eating.

 [00:55:25.720] - Dr. Gordon
Right. So the two that I just mentioned, almost everybody is 2,000 to 4,000 milligrams a day short of glycine. And the taurine deficiency tends to be between more between one and 2,000 milligrams. I think that's because I encourage so many people to eat a lot of fish. And in this study, Bruce Ames attributes Japan's lack of cardiovascular disease to their high taurine associated with eating more fish. And I think Japan's lower risk of heart disease could be attributed to about 25 things, and maybe this is one of them.

 [00:56:07.680] - Dr. Lemanne
Perhaps. Perhaps. Yeah. That's another whole conversation.

 [00:56:13.540] - Dr. Gordon
That is a whole conversation. About blue zones?

 [00:56:17.140] - Dr. Lemanne
Yeah, in Japan in particular.

 [00:56:19.740] - Dr. Gordon
Right. And the article that came out recently about blue zones is that maybe it's really been faulty record keeping.

 [00:56:28.350] - Dr. Lemanne
Perhaps that's the case. And that would be pretty cut and dried. But one of the things that I noticed, I grew up when I was a very young child in Hawaii, and there were a lot of people of Japanese descent there that we mingled with. And one of the things that I noticed was in those days, the Japanese adults were very, very short. So I was a small child and I was almost as tall as some of these adult Japanese people. And now, if you go to Japan or if you talk to people of Japanese descent, I'm often looking up. They're over six feet tall. There's been a big change in the physiognomy, if you want to call it that, of Japanese people, and I think people of other ethnicities who... A hundred years ago, when the adults of my childhood were growing up, there was not a lot of... There might have been some food issues in terms of the amount of foods, types of foods, and height. Absolutely. And one of the things that I have noticed about the Blue Zones is that these people are all short. And if you look at People, random centenarians in various parts of the world, generally they're on the short side.

 [00:57:51.200] - Dr. Lemanne
So there may be something going on in youth that... This is a hypothesis that I have, and it could be tested. There may be something going on in youth that contributes to greater or lesser height that also is associated with longevity in the long run. That's going to be hard to look at because you have to wait 100 years.

 [00:58:10.810] - Dr. Gordon
It is so hard to study.

 [00:58:13.180] - Dr. Lemanne
And so I think that just like large dogs, for instance, Great Daines die very young. Five, six, seven years of diseases of aging, cancer, heart disease, et cetera. And whereas chihuahua's can live to be 17, 18, 19 years, even though there. I don't know if you like chihuahua's, but anyway.

 [00:58:35.280] - Dr. Gordon
I've met some wonderful chihuahua's.

 [00:58:37.810] - Dr. Lemanne
I'm sure. And I'm sure I have to. I just can't remember. No. Anyway, so I wonder about the blue zone. Maybe it's not diet, maybe it's something else, at least not diet in old age. It might have been diet in youth, and it might have been a restriction of calories, in particular in youth, that then results in extreme longevity.

 [00:59:00.540] - Dr. Gordon
Well, we could go on and on forever talking, but I really would encourage people to look. I think we should link to this article. I think it's eminently readable. I think we should also include a link to the supplemental article that he gives for people who want to nerd out a little bit more and think about what they're supplementing their daily vitamins with. But this is just a fascinating concept that we can actually begin to think about what are the supplements that keep you healthy when you're young, that you're going to have to figure out an extra way to get them because they've been triaged to early life use, and you still need them in your late life.

 [00:59:48.690] - Dr. Lemanne
And you may need more because your body can't use them as well. And if there are things that you make, like torine, you may make less as you age.

 [00:59:57.330] - Dr. Gordon
Yes, exactly. Or vitamin D, which you make in response to You make less. Exactly. You make less.

 [01:00:00.780] - Dr. Lemanne
Thank you for reminding me of that.

 [01:00:03.480] - Dr. Gordon
And I would like to call everyone's attention to an episode, a few episodes ago, our episode about creatine, because if I had to pick one supplement that I think would best promote a healthy, vital long life, I would be stuck on creatine, but I think that's mostly been explained in our previous episode, and I'm going to amend those notes to add a little bit about longevity effects of creatine. Would you agree that creatine is important for longevity?

 [01:00:37.560] - Dr. Lemanne
I think creatine is very important for longevity, and I'll be interested to hear what your amendments are.

 [01:00:45.500] - Dr. Gordon
I'm always interested to hear what you've learned about creatine. It's my favorite, but there's lots more. And this was a really rich treasure trove of- We could talk about this article Let's talk about it again. Let's look. And if people have items in this topic that seem troublesome, contentious, mysterious to them, I'm fascinated by some of the ones that come from plants, come from fungus, the supplements that come from animals, of course.

 [01:01:17.980] - Dr. Lemanne
And that come from the E. Coli in our gut.

 [01:01:21.070] - Dr. Gordon
Okay.

 [01:01:22.170] - Dr. Lemanne
Our internal garden.

 [01:01:23.520] - Dr. Gordon
Our internal garden.

 [01:01:25.200] - Dr. Lemanne
That hopefully- I don't think I made that up. Other people have come up with that.

 [01:01:30.290] - Dr. Gordon
Yeah. That hopefully we've kept healthy by minimizing our use of gut microbiome antagonists. You know I'm referring to antibiotics without trying not to say that.

 [01:01:45.990] - Dr. Lemanne
I thought it might be. It's a word you're avoiding, a four-letter word, antibiotic. Deborah, it's always such a pleasure to talk to you. Thank you again for bringing this article to my attention. It's so It was a pleasure.

 [01:02:00.270] - Dr. Gordon
I felt like we had a play date today.

 [01:02:02.960] - Dr. Lemanne
Yeah, it was really fun.

 [01:02:03.990] - Dr. Gordon
That was great. Thank you.

 [01:02:05.740] - Dr. Lemanne
Okay. Bye-bye.

 [01:02:06.330] - Dr. Gordon
Bye. 


You have been listening to the Le Monde Gordon podcast, where Docs Talk Shop.

[01:02:15.170] - Dr. LemanneFor podcast transcripts, episode notes and links, and more, please visit the podcast website at docstalkshop.

[01:02:23.920] - Dr. Gordon
Com. Happy eavesdropping.

[01:02:30.940] - Dr. Lemanne
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[01:02:51.410] - Dr. Gordon
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[01:03:03.500] - Dr. Lemanne
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[01:03:17.930] - Dr. Gordon
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[01:03:24.780] - Dr. Lemanne
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[01:03:42.470] - Dr. Gordon
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