LifeMeter w/ Drs.Harvey Hanlen, Jim Stringham and John Nolan

Show Sponsors:

• CooperVision
• MacuHealth
• EssilorLuxottica

00:00:00] Dr. Chris Wolfe: Hello and welcome to Crystal Podcast on I Code Media. Today I’m excited to have a conversation with Dr. Harvey Handlin, Dr. John Nolan and Dr. Jim Stringham. We’re gonna talk about some new technology related to carotinoids and macular degeneration, and that’s the life meter. And so I want to kind of open it up to the problem of measuring Carotinoids, and it’s been a historical problem.

[00:00:25] Um, Harvey, tell me about this problem historically. 

[00:00:30] Jim Stringham: Well, the issue is that, uh, if we’re trying to measure Macular Caro, it’s been almost impossible to accurately do it in our offices as a practitioner. Uh, they do it in the labs and the scientists do it, and it’s very sophisticated. It takes a while. But when you’re in the air office, you need to make sure that you can do a tech, uh, test that’s quick, accurate, and you can explain 

[00:00:50] Dr. Chris Wolfe: easily to patients.

[00:00:52] And so, um, so the downside with that is that obviously historically what we’ve had is we’ve had a couple different devices or widgets that, that [00:01:00] occur. One is, I’ve seen one, well, one that’s been around for a long time, uh, measures macular. And the challenge with that is it uses technology that relies on a patient’s response.

[00:01:11] Jim, do you wanna talk about that at all? 

[00:01:12] Harvey Hanlen: Yeah, that’s right, Chris. Uh, historically we’ve, you know, seen, uh, clinical implementation attempts, uh, with flicker photometry. And, and so this is a subjective test, of course, and, and, uh, and I’ve used this in my lab over the years, over the past 25 years, and it can be a good measure of macular pigment, but, you know, there’s a lot of, you know, subjectivity.

[00:01:35] There’s variability that can be difficult for patients to do, can be time consuming. And so obviously if you’re. You know, looking to baseline and track a patient, you want something that’s, you know, not only accurate, but it’s gonna be less variable than something that’s all over the place. So you can have confidence in the measure.

[00:01:50] And so, despite many, many attempts at this, you know, hetero chromatic flicker, optometry method, uh, largely what we’ve seen is, you know, they become [00:02:00] paperweights and in the clinic and the office. 

[00:02:01] Dr. Chris Wolfe: So, yeah. Harvey, did you have one of these before? Did you ever have an office measuring like macular pigment 

[00:02:07] Jim Stringham: device?

[00:02:07] We did not. Yeah. Cause the one that was available at the time from another company, I didn’t think was accurate enough to 

[00:02:15] Dr. Chris Wolfe: run in the office. I mean, we felt the same way. We didn’t ever have one either. I knew, I knew a lot of people who, well, I knew some people who had them. And what Jim’s describing is the exact challenge with him is, yeah, is the reliability and repeatability.

[00:02:27] And John, you and I have had this conversation before as well. Uh, related to the devices that you use, Jim, you, you’ve used that device, that Mpod device in your studies, but, but John, you, you have used that, but you’ve also used one that’s sort of like a lab device. Yeah. Yeah. Why, what makes that 

[00:02:45] Professor John Nolan: different?

[00:02:46] Yeah, that’s a great question. Um, because, That device was from Professor Billy Wooden, um, his invention, essentially the, the ter the, the original Densitometer. And, um, you know, when we started [00:03:00] this kind of research with over tw nearly 25 years ago, you know, we didn’t have access to the type of technologies that are in iCare today.

[00:03:08] So we’ll come back to that in a moment. But in, in the research world, we didn’t need either. So, you know, we. In my, I actually had a device before Professor Wootens, um, from University of Westminster in London, uh, professor John Malaria. And it was a flicker device too, but it was highly limited in terms of what I could do because, to your question, in order to do an accurate measurement that’s reliable, that if you retest, you get the same, you have to optimize and customize if you like.

[00:03:41] The system for that participant, for that patient. Okay? And that takes a piece of work, a significant piece of work, which takes time, which is something that you don’t have in the clinic. So even in a perfect case scenario, we have another problem, and that is if you were to do a measure a hundred percent [00:04:00] accurate, you’re only getting a measure on that line of macular pigment.

[00:04:03] So if you think of the macular pigment like a mountain, Classically, you have a one degree stimulus, so you’re measured at the edge of that 0.5 degrees of retinal centricity. And you know, there was maybe 15 years of science that came out with that research measure. What happened in real time, and I saw it happen, was companies tried to, you know, take advantage of that science and commercialize the voices, but with the cost that they couldn’t.

[00:04:30] Provide, you know, this big, big system that you, you’re referring to that we have, which was set up to a customize the system. So just for CFFs, uh, lens age, all of these factors that are really, really important. Um, so it got everything from me very quickly. Got lost in translation. To the clinic, you know? Um, and there’s only one worse measure than not having a measure.

[00:04:55] And that’s a measure that’s not 

[00:04:56] Dr. Chris Wolfe: accurate. Yeah. Well, I would, I would say it’s probably worse, right? Like having an [00:05:00] inaccurate, unreliable measurement as you talked about, it winds up in the closet and it, it, and then it’s not repeatable, it’s. And it’s actually detracting because if I can’t know that this reading is valid, then well, I, do I make a strong recommendation?

[00:05:17] Do I make a weak recommendation? Is the eating green leafy vegetables, is that acceptable? So, I mean, it, it winds up a whole, it opens up a whole can of worms clinically, but 

[00:05:26] Professor John Nolan: even if it’s not valid from a, from a normative perspective, right? At the very least, you want it to be unique to the patient. So in other words, if you change their lifestyle or give them a supplement, That if there is a positive change in those scores that the system is capable to detected.

[00:05:41] And, and the variation with in test three tests on these devices is greater than, you know, change that you would expect to see with appropriate supplementation. So for me it was for many years, I’ve been saying this unapologetically on the stage for a long time that, you know, I, I, I think the optometrist needs to be protected [00:06:00] from the voices that are over commercialized, that, that.

[00:06:03] Are not valid in terms of delivering what they claim upon. It does a disservice to your industry. 

[00:06:08] Dr. Chris Wolfe: Mm-hmm. Yeah, I think, I think what, uh, I always think about when we’re thinking about disease state management and this, this is pretty much a comment for you, Harvey, is I. Where we get bogged down is if we don’t have good repeatable measures of how, what, what a patient is dealing with that are, is as objective as possible before we start a patient on treatment.

[00:06:31] And then after we start a patient on treatment, we’re sort of wondering how effective that treatment was. We see, I see this still continuously in, in doctors who are trying to integrate. Uh, ocular Surface Disease management into their practice. And the common mistake they make is they rely too heavily on patient symptoms to drive what the next step is, they know what they’re looking for.

[00:06:53] They’re looking for staining, they’re looking for other things, but they’re not being super accurate in the documentation of those things. [00:07:00] They might say corneal staining, as opposed to like one plus inferior s pk. Uh, or one plus temporal lissamine, green staining, or, you know, an osmolarity measurement of 345 or we, and then we took, put a, put a patient on treatment and they come back and they still might have some corneal staining.

[00:07:19] But our measure of success is do you feel better? And if the patient doesn’t feel better, but we don’t have any other reliable, repeatable, clinical indicators to know if we actually made that patient better, then we wind up going down this rabbit hole of like, well, I can’t tell if I put this patient on X medication or Y medication, why they’re doing better.

[00:07:39] Cuz sometimes they do better and sometimes they don’t. And then you just. Do you have any guidance? And, and I think in a lot of ways that’s where we’ve been within Carotinoids, in, in, in the macula. So then kind of fast forward Harvey into the skin carotenoid measures. So we’ve had something that measures Carotenoid in the skin.

[00:07:57] It’s been around for probably four or five years. [00:08:00] I don’t know. I haven’t evaluated it too much because of, because it is really linked to the sale of a specific carotinoids, so you know that that limits a lot of what you would want to do, especially if there’s better carotinoids available. So I, that’s why I haven’t really evaluated it.

[00:08:17] But to me, it seems like if we now have the ability to say, okay, this is what you are on this. Uh, or taking nothing, and we can repeat that in a month, two months. Two months. There’s a lot of strong critical clinical value to that. 

[00:08:31] Jim Stringham: I, I totally agree. And, and in fact, the, the new instrument, the, the life meter is very, very accurate.

[00:08:37] And, and not only is it accurate, Chris, for the doctor to know how the patient’s doing, but for the patient to know how the patient’s doing. You know, we have all of our patients that. They, they’re, they live on numbers. They’re diabetics. They want their a1c, their glaucoma patients. They want their IOP number.

[00:08:52] Well, when you put a patient on a supplement, they often ask, Doc, is this working? Well? We haven’t been able to [00:09:00] really tell unless they’ve given us some response, like I’m seeing better at night or my general vision seems better. Things like that. I think when you tell a patient that their number went from 200 to 300.

[00:09:14] And you know what the standard is, and we can talk about that shortly, is they feel better and they’ll stay on the supplement if you sort of don’t know what to tell them. And you’re wishy-washy in your, in your, in the few minutes that you have with that patient. What are they gonna do? Yeah, they’ll finish the bottle and they may buy another one and they may not, they need to see an objective finding that can help 

[00:09:37] Dr. Chris Wolfe: them.

[00:09:37] Well, especially when we are dealing with a condition like macular degeneration specifically, is that it is going to get worse. I mean, there’s nothing we do that’s gonna make it better at this point. We’re all our, all we can tell the patient is. It’s not getting worse. Right. And, and that’s a challenge, right?

[00:09:53] A as opposed to being able to say yes, you know, we’re, we’re seeing clinical findings on your macula that haven’t changed, [00:10:00] but also your numbers have gone from here to there. Or even better, Mrs. Smith, just like we do with. Intraocular pressure. Mrs. Smith, it’s looking like your pressures are a little high today.

[00:10:08] Have you been adherent to taking your medications? Are you missing drops here or there? I mean, we can have the same conversation now if we have something like the life meter that allows us to understand those numbers and really, frankly, It really allows you to do the Pepsi Coke Challenge. In some ways, you know, patients come in and they, I got this, I got this at Costco, and I can get this big jar of carotinoids that say, compared to preservation a reds two or com.

[00:10:34] I mean, I don’t think they’re comparing themselves to Macu health yet, but, but the point is, is that they’re in the, in the consumer’s mind. This is the same thing. Well, honestly, like I have this, my, my point to the patient would be, all right, if you’re taking that and your levels are 500, God bless you.

[00:10:51] Keep taking it. Mm-hmm. Right? Like, why am I gonna argue with that? But if you’re taking it and your levels are 200, then okay, well now we have a better conversation. Well, this is, [00:11:00] we’re gonna put you on this other one. We’re gonna start this other treatment. We’ll see you back in a month, two months, whatever.

[00:11:04] And now we can see, all right, we’re gonna remeasure this, we’re gonna recheck that. That I think, becomes way more empowering as a clinician. I, I 

[00:11:12] Jim Stringham: agree with you. One thing I want us to be careful about, Chris, I don’t want us to get stuck in the cubby hole of macular degeneration. Agreed, because it’s much broader than that visual performance in a younger person who may not be seeing as well, Quan qualitatively as they are, they may see 2020, but their quality of vision is not that good.

[00:11:31] And a lot of times it’s because they have low carotenoid levels and their visual performance is bad. So this I think, gives us an approach. We don’t have to talk about a disease process. We can start talking about visual performance now. Uh, irrespective of age. 

[00:11:49] Dr. Chris Wolfe: Yeah. Well, and Jim, you really, uh, you really got my dad with, with that sort of idea.

[00:11:54] You know, my dad’s 60, so he’s, so I’ll be 42. He’s 60, he’ll be [00:12:00] 65 this summer. And, um, and when he came, when you had hit a conversation with you about a month ago now, uh, and you know, he was like, I’m convinced my number, I think, so when I checked my number at cco, I was like four 10. Mm-hmm. And he checked his number, I think it was like two 50.

[00:12:16] And so he, so he’s been supplementing since then. He’s got no macular degeneration, is what you’re talking about. Uh, he doesn’t have a family history, but he is, you know, he keeps in good shape. He eats well. And so he’s excited to retest. What’s he gonna see after a month of, of being on a, uh, on Macu Health specifically?

[00:12:33] Well, I mean the 

[00:12:33] Harvey Hanlen: L MZ three. Well, right, right. What we’ve seen is. You know, you can move the needle and, and the lower you start, you, you, you have a little bit higher ceiling to go let, so I 

[00:12:43] Dr. Chris Wolfe: actually probably jumped the gun a little, Jim. So let, I’m gonna take a step back and say, okay, well what’s our normal ranges?

[00:12:48] What are the normal numbers? Um, and let let you start there and then we’ll go into, Uh, what is he gonna see? 

[00:12:54] Harvey Hanlen: Sure, sure. So from the literature, and there are over 30 publications on this device. And [00:13:00] then in my personal experience as well, uh, just measuring, well, hundreds of people at this point. The average is somewhere between, you know, two 50 to two 80, somewhere in there.

[00:13:08] And that’s, you know, generally the US population. That’s optic density, right? That’s, that’s an optical density measure. Uh, it’s a concentration of these carotinoids, just like we measure with optical density in the eye. Mm-hmm. And, and so, you know, they’re concentrating at virtually the same type of levels.

[00:13:23] There’s a strong correlation between skin and eye serum as well. And, and so what we’ve seen and, and we’ve got a couple of cases, one of them is my daughter. Uh, another is, uh, one of our managers at work, Emily. And, uh, so they both start in the mid 200 s kind of like your dad. Mm-hmm. And, and so they, they start supplementing and within about 30 days we’re seeing roughly a hundred point change.

[00:13:47] Now you extend that out and again, it’s an accumulation process. And so, you know, 60, 90 days, um, I think that judging from, uh, and again, this is a couple of individuals, In a couple of months, you can move it a couple [00:14:00] hundred points. I mean, and this is assuming you’re a non-smoker, you know, generally healthy, no, you know, systemic disease like diabetes, inflammation can use these nutrients up too.

[00:14:08] Hmm. And so, uh, and I think, you know, going back slightly to your previous, uh, question, uh, the, the. Topic. This idea of a good diet is, is an interesting one. And you know, when we talk nutrition, you know, for over a hundred years now, doctors are like, you know, diet and exercise, right? Do it. So people say, oh, I’ve got a good diet.

[00:14:28] Yeah. And I’m sure you’ve heard this as clinicians, you know, of course you, I’ve got a, my diet’s fine. You know, and so that definition is not standardized at all. And it can be really wildly variable. You know, I owe be McDonald’s once a week. Yeah. Right. Exactly. Or, or they say, well, I eat, you know, a couple salads a month and I have a piece of fish.

[00:14:45] Yeah. On, you know, the last day of the month, whatever it is. And, uh, it’s like, what, you know, you gotta do it consistently. And, and, uh, this is where, you know, you get those benefits and, uh, and so it’s, it’s been frustrating. I know for John and I, we see these things in the lab. Measuring very carefully and we see these [00:15:00] really strong effects.

[00:15:01] Um, you know, visual performance effects, holding off disease progression. These things are very real, but you’ve gotta be consistent. Yeah. Compliance with and compliance is huge. This is a, is a truth teller. Mm-hmm. It will tell you, the clinician, if. Your patients are compliant, it’ll tell you if they are compliant and it’s not moving, something else is going on.

[00:15:22] I mean, there’s, you know, something happening, uh, for the patient. You know, it’s, it’s very reinforcing. You know, you see the number, like you mentioned, patients go for, you know, all the numbers they want to, you know, and, and I measure athletes and they’re very competitive. They want to go up too, you know?

[00:15:34] Mm-hmm. And so, uh, like with your dad, you know, there are things he mentioned to me. You know, he struggles a little bit with glare at night. Mm-hmm. You know, oncoming headlights, that kind of stuff. Vision and low light. And so those things start to turn the corner after a few months. Yeah. You know, consistent, you know, adherence to either supplement or a very good diet.

[00:15:51] But yeah, in this case, I’m very excited to see where he is at. 

[00:15:54] Dr. Chris Wolfe: What I think about this, some of those symptoms in Harvey, you and I have talked about this before as well, is just that, you know, the [00:16:00] glare when I think, I mean, I, I don’t know if it’s just bias, but I always think, um, oh, glare and I’m 65 years old, you got cataracts.

[00:16:07] You know what I mean? Mm-hmm. Mm-hmm. And, um, and so this. These kinds of ideas where we know we can start to improve some of the cont contrast sensitivity, and even improve some of our nighttime vision symptoms and glare may be one of them. Sure. Uh, by having better carotinoids, just sort of as mind blowing and almost game changing, where you’re, you are now considering macular function in pa in conditions that.

[00:16:34] Are historically thought about as lenticular. Yeah. Well, 

[00:16:38] Jim Stringham: I’ll make a comment to you, Chris. Uh, so my night vision has gotten significantly better. I’m 74 years old, have had bilateral cataract surgery. Mm-hmm. So there are no cataracts. I’ve had, um, uh, the capsules open, so that’s done, had the capsulotomy says, happens a lot of times.

[00:16:56] The quality of my vision at night is far better. I [00:17:00] never wanted to drive at night. It doesn’t bother me anymore. Mm-hmm. And it’s really amazing for me to see that, um, since it, for so many years I was a high myop and so, you know, we tend not to, not to like nighttime vision better. So it’s been real. It’s 

[00:17:15] Dr. Chris Wolfe: very real.

[00:17:16] Yeah. Well, and so the, the, if we’re gonna kind of bridge the gap of, of kind of how do we get from. How do I know that the life meter, which measure measures M mac or measures pigment optical density in my fingers, how do I know that that’s gonna correlate to my macula? So we’ve gotta get it by, obviously, if we can increase the numbers, and I’m sure that we’ve got some studies that you can talk about related to, um, consuming ma.

[00:17:44] Um, Consuming carotinoids. Yeah. Leading to an increase in serum levels of carotinoids. That’s what we’re measuring through the life meter. And knowing that if that level is higher, then the macular pigment is gonna be more dense as well. How do we get [00:18:00] to that point? Yeah, because that’s, that’s kind of, sort of the, the, the only case that could be made from using a macular optical pigment density, uh, measure that.

[00:18:11] We could say, well, this is in your blood, but it’s not in your macula. So tell me, how do we get there? Uh, 

[00:18:16] Professor John Nolan: a couple of points, um, a couple of ways to answer that question. In, in the first instance, let’s be very clear. Um, I agree with Jim that you’ll see the changes in the skin maybe three, four weeks into consistent supplementation.

[00:18:29] That doesn’t mean that the macular crottin in the eye have changed at that point in time. We know from our studies that our. In a valid measure when we use like proper objective assessment of macular pigment, you’re looking at really six months to turn the needle in the eye. Um, but how do we, how do we know that there’s a correlation and there’s different ways to look at it.

[00:18:48] Before any interventions, let, let’s talk about what our data shows us. Number one, eh, H P L C of blood or skin. But we’re not gonna, we’re not gonna excise skin from [00:19:00] living people to do that analysis, but we can take blood, draw blood, that’s very specific. I’m very exact. Very time consuming. Very expensive.

[00:19:08] Again, not clinic friendly. So this is one way we know to measure with exactness, the carotinoids that we’re interested in. We know from all my studies, all gym studies and from many other people across the world that blood crottin concentrations are a really good correlate of, uh, retinal crot macular pigments.

[00:19:27] So that, that, that stands up. Cross-sectionally. Um, the, the good news is, Um, I have been using skin crot light measurement as part of my experiments, interventional experiments now for over, for many, many years. And I can confirm. And we have studies that when you supplement with macular specifically, um, you’ll change the blood levels and you’ll change the skin crot, nide levels, and they correlate highly well together.

[00:19:52] So the change that we see does really, really good together, and that also correlates with the macular pigment levels. So the, the [00:20:00] value of this is not just that we’ve been able to correlate this new technology with, um, blood levels. We have absolutely, absolutely been able to demonstrate that supplementation will change macular pigment level, and that correlates with the functions that we’ve been talking about.

[00:20:14] So we’ve done the work. Yeah. 

[00:20:16] Dr. Chris Wolfe: Well, I think, I think the, the only other question I would have would be from a clinical standpoint or even just a scientific standpoint, is when they don’t correlate. Uh, how often does that occur, and what is your thoughts on, well, if they don’t correlate, how often does that occur?

[00:20:32] And if it occurs, why? Like, what’s the mechanism, uh, underlying? So is there a one in a hundred chance that. You’re not gonna elevate it if you’re, well, well, 

[00:20:42] Professor John Nolan: if we don’t elevate the blood, right. We have a non-responder, you’re not gonna elevate the skin, you’re not gonna elevate the, I’ve never seen a situation that we’ve had a responder in, in, in blood and not in 

[00:20:53] Dr. Chris Wolfe: skin.

[00:20:54] So how do, so then that’s interesting. Then, then we could, you know, have the conversation of, well, you know, [00:21:00] Steve, my dad. Yeah. You’ve been taking your supplement once a day, just like we’ve, we’ve discussed and your levels are two 50. And he’s adamant that he does it. So what’s the next step? How do you know he’s a non-responder?

[00:21:12] Is he, does he have other enzymes that are not, uh, that are, that are not absorbing this the right way? Do we increase his dose? What, what, what do you know, like what can we gain from that? There’d be a 

[00:21:21] Professor John Nolan: couple of factors to, to look at. Maybe Jim would like to add to it, but one would be, um, we always have to be cognizant of, uh, lipoprotein profiles that the role they play, you know, the, the journey of the crottin night to be absorbed is, is quite complicated.

[00:21:35] We’re talking about. Fat soluble nutrients that go into a water based system that have to be encapsulated into a microm cell that have to be transferred to the intestine, oral limb system, and then into blood system. So there, there’s a bit of work to do. Mm-hmm. And that’s, that’s why we, we celebrate the, the new technologies of microm cell because it has allowed us, in a research world inform the clinic world on how to get a better result for all of your patients.

[00:21:59] Mm-hmm. [00:22:00] So that’s that, that. That’s important. Um, I’m not sure if you wanna add to that. Yeah, that’s 

[00:22:04] Harvey Hanlin: right. Well, I, I think primarily it’s, it’s a, an absorption thing. I would guess that would be my first guess. The second is that, you know, I think that we tend to look at carotinoids and the, and organs where they get deposited, the retina of the skin, uh, lycopene gets deposited in the prostate if you’re a male, uh, you know, those kinds of things.

[00:22:24] And. But they, these nutrients, the body is super efficient and it’s identified these nutrients that it’s expecting to get in a lot. Now granted, a lot of people don’t eat them, but they’re used systemically as well. And so it turns the blood into this antioxidant machine and it breaks the chain of inflammation.

[00:22:41] And so my next guess outside of absorption issues would be systemic inflammation. Yeah. Uh, you know, and if there’s a lot, there’s something going on, I mean, Diabetes is a great example. You know, it’s a, it’s a systemic inflammatory disease. And so you’ve got adipocytes, the fatty, you know, that release inflammation into the blood.

[00:22:59] I [00:23:00] mean, and that, that can reduce these carotinoids. So the body’s getting, they’re getting used up before they go. And we’re 

[00:23:04] Professor John Nolan: not a really important point, Chris, that you, you’ve alerted my brain to, and that is, and it’s back to absorption. That’s competition. So the, and that’s why. I get sometimes, like we can be casual about, okay, if Lutan is working, it’s working.

[00:23:17] But back to the whole understanding of what’s actually in the supplement piece. Mm-hmm. So, you know, for example, if you had Beta Carine in a supplement that, that you knew you were taking or that you didn’t even more she didn’t know you were taking, that will have an effect. On your dad’s ability to absorb the lutan.

[00:23:33] So he is taken a supplement to get the benefit of the lutan because these, these are the specific carotinoids. You know, Lutin is anin and meso as we know. So that’s what you need. You can have competition. Between these tants. That’s 

[00:23:45] Dr. Chris Wolfe: important. Well, that, that brings up an interesting point then, because the, the, um, the other side of the coin that you would hear often is why we don’t need to have meso xanthine supplemented, because it’s gonna compete with, and we can [00:24:00] convert lutin into meso xanthine.

[00:24:01] So why is that not part of the competition, have you not 

[00:24:04] Professor John Nolan: ar for this child? Well, 

[00:24:06] I’m 

[00:24:07] Dr. Chris Wolfe: joking. We got a little time. I’m, I’m willing to give you some time for it. Yeah. Okay. 

[00:24:12] Harvey Hanlin: Do you wanna go? You go 

[00:24:13] Dr. Chris Wolfe: ahead. You, you brought up the interesting part about competition, and I know, uh, you know, I’ve, I’ve looked at the literature in depth of, of that competition, so I think.

[00:24:23] Let’s explore that a little bit because it is interesting. Well, 

[00:24:25] Professor John Nolan: a showed us very clearly that, uh, high beta carine consumption suppresses lutan. So crottin, I always explain where that the blood system is like a taxi system, and if we over supplement with Annie one CARite, you will suppress another crottin nite.

[00:24:39] And that’s why getting the balance right in the formulation. You know, we, with, with our interventions in Waterford, we didn’t just pick Mac Health. We looked at all different variations of, of, of the Tite that we could work with. It happened to be that the Mac Health ten, ten two, so one gave us the best results, so we chose that for the experiments.

[00:24:57] Mm-hmm. Um, so, so, so that’s [00:25:00] important, um, to the meso point. Um, Okay, so what we know is that we have about 15% of the population that have what we’ve coined and, and it’s been validated by my center, by the other centers. Now from across the world. We, instead of having your mountain profile, you have this kind of volcano, this dip centrally.

[00:25:17] And we know from the anatomy studies that when you, when you analyze a retina macula, you’ll see that the Zins and Paul Bernstein has recently done beautiful work on this. Um, even imaging shown zin and meze, anin being the very central carotinoids. So, uh, many years ago I hypothesized, um, that the dips that we were seen, which I confirmed were real, which we knew were highly prevalent in those at high risk of macular degeneration, were because of a deficiency of meso zin.

[00:25:46] And an inability of that patient may be like, may be enzymatic to do that lutan conversion. So that’s why, you know, LTA on its own is, is not enough. You know, and 

[00:25:59] Dr. Chris Wolfe: so you [00:26:00] basically, so, so Mac Health, the ten ten two formulation is basically solved for that 15% of patients who are going to have dips because they can’t convert.

[00:26:08] Yeah. Tine into me. 

[00:26:11] Professor John Nolan: Well, we came from a world where in my interventional studies we had about 15, 20% non-responders. Yeah. To a world where we have a hundred percent response. Yeah, it 

[00:26:19] Harvey Hanlin: was frustrating because we’d do supplements Back in the, you know, late nineties and early two thousands, the only available supplements were just lutein alone or LT zin.

[00:26:27] And you’d get, and, and these are normal individuals. These aren’t folks at risk necessarily. They’re college-aged students, 15 to 20%. Non-responders in the center, and they’re like, what is going on? They’re going up in the blood, not in the eye. So it wasn’t an absorption issue. And then there are recent reports that indicate that around 40 to 50% of those with AMD have this deficient conversion enzyme.

[00:26:51] Uh, it’s, and it’s a continuum. Sometimes the enzyme doesn’t necessarily work at all. Sometimes it’s. You know, slightly deficient. And so it’s, uh, it’s interesting that [00:27:00] the, the genetics for all of this seem to fit. And, uh, and so, you know, of course that’s right where you need the densest pigment is right in the center, you know, over that fo viola and, uh, where the highest, you know, cone photoreceptor density is, and, you know, potential peroxide of stress, et cetera.

[00:27:14] Light focus. 

[00:27:14] Professor John Nolan: I think we need to be clear as well with the skin measurement. We’re measuring a composite of crottin nodes. We’re not measuring any particular crottin, so there’s other crottin nodes. There’s other crottin lines in the skin that are not found in in the maculate. So, uh, lycopene. Um, 

[00:27:30] Dr. Chris Wolfe: and that doesn’t confound the, because you, well, the surprise to 

[00:27:34] Professor John Nolan: me because the, yeah.

[00:27:35] The surprise to me was I never, I wondered, and I actually didn’t believe that taking Lutin, Anin and Meso would change the needle in skin the way we’ve seen it, because I thought you’d be looking at more of a, a lycopene beta carine supplement to do that. But, but actually now looking at the H P L C data on skin crottin and.

[00:27:54] It matches perfect. That of blood. So Lutan is a very big Aziz Anin, very [00:28:00] big, um, present in, in, in, in skin. Mm-hmm. Um, and I know from our animal works, As well. When we, when we do this, we were able to look at all parts of, of the, when we worked with the hen model and we did interventions, that was where we actually started our work in terms of bio availability in and, and, uh, micro cell di acetate.

[00:28:19] Um, you can see these crottin nodes have to kind of fill up the reservoirs within ourselves. They’re fats olive, right? So, So some of us have nearly 50% fat in our bodies. No, we don’t want it to be in that place, but, you know, maybe 25% anyway. So there’s a lot, there’s a lot to kind of satisfy before we can target it to the tissues.

[00:28:39] Interesting. The retina and the brain. 

[00:28:41] Dr. Chris Wolfe: So, yeah, so I like the, the idea of the six month. And so I think that kind of will allow us to wrap our, wrap up the conversation maybe with a clinical discussion, Harvey, of if we’re gonna integrate this into a practice, um, a practice like mine, which I don’t have this yet, um, would be.

[00:28:56] Uh, okay. Well, Harvey, you’re saying, look, [00:29:00] we’re thinking about visual function beyond macular degeneration now. So if, if I’m convinced that that’s what I want to do, then how do, how do I set this up in my practice so that it’s minimally, uh, impactful? On the patient flow and maximally impactful in the conversations I get have with patients.

[00:29:18] So I think 

[00:29:19] Jim Stringham: there’s a couple of ways you can do that, Chris. Some practices are, when I’ve talked to doctors, actually want to have it done at the front desk. Mm-hmm. And we have offices doing that on every patient. Um, there are some practices that want to have it done by their technician as part of their pre-test.

[00:29:35] It’s a very quick test. Jim, what’s it take? Three minutes? Yeah, under three minutes, probably two. Okay. So, and, and some doctors say three minutes, you know, I have to, I gotta save three minutes. Well, you know, my philosophy about how long we spend with patients Yeah. It’s a lot longer than that. So, um, I, I personally believe that when you’re doing a medical test, You want to show value and you do it as part of the medical [00:30:00] testing.

[00:30:00] I think I’m not the one that loves the idea of the front desk, but it seems to be an idea that doctors believe will work well for them. Hmm. So I think there’s different ways to incorporate it. I think what has to happen is that that number needs to follow the patient. So either. The technician or the doctor, or perhaps if you have a trained person at the front that can, that understands it on the patient’s way out, that they can be going through that with the patient about their number.

[00:30:28] So I think that’s how you do that. I wanna make one observation to you, Chris, cuz I was listening to the conversation about what happens if that number doesn’t go up. Yeah. And what, what enters my mind if I’m the practitioner? And I have a younger person in the twenties or thirties where their number doesn’t increase.

[00:30:45] The first question I guess I would ask at that point is, When’s the last time you had a physical exam? Mm-hmm. Is there something, something systemically going on in an inflammatory way that may be taking these carotinoids and using ’em? Because, [00:31:00] you know, we know that the average younger person doesn’t have regular physical examinations, and there may be things going on now that are gonna rear their ugly head coming in the future.

[00:31:09] So I look at this in a couple of different ways of how we as a clinician, Can look at the, not only a number for the, for the patient, whether it’s done at the front desk or whether it’s done in a, in a, in a tech setting. Uh, but what, what do we see when the follow up number occurs? Yeah. And it’s not, that’s the, the challenge and it’s not what we think it should be.

[00:31:30] Yeah. Are we going to be the full scope practitioner and discuss that with them, or are we just going to focus on those two eyes six inches apart and that’s it? Yeah. I think we need to be 

[00:31:41] Dr. Chris Wolfe: the full scope practitioner. Yeah, I would agree. I, I think that’s the, the challenge from a lot of people that would, would be that, okay, well what happens is the same thing when we think about dry eye.

[00:31:50] I prescribe this treatment and the patient doesn’t feel better. Or my number, even if I’m majoring all numbers. Well, what, what’s next? Well, If you’ve [00:32:00] got, you know, then it’s like, well now we gotta figure out what’s next. And if you’re ready, if you’re willing to figure out what’s next and have the conversation with, well, let’s see if there’s something else systemically going on, or, you know, maybe we are, uh, absorbing too much in our adipose tissue, then it’s a, you have to be willing to have the conversation, but also not letting the potential, the small potential for the having to have that conversation break down the good that you could do.

[00:32:25] Uh, last question. How many patients do I need to treat with, uh, this in order to harm somebody? What’s the harm that’s gonna come from, you know, patients asymptomatic young? Um, we measure them and their numbers are low, and so we, we talk to them, they understand the importance. They do it. How am I gonna harm that patient?

[00:32:53] Is there any downside? I mean, I think a lot of times we wonder about the downside or we don’t wonder about the downside effects of a [00:33:00] nutraceutical, but are there any, uh, for that long duration, 30 year old patient, we think of only benefit, only vi visual benefit. But are they gonna, you know, is there a potential, obviously the cost they have, you know, there, there’s a cost involved, but is there an anxiety now that all of a sudden they’re worried about other things?

[00:33:19] Is there. You know, other, and I haven’t seen it. I’m just trying to think, well, what’s the downside of treating somebody for, for years and years and years in supplementation? You might know this better. Yeah. I mean, 

[00:33:31] Harvey Hanlin: I was gonna go cost. Yeah, I mean, that’s the primary one I would think. Because, you know, medically, I mean, there’ve been so many toxicity, mut, immunogenicity, studies that have shown, you know, that you can.

[00:33:42] Throw 3000 milligrams a day, uh, at the human body, and it can, you worry about lipid soluble nutrients with the liver. Liver enzymes don’t change. Um, you know, the saturation, if the body is saturated, it gets rid of the nutrients. It, it’s, there’s really cool transport systems that [00:34:00] help with that. So medically, virtually no risk.

[00:34:02] And that’s, I mean, I’ve dug deep into this. I know Professor Nolan has as well. There’s just adverse events. I’ve measured thousands of individuals. You know, I know John has as well in his studies. I’ve never reported an adverse event in a study. No. Um, 

[00:34:19] Dr. Chris Wolfe: I mean that’s, I’ve, I’ve done a scan of the literature as well, and one of the things I, I wonder, again, not knowing, uh, all of the.

[00:34:25] You know, exc discretionary or excrete excretory mechanisms. But one of the things I thought about is, well, is it, are there oxalates? Will we worry about like patients that would have kidney stones or any of those sorts of things? But that’s not even the same pathway as, 

[00:34:41] Harvey Hanlin: no, it’s not. And you would get that from leafy greens if you were to eat the actual That’s right.

[00:34:45] Yeah. Not in the. Carotenoid itself. It’s not on the purified carotinoids. 

[00:34:48] Dr. Chris Wolfe: Yeah, no. Yeah. So that was the one thing I was thinking about too is like, okay, well maybe we already are high and we’re trying to excrete these, and then they get bogged down in the plumbing. Right? Yeah. 

[00:34:57] Harvey Hanlin: It’s a good thought, but no, that’s not the case.

[00:34:59] Yeah. 

[00:34:59] Professor John Nolan: The [00:35:00] only other, eh, I mean, if we look at s again, to go back to the s, they made a, a very careful decision to remove beta car once again because of the significantly high risk of, uh, lung cancer and cigarette smokers. Right. So that’s the. You know, the beta carine is important. In some instances we need to obtain it from our diet and so on.

[00:35:21] Um, but in terms of targeting the macula to deal with this specific condition, we know how to do it. Yeah. 

[00:35:28] Harvey Hanlin: And most nutrients we need, you know, enough, but not too much. You know, you talk about, well, like zinc for instance, right? I mean, that’s, it’s a little bit horrifying. How much is in the arids? Two formulations?

[00:35:40] Yeah. 80 milligrams. But we don’t, that’s a topic for another day. But yeah. Um, you know, we need about 10 or 11 milligrams a day, and then really not much more. And we don’t, you know, the FDA set the upper tolerable limit at 40. Milligrams a day, and yet we’ve got 80. Yeah. 

[00:35:54] Dr. Chris Wolfe: And that’s Yeah. In the most, you know, most widely used.

[00:35:56] Yes. Oh, it scares me. 

[00:35:58] Harvey Hanlin: Yeah. It really scare. I mean, it can be [00:36:00] neurotoxic, right? So anyway, when, when I 

[00:36:02] Professor John Nolan: won the CREST program in 2011, one of the big claims I had in the grant was that we had identified a deficiency in, in specific nutrients that needed to be addressed because of nutrition and evolution, because of the basic fact that our kids are not consuming enough during their life, even even.

[00:36:19] Homes that are fortunate and have access to good foods, we’re 20 times away from where we need to be. Yeah. And that’s why asked John, are you saying that you think everyone should be on this? Yes, I am. Yeah. A 

[00:36:30] Dr. Chris Wolfe: hundred percent. Yeah. All right. So I’m gonna be respectful of your time. Tell me how, how do I get ahold of this, uh, life meter and, um, And any other party thoughts?

[00:36:43] Nobody here we’re the scientist. 

[00:36:46] Jim Stringham: So Mac Health is, is selling the life meter. Mac Health is a supplement company, okay? They are not an equipment company. This is not their science. This is a science that’s been. Been developed by a very, very [00:37:00] smart scientist. Um, and there are many studies about this, this technology that, that proves it.

[00:37:06] So the, the sales team for Macu Health will have the life meter. They’re gonna be able to demonstrate it. Uh, they’re gonna be able to give you the information about it as a practitioner, and I think the key is to, to actually try to see it and, and to, to test yourself, test your staff. That’s been the real interesting thing.

[00:37:28] Doctors sometimes supplement themselves and they find they’re doing pretty well, and then they test their staff and their staff’s at 200, 2 10, but you can get this. Through Mac Health and their sales reps. It’s a 

[00:37:39] Professor John Nolan: very sophisticated kit. You know, it’s, it’s a spectrophotometer essentially, it’s equivalent to what we have in the best lab in the world.

[00:37:45] But the, the magic here is it’s been able to be, you know, made in, into a size and available to what will work in the clinic. And that’s what’s unique about this. Yeah, 

[00:37:54] Harvey Hanlin: that’s right. And it’s not tied to any supplement. Yeah. You use it how you want to use it 

[00:37:59] Dr. Chris Wolfe: if you buy it. [00:38:00] Yeah. I think that’s great. So John Harvey.

[00:38:04] Jim, thanks again so much for being on the podcast. I really appreciate it. It’s been a lot of fun. Thank you, Chris. Thanks for having us. Welcome, Travis. Appreciate it. You’re welcome. Thanks guys.[00:39:00] [00:40:00] [00:41:00] 

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