#256: Immune Cells Use Sugar to Drive Inflammation, Fats Restore the Peace w/ Alena Guggenheim, ND

by Mike Mutzel

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Link to Show Notes:

04:46 Your immune system can accidently attack the body or it may miss something that has gone wrong, like cancer growth. We initially thought that the immune system was there to sense pathogens and eliminate them.

05:12 The immune system, via inflammation, plays a role in all sorts of diseases and chronic diseases, like diabetes and heart disease.

05:44 The immune system has preferred food sources. Types of basic macronutrients can feed one part of the immune system versus another part of the immune system.

06:28 Dr. Guggenheim sees the immune system as a military: army, navy, special ops. When you deploy a certain immune response, just like a military response, it is costly.

07:07 Our immune system has peacekeepers, T-regulatory cells and B-regulatory cells. The depletion of Treg and Breg cells is implicated in every autoimmune disease.

07:50 Everything the immune system does is metabolically costly and takes money, in the form of ATP. The peacekeepers are metabolically distinct from the warriors. The warriors go through a glycolytic switch, like cancer cells do. They put up glucose transporters over the cell membrane to bring in more sugar to run mitochondria to supply the energy needed to be a warrior.

08:55 T-cells in autoimmunity go through the same glycolytic switch and their glucose consumption goes up 10 times the norm.

09:30 The peacekeepers prefer fatty acid metabolism. They do not have many glute-1 transporters and do not go through the glycolytic switch.

11:13 High CRP is not your body responding to any specific thing. Your basal metabolic rate goes up when your CRP is elevated. Your brain responds to this higher metabolic rate by eating more calories, which feeds the inflammatory response.

14:00 Metformin is being researched of its use in treating Lupus. It seems to decrease mTOR. mTOR is a molecule of human ageing. It changes how cells are broken down and go through autophagy. mTOR can spike, and that is probably related to mitochondrial dysfunction.

15:39 Mitochondria are responsible for metabolism, making energy in your cells. Mitochondrial dysfunction can make mTOR rise. mTOR can precipitate autoimmune flares.

16:42 Lupus treatments being explored include combinations of Metformin with other mitochondrial nutrients, like N-acetylcysteine.

16:57 Mitochondrial dysfunction is present in inflammatory disorders. When you change the electron gradient that drives the ability to go through the process to make energy inside the mitochondria, reactive oxygen species accumulate and holes form in mitochondria.

17:35 Our mitochondria are symbionts that probably came from bacteria and are vulnerable to some of the same things that damage bacteria, like antibiotics and pesticides.

19:16 You can only poison your mitochondria so much. When they death rattle, with reactive oxygen species, they use all of your glutathione. Intracellular glutathione is about 10 times lower compared to a healthy cell. Glutathione is the clean-up crew.

20:20 The cheapest and most effective mitochondrial nutrient is N-acetylcysteine. It improves intracellular glutathione production.

21:46 Berberine is similar metabolically to Metformin, but there is not the body of evidence that there is with diabetic research. Metformin can deplete certain B vitamins.

24:58 If you don’t have enough mTOR, you will not get new cell building and you go into breakdown phase. It also causes problems if you have too much mTOR or mTOR in the wrong situation (like an inflammatory event without enough glutathione to clean up.) Mitochondrial DNA floating extracellularly incites an immune response.

27:53 Beta hydroxybutyrate feeds your peacekeeper T-regs.

29:20 Macrophages are probably the key to the concept of inflammaging. They are sentinels, to sense the general environment. They sense microbes, metabolism, nutrients, temperature and can probably sense light. m1 macrophages make anti-inflammatory cytokines like TGF Beta, IL-10. M2 macrophages make inflammatory cytokines like TNF-alpha.

31:33 The macrophages inside visceral fat tend to be m2 and cause metabolic disturbance, increasing levels of inflammation.

36:18 T-reg signaling is dependent upon vitamin D. Being vitamin D deficient will decrease T-regs. T-regs will rise with 8 weeks of aggressive vitamin D replacement. The range of 40 to 90 is beneficial, depending upon SNPS and disease phenotype. Many different inflammatory processes can make you into a hyper converter of 1,25 dihydroxycholecalciferol. Dr. Guggenheim has had patients with profoundly low vitamin D and high out-of-range 1,25 vitamin D. This may be the result of being in a high inflammatory state or infection.

38:04 Labs for immune, metabolic or hormone health are snapshots, especially with diurnal hormones. It takes a lot of data, sometimes months of data, to establish patterns.

42:01 The first thing you can do to improve your metabolic health is to follow the Okinawan Hara Hachi Bu. Eat until you are 80% full. To do this, you must eat slowly and be aware of your signals. Eating too many calories, it is really bad for our immune system. The

43:39 You cannot listen to your satiety signals if you eat quickly. A study of young children (about 4 – 6) set out a huge variety of foods and meticulously recorded what the children ate. Their obesity rates 5 years later were reflected in the speed in which they ate.

46:56 Dr. Guggenheim’s morning routine centers around her kids. First thing, she drinks something warm. She no longer listens to the news on her morning commute. She now does a driving meditation on her way to work.

49:45 Dr. Guggenheim’s desert island nutrient is curcumin.

50:42 Dr. Guggenheim’s elevator pitch is a recommendation for a policy change to discontinue food subsidies. Many of our medical problems are driven by subsidies to foods that cause disease.



  1. Great episode! I have a question about an item you touched on at 8:20 where you touch on individuals who do an ige test at their doctors office and it shows a host of “allergens” (in my case onions, garlic, tomatoes, almost all nuts, coconut, etc. but not in the severe anaphylaxis range. I understand my immune system is compromised by my inflammation and the overall message is to eat less, but in the meantime should i avoid the foods that came back positive on my ige test until I lessen my inflammation.

    Thanks for all you do!!!

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