Your Genes Are Calling, and They Want A Different Workout!

What if your workout isn’t the problem… but your DNA holds the solution? In this episode, Dr. Mary Louder sits down with exercise physiologist and endurance expert Todd Buckingham, PhD to unpack why traditional fitness plans don’t work for everyone—and how personalized movement medicine can change everything. We explore: 

- What an “exercise prescription” really means 

- How VO₂max, DEXA scans, and sweat testing optimize performance 

- Why some people burn out or get injured on standard programs 

- How the 3X4 Genomic Test reveals your unique recovery, injury, and inflammation patterns

 - The future of exercise: science + genomics + soul 

Ready to Move Smarter, Not Harder? Order your 3X4 Genomic Test and get personalized insights into your exercise, metabolism, inflammation, recovery, and more. Visit www.drmarylouder.com → Click “Shop” 

Exercise Coaching with Todd Buckingham, PhD: Want a personalized training plan based on lab-tested data and integrative insight? Contact us here: 

https://www.drmarylouder.com/contact 

Strategy Session with Dr. Mary Louder, DO: Explore a soul-rooted, genomically-informed approach to your health. Book at: www.drmarylouder.com 

Learn More About Creatine:  https://docs.google.com/document/d/15obmY-Apvxz9BC3-44OBuiwmDOMclct6XNiXrU1nVhk/edit?usp=sharing

You can learn more about Dr. Buckingham here: https://www.toddbuckingham.com/

Transcript

Mary Louder: 0:57

Hi and welcome to another episode of The Dr. Mary Louder podcast. I'm your host, Dr. Mary Louder. Today, our podcast is called, "Hello, your genes have called and they want a different workout plan." Our guest today that I'm in conversation with is Dr. Todd Buckingham. Todd is an exercise physiologist, a coach and an endurance athlete with deep expertise in performance science. Todd earned his doctorate at in exercise physiology at Michigan State University, and has worked with athletes of all levels, performing VO2 max testing, lactate threshold testing, sweat analysis and DEXA scans. He currently works at PTSportsPRO in Grand Rapids, and he teaches at Grand Valley State University, helping shape the next generation of movement scientists. He also runs his own coaching business, crafting personalized training plans for runners, cyclists and triathletes. Todd is featured in Runner's World, CNN, The Today Show, and over 130 media outlets. He brings a rare blend of academic rigor, real world coaching and elite personal experience. He's a nine time national champion and a four time world champion in the triathlon. And yes, he still reigns--still trains hard and races for fun. In fact, he works out every single day. So welcome Todd Buckingham, to the Dr. Mary Louder Podcast show. Well, hey friends, welcome back. Dr. Louder here and on my podcast show today, I've got a special guest. We're pulling on our sneakers, grabbing our DNA reports, and we're going to get curious about why your workout may or may not be working. So this is could be absolutely game-changing for you. So my special guest today is, and I'm going to call him the brilliant Todd Buckingham. He's, he says he undersells himself. I think he's brilliant. So he's an exercise physiologist, a researcher and a triathlete, and he literally tests the limits of human performance himself. Todd works with elite athletes and everyday humans that would be me alike, to craft evidence based performance boosting training plans based on measurable science, things like VO2 max, sweat rate testing, and metabolic rate, and what's the other one? DEXA scan testing. So, and then I'm going to come in with some genomics. We're going to support some of Todd's scientific brain with some insights on genomics, and this is something he's not been exposed to, so it's going to be really fun to share with him some of the ways that we do medicine and how it might enhance even exercise prescriptions. So welcome Todd, and tell us about your background and your passions and your races and things like that.

Todd Buckingham: 3:55

Yeah, thanks for having me, Mary. It's, it's a pleasure to be here. So a little about myself, like you said, you said, brilliant, I, again, I would push back on that, but I do have my PhD in exercise physiology. I graduated from Michigan State in 2018 where I studied performance indicators in triathlon. It was a very self serving dissertation. I was wondering how I could be a better athlete, and so I studied it. Prior to my PhD, I played baseball in college. I grew up as a three sport athlete in high school, playing baseball, basketball and soccer, so triathlon and running was the furthest, thing from what I wanted to do if, if I was running, it was because I was chasing a ball. If I wasn't chasing a ball, I wasn't running. So, you know, I got into exercise physiology, exercise science, because I was an athlete, and I really enjoyed it. And I thought, hey, what better way to get more involved than to study it. And so it really just went hand in hand with my interests outside of school. And so it was kind of a no brainer, which is funny saying that now, because when I graduated from high school, I thought I wanted to be an engineer, because I really like science, I really like math, and I still to this day, love math, and I have a bunch of spreadsheets and things, but I went to one engineering class in college. I didn't even sit through the entire thing. I was like, This is not for me. So I was undecided for maybe, like, a semester or two, and just taking the gen eds. And then the athletic trainer on the baseball team said, Oh, try exercise science, and the rest is history. So I'm glad that it, that it worked out that way, and I was able to, you know, go through all 11 years of college, and, you know, here we are now. And so I, yeah, I'm glad on the path that it took me and and then after baseball was done, I got into triathlon, because, you know, why does any guy do anything but for a girl? So the girl I was dating at the time, she and her roommates were doing a triathlon, and I was like, you know, I've seen that on TV. Maybe I'll give it a try. I never swam, except, you know, when you have to swim in the deep end to get your button to be able to jump off the diving boards at the local pool, I think I rode my dad's bike. And I was like, oh, you know, I'm a collegiate athlete. Like, I can, I can run 5k. And man, oh, man, that first triathlon was rough. I was, I was getting passed with old guys with beer bellies. And I was like, I'm a collegiate athlete. How is this happening? And so, you know, it really just kind of gives you an idea of specificity of training is really important. You can't be a baseball player and, and go think you're going to dominate this triathlon, like there's specific things that you need to do in order to be a good triathlete. So, and that's where I said, you know, I studied that. And so, yeah. Now here we are, 12 years after my first triathlon, maybe 13 now. 13, yeah, because 2012. So time flies.

Mary Louder: 6:55

You've won some triathletes, some triathlons, right?

Todd Buckingham: 6:59

I've won a few. Yes, I have four World Championships, 19 national championships, and I've won two overall, 70.3 Ironman races. And then, you know, I don't even know how many local 5Ks, 10Ks, triathlons. So, yeah, I've been able to be pretty successful. And it's, it's not like I do anything special. A lot of people are like, Oh, what's the one workout that you do? And I'm like, Well, you know, the only one workout I do is being consistent, and I work out pretty much every day, whether it's swimming, biking, running, walking, lifting, doing something every day. And the last day I took a day off was actually in 2018 and it's because I was flying back from Australia after winning two world championships in Australia, and the day didn't exist, because the time changed from Australia to the United States, like the day just didn't exist. So that's the only day that I've taken off in the last, what, seven years. But you better believe on that plane, I was walking up and down the stairs on the back of the plane just to get some movement in. So like, the one workout I do is I'm just consistent. And when it comes to endurance performance, consistency is key. And so, yeah, I've been fortunate enough to be extremely successful and and really healthy and able to continue doing it for, you know, as long as I have so far.

Mary Louder: 8:23

Yeah.Ooh, that's awesome. That's a great story. I like it the day didn't exist, like getting off at the thirteenth floor, it's really the 14th floor or something, right? You know, exactly all right. So, yeah, and I was reading an article the other day about swimming. I've been doing a lot of swimming, and they said the perfect body type is tall, long torso, broad shoulders and short legs. I would like to

report I have one of three: 8:50

short legs.

Todd Buckingham: 8:53

Short leg--me too. Me too.

Mary Louder: 8:56

It's kind of like, okay.

Todd Buckingham: 9:00

Yep.

Mary Louder: 9:00

So I get a kick out of that. I thought, well, one of three is not bad. I'll still get in the pool. Alright. So looking at, really what exercise prescriptions are, as a doctor, I write a lot of prescriptions more. You know, that's probably the thing I've done the most in my career. Sometimes a person leaves an office with three to five prescriptions written. We used to handwrite them. Man, I had the best signature. Now they're electronic, not quite as fun, right? But let's start with an exercise prescription. What exactly does that mean?

Todd Buckingham: 9:32

Yeah, that's a great question. So an exercise prescription is, I mean, kind of what it sounds like. It's a prescription for exercise, but there are a few different things that you have to take into account with an exercise prescription. And we call it the FITT principle. So f, i, t, t, so you have frequency, how often are you doing the exercise intensity? How hard is the exercise time? So how long are you doing the exercise? And then type, so is it running? Is it swimming? Is it biking? Is it weight lifting? So all four of these factors, the FITT principle, go into creating an exercise prescription. So, it's really, I don't wanna say it's easy to create an exercise prescription, but it's easy to create a general exercise prescription. The hard part is making it not cookie cutter exercise prescription for everyone. And so, I know a lot of exercise prescriptions, or like fitness training plans online, it's the same thing for everybody, regardless of how experienced you are, or how competitive you are, or how much free time you have, and so that's one thing that I really take into account with all of my exercise prescriptions that I use for my athletes, is that I'm not going to give you 10 hours of workouts a week if you only have time for five. I'm not going to tell you, Hey, go run at 10 miles an hour, if you can only run at six miles an hour. And so a lot of these things we go through with my athlete, I have them fill out a questionnaire before starting, and, and get a better sense of like, who you are, what you have time for. And then I also work at an exercise testing lab where I can do VO2 Max testing, lactate threshold testing, DEXA scans, sweat testing, kind of those things that you mentioned at the beginning, which allows me to further personalize the training plan for the athlete. Because if it's just a cookie cutter, then it's not going to be very specific to you, and you may not be getting the right stimuli that you need to improve as best you can. Now, will you still improve if you're following a structured training plan? Probably, but that's just because you're being consistent in doing something. I wish that I would have started when I first got into triathlon, was like, actually doing things that were beneficial for me, because I just feel like I wasted a lot of time, whether it was, you know, doing the wrong types of training runs or the wrong intensity swims, or whatever it was, and it is like--I still got better, but in hindsight, I ended up wasting a lot of time because I wasn't training at the appropriate intensities or durations or frequencies.

Mary Louder: 12:26

Gotcha, let's go back to those alphabet soup, DEXA scan, VO2 Max.

Todd Buckingham: 12:32

I love that, alphabet soup.

Mary Louder: 12:33

Yeah, because when so I took exercise physiology courses in undergraduate and graduate school, and I loved it, but I also really loved the clinical part of being a physician, so I had to really go do that. But you know, when we did those testing, it was for athletes who were relatively elite, but now we've moved this into not only folks who are elite, but also people who just really want to work on their fitness and understand things, right?

Todd Buckingham: 13:03

Yeah, absolutely. And honestly, I think it's more beneficial for those who are not elite, because the elites, athletes like myself, we kind of know what it takes to do what we need to do and the intensities that we need to run, because it's not like I became elite overnight, right? Like I mentioned, it's been 12 or 13 years that I've been doing this and in the right way. And like I myself, have a coach who was an Olympic triathlete when she competed, and she got her Masters in exercise science from Stanford University, and so, like, she was the world number one ranked triathlete in the world, like, back in the early 2000s, late 90s. So, you know, I have been working with her for, what, eight years, 10? No, it's been over 10 years now. And so like, I know what I'm doing and I know what I need to do, and it's not like doing a VO2 Max is going to tell me anything that I probably don't already know. It's likely just going to confirm that, hey, you're really fit. Okay, thanks. But for those who are new to whether it's endurance sport or weightlifting or really just like, want to learn more about their body, it's going to be so much more beneficial, because you're not going to end up wasting all that time. The things that I just mentioned a few minutes ago was like being able to exercise at the appropriate intensity with the correct duration and frequency. Because you may just kind of be throwing mud at the wall and seeing what sticks, right? But doing those tests are going to give us better direction and be able to help you improve that much faster, as opposed to the elites, like you might be making small tweaks in their training. With the average everyday person, it's going to be so much more beneficial, because I can't tell you how many people I get in the lab and do a VO2 max test or lactate threshold test. And I'm like, Yeah, you're probably running like, two minutes per mile too fast on your on your runs.

Mary Louder: 15:01

Wow.

Todd Buckingham: 15:01

That's typically what it is, like people run way too fast for the most part. But those changes like that is a big change, right? Whereas, you know, for an elite it's going to be, oh, yeah, we need to do this interval at 63 seconds instead of 65 seconds. So it's like, you know the difference between two seconds and two minutes is, is, I mean, everybody knows.

Mary Louder: 15:26

So what I'm hearing is, like, the elites, the margin is smaller, but also the training changes are smaller.

Todd Buckingham: 15:34

Correct. Yeah, the tweaks and changes that you make with elites are gonna be much smaller than the general population, just because they're already so dialed in. Like, if I had an Olympian come into the lab, I'm probably not going to be changing their training drastically. It's gonna be like, Okay, well maybe, like, we tweak it a little bit here and there, but for the average person, I can almost guarantee that there will be some big changes that, that are made.

Mary Louder: 16:04

Yeah. So what does VO2 Max measure?

Todd Buckingham: 16:08

That's a great question. So VO2 Max stands for the volume of oxygen you're able to use at maximal exertion. And so that's essentially what it measures. It measures how much oxygen your body is able to take in, transport to the muscle, and use during maximal exertion exercise. So typically we say, the higher your VO2 Max, the better your capacity for endurance performance. If we want to put this in a real world situation, like a marathon, person with a higher VO2 Max is typically going to outperform someone with a lower VO2 max. Now for men, a VO2 max of about 70 is considered elite. For women, it's about 60. And once you hit those numbers for men and women respectively, if you go over that, other things like lactate threshold and exercise efficiency become more important than VO2 max. So for example, my VO2 Max is 83. I get beat by people with lower VO2 maxes than me all the time. But it might be because their efficiency is better, or their lactate threshold is better. So just having high VO2 Max isn't the end all be all for endurance performance. However, if we look at the other side of the spectrum for the general population, VO2 Max is extremely important for health and longevity. It is inversely correlated with the risk of early death and all cause disease. So higher your VO2 max is the lower risk of developing cancer, obesity, hypertension, dyslipidemia, I mean, name a disease, the risk is lower if your VO2 Max is higher. And so it's one of the biggest and most important markers for health in the general population.

Mary Louder: 17:53

Is there a range? So if you're at 83, where would the general population really find some sweet spots? Maybe the middle ground?

Todd Buckingham: 18:03

Yeah, that's a good question. So the highest value ever recorded is like 98. So on average, typical college aged males have VO2 Max in the mid 40s. Females is like high 30s, low 40s. So, you know, unless you're an endurance athlete, you're probably not going to see values in the 60s or 70s, but you may see like in the 40s or 50s. I mean, 50 would be pretty good for just the average person, especially, you know, if you don't exercise. Typically, I only see in the 50s with people who consistently exercise, whether that's resistance training or endurance training. And you know, there's not really like, Oh yeah, you have to hit this number in order to be free of disease or whatever, but just wherever you're at now, if you can just go up a little bit, your risk of death and disease will decrease. And so, you know, adding in, even if it's a 10 minute walk after dinner or something, just do something, it's going to be beneficial. And I always struggle with talking with my wife about this, because she's like, Well, I only have, you know, 20 minutes to do something. It's not even worth it. And it 100% is. Because even if you do something for 20 minutes twice a week, that's better than zero minutes zero times a week. So, you know, just the more that you can do, the better it's going to be. Okay,

Mary Louder: 19:33

great. Okay, so VO2 Max. The lactic acid threshold, I'm assuming, I'm going to guess somewhere between your aerobic and anaerobic capacity and your ability to recover?

Todd Buckingham: 19:47

Kind of. So we, we tend not to use like, the term anaerobic anymore, because we're always using oxygen, right? And so even when you are quote, unquote anaerobic, your body is still using oxygen. So we have three energy pathways. We have the ATP, PCR, glycolysis and the aerobic metabolism. None of those pathways are ever 100% off. And so that means that you're always using some oxygen at some level. So but lactate threshold. The definition of lactate threshold is when the production of lactate exceeds the clearance of lactate, because our bodies can actually use lactate as a fuel. Right now, us, everybody that's listening can is using lactate, right we're producing lactate in the muscle. The difference is that when you start feeling that burning sensation in your muscles, that means that lactate is building up in your blood. And so what happens is, at rest, during exercise, when you produce lactate, it gets produced in the muscle. It gets sent to the liver via the bloodstream. It goes through a process called gluconeogenesis, which means turning a something into glucose that was not glucose before, so it gets turned into glucose in the liver and then gets sent back to the muscle to be reused as energy. So lactate is actually a fuel source for the body, and I know it's gotten a lot of bad press within the last 20 or 30 years, but lactate is actually a fuel source that we use for our body. The problem is that when I talked about when production exceeds clearance, so when you work at higher and higher intensities, at a certain point, you reach your lactate threshold where that production exceeds clearance, and so you have more lactate that you're producing than you can clear it. And it makes sense, because if you imagine lactate is like logs in your bloodstream, if you have a lot of lactate, that process of gluconeogenesis takes a really long time to occur, and so the the lactate kind of creates a log jam in your blood vessels, and that's when it starts to spill over, and then we just have excess lactate in the blood, and that's that burning sensation. But I do want to point out that it's not actually the lactate that causes burning in your muscles, like we just talked about, lactate is a fuel source that we use. The burning sensation actually comes from a hydrogen ion that's associated with every lactate molecule. And so if we remember back to high school chemistry class, the more hydrogen ions in a solution, the more acidic the solution becomes. And therefore, if you have more lactate, you also have more hydrogen. And then the solution, which is your bloodstream, becomes more acidic, which causes that burning sensation. So it's not actually lactate, or lactic acid, as some people call it, which it's not actually lactic acid, because the body just produces lactate. But that's another story. So it's not the lactate, but it's, it's the hydrogen ions that are causing that burning sensation. So, so yeah, that's what the lactate threshold is. It's essentially when production exceeds clearance. And for kind of, like, a general sense of, like, how fast that is, it's it's defined as the pace that you could, swim, bike, run, whatever, for one hour, if you're going as fast as you could for that one hour. So if you think about that, like running, if you were to run a 10k in one hour, so 10k is 6.2 miles, so you're running 6.2 miles an hour, that would be your lactate threshold. So some people are a little slower than that. Some people are a little faster than that. Some people are a lot faster than that, where they can run a half marathon or more in less than an hour. So not me, but some, some of those pro runners, they're running half marathons in like 57 minutes nowadays, which is just insane.

Mary Louder: 23:32

Yeah.

Todd Buckingham: 23:32

But yeah, so that's, that's what the lactate threshold is.

Mary Louder: 23:36

Okay. What about the DEXA scan? When I hear DEXA scan, I think a bone, bone density, but is this like more of a whole body scan? Or what is that?

Todd Buckingham: 23:48

Yeah, yeah, it can be a whole body scan. So we typically do whole body scans in the lab, but you could do segmental analysis, where, if you wanted to look at the lumbar spine or the cervical spine or forearm or head of the femur, and those are the segmental are typically more for bone density, but you're correct. DEXA scan stand. DEXA stands for dual energy X ray absorptiometry. Essentially, we're taking a very low dose X ray of your body to get your bone density, but also get your muscle mass and fat mass, and we can see where that is located throughout your body, and then kind of prescribe exercise based on that. Now I will say it's not often that I'll prescribe exercise targeting certain areas, because there is no such thing as spot reduction. So if you have a lot of fat mass in your waist and hips, doing squats is not going to decrease the fat mass in your thing I'll say about bone density that I don't think a lot waist and hips. But one of the great things about our DEXA scanner is that we're able to see differences between right and left sides of the body. So we can see the different amounts of muscle mass between right and left sides of the body. So if I have, like, a single sided athlete, like a baseball player or a tennis player or a pickleball football player, pickleball There you go, pickleball player. You know I can, I can look at that and see, okay, is one side out of whack with the other side. And so then we can target, okay, like we need to start doing two sided activities, as opposed to single arm or something like that, so that we don't have these muscular imbalances, so that the risk of injury is not quite as high. of people understand is that you can increase your bone density.

Mary Louder: 26:06

Yes.

Todd Buckingham: 26:06

Your bones are just like your muscles, where the more stress that you put on them, the better and stronger they become. Now bones are a little harder to increase the density and strength, because they don't have the same blood flow that your muscles do, but they do have blood flow, and so it just takes a little longer for your bone density increase than, say, like your muscle mass, but doing weight bearing activities like running or weight lifting, those things will improve your bone density.

Mary Louder: 26:35

Yeah, and that's based upon Wolf's law, a stress placed upon a bone, the bone will respond and get stronger. What's interesting is what we've used in medicine to treat osteoporosis, whether it's a medication like Fosamax or Boniva, the mineralization increases, but not the cross bridging inside of the bone, so the bone gets brittle on the outside and becomes a stronger tube without the interior scaffolding being strengthened, the--

Todd Buckingham: 27:07

Oh, interesting.

Mary Louder: 27:08

--things called trabeculae, and those just don't get strengthened, and so the bones become more brittle, actually. And what's interesting too is with Fosamax, or Boniva I know they're using brand names. I don't have any link to the brands here, but we used to prescribe those indefinitely. But bone turns over, we figured in about 18 to 24 maybe 30 months, the entire body. But people kept on the medications for years. And I started taking people off the medications at three years max, usually somewhere between two and three years, and we actually had better outcomes. The other thing that I learned is how much vitamin D is needed to strengthen bones. Look at their activities, and then the following thing is, which is fascinating, and you may what you may be aware of this, but bone is actually an endocrine organ because it has a lot of insulin receptors. And so I think where we see that cross sectioning of women post menopausally, the change in estrogen, which estrogen is anti inflammatory, cortisol comes more to the front. Insulin kind of takes a hit. It's not as sensitive. Muscle to fat ratio changes, signaling changes. I think that's where bones can take a really, really big hit in women. And if we understand metabolism over menopause, then I think we can strengthen and keep bones stronger longer.

Todd Buckingham: 28:49

Yeah, absolutely.

Mary Louder: 28:50

Yeah. So that's kind of cool. Alright. Well, here's where it's going to get a little tricky. This will be fun. This is something you're not exposed to yet. And I I did this on purpose. I love it, not to make you blush, but to get I want you-- Put me on a hot seat. Exactly! Well, I want to get your honest opinion. And I know you know what results I've had, but I want to just see your insight when we look at genomics coming into exercise prescribing. And what that means is, and this is where, in my practice, I use a particular test with a company that looks at 36 different pathways, including inflammation, injury risk, VO2 potential, recovery, and even motivation and dopamine metabolism and insulin sensitivity and vascular health. So picture this. If I had a patient who was doing everything right but felt wrecked after workouts and their genomic tests showed poor recovery genes, especially with a gene called COMT, then that has a lot of influence in the liver, phase two of detoxification, and IL6 variants, which is one of the biggest anti inflammatory genes, or inflammation genes, once she shifted to what a lower volume or more restorative training, all of a sudden there's a game changer for her, just based upon knowing her genome. So if you had access to what these genes did, what the person's report was while you were building an exercise prescription, would that give you more insight?

Todd Buckingham: 30:32

Yeah, absolutely. And in the exercise science world, we like I teach my students, 50% of your VO2 Max is heritability. So what comes from your parents. So that means that your peak vo two is determined based on your parents--probably more specifically, your mother, because you get all of your mitochondria from your mom. So if you're a bad endurance athlete, you have your mom to blame. So thankfully, my mom did something, right, so I can't, you know, I can't say anything to her. But not only is your VO2 Max 50% heritability, but your ability to improve your VO2 Max is also about 50% genetically determined. And so knowing that would definitely like change how I--not necessarily, maybe not necessarily, how I prescribe exercise, but it would definitely give me and my athletes better expectations of what is going to happen. Because every athlete wants to improve and decrease their times by, you know, an hour in a marathon or something like that, right? But you know, if, if they're already at their potential peak performance and their VO2 heritability is just low, then it allows us to set more realistic expectations and kind of avoid the disappointment that may come with, you know, signing up for a coach and getting this exercise prescription. And now I do think that anybody who hires a coach, whether it's me or another coach, will improve. But like I said, it's, it's mainly because, you know, you're paying somebody to do something, and you're going to be doing it, and so then, you know, you're going to get a little bit better. But you know, kind of where I think I differ from others is that it's, it's much more specific than that. It's not just a cookie cutter model thing. Ask every one of my athletes, and it's like, Oh, yep, we're doing something different, and it's really specific to me. And you know, we change training throughout the week if need be. And so, yeah, really like, and you'd mentioned the recovery. The recovery is a super important part as well, and it kind of determines, like, how much volume you can handle. And so I have an athlete who who really wanted to go all in with triathlon, and they were super excited to start. And we started together over a year ago, and they improved really quickly. And then all of a sudden, it was like a few months ago, they said, you know, hey, I think I need a recovery week this week. I'm just kind of feeling tired and worn down. So we did recovery week and then got back into training, not like where we were before the recovery week, but, you know, kind of just like building back into the training, and then, you know, a week later, they were like, Oh my gosh. Like, I'm still just, I cannot do anything. And so I'm like, man, like, this is really weird. Like, everything was going great for a while, and now it's just, like, you just can't even train. And now they've had to take a break because they just were tired, run down, almost maybe burnt out from the training that that was happening. And so, you know, knowing that going in, and I even told them, I was like, yeah, maybe if, when we started, we weren't doing 12 to 15 hours a week like you wanted to do, because they had time to do all of that training. It's not like I was giving them something that they didn't ask for, but they, you know, they really wanted to improve, so we were doing 12 to 15 hours of training. But if I had known, maybe they had, you know, the COMT or IL6, variants for those recovery genes that maybe I would have gone with eight hours of training a week, instead of 12 to 15, so that it allowed them time to recover and absorb the training, as opposed to beating them into the ground, more or less.

Mary Louder: 34:39

Right. Well, what's interesting, I've got the genes that it takes my VO2 Max a very long time to gain, and I have my resting metabolism is below average. My response to exercise is below average. So I know see where I'm going this one recovery time is well above average. Okay, and I don't know. So what I experienced as a young'un, you know, when I was in junior high to high school and getting ready for college is two days after a big workout, I would just hurt so bad, and I would take, in those days it was aspirin and Epsom salt soaks, you know, that's what I didn't and that was, you know, that was kind of rock and roll then that was kind of rocket science and but what I also then tried to do was go, Well, yeah, I'm an athlete. I should be able to go run a 10k. And I got so sick, you know, I I've crossed the finish line. I literally kind of just kept jogging home because it was at the University, and then I was sick for like the next half a day. I was. So, you know, so it was, and it took me about four days to recover. And I had been jogging, but I hadn't really been running, which are two distinctly of yeah things. And so now, as I'm certainly a lot older, I have had to taper and really watch and I've had some hits with some couple different injuries and illnesses that have really challenged my health, that now I have to literally build according to my genome. And so if I'm tired, I have to not do something, and I have to really listen to my body. And if I don't, it's not fun at all.

Todd Buckingham: 36:33

Right. And that's that's one thing that I always encourage my athletes to do is, you know your body better than anybody else. The training that I write is a suggestion, and what I, what I, based on my experience and what the science says should be able to get you where you need to go. But you know your body better than anybody else, and if you feel like you need a break, then you need to make that call. And just because it's on the schedule doesn't mean you have to do it. So I think that's a really important point that you make, that yeah, like you gotta, you gotta know how you feel and and really tune into your body. And I think some of that testing that you're doing could help people understand that even better. So, yeah, I think that's--

Mary Louder: 37:18

Because when I realized I needed that long time to recover, I started taking naps, and it was super helpful and and I also see where, you know, my patients were able to avoid injury. So because I've been building since last fall with my swimming, where I'm swimming now three miles a week, which is pretty good over that length of time, I haven't had a shoulder injury, a knee injury, a low back, nothing. I've had some tight muscles, but I haven't really missed a day for any type of muscle or overuse injury, which is actually pretty good.

Todd Buckingham: 37:58

Yeah.

Mary Louder: 38:00

So, so the genomics actually tell the story we build. And when, when I do that with folks, I take them right through and and I ask them, does this look like you? You know, when we look at those dials, does this feel like you? Is this your story? And they're like, oh my gosh, it totally explain why certain things happen. So it really--

Todd Buckingham: 38:19

Oh, that ex-- that explains why I am the way I am,

Mary Louder: 38:22

Exactly, exactly. So well, we're going to take a quick commercial break and hear from our sponsor, and I'm glad you're here, and we'll come back. And everybody come back with us, because we'll be glad for the next segment here. So stay tuned. We'll be right back with you. Alright, friends, time for a quick breather, or, as I like to say, a little cellular check in. This commercial break is sponsored by mycoVIM, the functional mushrooms, rooted in science, balanced for life. And I've got special for you, the five core adaptogenic formula that's designed to support resilience, immunity and whole body vitality. And it's called mycoVIM core support, and it's my daily go to functional mushroom, especially on the days when I'm juggling both mitochondria and meetings. And let's be honest, most days are those days. I make sure that I really take the blend every day and then I augment it with the individual formulas. That's how I do my functional mushrooms. And for those looking for extra recovery and movement as that's what this podcast is about, let me spotlight one of our standouts, Cordyceps. That's a powerhouse mushroom shown to support oxygen utilization, endurance and energy without that wired crash. It's like nature's gentle performance enhancer, but yet without the drama. So if you're training, recovering or just trying to keep up with your life, this is your mushroom. And here's where it gets personal. I want you to know exactly how your body responds to stress, inflammation, exercise and recovery, and we can look at that through your DNA and using the 3x4 genomic test in my practice, I guide everybody from fitness to supplementation into their next level of health and wellness, called the hero's genome. And this is really next level personalized medicine, where we stop guessing and we start aligning with your biological truth. So if you want to learn more either about the genetic genomic testing and the full line of the mycoVIM formulas, including Cordyceps, go to drmarylouder.com and click on Shop or click on mycoVIM, and there you'll find the tests. And if you want to schedule an appointment to go over your genomic test, let us know again at drmarylouder.com now back to this episode. You. All right, welcome back. It's Dr. Louder and special guest Todd Buckingham, our exercise scientist and triathlete extraordinaire. So I went from brilliant,

Todd Buckingham: 41:05

I think, I think you forgot, brilliant, yeah, oh, okay, extraordinaire, brilliant, okay, I'll, I'll take it. I'll take it.

Mary Louder: 41:13

You know, kind of alphabetically, yeah. So Todd asked a great question at our commercial break, how do you measure the genomic test? Well, it's a cheek swab. Now, up here, this cheeky swap, so you get a--we order a test from the lab. 3x4 is the company that I use. I don't get any money by saying that, just telling folks that's the one I use.

Todd Buckingham: 41:35

Not a sponsor.

Mary Louder: 41:37

Yeah, they're not our sponsor. And then about two and a half weeks later, a test comes back, a 32 page report. And so it literally tells the story. I've then taken that and developed what's called The Hero's Genome. I look at our health as a journey. And so just like the hero's story or the hero's journey I took and made The Hero's Genome, and we use the genome as a blueprint, as a way for you to understand your health and for us to rebuild, repair, restore, recover and prolong your health and wellness. And then from there, we reflect your genome on testing, whether it's a functional test, like a stool test, whether it's regular lab tests, B12 levels, vitamin D levels, complete blood count, iron studies, whatever we need, and then we reflect it back on the genomic report. The genome is never diagnostic. It's what are the SNPs or the changes in the genes that we can say, yes, thank you Mom, thank you Dad. Or, off to therapy I go, and when we put that together to really create, you know, a wellness plan. So it works really wonderfully. I've taken people who've had--women who've had breast cancer and they've needed hormone replacement after breast cancer, and we've been able to reverse engineer to safely treat them. People have had heart disease, valvular heart surgeries, and we found things relative to cholesterol, vascular inflammation, how to exercise to create a safer protocol for their cardiac rehab. It's just really a wonderful test. And so I can't wait as we begin some of our work together. I can't wait to teach you about some of the genomics and seeing some of the athletes and folks use that test and and you'll be, I think you'll like that bit of information.

Todd Buckingham: 43:33

Yeah, I'm looking forward to it. Just, it's another, another tool in the toolbox, right?

Mary Louder: 43:37

Yeah, exactly. That's exactly right. And I use that because I quit--I wanted to quit guessing, you know, things that seemed like a good idea at the time, and also to avoid injury. And so it's helped me be able to do that. And like I said, personally, I've not had overuse injuries since I started following, really how my genomics look. And then I do have to use, and I do have patients use, sometimes certain supplements to support the pathways. Like, one of the big pathways is MTHFR methylation. And everybody goes, Oh, I have MTHFR, great. You'll die with it, not from it, just so you know, and it's never one gene or one SNP--Single Nucleotide Polymorphism--that makes any problem. It's when they are clustered together in certain patterning or nutrients that are needed to support them that are missing. And I found with my methylation, it's not just pushing a bunch of B vitamins down the pathway, because that actually shuts off my MTHFR pathway. I needed more magnesium, more zinc and a hell of a lot more choline. Well, who knew not until I did my genome test and saw the SNPs and choline, as well as glutathione, which is one of your main intracellular antioxidant and once I put the glutathione in and the choline and the magnesium, all of a sudden my methylation improves significantly. And then I could kind of sprinkle the B vitamins in there. And I really don't run into the muscle soreness. I really don't run into the profound fatigue. And I can, you know, my endurance activities can be a lot longer, so kind of fascinating.

Todd Buckingham: 45:23

Yeah, and I love--test. Don't guess.

Mary Louder: 45:26

Yes.

Todd Buckingham: 45:27

That's one, that's one thing I say in the lab all the time, test, don't guess. Like, why? Why would you, why would you guess on it, If you can just test it?

Mary Louder: 45:34

Yes, that's exactly right. Alright. So this now we're going to come to a fun part, the gadgets, gimmicks and gotchas. It's the reoccurring segment I got here. And what we're going to do is talk about an item that we use in training, and we're going to decide together what category it fits into, a gadget, a gimmick, or a gotcha. So for folks who this is the first time listening, a gadget is something useful, right? A gimmick is, well, hmm, interesting, I wonder about that. And of course, the gotchas is pretty much something you want to return, so keep your receipt ,right? So we're going to talk about the supplement creatine. And if anybody has been online, anywhere online, Instagram, Facebook, YouTube, you don't tube whatever. It's there. Creatine is there. And it's there in high volume. It's there in lots of forms. It's there in gummies, it's powder, it's

capsules, it's: 46:35

I'm the best. I've got the best. You're not the best. I'm the best. This is how it works. And it's got some very interesting claims behind it, to making you very strong, to recovery, to brain health, to mental health. And so let's break this down a little bit. And Todd, I want your take on what you see and how you see creatine in one of the G's, a gadget, a gimmick or a gotcha.

Todd Buckingham: 47:04

Yeah. So creatine is one of, if not the most widely studied supplement over the last 25 or 30 years from like the late 80s, early 90s to now, and it has been proven over and over again that it will improve. Short, endure--not endurance. Short, high intensity, sprinting, lifting activities, particularly in repeat bouts of exercise. So some studies show some improvements with like, a single sprint, but it's better when you have the repeated sprints. The great thing about creatine is that there really are no adverse effects to taking it, except maybe a little bit of weight gain when you first start, because it leads to water retention. But other than that, like there's no GI distress, there's no emotional mental issues with taking it, like a lot of, you know, medications that are prescribed nowadays. Yeah, there are really no adverse effects to taking creatine, other than potential weight gain. And so that makes it one of the best supplements and one of the best legal supplements to take, for athletes and non athletes alike. I know that a lot of athletes are unable to take certain supplements because they're banned by--whether it's the World Anti-Doping Association or the United States Anti-Doping Association, things like caffeine, even caffeine is a banned supplement if you have it in too high of a dose. Now, in order to consume the amount of caffeine that you would need to fail a drug test, it would be like 10 pots of coffee. So not really realistic, but you could potentially overdose, in quotes, on caffeine and test positive for, you know, a drug test. But creatine is not banned by any of the governing bodies, which makes it, you know, a great performance enhancement tool for, really, any, I won't say any. For most athletes. And it's great for the normal person as well. It can improve mitochondrial function. And I know you and I talked a little about some of the things that it does, but you know, there are so many different things other than just performance that it improves. Recovery, like I said, mitochondrial function, and so, yeah, it's, I'm a fan of creatine for almost all situations.

Mary Louder: 49:42

Okay, well, I've prepared in the show notes on the gadgets gimmicks, and gotcha, a document so people can go download this, because it's got how creatine can work. And I took this out of the 2023 article in the International Society of Sports Nutrition. So I've got it fully cited, fully referenced, and it's an effective ergonomic aid to augment resistance training, improve intense, short duration, as you mentioned, intermittent performance, and the endurance performances are less known. I think this study just didn't look at the endurance, because I've got other articles on endurance, and I even have an article of using creatine in women, how it changes the function of women and strengthens them throughout their monthly cycling. And I don't mean bicycling, of course, we know what the monthly cycle is, but here's a couple things. So increases your ventilatory threshold, decreases--so it means you're you're able to intake more oxygen, right? Am I correct there? So, because then--

Todd Buckingham: 50:45

So, the ventilatory thresholds, we actually have two ventilatory thresholds. One occurs near the beginning of exercise, and it's when the muscles send a signal to the brain saying, hey, we need more oxygen to be able to do this exercise. So then the brain sends a signal to the lungs to increase ventilation in order to get more oxygen to the muscles. The second ventilatory threshold occurs later in exercise at higher intensities, and I say beginning of exercise and later in exercise, I mean at lower intensities, VT1 occurs, at higher intensities, VT2 occurs. So VT1 occurs when the muscles need oxygen. VT2 occurs when the muscles have an increase in carbon dioxide. They send a signal to the brain say, hey, we need to get rid of this carbon dioxide. The brain then sends a signal to the lungs to increase breathing, again, ventilation and to get rid of that carbon dioxide that's being produced in the muscles. So that's what ventilator--there are two ventilatory thresholds. So that's what ventilatory threshold is. Essentially, it's a spike in ventilation.

Mary Louder: 51:45

Okay, so for folks, ventilation is the air movement, just like when you open two windows, you ventilate the room. Respiration is when the oxygen diffuses across the cell membrane in the lungs, carbon dioxide out, oxygen in, that's respiration. So we've got two things with air movement that lungs do, respiration, the in the cell level, and ventilation with the bigger movement of air. Couple other things I'll just

whip through these: 52:10

decrease reactive oxygen species, meaning the oxidative damage of cells, and we're going to preserve fast twitch muscles. Decrease inflammation, as you mentioned, increased mitochondrial biogenesis. It buffers that--the hydrogen, so you talked about that at the lactic acid threshold, right? Increases glycogen production, which is what the muscles use for energy and PCR and recovery of PCR. So I'm thinking that's with ATP production as well, right?

Todd Buckingham: 52:45

Yeah, PCR is just phosphocreatine. That's the the type that's in the body. So the ATP-PCR system is our short, short, ultra short term energy system that lasts about 10 to 15 seconds. So we have ADP and PCR, so adenosine diphosphate and that phosphocreatine that with the enzyme creatine kinase, can give us ATP, and that's how energy is created, yeah.

Mary Louder: 53:12

Great. And I used my ultra fast muscles the other night when I ran down the steps in the tornado.

Todd Buckingham: 53:18

Yes, yes.

Mary Louder: 53:20

So thank goodness. Now. Okay, so then let's look at a little bit of dosing. So I think we've decided that this is really in the gadget category, right? It's going to be helpful, useful for both folks, for endurance or for quick, you know, muscle gain activities intermittent. And I think I've seen the studies on endurance, and I think that, I think we've got some, we've got some methodology there. So they're saying between three to five grams of creatine per day, which can be achieved through powder or capsules. They talk about a loading dose. And I've honestly had mixed results with the loading dose in folks. I've had where it's created that water retention and folks haven't enjoyed that, and then it's also created more discomfort. I have had a little bit of GI upset with people when they did the higher doses. So I literally start them at two to three grams, build up to five grams if there's more intense, but otherwise I keep--and also I change it with their body weight and body mass. So I've got some people who are slighter, they're petite, and I do the lower doses, and they're getting the results without any of as much of the water retention.

Todd Buckingham: 54:44

Yeah. And I think the the car--car--bloating, the creatine loading, was the first kind of protocol that was created to, you know, ingest creatine. And now we've kind of seen that it's not absolutely necessary, like you can get away with three to five grams a day and still see some of the same benefits that you get from doing 20 grams a day for a week. So you know that that's when I said, you know, not a lot of GI discomfort, whatever. That's kind of I was going with the more updated recommendations bit based on the science. Because, yeah, if you're taking 20 grams a day, especially as you said, if you're a slighter individual that, you know, may only weigh 100 to 120 pounds, 20 grams a day is going to be way more than you know point five grams per kilogram a day.

Mary Louder: 55:37

Yes, right. Okay. And then I don't think it matters powder or gummy or tablet or capsule form. I think people--

Todd Buckingham: 55:46

No, I hadn't seen. I think the one thing that people need to keep in mind is it's creatine monohydrate that is the specific supplement that you need to take. Because that's the one that has been studied, and make sure that it's, you know, what's the NSF, the Safe, Safe Sport Certified, so that you know what's in it. Because there are so many supplements out there that are not regulated, and we don't actually know what's in them. So, you know, I mentioned off-air Mary, that my wife does pre-admissions calling for a hospital. She's a nurse, and she has to ask people what supplements they take, and tell them to stop taking certain supplements X number of days before their surgeries, because if there is a substance in those supplements that does not interact well with anesthesia, they could have some pretty serious complications and so--but the whole point is that there are supplements that you may have in your cupboard right now that don't have all of the ingredients on them that it says are on them if they are not certified.

Mary Louder: 56:55

Yeah, yeah. That's a fair that's a very fair statement. And thank you for that, because the supplements that that we use through our practice come where only physicians can obtain them, and--

Todd Buckingham: 57:07

That's great.

Mary Louder: 57:07

Yeah. And so when I prescribe them, I also know the dosing, how to use them, what's in them, and they've been clinically or scientifically studied 100% of our stuff. So that really is good. So alright, so I would say, folks, creatine monohydrate three to five grams a day. Doesn't matter when you take it around your workout, just before, after, during, just get it in throughout the day, and even on days, I have seen lower doses used on days they aren't doing a workout, but maybe in a recovery, and it has helped those folks with the extra long recovery. I'm raising my hand again. And I have noticed the difference in being in my recovery, being just much more comfortable. And so that's that's kept me going. Alright. So if we pull this all together, then, I mean, it looks like it would might be fun to come back in a bit of time after we've done some work together to put exercise prescriptions and genomics together and look at some cases that might be kind of fun.

Todd Buckingham: 58:15

Yeah, absolutely.

Mary Louder: 58:17

And so I think we'll plan for that so, and we will, for sure, alert--alert our audience for when that occurs. And so I would say, you know, as we go forward, we've got the science, we've got the genomics, we're going to honor the body's limits, the strengths, the challenges. And instead of white knuckling our way through, I think we might find a flow and really get some good results. And folks really have some happy results and low injury and and a really good--get their, some of their personal best times.

Todd Buckingham: 58:55

Yeah, and you never want to white knuckle anything in, in sport, one of the one of the sayings that I use most in the lab when people are doing a VO2 max test. So the VO2 max test, essentially is a progressive test, where you start at a slow speed, but then you end up running as fast as you possibly can, just before you fall off the treadmill. And one thing that I always say to people is smooth is fast. You cannot run fast if you are clenched and tight and white knuckling because you're tensing up and you're not allowing your body to do what it needs to do. So yeah. If we can, if we can stop white knuckling our way through through training, through health and wellness, I think that it will be so much better for patients, athletes alike, and we can just all go through this great process together and improve.

Mary Louder: 59:50

Yeah, great. Well Todd, thank you for being our guest today, and I look forward to inviting you back. We'll do some case studies and see some improvements when we put some of the genomics together. I think that's going to be a lot of fun. So everybody look in the show notes for some of the gene information, creatine information, and I thank everybody for listening in today on this episode of The Dr. Mary Louder Podcast, and we'll see you guys next time.