Brent Cosnett

Holistic Coach. I help people heal gut and chronic health issues and reclaim optimal health IG

[Brent Cosnett @Seeking_Optimal]

Chronic NSAID use measurably reduces serum levels of all three.

Possible downstream effects of depleting these 3 nutrients…

Fatigue (B5 + lipoic acid)

Brittle hair and nails (biotin)

Blood sugar instability (biotin + lipoic acid)

Slower recovery from training (B5 for stress hormone production)

[Brent Cosnett @Seeking_Optimal]

The difference between salmon roe and concentrated fish oil isn't dose. There's a real difference in molecular position and absorption.

Real fish hold their omega-3s in the SN-2 position on the glycerol backbone. That position is what determines how the fatty acid gets digested, transported, and delivered to cell membranes.

Concentrated fish oils strip the omega-3s, then re-esterify them. The fatty acids end up randomised across SN-1, SN-2, and SN-3 positions. Your gut pancreatic lipase preferentially cleaves SN-1 and SN-3, leaving SN-2 monoglycerides for absorption.

When the omega-3 is sitting in SN-1 or SN-3 (which it is in most concentrated oils), it gets cleaved off and competes for transport. Bioavailability drops. Tissue incorporation drops further.

This is one reason RCT data on fish oil supplementation is so mixed despite epidemiology showing clear benefits from eating fish.

The fix is whole food: salmon roe, sardines (with bones), mackerel, anchovies, oysters. 2-3 servings a week covers what 4 caps of cheap fish oil doesn't.

If supplementing, look for natural triglyceride form (rTG) or phospholipid-bound (krill, salmon roe extracts) over ethyl ester.

[Brent Cosnett @Seeking_Optimal]

@Scobleizer @blevlabs I can’t use Fable for any prompt in Claude cowork. I’m a nutritional therapist and health coach so it reads my Claude Md and switches model instantly 🤣👎🏼

[Brent Cosnett @Seeking_Optimal]

On average people get about 3g potassium per day.

That's below the RDA (3.4-3.8g). And the RDA itself is too conservative. It assumes a sedentary baseline, no sweat loss, no real training volume.

For hard-training individuals, 6g/day is the floor.

Why it matters: potassium is the cation that pulls magnesium and sodium into cells, keeps blood pressure regulated, and drives the sodium-potassium pump that uses ~20% of your resting energy budget.

When potassium is chronically low:
- Blood pressure drifts up (sodium-K ratio)
- Muscle cramps and twitching
- Insulin sensitivity drops
- Aldosterone rises (chronic stress signature)
- Magnesium can't enter cells properly

The shortfall isn't from "not enough banana." A banana is 422mg. To hit 6g, three practical lanes:
- Potassium-rich electrolyte mix: 500-1000mg per serve
- Coconut water: ~2g per litre
- High-potassium foods: avocado (~700mg), potato (~900mg), salmon (~500mg), cooked greens (~800mg per cup), beans (~600mg per cup)

Caveat: if you're on potassium-sparing diuretics or have kidney disease, get the bloodwork before pushing intake.

[Brent Cosnett @Seeking_Optimal]

Ibuprofen and aspirin don't just thin your blood and irritate your gut. They compete for the SMVT transporter, blocking 3 nutrients at the same time:

- Vitamin B5 (pantothenic acid) → coenzyme A, hormone synthesis, energy
- Biotin → fatty acid metabolism, blood sugar regulation
- Alpha-lipoic acid → glucose uptake, mitochondrial protection

Chronic NSAID use (more than 3 days/week) measurably reduces serum levels of all three. The downstream signs people don't connect to ibuprofen:
- Fatigue (B5 + lipoic acid both contribute)
- Brittle hair and nails (biotin)
- Blood sugar instability (biotin + lipoic acid)
- Slower recovery from training (B5 for stress hormone production)

If you're taking NSAIDs more than occasionally, supplement around the block. B5 50mg, biotin 1mg, ALA 200mg covers the deficit. Better fix: address why you need the NSAIDs in the first place.

[Brent Cosnett @Seeking_Optimal]

Coenzyme A runs roughly 4% of all enzymatic reactions in your body.

The list of what stops working when CoA is low:
- TCA cycle (energy production)
- Fat burning (β-oxidation)
- Cholesterol and steroid hormone synthesis
- Heme production (oxygen transport)
- Acetylcholine synthesis (memory, neuromuscular signalling)
- Melatonin production (sleep, antioxidant defence)

CoA is built from vitamin B5 (pantothenic acid). B5 deficiency is rarely tested and almost never diagnosed because subclinical signs (fatigue, low cortisol response, slow wound healing, peripheral neuropathy) get attributed to everything else first.

Highest food sources: liver, egg yolks, salmon, mushrooms, sunflower seeds, avocado.

If you've been chronically NSAID-using, drinking regularly, or under prolonged stress, B5 is probably low. 500mg pantothenic acid daily for 8 weeks is a cheap test. Energy, recovery, and skin quality usually shift if it was the bottleneck.

[Brent Cosnett @Seeking_Optimal]

Patterns I look for on basic bloodwork that almost never get flagged in standard care:

- Low-normal ferritin (30-50) with high TIBC, low serum iron, low MCV and low MCH → early iron deficiency. Standard care waits until you're anaemic.
- High-normal MCV (>92) with low folate/B12 → functional B12 issue, often MTHFR or absorption-related
- Low ALT or AST (below 12) → likely B6 deficiency
- High SHBG with low-normal free T → liver-driven sex hormone binding, often insulin resistance upstream
- TSH 2.5-4.5 with below optimal T3 → subclinical hypothyroidism that standard care calls "normal"
- Reverse T3 > 24 with low FT3 → cellular thyroid resistance from stress, inflammation, or under-eating
- CRP 1-3 mg/L → low-grade chronic inflammation, usually missed
- Neutrophils below 2.5 and MEB (monocytes + eosinophils + basophils combined) below 0.45 good clue for chronic leaky gut if symptoms match
- Uric acid >0.325 mmol/L in women, >0.35 mmol/L in men → metabolic dysfunction marker before HbA1c moves

Normal range is built around the sick population. Optimal range is built around what's actually healthy.

[Brent Cosnett @Seeking_Optimal]

Kids who live with a dog from 3 months old have 90% lower odds of food allergy by age 3 (Marrs et al. Allergy 2019).

The mechanism is microbial diversity. Dogs are the daily delivery system for soil microbes, environmental bacteria, and a constant low-grade exposure to non-pathogenic organisms. That diversity is what trains the infant immune system to tolerate food proteins instead of mounting an allergic response.

The same mechanism is why farm-raised kids have lower asthma and allergy rates. And why C-section babies (who miss the vaginal microbial inoculation) have higher rates of both.

The actionable piece for adults: your microbiome is still trainable. Daily contact with soil (gardening without gloves, walking barefoot, eating from local farms) does what the dog does for the kid. Fermented food variety matters more than fiber volume for diversity (Stanford 2021, PMID 34256014).

[Brent Cosnett @Seeking_Optimal]

Doctors run cardiac stress tests after 50. Your body runs one every night.

Morning wood is a vascular event before it's a sex thing. Healthy nocturnal erections need three systems firing:
- Free testosterone above 400 pmol/L
- Nitric oxide synthesis (endothelial function)
- Low chronic inflammation (hsCRP under 1.0 mg/L)

When you stop having them in your 30s and 40s, one of those three is breaking. That's vascular disease, hormonal disruption, or systemic inflammation showing up 10 years before it shows up on a stress test.

What to check before reaching for TRT:
- Free testosterone (not just total)
- Oestradiol
- hsCRP (chronic inflammation suppresses NO production and Leydig cell function)
- HbA1c and fasting insulin (insulin resistance kills endothelial function)

Most men I work with assume it's their T. Half the time the T is fine. It's the vessels, the inflammation, or the insulin.

[Brent Cosnett @Seeking_Optimal]

@DamionKnudsen Yeah 100% P gingevalis is one culprit or oral to
Gut transfer that’s causes dysbiosis

[Brent Cosnett @Seeking_Optimal]

You swallow more bacteria from your own mouth every day than you'd get from most probiotic supplements.

1 mL of saliva holds around 100 million bacteria, and you swallow roughly 750 mL of it a day. That's about 80 billion bacteria heading into your gut every 24 hours.

They don't all get wiped out in your stomach. A big fraction survive and seed it.

- Your mouth is the upstream source of your gut microbiome
- A dysbiotic mouth re-seeds it with the wrong bugs daily
- There's a free routine and one specific oral probiotic you can use to fix it.

Here's the oral-gut axis, and how to clean up the upstream end.

[Brent Cosnett @Seeking_Optimal]

Then add the targeted strain.

1. BLIS K12 lozenges. NOW OralBiotic is a good option. 2 lozenges once or twice a day.
2. Take them AFTER brushing, so you don't remove most of them while brushing.
3. For stubborn oral issues: morning and night, swish 10 to 20 minutes, then spit.
4. Pair the whole routine with your actual gut work. The two ends reinforce each other.

[Brent Cosnett @Seeking_Optimal]

So here's the full routine. Start with the daily mechanics:

1. Brush at least twice a day, ideally after meals. The mSphere study is why frequency matters, you're physically removing the bugs before you swallow them.
2. Scrape your tongue. The back of the tongue is the biggest reservoir of the anaerobes that pump out bad-breath sulfur compounds. A scraper clears that film in seconds.
3. Oil pull with coconut oil. Swish a tablespoon for 10 minutes, then spit. The lauric acid has antimicrobial and antifungal action and helps lift the biofilm.
4. Ditch antiseptic mouthwash if you use it.