How to Enhance Your Immune System

00:00:00.000 | - Welcome to the Huberman Lab Podcast,

00:00:02.240 | where we discuss science

00:00:03.720 | and science-based tools for everyday life.

00:00:05.920 | I'm Andrew Huberman,

00:00:10.320 | and I'm a professor of neurobiology and ophthalmology

00:00:13.400 | at Stanford School of Medicine.

00:00:15.320 | My guest today is Dr. Roger Schwelt.

00:00:17.920 | Dr. Roger Schwelt is a board certified medical doctor

00:00:20.720 | in pulmonology,

00:00:22.080 | which is the understanding and treatment of conditions

00:00:24.040 | that impact the respiratory system,

00:00:25.880 | such as colds, flus, and other viruses,

00:00:28.480 | mold infections, asthma, and more.

00:00:30.800 | Dr. Schwelt is also board certified in sleep medicine.

00:00:34.040 | He does his clinical work

00:00:35.320 | in the intensive care unit at Loma Linda University,

00:00:38.120 | and he's actively involved

00:00:39.480 | in medical and public health education

00:00:41.640 | through his terrific online channel called MedCram.

00:00:44.560 | Today, we discuss how to avoid getting colds,

00:00:46.600 | flus, and other viruses,

00:00:48.400 | and how to treat them to minimize discomfort,

00:00:50.640 | accelerate healing, and avoid long-term consequences.

00:00:53.920 | During today's episode, we discuss long COVID,

00:00:56.560 | as well as the use of sun and red light

00:00:58.360 | to stimulate mitochondrial and therefore metabolic health

00:01:01.300 | across the entire brain and body.

00:01:03.200 | That opens up a broader discussion about phototherapy,

00:01:05.720 | which is the use of light to control health,

00:01:07.920 | and temperature and other levers

00:01:09.800 | for improving brain and bodily function.

00:01:12.280 | Dr. Schwelt emphasizes that sun and red light therapy

00:01:14.800 | have a long and well-established medical history,

00:01:17.280 | and their mechanisms of action are known,

00:01:19.800 | and therefore it's not just biohacking as many people think.

00:01:22.720 | We also discuss the sometimes controversial topic

00:01:25.120 | of the flu shot, and if and when you should get one.

00:01:28.960 | Dr. Schwelt, as you'll soon hear,

00:01:30.840 | is world-class at making medical concepts

00:01:33.240 | and the actionable items related to health

00:01:35.480 | exceptionally clear.

00:01:37.120 | As a consequence, I'm certain that you'll truly appreciate

00:01:39.640 | the knowledge that he shares in your efforts

00:01:41.680 | to be and stay healthy at any age.

00:01:44.160 | In fact, by the end of today's episode,

00:01:46.140 | you'll be armed with the real knowledge

00:01:48.120 | on how to best get over nasty infections

00:01:50.120 | of the sinuses, lungs, and throat faster,

00:01:52.360 | should you happen to get one,

00:01:53.720 | and even better, how to avoid them altogether.

00:01:56.760 | Before we begin, I'd like to emphasize that this podcast

00:01:59.600 | is separate from my teaching and research roles at Stanford.

00:02:02.240 | It is, however, part of my desire and effort

00:02:04.400 | to bring zero-cost to consumer information

00:02:06.400 | about science and science-related tools

00:02:08.160 | to the general public.

00:02:09.500 | In keeping with that theme,

00:02:10.780 | this episode does include sponsors.

00:02:13.200 | And now for my discussion with Dr. Roger Schwelt.

00:02:16.380 | Dr. Roger Schwelt, welcome.

00:02:18.600 | - Thank you so much, Andrew, for having me.

00:02:20.220 | - I discovered you because you were putting out

00:02:22.240 | and continue to put out incredible information

00:02:24.360 | about how to stay healthy amidst infectious diseases,

00:02:29.240 | airborne infectious diseases,

00:02:30.840 | skin contact-based infectious diseases, and on and on.

00:02:34.840 | And nobody likes to be sick.

00:02:37.080 | And you've provided me tremendously valuable information

00:02:40.880 | about how to avoid getting sick,

00:02:43.140 | and in many cases, how to accelerate the progression

00:02:45.600 | from sick to healthy again.

00:02:48.800 | It's been tremendously helpful

00:02:51.640 | for getting me back into life, as it were.

00:02:54.800 | Let's talk about some of the things that one can do

00:02:56.480 | to avoid getting sick

00:02:57.560 | when in the presence of airborne viruses,

00:02:59.960 | in particular, colds and flus, and other viruses, as it were.

00:03:04.760 | If you were to think about the major pillars

00:03:09.360 | of remaining healthy,

00:03:11.000 | especially when one is exposed to colds and flus from kids,

00:03:14.560 | in your case, also in the intensive care unit

00:03:17.800 | where people are coming in specifically

00:03:19.120 | because they're sick,

00:03:20.280 | often with infections like colds and flus or worse,

00:03:24.360 | you need to take specific precautions

00:03:27.200 | to avoid getting sick.

00:03:28.500 | What do you think of as the fundamental layer

00:03:31.120 | of keeping a healthy immune system to avoid getting sick?

00:03:35.240 | And then we'll talk about how to get over

00:03:37.640 | and move through being sick more quickly.

00:03:39.640 | - Yes.

00:03:40.840 | Well, the question is how do you avoid getting sick

00:03:44.800 | in terms of infectious diseases?

00:03:46.800 | And as it turns out,

00:03:47.680 | the answer to that is actually the same

00:03:50.720 | in terms of avoiding getting sick for anything.

00:03:53.480 | And it sort of goes to the pillars, as you call it.

00:03:57.380 | In my mind, there's actually a physician

00:03:59.640 | that I know very well,

00:04:01.000 | just outside of Stanford, actually,

00:04:03.160 | in a place called Weimar,

00:04:04.880 | Weimar University, Dr. Neil Nedley.

00:04:06.720 | And he's actually coined this mnemonic called Neustart.

00:04:11.360 | And each of those letters, to me in my mind,

00:04:15.120 | is something that I go to when I want to improve health

00:04:18.080 | in people in general.

00:04:19.280 | So the N starts for nutrition.

00:04:21.320 | And we can talk about nutrition

00:04:22.740 | and what that does to the human body.

00:04:24.540 | Obviously, as natural as possible,

00:04:28.100 | staying away from processed foods.

00:04:29.780 | That's something there.

00:04:31.240 | Exercise is E.

00:04:33.260 | And when I'm talking about exercise,

00:04:36.020 | I'm talking about the understanding

00:04:38.600 | that we have regarding exercise,

00:04:40.200 | not to build muscle, necessarily be stronger.

00:04:43.360 | I'm talking about exercise in terms of health.

00:04:45.280 | And that has more of a J-hook type of picture.

00:04:49.260 | What I mean by J-hook is,

00:04:50.800 | if you're not doing any exercise,

00:04:52.600 | you're gonna have higher levels of inflammation.

00:04:54.400 | As soon as you start to do some exercise,

00:04:56.640 | even mild to moderate exercise,

00:04:59.720 | the amount of inflammation in your body starts to come down.

00:05:02.820 | But as you start to do more and more exercise,

00:05:06.160 | you do have to be careful in terms of your general health.

00:05:08.800 | This is exactly what happens with athletes.

00:05:12.320 | They have to be very careful

00:05:13.400 | that when they're doing that type of elite athletic exercise

00:05:16.240 | that they're not sick on the day of performance.

00:05:18.240 | And so that's an issue.

00:05:19.320 | So I'm referring to just mild to moderate exercise is good.

00:05:22.940 | The next one would be W, water.

00:05:27.020 | So this is something that's really interesting.

00:05:28.720 | Obviously, it seems pretty obvious,

00:05:31.520 | but not only the use of internal water, but external water.

00:05:34.600 | So in that area, we can talk about sauna, cold plunge,

00:05:37.940 | things of that nature

00:05:38.780 | that can actually help with our immune system.

00:05:40.520 | That's a whole interesting area of discussion.

00:05:43.280 | It involves the innate immune system.

00:05:44.960 | It involves interferon.

00:05:46.640 | There's a lot of history and data

00:05:47.960 | that goes back over 100 years on how that's been used.

00:05:51.600 | Start, S-T-A-R-T.

00:05:53.480 | So S is sunlight.

00:05:55.640 | I've been a real proponent

00:05:57.120 | of getting people outside into the sun,

00:06:00.840 | and we can talk a lot about that.

00:06:02.000 | There's a lot of interesting research,

00:06:03.500 | not only in terms of sunlight, in terms of influenza,

00:06:07.140 | but also COVID, and just about any natural disease.

00:06:10.320 | A lot of interesting information there.

00:06:12.640 | T, T stands for the old term called temperance,

00:06:16.520 | which you may recall is a term that we use

00:06:18.720 | to prevent us from taking in toxins into our body.

00:06:21.760 | That's a whole 'nother discussion.

00:06:23.440 | So staying away from things that would make you sick.

00:06:25.920 | A is air, and when I talk about air,

00:06:28.920 | it's not just what we focus on,

00:06:30.800 | which is keeping bad things out of the air,

00:06:32.520 | so having fresh air,

00:06:33.920 | but there's a whole discussion to be had

00:06:36.120 | in terms of air that has good qualities in it.

00:06:39.760 | So there's a whole area of research that looks at,

00:06:42.520 | for instance, phytoncides,

00:06:43.800 | which are chemicals that come off of trees.

00:06:46.320 | You may have heard of forest bathing.

00:06:47.880 | They've done a lot of research in Japan on this,

00:06:50.640 | and getting out into nature,

00:06:52.020 | there are actual chemicals that are in the air

00:06:54.480 | that you can breathe that actually have an impact

00:06:56.120 | on your innate immune system.

00:06:58.000 | Finally, R, and we'll get into R and T at the end.

00:07:00.440 | R is rest.

00:07:01.600 | Now, this goes without saying,

00:07:04.080 | but people who have good sleep habits

00:07:06.840 | are gonna have much better immune systems,

00:07:08.480 | whether you're talking about

00:07:10.120 | the antibody response after a vaccine

00:07:13.480 | versus just the number of times per year you're sick.

00:07:17.180 | There's very good data, very good research

00:07:19.360 | that shows that getting seven, eight hours of sleep a night

00:07:22.480 | is gonna be very beneficial for your immune system.

00:07:24.640 | It has to do with cortisol and beta receptors

00:07:26.820 | and all sorts of things.

00:07:28.400 | And the last T, which is trust,

00:07:30.840 | and for some, it is trust in a higher power,

00:07:34.360 | trust in God.

00:07:35.700 | These are the sorts of things

00:07:36.780 | that can help us relieve stress.

00:07:40.320 | If someone else is helping you, if someone else is there,

00:07:43.440 | T would also include community, people that are around you.

00:07:46.760 | These are some of the less tangible ways of measuring it.

00:07:51.600 | But when someone asks me a question,

00:07:53.120 | what can I do to avoid getting sick?

00:07:55.920 | And as you just asked me in terms of influenza,

00:07:57.960 | there's a lot of specific things we can talk about,

00:07:59.640 | but that's where I start out with the pillars of health.

00:08:03.800 | I'd like to take a quick break and thank our sponsor Juve.

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00:08:10.440 | Now, if there's one thing

00:08:11.280 | that I have consistently emphasized on this podcast,

00:08:13.820 | it is the incredible impact

00:08:15.280 | that light can have on our biology.

00:08:17.320 | Now, in addition to sunlight,

00:08:18.560 | red light and near infrared light sources

00:08:20.880 | have been shown to have positive effects

00:08:22.720 | on improving numerous aspects of cellar and organ health,

00:08:25.460 | including faster muscle recovery,

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00:09:15.480 | Today's episode is also brought to us by Eight Sleep.

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00:09:22.420 | Now, I've spoken before on this podcast

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00:10:45.360 | - Let's start off with one of my favorite topics

00:10:48.540 | would be the S in New Start.

00:10:51.660 | Let's talk about sunlight.

00:10:52.960 | Listeners of this podcast

00:10:54.520 | or anyone that's heard me on social media

00:10:56.580 | know that I'm as big a proponent

00:11:01.100 | of getting morning sunlight in one's eyes

00:11:03.180 | as one could possibly be

00:11:04.820 | without repeating himself 10 million times per year.

00:11:08.300 | It's a daily activity that we just know

00:11:11.020 | has such an outsized positive effect

00:11:12.940 | on the whole setting of the circadian rhythm

00:11:15.380 | and thereby improved daytime mood focus

00:11:17.880 | and alertness in nighttime sleep.

00:11:19.700 | But the way you describe sunlight,

00:11:22.380 | it goes beyond just getting morning sunlight in one's eyes.

00:11:25.220 | So if we want to parse this S, sunlight, in New Start,

00:11:28.680 | how are you thinking about sunlight?

00:11:31.120 | Is it sunlight on the skin?

00:11:32.380 | Is it also midday light, not just morning sunlight?

00:11:35.400 | Is it a certain amount of sunlight?

00:11:37.060 | And then maybe we can also talk about

00:11:38.380 | some of the underlying mechanisms.

00:11:40.260 | - Yeah, exactly.

00:11:41.820 | So when you talk about sunlight, and I'm a big believer,

00:11:44.540 | I'm board certified in sleep medicine

00:11:46.340 | and I'm cheering you on when you talk about these things

00:11:49.500 | 'cause it's so important that light into the retina

00:11:52.340 | does have an effect on the circadian rhythm,

00:11:55.500 | super chiasmatic nucleus.

00:11:56.820 | It does have an effect on mood,

00:11:58.580 | goes to the perihabendular nucleus in the brain

00:12:00.940 | and has an effect there.

00:12:03.020 | Those are well-known and very important.

00:12:06.180 | What I'm talking about when I'm talking about sunlight

00:12:08.400 | is an aspect of light that is not very well-known

00:12:13.400 | in terms of its visible effects.

00:12:15.200 | So we know about the visible effects of light.

00:12:17.620 | These are photons that are coming into the eyes,

00:12:19.480 | that we can see.

00:12:20.760 | What I'm discussing and what I'm talking about

00:12:22.900 | is the effect of sunlight on the human body,

00:12:27.260 | the skin penetrating into the human body.

00:12:29.500 | Now this at first sounds kind of woo-woo, I guess,

00:12:33.220 | we could say, but the point that I wanna make here

00:12:36.220 | is understanding that when we look at the sun,

00:12:38.580 | we are seeing about 38% of that energy

00:12:42.220 | coming from the sun is in the visible spectrum.

00:12:44.020 | There's a whole nother 52% of the photons

00:12:47.320 | coming from the sun in the infrared spectrum.

00:12:49.820 | And on the other end, on the ultraviolet side,

00:12:51.980 | this is the part we have no problem understanding

00:12:54.560 | because we know that ultraviolet B light

00:12:57.220 | comes into our skin and it's high energy,

00:12:59.460 | so it's able to actually move the bonds

00:13:02.100 | on these cholesterol derivatives in order to make vitamin D.

00:13:06.440 | So we know that.

00:13:07.280 | So now what do we say?

00:13:08.580 | When I say, "Hey, I wanna go outside to get some vitamin D,"

00:13:11.820 | we know that we're going outside

00:13:13.140 | to get this light that we can't see

00:13:15.180 | that's very imperative to giving us

00:13:16.820 | something called vitamin D,

00:13:17.900 | which is a hormone in our body,

00:13:19.700 | and it's very, very important.

00:13:21.280 | On the other side of that, though,

00:13:22.900 | on the infrared side, is something that there's new science,

00:13:27.020 | new data that is coming out that is showing

00:13:29.900 | that it's actually very, very important.

00:13:31.580 | And to that, I would point to an article

00:13:34.640 | that really changed my thinking on this

00:13:37.900 | and really opened my eyes, no pun intended.

00:13:40.460 | There was an article that was published in 2019

00:13:43.260 | in Melatonin Research by Scott Zimmerman and Russell Ryder.

00:13:47.180 | And the name of that article was

00:13:50.140 | Melatonin, Optics of the Human Body,

00:13:53.820 | the Optics of the Human Body.

00:13:54.940 | And what Scott Zimmerman and Russell Ryder set out to show

00:13:58.380 | is that, in fact, infrared light,

00:14:02.300 | because of its very long wavelength,

00:14:06.100 | it can penetrate through into the skin actually very deep.

00:14:10.780 | And we're not talking about

00:14:13.060 | how long a path length goes through.

00:14:15.340 | You have to remember that this type of long wavelength

00:14:18.500 | can scatter, and it can scatter throughout up to,

00:14:22.380 | they say, up to eight centimeters,

00:14:24.120 | according to this data.

00:14:24.960 | - A single photon.

00:14:26.060 | - A single photon can bounce around.

00:14:27.880 | It's a very low-energy photon.

00:14:30.980 | But low-energy photons, because they're very long

00:14:33.640 | in wavelength, can penetrate very deeply.

00:14:35.820 | A good way of thinking about this is, you know,

00:14:37.540 | you pull up to a stop sign, and a car pulls up next to you,

00:14:40.580 | and they're playing this really loud music, right?

00:14:43.220 | What do you hear in your car?

00:14:44.580 | It's very low-frequency sound.

00:14:47.000 | And the reason why that's what you hear

00:14:48.780 | is because low-frequency sound

00:14:50.540 | is the only kind of sound coming out of that guy's radio

00:14:52.980 | that's able to penetrate not only his car,

00:14:55.520 | but go into your car and shake the steering wheel

00:14:57.880 | on your car.

00:14:58.900 | It's the same thing, like, for instance,

00:15:00.300 | if you were to go to the Grand Canyon,

00:15:01.640 | and there's a storm coming, storm very far away,

00:15:04.660 | what's the first thing that you're gonna hear?

00:15:06.500 | It's low rumbling.

00:15:07.700 | It's because that low-frequency energy

00:15:09.660 | is able to penetrate very deeply.

00:15:11.460 | There's a astrophysicist in Europe,

00:15:15.820 | in England, actually, Bob Fosbury.

00:15:17.820 | He sent me a photograph of his hand

00:15:20.300 | in front of a infrared light source.

00:15:22.220 | And it was almost like the first guy

00:15:25.740 | who took an X-ray of his hand, Rotigen,

00:15:28.860 | I guess is his name, and he said, he looked at his hand,

00:15:32.460 | he says, "I almost, like, saw my own death,"

00:15:34.360 | 'cause he could see the bones in his hand through the X-ray.

00:15:37.240 | Well, Bob Fosbury, who's at the European Space Agency

00:15:40.440 | and is well-tuned into this type of understanding,

00:15:43.160 | he put his hand in front of a infrared light sensor,

00:15:46.160 | or infrared light source,

00:15:47.400 | and took a infrared light photograph.

00:15:50.500 | And the light comes through the hand.

00:15:52.800 | It illuminates the entire hand.

00:15:55.320 | And this is, of course, a lot more than a few millimeters.

00:15:58.060 | And the mind-blowing thing about it was

00:16:00.120 | you could not see any bones.

00:16:01.960 | It was either penetrating through the bone,

00:16:04.080 | or it was going around the bone.

00:16:06.200 | And very clearly, you could see that infrared light

00:16:09.400 | is able to go much more than just skin deep.

00:16:12.240 | It penetrates through your clothes.

00:16:14.040 | You can actually test this out on a summer day,

00:16:17.120 | or even on a winter day, if the sun is out.

00:16:19.520 | Wear a few layers of clothing, go outside, close your eyes,

00:16:24.440 | and move around and see if you can feel where the sun is.

00:16:28.320 | You can.

00:16:29.440 | And the reason is is because it's that infrared radiation

00:16:32.720 | that's able to penetrate through the clothes,

00:16:34.840 | penetrate through your skin,

00:16:36.160 | actually activate the heat sensors in your body,

00:16:39.160 | and actually go much deeper than that.

00:16:40.880 | That's actually in a straight line.

00:16:42.040 | After it does that, it hits something,

00:16:43.920 | and then it bounces around a couple of more times,

00:16:46.360 | maybe a few hundred more times.

00:16:48.000 | And so the point of that paper,

00:16:49.640 | "The Optics of the Human Body,"

00:16:51.460 | is that we have this understanding or this idea

00:16:54.800 | that light simply hits our skin, and that's where it ends.

00:16:57.800 | And that's not the case.

00:16:59.840 | Why that's important is because of the effect

00:17:04.320 | of this type of infrared light has on mitochondria.

00:17:08.680 | And that's really the mind-blowing aspect of this,

00:17:13.000 | is that mitochondria are like engines in your cells, right?

00:17:18.000 | They're like engines in your car.

00:17:20.240 | The engine in your car burns fuel, makes locomotion,

00:17:23.760 | and in the process of making that locomotion,

00:17:27.160 | it creates heat.

00:17:28.200 | And that heat, if not dealt with, can shut down your engine.

00:17:32.200 | Well, in the mitochondria, you've got this process occurring

00:17:35.520 | making ATP, which is basically

00:17:37.480 | the currency of energy in the cell.

00:17:39.800 | And in the process of doing this, it makes oxidative stress,

00:17:43.720 | oxidative reactive oxygen species.

00:17:45.760 | If you don't deal with those reactive oxygen species,

00:17:49.280 | that could shut down the mitochondria.

00:17:51.280 | And quite truly, just about every single chronic disease

00:17:56.280 | that we have in this country, whether it's diabetes,

00:17:59.200 | hypertension, heart disease, dementia, all of those,

00:18:03.400 | they all have at the root of them mitochondrial dysfunction.

00:18:08.000 | And this goes to a much bigger picture

00:18:10.160 | of the mitochondrial theory of aging.

00:18:13.880 | We know that after 40 years, the output of mitochondria,

00:18:17.480 | which is ATP, drops by about 70%.

00:18:19.800 | - Seven zero? - Seven zero.

00:18:21.600 | Can you imagine being in your house

00:18:23.000 | and somehow the energy production to your house

00:18:25.360 | drops by 70%?

00:18:27.200 | Can you imagine what an impact that would have

00:18:28.600 | on just about every function that goes on in your house?

00:18:31.760 | This is exactly what's happening in the cell.

00:18:34.200 | And so what does this have to do with sunlight?

00:18:36.680 | Well, here's what they've shown,

00:18:38.480 | that the mitochondria actually make on-site melatonin

00:18:44.760 | in orders of magnitude higher concentration

00:18:49.960 | than is made in the pineal gland.

00:18:51.640 | - Really? - Yes.

00:18:53.040 | So they've actually done the work where they have serotonin.

00:18:56.120 | They are actually labeling the carbons in serotonin

00:19:00.640 | and showing that that melatonin

00:19:02.760 | in orders of magnitude higher concentration

00:19:05.280 | are being made on-site in the mitochondria.

00:19:08.960 | - Okay, I have to ask about this.

00:19:10.480 | - Yes. - Most people, including me,

00:19:12.120 | are familiar with melatonin secretion

00:19:14.120 | from the pineal gland. - Correct.

00:19:15.960 | - Being suppressed by light

00:19:17.480 | via some neural circuit pathways

00:19:19.720 | that go from eye to suprachiasmatic nucleus

00:19:21.800 | to there's a circuitous loop to the brainstem

00:19:26.360 | and then up to the pineal.

00:19:29.260 | So light suppresses melatonin release from the pineal.

00:19:32.320 | We know that. - Yes.

00:19:33.840 | - In that context, melatonin is the hormone of darkness

00:19:38.840 | and causes sleepiness. - Correct.

00:19:41.400 | - What is the role of melatonin

00:19:43.880 | in the context that you are describing?

00:19:45.840 | Because if indeed infrared and other long wavelength light

00:19:51.680 | is causing the production of melatonin

00:19:54.080 | from the mitochondria in the rest of the body,

00:19:57.400 | I'm assuming that's not to increase

00:19:58.920 | our levels of sleepiness. - That is correct.

00:20:00.960 | - And I do know that melatonin is a powerful antioxidant.

00:20:04.280 | - Yes. - So I'm guessing

00:20:05.640 | that next you're gonna tell me that it is combating

00:20:08.440 | the reactive oxygen species that are produced

00:20:12.600 | as a function of mitochondrial metabolism.

00:20:15.440 | - Absolutely. - Okay.

00:20:16.560 | - Absolutely.

00:20:17.440 | So the mitochondria make melatonin on-site.

00:20:20.680 | This is not being secreted into the blood.

00:20:22.840 | It's being used on-site.

00:20:24.560 | So this is not being used as a secondary messenger

00:20:27.640 | to tell the body anything about circadian rhythm.

00:20:31.020 | This is a extremely powerful, as you know,

00:20:33.040 | extremely powerful antioxidant.

00:20:34.880 | It's actually one of the most powerful antioxidants

00:20:37.160 | in the human body.

00:20:38.000 | It actually up-regulates the glutathione system

00:20:40.320 | by regulation.

00:20:43.240 | So what this melatonin does is it's able to mop up

00:20:48.240 | these reactive oxygen species.

00:20:50.560 | Let's back up a little bit there.

00:20:52.240 | Reactive oxygen species, what are they?

00:20:55.000 | So if you, let's get nerdy, let's get into the details.

00:20:58.720 | In the mitochondria, the way it works

00:21:00.640 | is that you burn fuels.

00:21:02.120 | You burn carbohydrates, proteins, and fats.

00:21:05.120 | And as a result of that, you make these very reduced agents,

00:21:08.280 | NADH, FADH2.

00:21:10.900 | They go to the electron transport chain.

00:21:12.480 | And just as the Colorado River,

00:21:15.040 | as it goes down through various different dams

00:21:18.240 | and then dumps out into the Gulf of California,

00:21:22.200 | the same thing happens with these very highly charged

00:21:24.680 | and electronegative electrons.

00:21:26.280 | They, as they start to fall down

00:21:27.920 | and get transferred from one enzyme to another,

00:21:31.760 | they cause the out-production or the out-transfer

00:21:35.600 | of protons into the inner membrane space.

00:21:38.200 | The problem is, though, is when you finally get done

00:21:40.520 | with these electrons, they've been completely spent.

00:21:42.640 | There's nothing else to accept them.

00:21:44.640 | And the only thing that can actually do that

00:21:46.400 | is something so electronegative

00:21:48.200 | that it would actually take these electrons,

00:21:49.880 | and that's oxygen.

00:21:51.400 | And that's the reason why we breathe oxygen.

00:21:54.080 | It's because we need an electron acceptor

00:21:56.680 | for these spent electrons.

00:21:58.100 | It's very near and dear to my heart as a pulmonologist,

00:22:00.800 | a critical care specialist.

00:22:02.880 | We need to have oxygen.

00:22:03.960 | If you don't have oxygen, things shut down very quickly.

00:22:07.180 | - For those that aren't familiar

00:22:08.240 | with these biochemical pathways,

00:22:10.280 | maybe one way for them to think about it

00:22:11.920 | is that free electrons are not a good thing in this system.

00:22:15.920 | You don't want electrons floating around.

00:22:17.600 | And in these biochemical steps that convert energy

00:22:20.380 | into the stuff that cells can use more readily to move

00:22:24.160 | and do everything that we do, electrons are kicked off.

00:22:28.700 | Oxygen can work with those free electrons.

00:22:33.600 | I'm trying to use language here

00:22:34.680 | that divorces us from the classic biochemical pathways

00:22:39.680 | so that more people can grasp it,

00:22:41.360 | 'cause it's really a beautiful mechanism.

00:22:43.880 | So if you have a positive charge

00:22:46.280 | to effectively work with the free negative charge,

00:22:49.120 | then the system is stabilized

00:22:52.000 | or at least isn't pushed in the direction of inflammation.

00:22:56.640 | Many people have heard of free radicals.

00:22:58.240 | - Exactly.

00:22:59.080 | - And that's what we're referring to.

00:22:59.900 | - Exactly.

00:23:00.740 | - You want to offset the free radicals.

00:23:02.520 | - Correct.

00:23:03.400 | - And to the biochemists out there and the biologists,

00:23:05.560 | I'm using the term offset loosely.

00:23:08.600 | Okay, so melatonin in the context

00:23:11.460 | of how sunlight can activate melatonin within cells.

00:23:16.460 | Maybe it's worth pointing out to people

00:23:19.600 | that when the pineal gland releases melatonin

00:23:22.320 | to make you sleepy,

00:23:23.680 | that's an endocrine or hormone type mechanism.

00:23:26.840 | Hormones act on local tissues

00:23:28.520 | and more distant tissues in the body.

00:23:30.240 | - Correct.

00:23:31.080 | - Pheromones act between bodies.

00:23:32.120 | - Right.

00:23:33.240 | - In the context that you're describing,

00:23:34.460 | melatonin is acting within cell.

00:23:36.560 | - Correct.

00:23:37.400 | - Okay.

00:23:38.220 | - So let's think of this dichotomy.

00:23:41.400 | The mitochondria always needs to have antioxidants.

00:23:45.560 | Otherwise it's going to become damaged.

00:23:46.840 | Like if these free radicals are produced,

00:23:49.140 | the very next molecule that they bump into,

00:23:51.420 | it's going to change it.

00:23:52.560 | And if that's the mitochondria,

00:23:54.000 | the mitochondria is going to be damaged.

00:23:55.980 | So it needs a cooling system.

00:23:57.700 | Just like your car has a cooling system for heat,

00:23:59.720 | the mitochondria needs a cooling system

00:24:01.800 | for oxidative stress.

00:24:04.420 | What's the cooling system during the day?

00:24:06.980 | Sunlight comes in, activates these,

00:24:10.220 | it upregulates melatonin, which does that.

00:24:12.400 | Well, when there is no sunlight,

00:24:14.300 | what is the cooling system then?

00:24:16.360 | It's the system that we've always known about.

00:24:18.320 | And the reason why we've always known about it

00:24:20.160 | is because we can draw blood samples.

00:24:21.900 | It's much easier to detect melatonin in the blood

00:24:25.560 | because we've developed techniques first

00:24:27.240 | to detect things in the blood.

00:24:28.680 | But what we're talking about now

00:24:29.960 | is how do we detect things not only intracellular,

00:24:32.960 | but intraorganelle.

00:24:34.480 | That's a much more sophisticated.

00:24:36.120 | Yet, now we do have the technology to show.

00:24:38.780 | And the amount of melatonin we're talking about

00:24:40.540 | is 20 times higher than we're picking up in the blood.

00:24:43.300 | So at night, the system is,

00:24:46.260 | melatonin is secreted from the pineal gland.

00:24:48.840 | It goes into the blood, diffuses into the cell,

00:24:51.500 | diffuses into the mitochondria, and does the job.

00:24:54.020 | Do you think that that role of melatonin

00:24:56.180 | from the pineal at night

00:24:58.100 | is part of the reason why sleep is so restorative?

00:25:01.580 | Absolutely.

00:25:03.700 | It's probably no coincidence then

00:25:06.460 | that when we fall asleep,

00:25:09.260 | it's at least correlated with, and in many ways,

00:25:12.220 | caused by the reduction in core body temperature.

00:25:15.180 | It's very unusual for melatonin levels to be high

00:25:17.660 | when body temperature is high.

00:25:19.940 | These things normally are coordinated at night.

00:25:22.020 | I'm not aware that it actually drops body temperature,

00:25:24.600 | but it might.

00:25:25.440 | I'm just not aware of the literature.

00:25:26.500 | But what you're describing is amazing.

00:25:28.100 | I mean, first of all,

00:25:29.740 | most people's minds, including mine,

00:25:31.780 | are gonna be blown by the fact that

00:25:33.900 | long wavelength light can actually go through clothing

00:25:37.060 | and skin, and so you can imagine

00:25:38.500 | that if you have a minimum of clothing on,

00:25:40.180 | whatever's appropriate for that context,

00:25:42.220 | and you get some sunlight on your skin,

00:25:43.380 | even on a cloudy day,

00:25:45.060 | some of this should be coming through.

00:25:46.060 | We could talk about that.

00:25:46.900 | It's more UV light, short wavelength light,

00:25:49.100 | that's gonna break through thick cloud cover.

00:25:50.980 | Correct.

00:25:51.820 | Cloud cover because it's water vapor,

00:25:53.880 | and water vapor does absorb infrared.

00:25:55.780 | It will be substantially less,

00:25:57.260 | but much more than being inside.

00:25:59.400 | And on a clear day or partially cloudy day,

00:26:02.200 | we're getting a lot of red light,

00:26:03.920 | long wavelength light,

00:26:05.040 | and infrared and near-infrared light coming through.

00:26:08.360 | Absolutely.

00:26:09.180 | I think a lot of people don't realize that

00:26:10.020 | because in this age of red light devices

00:26:12.760 | and infrared light devices,

00:26:14.800 | of which I own one and I love and I use,

00:26:17.800 | but people forget that the primordial

00:26:21.540 | and arguably, I'll say,

00:26:24.280 | the best source of red light

00:26:26.440 | and near-infrared light and infrared light

00:26:28.600 | of the sort that we're talking about right now

00:26:30.560 | is going to come from the sun, right?

00:26:32.580 | I mean, there's no device that can replace the sun.

00:26:35.000 | 100%, 100%, yeah.

00:26:36.780 | Okay, great.

00:26:37.620 | So how does this keep us safe from infection?

00:26:42.620 | As long as we're here,

00:26:44.960 | what else is it doing to offset the 70% reduction

00:26:47.600 | in mitochondrial function?

00:26:48.720 | 'Cause what we're talking about now

00:26:49.720 | is the role of melatonin within cells

00:26:52.360 | to lower temperature

00:26:55.200 | and reduce these reactive oxygen species.

00:26:58.200 | Yes.

00:26:59.040 | Does that somehow offset the reduction in mitochondria

00:27:01.600 | that normally occurs?

00:27:02.880 | It does.

00:27:03.700 | So the increase in melatonin from infrared radiation

00:27:09.200 | going into the mitochondria is one aspect.

00:27:11.280 | There's a whole host of other aspects that occur.

00:27:13.220 | There is cytochrome 4 oxidase.

00:27:15.240 | Again, one of those enzymes in the electron transport chain

00:27:18.280 | can absorb infrared light.

00:27:19.780 | There's nitric oxide.

00:27:21.560 | What the whole effect of this is,

00:27:24.000 | and the bottom line is,

00:27:25.120 | is that when you have red light to near infrared light

00:27:28.240 | getting in that deep,

00:27:30.160 | there is a increase in the efficiency of the mitochondria.

00:27:35.160 | So this is the key point,

00:27:37.280 | because if, in fact,

00:27:38.920 | with the theory of mitochondrial aging,

00:27:40.960 | that we're having a decrease in the efficiency

00:27:43.160 | of the mitochondria as we get older,

00:27:44.960 | if there is something that we can do to reverse that

00:27:48.040 | or to at least prevent that from happening,

00:27:50.760 | that can have a tremendous impact in our health overall.

00:27:53.980 | So one point about infrared light and its characteristic,

00:27:58.980 | and then number two, let's actually get to some data,

00:28:01.460 | because we're saying a bunch of things,

00:28:03.360 | but what we really need is evidence-based stuff.

00:28:05.360 | Okay, so the first thing,

00:28:06.920 | there's one other thing that I should mention

00:28:08.500 | about the effect of infrared light, especially in nature,

00:28:12.960 | and that is that not only can it penetrate through clothes.

00:28:15.940 | You may remember the Sony cam night vision thing

00:28:19.460 | back in the '90s,

00:28:20.340 | where Sony came up with a night vision camera

00:28:23.080 | that you could take pictures at night,

00:28:25.120 | and some enterprising youth, probably a man,

00:28:28.000 | figured out that you could use it during the day

00:28:30.360 | and you could see through clothes.

00:28:31.760 | - And presumably, they took that off the market.

00:28:33.880 | - They took it off the market pretty quick, yeah.

00:28:36.360 | But there's one other thing

00:28:37.240 | that's really important to understand, too,

00:28:39.220 | and that is that, believe it or not,

00:28:41.040 | but the leaves on trees and grass,

00:28:43.760 | anything with chlorophyll,

00:28:45.460 | is highly reflective of infrared light.

00:28:49.320 | What that means is that if you go outside on a sunny day,

00:28:53.260 | versus going outside on a sunny day

00:28:54.900 | surrounded by green, green spaces,

00:28:59.300 | you're gonna get probably two, three, four times

00:29:01.660 | more infrared light in that environment

00:29:04.420 | than you would without that environment.

00:29:06.780 | If you, you could check this out.

00:29:08.340 | You go to Google and just type in infrared photography

00:29:12.240 | and click images,

00:29:13.700 | and you will see any kind of infrared filtered light.

00:29:17.020 | When it shows a tree or grass,

00:29:18.540 | it looks like it's lit up, like it's got snow on it.

00:29:21.060 | It's bright white.

00:29:22.660 | It's very reflective.

00:29:24.300 | On a hot summer day,

00:29:25.140 | if you go outside and touch some object that's in the sun,

00:29:28.700 | it's gonna be extremely hot.

00:29:30.180 | Touch a leaf, it's not hot at all.

00:29:33.840 | It's because it's reflecting that light.

00:29:35.500 | In fact, the coolest place in a garden

00:29:38.060 | on a hot summer day is where?

00:29:39.300 | It's under a tree,

00:29:40.820 | because all of that infrared light is being reflected off.

00:29:44.980 | And just to jump ahead here,

00:29:46.500 | but we know from years and decades of data

00:29:50.360 | that people who live in green spaces have reduced diabetes,

00:29:54.700 | reduced hypertension, reduced mortality,

00:29:57.580 | just living in green spaces.

00:29:59.300 | - Is it possible to tease away the effect

00:30:02.460 | from the other things associated

00:30:03.900 | with living in green spaces? - Yes.

00:30:05.000 | - Because fortunately,

00:30:06.000 | our audience is trained to think scientifically

00:30:08.100 | and they'll know, well, it's not necessarily causal, right?

00:30:10.660 | People who live in green spaces tend to walk more.

00:30:12.620 | They tend to perhaps eat more fruits and vegetables

00:30:14.940 | and on and on.

00:30:16.020 | - So getting onto that,

00:30:19.260 | there was a study that was just done in Louisville, Kentucky.

00:30:22.260 | Four square miles.

00:30:25.080 | They measured everybody in that four square miles HSCRP.

00:30:29.480 | What's HSCRP?

00:30:30.360 | It's basically it's a surrogate marker

00:30:32.220 | for inflammation in the body.

00:30:34.320 | And then they did this.

00:30:35.400 | They did something incredible.

00:30:36.760 | They brought in 8,000 plus trees, mature trees,

00:30:41.760 | and they planted those trees in that four square mile area.

00:30:46.340 | Took them about a year.

00:30:47.800 | Two to three years later, they went out.

00:30:49.800 | Nothing, the income of these people

00:30:53.000 | living in this four square mile area did not change.

00:30:56.200 | Presumably, they did not do any exercise programs

00:30:58.580 | in this area.

00:30:59.420 | Everything was the same.

00:31:00.240 | The only thing they did was plant trees.

00:31:02.200 | And they went out and they rechecked

00:31:03.560 | everybody's highly sensitive CRP levels.

00:31:06.960 | They dropped by 13%.

00:31:08.480 | - Wow.

00:31:09.320 | - And that's about on the order,

00:31:11.300 | almost on the order of doing exercise three times a week.

00:31:15.340 | - I should mention that CRPC reactive protein

00:31:17.940 | has been associated with a number of blinding eye diseases,

00:31:20.840 | associated with inflammation,

00:31:23.660 | and basically everything bad you can imagine

00:31:27.380 | in every organ of the body, heart attack, ischemia.

00:31:30.820 | Yeah, this kind of thing.

00:31:32.060 | Incredible.

00:31:34.480 | - Yeah.

00:31:35.320 | So let's actually look at some data.

00:31:36.940 | So we've talked about, you know,

00:31:38.740 | any astute person listening to this is like,

00:31:40.580 | okay, so you talked about a lot of observational stuff.

00:31:43.340 | Is there any interventional stuff?

00:31:45.020 | So I turned to Glenn Jeffrey,

00:31:47.720 | who is, he's in the Department of Ophthalmology.

00:31:50.220 | You know him well, actually, at University College London.

00:31:54.380 | And he's done some really interesting experiments

00:31:56.980 | in the last two to three years looking at red light.

00:31:59.500 | One of them was, the first one that he did

00:32:02.420 | was he took older subjects who had difficulty

00:32:07.040 | with color sensitivity in their vision.

00:32:10.000 | And he exposed them to 670 nanometer, which is red,

00:32:13.360 | it's visible light for just three minutes in the morning.

00:32:17.940 | It only worked in the morning in this case,

00:32:19.420 | which is interesting.

00:32:20.940 | And he showed that there was a 17% increase

00:32:24.620 | in color sensitivity that lasted for days.

00:32:28.340 | Now, why would that be?

00:32:29.420 | Again, you should know that the retina

00:32:32.580 | is the one tissue in the human body

00:32:35.460 | that has the highest concentration of mitochondria.

00:32:37.700 | And if you understand what's going on in light,

00:32:39.980 | and I know you do, but our audience might not,

00:32:42.340 | is when you have visible light coming in to the retina,

00:32:45.520 | it is causing a photochemical reaction

00:32:47.900 | that requires a tremendous amount of energy.

00:32:50.500 | Vesicles budding off, things diffusing,

00:32:54.500 | electrical conductions being,

00:32:55.900 | and it has to happen very, very quickly.

00:32:58.280 | Otherwise, what you see is gonna be there as a blur.

00:33:01.580 | So this is constantly being updated.

00:33:03.860 | So it's no surprise that mitochondria

00:33:05.900 | is so concentrated there.

00:33:07.660 | So what's actually going on there?

00:33:09.260 | What we believe is going on is that this red light

00:33:11.500 | is actually stimulating these mitochondria

00:33:13.500 | to produce more ATP, and it's improving the sensitivity.

00:33:17.340 | But the court de gras, or the piece de la resistance,

00:33:21.420 | was his next study, which he did,

00:33:23.380 | where he took 30 subjects,

00:33:25.820 | he gave them 75 grams of glucose,

00:33:28.540 | and in a blinded way,

00:33:30.020 | so they couldn't tell if the light was on or off,

00:33:32.460 | he exposed their backs to the same 670 nanometer light,

00:33:37.460 | and he monitored their glucose over time,

00:33:41.180 | over the next two hours, basically, multiple points.

00:33:45.380 | And what did he find?

00:33:46.340 | He found that those that were exposed to red light

00:33:49.100 | and didn't know it had lower glucose concentrations.

00:33:52.860 | So he surmised that the mitochondria

00:33:55.520 | were working more efficiently,

00:33:57.020 | they were using up more energy,

00:33:58.340 | and this is the reason why the glucose didn't peak as high.

00:34:01.860 | But he couldn't be sure unless he also monitored

00:34:04.980 | for the output of metabolism.

00:34:06.900 | So what happens when the mitochondria is working?

00:34:08.620 | It's making carbon dioxide.

00:34:10.220 | So he also measured carbon dioxide.

00:34:12.100 | And sure enough,

00:34:13.500 | those subjects that had the intervention of the red light

00:34:15.900 | had statistically significantly higher

00:34:17.940 | carbon dioxide levels on exhalation.

00:34:20.620 | - Awesome.

00:34:21.460 | Too bad the guy's in England.

00:34:23.420 | That's a joke for my British friends.

00:34:25.820 | Yeah, it tends to be very overcast there,

00:34:27.460 | but the sun does come out in England as well.

00:34:29.460 | - So here we have, basically,

00:34:32.600 | this is a randomized controlled intervention trial,

00:34:35.320 | which showed that red light's doing this.

00:34:36.940 | And there's a whole host of other trials

00:34:40.060 | that show the same thing.

00:34:40.900 | So when I started to see this in my patients,

00:34:44.300 | and what caused me to even do this,

00:34:45.820 | you might ask what's a pulmonary critical care doc

00:34:48.380 | talking about mitochondria in the eye?

00:34:51.080 | What really spurred me on to look at this

00:34:52.860 | was when I was in the middle

00:34:54.380 | of something called the COVID pandemic,

00:34:56.620 | and I was seeing patients in my ICU that were dying.

00:34:59.500 | And what were they dying of?

00:35:01.140 | COVID, but what were they in there for?

00:35:03.400 | They had things like diabetes, hypertension, dementia,

00:35:09.980 | all of these things which have at the root of them

00:35:12.300 | mitochondrial dysfunction.

00:35:13.500 | So what we have is an epidemic, I believe,

00:35:17.640 | of mitochondrial dysfunction.

00:35:19.420 | And how are we going to repair that?

00:35:21.880 | I think sunlight is one of the ways to do it.

00:35:24.500 | So I started looking around at the evidence.

00:35:26.700 | There was a study that was done,

00:35:29.160 | Oxford and the University of Leiden in Netherlands,

00:35:32.740 | where they looked at about 10,000 subjects.

00:35:35.480 | They just drew their blood, and they said,

00:35:36.980 | let's just check triglycerides and insulin sensitivity.

00:35:40.140 | And then what they did was they looked

00:35:41.500 | over the previous 10 days at the weather report,

00:35:45.260 | and they were able to show that by the hour,

00:35:49.620 | the more sunlight that there was in the previous seven days,

00:35:53.140 | that actually predicted an improvement

00:35:55.700 | in insulin sensitivity and a reduction in triglycerides.

00:35:59.500 | That fast, over a seven-day period of time.

00:36:01.660 | There was another study that was done.

00:36:04.140 | This was in Sweden.

00:36:06.020 | So this was an epidemiological study,

00:36:08.140 | but maybe actually showed some causation.

00:36:10.620 | They looked at Swedish women.

00:36:11.900 | It was about 30,000 Swedish women

00:36:14.460 | living in Sweden at the time, of course.

00:36:18.140 | And they divided them into three groups,

00:36:20.980 | those that avoided the sun,

00:36:22.860 | those that got moderate sun exposure,

00:36:25.820 | and those that got a lot of sun exposure.

00:36:28.380 | And what they showed after following them for 20 years,

00:36:31.900 | so a long period of time,

00:36:33.660 | was that those women that were out in the sun

00:36:37.660 | not only had lower all-cause mortality,

00:36:40.820 | but they also had lower cardiovascular mortality.

00:36:44.220 | And what's really interesting

00:36:45.740 | is they had lower cancer mortality,

00:36:48.780 | and it was in a dose-response curve,

00:36:51.820 | which suggests, Bradford Hill criteria,

00:36:53.740 | that there was maybe some causation here.

00:36:55.780 | What was really interesting about that study

00:36:58.740 | is that they looked at smoking.

00:37:00.700 | So what was the difference here?

00:37:01.980 | It wasn't a small difference.

00:37:03.860 | It was actually such a large difference

00:37:07.060 | that the sunlight made that they were able to show

00:37:09.260 | that those women in Sweden who were in this study

00:37:13.300 | who went out into the sun avidly and smoked

00:37:16.860 | had the same mortality as those women

00:37:21.140 | who avoided the sun and didn't smoke.

00:37:24.140 | The first thing that hit my mind was,

00:37:26.900 | is what do we do to people here in this country

00:37:29.220 | that want to smoke?

00:37:31.060 | We tell them to go outside.

00:37:32.460 | I'm not encouraging people to smoke.

00:37:35.780 | Clearly, the best outcomes are going to be

00:37:37.740 | from not smoking and from getting sunlight,

00:37:41.060 | but it is a remarkable study.

00:37:43.140 | I mean, this is, certainly,

00:37:44.860 | smoking would be under the T for temperance.

00:37:47.380 | That would be where I would put a new start.

00:37:49.060 | We would not want to do that.

00:37:50.820 | But that same study was repeated basically again.

00:37:55.060 | University of Edinburgh, they did a biobank study,

00:37:57.460 | 10 times the amount of people, 400,000.

00:37:59.660 | Repeated the study, showed exactly the same,

00:38:03.180 | both men and women.

00:38:04.940 | Except this time, they actually measured UVA.

00:38:09.140 | So they used ultraviolet A radiation

00:38:12.500 | as a surrogate for infrared and for sunlight in general.

00:38:16.380 | They found exactly the same thing, reduction in mortality.

00:38:19.420 | Such so is the evidence that even dermatologists

00:38:24.220 | are starting to rethink.

00:38:25.100 | There was an article that was published

00:38:26.660 | in the Journal of Investigative Dermatology

00:38:29.820 | by Richard Weller.

00:38:31.500 | And the name of that article was published last year.

00:38:34.060 | It was titled, "Sunlight, Time for a Rethink."

00:38:38.100 | And he said, look, there are societies that are seeing this,

00:38:41.700 | and they're already saying that there's a potential benefit

00:38:44.420 | for getting out into the sun.

00:38:46.020 | Yeah, the dermatologist that I hosted on this podcast,

00:38:50.780 | Dr. Teo Soleimani, also happens to be a derma oncologist.

00:38:55.780 | So his specialty is skin cancers.

00:38:57.760 | And I was surprised to learn,

00:39:00.700 | but we've talked about several times now offline as well,

00:39:04.060 | Teo and I, I was surprised to learn

00:39:05.940 | that the sunlight-induced cancers of the skin,

00:39:10.940 | while they do exist, that's real, right?

00:39:13.140 | Get too much UV exposure,

00:39:14.340 | you're going to age your skin more rapidly.

00:39:17.100 | You're going to increase the likelihood

00:39:19.620 | that you'll get a skin cancer.

00:39:20.820 | However, this was really surprising to me.

00:39:24.740 | According to him, there is no evidence

00:39:27.620 | that sunlight induces the deadly types

00:39:30.740 | of cancers like melanoma.

00:39:32.460 | Those are more genetically determined.

00:39:34.140 | - Yeah, yeah.

00:39:35.220 | - That's not to say that sunlight can't damage skin,

00:39:37.940 | but it is really interesting that more and more data

00:39:41.740 | and clinical trials included are pointing

00:39:44.140 | to exactly what you're saying,

00:39:45.300 | which is that more sunlight exposure is beneficial.

00:39:50.220 | And the risks of sunlight exposure can largely be offset

00:39:53.620 | by limiting your exposure to excessive UV.

00:39:57.380 | And it's pretty easy nowadays with any app,

00:40:00.100 | a lot of zero cost apps out there.

00:40:01.580 | I can put links to one or two in the show note captions

00:40:04.360 | that I like that have no affiliation to whatsoever,

00:40:06.860 | by the way, will tell you when the UV index is highest.

00:40:10.020 | It's in the middle of the day, typically.

00:40:11.540 | And so it's possible to get plenty of sunlight

00:40:14.300 | on your skin without exposing yourself to excessive UV.

00:40:17.660 | - Yeah, and I'd even take it a step further

00:40:19.180 | because we know that a single layer of clothing

00:40:22.940 | can actually, is pretty good

00:40:24.660 | at blocking ultraviolet lights, right?

00:40:26.980 | But remember what we talked about infrared.

00:40:30.100 | Infrared can penetrate through.

00:40:31.500 | So if someone is fair skin

00:40:33.620 | and they're concerned about getting skin damage,

00:40:35.500 | wear a broad rimmed hat, put a long sleeve shirt on,

00:40:39.300 | but get outside because that's where the infrared,

00:40:42.140 | especially if you're around, you know,

00:40:44.180 | green shrubs and leaves and things,

00:40:48.420 | 'cause there's a lot of infrared light.

00:40:50.260 | We know that green spaces are beneficial in terms of that.

00:40:54.780 | And we've talked about, you know, Louisville, Kentucky,

00:40:57.300 | that there's a benefit there just by putting the tree there.

00:40:59.860 | - I love those data.

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00:43:32.700 | In terms of your original question,

00:43:34.380 | which is getting back to influenza or flus or things,

00:43:38.400 | so there's a great study

00:43:40.160 | that I always love to talk about in terms of this,

00:43:42.820 | and it was actually done by Harvard.

00:43:44.520 | It was a Harvard-Kennedy School,

00:43:46.580 | which is not the medical school.

00:43:49.080 | This is the public policy/politics school,

00:43:52.200 | and what they did was they looked

00:43:53.720 | at this very question of influenza

00:43:56.880 | and why do we always get it in the wintertime

00:43:58.520 | and what's potentially beneficial for it,

00:44:00.480 | and the problem is is that

00:44:02.840 | we always have this influenza season,

00:44:05.460 | which is in the wintertime.

00:44:06.660 | We can talk about why that might be.

00:44:08.060 | I would suggest to you that it's because

00:44:09.660 | that's when we have the shortest day of the year,

00:44:12.340 | but we also have other things that happen at that time.

00:44:14.580 | What else is happening?

00:44:15.420 | We're having parties at that time.

00:44:16.860 | There's Thanksgiving.

00:44:17.900 | There's New Year's.

00:44:18.740 | It's cold.

00:44:20.340 | Does the temperature have anything to do with it?

00:44:23.220 | We're also inside because it's cold.

00:44:25.460 | So what is it that's actually doing it?

00:44:27.020 | Well, 2009 was a banner year

00:44:29.820 | because 2009 was the year that we had the H1N1 pandemic,

00:44:34.820 | and that was a boon for us.

00:44:36.880 | The reason is is because,

00:44:38.560 | not because of the deaths that we had,

00:44:39.940 | but from a scientific standpoint,

00:44:42.000 | this epidemic actually peaked in the summertime,

00:44:45.020 | and it was in areas where the humidity was sometimes high

00:44:49.280 | and sometimes it was low,

00:44:50.560 | and sometimes the temperature was high.

00:44:51.920 | Sometimes the temperature was low.

00:44:53.000 | Sometimes the sun was out.

00:44:54.400 | Sometimes it was cloudy.

00:44:55.660 | In other words, we uncoupled the influenza virus in 2009

00:45:00.660 | from it being in the wintertime

00:45:04.300 | and all of those things that were associated.

00:45:05.660 | So now we have all of these data points,

00:45:08.100 | and so Harvard went to work

00:45:09.980 | at looking at all these data points.

00:45:12.020 | They looked at solar radiation data at that time,

00:45:16.340 | and they were actually able to look specifically

00:45:18.780 | where that person came from

00:45:20.700 | and what was the solar radiation in that particular area,

00:45:24.220 | and what they came up with was, absolutely.

00:45:27.600 | They said, quote, "Sunlight strongly protects

00:45:32.100 | "against getting influenza."

00:45:35.580 | It was an amazing study.

00:45:38.300 | I'm reminded of a study that was published in COVID.

00:45:42.040 | This was published in 2021,

00:45:46.120 | and it was looking at this very question.

00:45:48.680 | Is it temperature?

00:45:50.820 | Is it humidity?

00:45:52.040 | Or is it sunlight?

00:45:54.000 | So what they did was they looked at the autumn surge

00:45:57.600 | of COVID in the wintertime in Europe, in autumn, actually,

00:46:02.200 | and they asked this question.

00:46:04.160 | When there was the surge date in this country,

00:46:06.840 | whatever country it was in Europe, when did it happen,

00:46:09.160 | and what were the things that caused it to happen?

00:46:12.200 | So they put all the data out there for temperature,

00:46:16.220 | and it was a flat line.

00:46:17.400 | Temperature did not predict which country,

00:46:21.040 | how the country got COVID-19

00:46:23.480 | when the surge started to happen.

00:46:25.600 | They did the same thing for humidity, flat line.

00:46:28.880 | When they got to latitude, it was a perfect correlation.

00:46:33.760 | In other words, as the sun in the wintertime

00:46:37.340 | started to peel back off of the northern hemisphere,

00:46:40.120 | it started to sink below the equator,

00:46:42.280 | and when there was a critical period of time

00:46:45.160 | that the day shortened to the point

00:46:47.280 | where at first Finland got the shortest day,

00:46:50.600 | or short enough day, and then Germany, and then further on,

00:46:55.160 | what it showed was latitude actually perfectly predicted

00:46:59.320 | when the surge dates would happen,

00:47:00.680 | starting off with Finland

00:47:02.080 | and ending up with Greece at the bottom.

00:47:04.520 | - Wow.

00:47:05.360 | Do you see influenza at the equator?

00:47:07.480 | - You do see, certainly, influenza at the equator,

00:47:11.880 | but what's really interesting about that

00:47:15.160 | is that if you look at, for instance,

00:47:17.840 | the influenza mortality in the United States,

00:47:22.080 | obviously in the northern hemisphere,

00:47:23.800 | what you will see is you will see it peak

00:47:27.440 | generally one to three weeks

00:47:29.400 | after the shortest day of the year,

00:47:31.560 | which is around now, in December and January.

00:47:34.600 | Now, if you look at Australia,

00:47:36.320 | what do you think you'd see?

00:47:38.960 | - The inverse.

00:47:40.000 | - Exactly.

00:47:41.120 | It's actually, in Australia,

00:47:43.280 | the influenza season peaks late June, early July.

00:47:47.640 | So if you now go look at something like Singapore,

00:47:51.600 | Singapore is, I think, within 100 miles of the equator,

00:47:54.360 | you will see that in Singapore,

00:47:56.920 | there is influenza peaks and troughs,

00:48:00.120 | but it's not seasonal.

00:48:01.840 | It's just almost random.

00:48:03.520 | - Is it not the case that in hospitals

00:48:08.760 | and other recovery wards, as it were,

00:48:13.760 | that there used to be, classically,

00:48:16.520 | there was a habit of putting people out into the sun,

00:48:20.480 | like sun decks on the roof of hospitals

00:48:23.200 | and things of that sort?

00:48:24.160 | - I'm smiling because you're absolutely correct.

00:48:26.960 | You're absolutely correct.

00:48:27.960 | And as I started to go through this and look at this,

00:48:30.440 | I started saying to myself,

00:48:31.280 | "We need to get people out in the sun."

00:48:32.440 | And then I realized,

00:48:34.080 | not only am I not the only one saying this,

00:48:36.760 | but certainly this was being done 100 years ago,

00:48:39.360 | 150 years ago.

00:48:40.920 | - Just as a speculation,

00:48:42.640 | why do you think we've migrated away

00:48:45.000 | from this, frankly, basic biochemical, cellular understanding

00:48:49.680 | of how the sun can benefit us?

00:48:51.640 | I mean, I feel like so much attention has been paid

00:48:53.960 | to how the sun can damage our skin

00:48:55.640 | and "give us skin cancer"

00:48:58.000 | that perhaps we overshot the mark.

00:49:00.440 | - I think it has to do with scientific reductionism.

00:49:04.880 | And what I mean to say by that is we've had a lot of data

00:49:07.920 | that shows that ultraviolet light can cause cancer.

00:49:12.040 | And so we've assumed that anything

00:49:14.240 | that has ultraviolet light can cause cancer.

00:49:17.760 | There's this complete dismissal of the fact

00:49:19.840 | that this ultraviolet light is packaged

00:49:22.480 | for the entire existence of human nature

00:49:25.560 | along with infrared light.

00:49:27.800 | And it's a beautiful thing when you start to look at this,

00:49:31.120 | because you start to realize that the infrared,

00:49:33.800 | we never get blue light or ultraviolet light ever

00:49:37.640 | without the presence of infrared light.

00:49:39.920 | - Unless it comes from an artificial source.

00:49:41.640 | - Exactly.

00:49:43.080 | So this is really the first time in human history

00:49:45.320 | that we've had this preponderance of short wavelength,

00:49:47.880 | aka blue and green light in the absence of red light.

00:49:51.920 | In fact, maybe we should just spend a couple of moments

00:49:54.920 | talking about what kind of sunlight exposures

00:49:56.720 | you recommend for people, depending on time of year.

00:49:59.360 | And then after that, I'd like to talk to you briefly

00:50:02.000 | about this shift away from incandescent bulbs

00:50:05.240 | to indoor lighting with LEDs.

00:50:07.280 | But just to make sure that I don't move us along

00:50:10.160 | before providing some of the key takeaways.

00:50:14.960 | - Yes.

00:50:15.880 | - How much sunlight should we get each day

00:50:18.360 | in the shorter days of winter and in the fall?

00:50:21.680 | And when should this be done?

00:50:23.280 | In the Jeffrey study,

00:50:24.160 | it was clear that there was circadian regulation,

00:50:26.160 | as you mentioned, getting that sunlight,

00:50:27.920 | excuse me, getting that red light,

00:50:29.120 | infrared light into one's eyes early in the day

00:50:31.080 | was important.

00:50:32.320 | If I'm living a standard life of work and job

00:50:36.000 | and people are managing kids and all sorts of things,

00:50:38.480 | sometimes it's hard to get into the sunlight

00:50:40.200 | because you're just following a schedule.

00:50:42.120 | How much time each day do you recommend

00:50:44.560 | independent of anything related to getting sunlight

00:50:47.360 | in one's eyes for circadian rhythm setting?

00:50:49.160 | - Right.

00:50:50.000 | - So how much time, what time of day

00:50:52.760 | and what frequency across the week?

00:50:54.960 | - Excellent question.

00:50:56.000 | And you've hit on exactly the issue.

00:50:57.940 | Based on Glenn Jeffrey's studies,

00:51:01.720 | based on another study that was actually done in Brazil,

00:51:05.160 | it was actually an interventional study in COVID

00:51:08.040 | that showed that just 15 minutes a day for seven days

00:51:13.040 | was enough to actually get people with COVID

00:51:15.760 | out of the hospital faster.

00:51:17.000 | This was a randomized placebo-controlled double-blinded,

00:51:20.640 | amazing study, 940 nanometers.

00:51:23.560 | So when I talked to Glenn Jeffrey about this,

00:51:26.120 | he says he sees it in humans, he sees it in bees,

00:51:30.520 | he sees it in insects, it's all the same.

00:51:32.480 | The mitochondria behave exactly the same.

00:51:34.400 | - When you say 940 nanometers,

00:51:36.400 | you're talking about long wavelength,

00:51:37.440 | like coming from an artificial source?

00:51:38.920 | - Correct.

00:51:39.760 | - Okay.

00:51:40.580 | - Yeah, that was 940.

00:51:41.420 | And it was actually very low.

00:51:42.240 | It was about 2.9 milliwatts per square centimeter.

00:51:45.960 | - So lower energy.

00:51:47.000 | Most people are not going to own a far-red

00:51:52.000 | or an infrared light.

00:51:55.660 | So I just want to emphasize again for people,

00:51:58.680 | you can get that wavelength

00:52:00.400 | and all the other relevant wavelengths from the sun.

00:52:02.640 | - Exactly.

00:52:03.480 | - That's your red light therapy, folks.

00:52:04.880 | - Exactly.

00:52:05.720 | And this is what I'm trying to say.

00:52:06.560 | This is not like some powerful laser that they were using.

00:52:09.560 | This is 2.9 milliwatts.

00:52:11.360 | I mean, sunlight,

00:52:12.640 | all sunlight is about 100 milliwatts per centimeter squared.

00:52:17.640 | - By time it reaches?

00:52:19.360 | - Through the atmosphere.

00:52:20.200 | - Through the atmosphere.

00:52:21.020 | - Yeah, so 130 when it hits the atmosphere.

00:52:23.120 | By the time it hits you, it's about 100.

00:52:25.160 | If you're looking at just infrared light,

00:52:27.180 | we're talking about 20 milliwatts per square centimeter.

00:52:30.920 | And so this was 2.9 at a very specific wavelength.

00:52:34.180 | So something that's completely doable, okay?

00:52:37.360 | And so what they did,

00:52:38.200 | it was 15 minutes a day for seven days.

00:52:40.960 | And what Glenn Jeffrey was telling me is that,

00:52:44.760 | he says, "Roger, it doesn't matter if it's in insects,

00:52:48.200 | "if it's in bees, if it's in humans.

00:52:50.160 | "Once you hit a certain point, 15, 20 minutes,

00:52:54.020 | "diminishing marginal utility.

00:52:56.520 | "The improvement after that point is so minimal

00:52:59.960 | "that you only need about 15 to 20 minutes."

00:53:02.440 | That's why he was able to do his experiment in the eye.

00:53:04.920 | About three minutes was all that was necessary.

00:53:07.040 | - So is this 15 minutes outside

00:53:09.560 | in the first three hours of your conventional day,

00:53:13.440 | as I call it?

00:53:14.260 | 'Cause people will say,

00:53:15.100 | "Well, the sun comes up later this hour."

00:53:16.680 | Conventional day, meaning after the sun

00:53:18.920 | has crossed the horizon, it has risen.

00:53:20.720 | - I don't think it matters.

00:53:21.880 | I don't really think it matters.

00:53:23.080 | I think what would matter

00:53:26.000 | is if there's a lot of ultraviolet light,

00:53:28.400 | which would be when the sun is high.

00:53:29.880 | And for people who are skin sensitive,

00:53:31.560 | that could be an issue.

00:53:32.400 | But if you're covering up, it doesn't matter.

00:53:34.320 | And here's the issue.

00:53:35.640 | The issue is that when you need it the most

00:53:38.480 | in the wintertime is when it's the hardest to get.

00:53:40.980 | So you really have to make a concerted effort.

00:53:44.580 | And for a lot of people,

00:53:45.680 | and this is what happens probably right after November,

00:53:49.400 | and probably going through to mid-January,

00:53:51.320 | is this is what happens.

00:53:52.480 | People get up in the morning, they go to their car,

00:53:55.240 | they get into their car, they drive to work,

00:53:57.120 | the sun's not up yet.

00:53:58.680 | They get to their work, the sun comes up,

00:54:00.480 | but they're inside.

00:54:01.800 | Then what happens is they get done with work,

00:54:03.560 | the sun is already down, they come home from work.

00:54:05.800 | And so there literally is weeks on end that occur

00:54:09.640 | where they're not even getting 15 minutes of sunlight.

00:54:12.440 | And I think this is the reason why

00:54:14.960 | we have the influenza surge at this time.

00:54:18.120 | If you look to see, the EPA did a study,

00:54:20.300 | and they looked at Americans.

00:54:21.520 | 93% of our time is spent inside.

00:54:24.100 | 86% inside a building, 6% to 7% inside of a vehicle.

00:54:29.120 | - And this is a relatively new thing.

00:54:31.000 | - I mean, certainly when I was growing up,

00:54:33.560 | if I came home and had a snack after school,

00:54:35.760 | I was getting kicked out of the house to go outside.

00:54:38.520 | It was routine for parents to tell kids

00:54:42.980 | they had to go outside.

00:54:44.700 | And I think there's also, it's also the case,

00:54:49.160 | as you mentioned, that we're working later,

00:54:53.240 | or at least on devices later into the evening,

00:54:56.360 | which means there's more exposure to short wavelength light

00:54:59.320 | from devices and artificial sources.

00:55:01.080 | - Absolutely, absolutely.

00:55:02.080 | So my recommendation,

00:55:03.640 | which is what the original question was,

00:55:05.520 | is take your lunch break outside.

00:55:07.960 | It's something as simple as getting outside,

00:55:10.360 | even if it's at lunchtime.

00:55:11.600 | Yes, the ultraviolet is probably the highest at that point,

00:55:14.780 | but if that's the only time

00:55:16.160 | that you're gonna get sunlight, take it.

00:55:18.440 | Now for some, you know, we can say this,

00:55:20.080 | I can say this, I live in Southern California.

00:55:21.880 | I'm blessed by 300 and some odd days of sunlight every year.

00:55:26.100 | What do you do when you're in Boston?

00:55:28.440 | What do you do if you're in New York?

00:55:29.720 | What do you do if you're in England and Sweden

00:55:31.520 | and these places where there isn't a lot of light?

00:55:34.560 | Well, there's a study that was done

00:55:35.640 | looking at infrared lamps, right?

00:55:39.160 | So you've gotta be careful there

00:55:40.720 | because if the infrared lamps are too high in amplitude,

00:55:45.720 | this result from infrared light in the body

00:55:48.680 | is something known as a biphasic response.

00:55:51.000 | And that's really important to understand.

00:55:53.120 | Don't come into this

00:55:54.440 | if you're gonna get a red light therapy

00:55:55.960 | and think that more is better

00:55:57.960 | because more may not be better.

00:56:00.060 | You actually could do detriment

00:56:01.800 | if you have the red light at too high of a level.

00:56:04.760 | So I would match it to what we're getting from the sun.

00:56:07.880 | As you said, the sunlight is your best infrared or red lamp.

00:56:11.960 | So there was a study that was done looking at wellbeing

00:56:15.080 | and they did a red lamp, red light lamp, infrared light.

00:56:20.920 | So it was coupled with 850, I think was the nanometer.

00:56:23.300 | So that is definitely in the infrared spectrum.

00:56:26.000 | - Yeah, you can't see that.

00:56:27.040 | - You cannot see it.

00:56:27.880 | And they had it set up at a desk

00:56:29.320 | that some guy was sitting in front of

00:56:31.640 | for four hours a day for eight weeks.

00:56:34.200 | And they did the study and they did it in the summertime

00:56:37.520 | and they did it in the wintertime.

00:56:38.840 | And this is really telling.

00:56:40.560 | There was no effect on the subjects

00:56:42.960 | when they looked at those that had it in the summertime.

00:56:45.780 | I would say probably

00:56:46.620 | because they were getting plenty of infrared light elsewhere.

00:56:50.320 | They only showed a statistically significant effect

00:56:52.880 | in the wintertime.

00:56:54.320 | And so if you look at influenza,

00:56:58.920 | I would even go beyond that.

00:57:00.400 | Look at a chart of the United States

00:57:03.160 | throughout the entire year

00:57:05.200 | and look at all of the natural causes of death,

00:57:08.880 | not just influenza and pneumonia.

00:57:10.480 | Look at cardiac disease.

00:57:11.840 | Look at kidney disease, Alzheimer's disease.

00:57:16.200 | All of those deaths go up all at the same time

00:57:19.960 | and they all go up about one to three weeks

00:57:22.640 | after the shortest day of the year.

00:57:24.000 | And they all come down and they all are at the nadir

00:57:27.080 | about one to three weeks after the longest day of the year.

00:57:30.340 | When you see that,

00:57:31.440 | and you just start to just digest what you're seeing there,

00:57:35.600 | and then you start to understand

00:57:37.200 | that infrared light from the sun,

00:57:38.720 | which we have filtered out with LEDs and all this,

00:57:40.920 | we can get to that.

00:57:42.360 | All of that's gone,

00:57:43.200 | that we're spending 93% of our time indoors.

00:57:46.220 | Put that all together

00:57:48.240 | and the fact that infrared light helps the mitochondria

00:57:50.560 | and the fact that the mitochondria

00:57:51.880 | is at the sort of the core of all of these chronic diseases

00:57:54.600 | that we're battling,

00:57:55.600 | it really wakes you up.

00:57:59.400 | And you start to realize that maybe the lowest hanging fruit

00:58:02.240 | that we can do right now today for literally no money

00:58:06.900 | is simply to just work on getting more sun exposure

00:58:09.820 | in the wintertime.

00:58:10.720 | - Two questions.

00:58:12.880 | One, it's hard to attach a single number to this,

00:58:16.960 | but what fraction of the obesity epidemic

00:58:21.960 | that we observe in the United States

00:58:24.280 | do you think is caused by altered interactions

00:58:29.280 | with sunlight or artificial light and its consequences,

00:58:33.720 | or put differently?

00:58:34.640 | Let me phrase the question differently.

00:58:36.940 | If we were designing an experiment

00:58:39.000 | and I wanted to wager the hypothesis

00:58:42.500 | that exposure to 15 minutes a day of sunlight

00:58:46.360 | could help reduce adipose tissue, et cetera,

00:58:51.360 | independent of caloric intake,

00:58:54.560 | I know this is kind of a heretical idea,

00:58:57.560 | independent of additional exercise and all that,

00:58:59.960 | and I designed the experiment with you

00:59:02.520 | and we said, okay, people are gonna go outside

00:59:04.200 | for 15 minutes a day,

00:59:05.400 | they're gonna wear short sleeves if they can,

00:59:06.900 | or just a simple long sleeve clothing,

00:59:08.700 | they're gonna get this long wavelength light from the sun

00:59:10.840 | 15 minutes a day.

00:59:12.600 | Based on what you told us about the light shown on the back

00:59:15.840 | and the lower glucose response,

00:59:17.760 | independent of all other variables,

00:59:20.440 | what percentage improvement in sort of the overall metrics

00:59:25.440 | of obesity and metabolic disease do you think you would

00:59:30.400 | predict if we were just gonna,

00:59:31.920 | we'd bet a sushi dinner, for instance.

00:59:33.520 | - Yeah, yeah.

00:59:34.960 | I guess another way of asking the question is,

00:59:37.200 | at what level would I be really surprised?

00:59:38.600 | If it was 50%, I would be surprised.

00:59:40.480 | - Same.

00:59:41.320 | - Yeah, if it was 20 to 30%,

00:59:43.240 | I think that would probably be where it is,

00:59:44.880 | but that's significant.

00:59:46.360 | - That's still significant.

00:59:47.400 | Okay, so that's very helpful.

00:59:49.420 | I think a lot of people hearing about the role of sunlight

00:59:53.120 | and long wavelength light in particular,

00:59:55.120 | its potential influence on improving

00:59:57.840 | overall immune system function, metabolic health, et cetera,

01:00:01.880 | might think that this sounds a little bit kind of biohacky

01:00:04.640 | because the moment we get into red lights,

01:00:06.800 | that's sort of like cold plunges,

01:00:08.640 | it's kind of immediately associated

01:00:10.440 | with kind of biohacking.

01:00:12.600 | People say it's bro science, this kind of thing.

01:00:15.040 | I just wanted to remind people that in the early 1900s,

01:00:19.280 | a Nobel prize was given for the use of phototherapy,

01:00:22.760 | which is what we're describing for the treatment of lupus.

01:00:25.000 | So the idea that specific wavelengths of light

01:00:29.240 | can be used in order to treat cellular health

01:00:31.520 | or offset cellular disease is not a new idea at all.

01:00:35.320 | And you mentioned this earlier,

01:00:36.240 | but I just wanted to underscore that for people.

01:00:38.880 | The other way of looking at all this

01:00:40.220 | is that it's primitive.

01:00:41.820 | So some people will say, oh, this is biohacking, right?

01:00:44.360 | Other people will say, well, this is just primitive,

01:00:45.880 | like get sunlight, of course.

01:00:47.440 | But you made a very key point,

01:00:49.840 | which is that the way we interact with light

01:00:52.880 | and particularly with sunlight nowadays

01:00:55.080 | is so disrupted compared to how it was just 10, 15,

01:00:59.120 | especially 20 years ago.

01:01:01.160 | I would just encourage people to pay attention for one week

01:01:05.240 | to how much time you're actually getting outside.

01:01:07.340 | Now, a few people will already be getting

01:01:09.120 | a lot of time outside, but just pay attention.

01:01:10.880 | How much time each day do you actually get outside

01:01:14.220 | without sunglasses on and just measure your total exposure

01:01:20.220 | to outdoor time, let alone sunlight?

01:01:22.980 | I think that's just an important experiment

01:01:24.660 | for people to do.

01:01:25.500 | And because when one does that, you start to realize,

01:01:27.420 | my goodness, I'm hardly getting outside at all.

01:01:29.540 | - Yeah, there was a study that was done

01:01:31.760 | looking at just this, except they actually used watches

01:01:34.940 | that was able to detect how much light.

01:01:37.780 | And it wasn't infrared light, but just total light.

01:01:40.060 | And the name of the study was basically

01:01:43.100 | dark days and bright nights.

01:01:45.580 | And that is associated with higher mortality.

01:01:47.980 | We know, of course, about bright nights not being good.

01:01:50.860 | So not having a dark room to sleep in.

01:01:53.160 | These are things that can impair melatonin.

01:01:55.080 | That's associated with all sorts of bad things.

01:01:57.940 | But the dark days was something

01:01:59.860 | that we really had not seen.

01:02:02.520 | And it was very interesting.

01:02:03.520 | They actually could show by the hour

01:02:06.020 | that if you were having light coming in,

01:02:08.640 | exactly what that did to your mortality.

01:02:10.860 | And mortality went up dramatically

01:02:13.340 | as you were still in daylight about midnight,

01:02:16.460 | but right around seven o'clock in the morning,

01:02:18.300 | eight o'clock in the morning,

01:02:19.580 | if you were out there and you're getting light now,

01:02:21.420 | instead of light being a liability,

01:02:25.340 | it was now a benefit and it dropped dramatically.

01:02:28.620 | - I also wanna point out that when it's raining out

01:02:32.540 | or when it's very cold out,

01:02:33.860 | even when it's dark and cloudy, quote unquote dark and cloudy

01:02:37.780 | there's far more photons coming through the cloud cover

01:02:41.360 | during the day than at night.

01:02:42.580 | People, I can't tell you if I had a dollar

01:02:44.600 | for every time somebody said to me online and in-person,

01:02:47.760 | there's no sunlight where I live.

01:02:49.240 | Listen, go outside on the shortest day of the year.

01:02:53.880 | Go outside folks and look at how bright it is

01:02:58.720 | at 10 a.m. or even 2 p.m.

01:03:02.240 | Compare that to the middle of the night.

01:03:03.920 | There is sunlight.

01:03:05.040 | Unless you live in a cave, there's sunlight all year round.

01:03:08.880 | It's just striking.

01:03:10.160 | So this morning, for Southern California,

01:03:12.400 | it's pretty overcast today.

01:03:14.000 | It's a misty rain, a little bit more.

01:03:16.400 | And I didn't wanna go outside

01:03:17.980 | and get my sunlight this morning,

01:03:19.400 | but I know I was gonna be in the studio all day.

01:03:21.600 | And so I went downstairs and I put on a beanie cap

01:03:24.160 | and a hoodie and I just got outside with no sunglasses

01:03:26.480 | and got some sunlight in my eyes.

01:03:29.400 | It's really bright outside even when it's raining.

01:03:32.440 | It's really bright outside even when it's storming.

01:03:35.120 | And I think people somehow,

01:03:37.240 | they think that if it's not a clear sunny day,

01:03:39.440 | there's no sunlight to be had.

01:03:40.840 | - Correct.

01:03:41.680 | - And there are many gems that you're providing us today,

01:03:44.040 | but one key takeaway is I want people to understand

01:03:46.860 | there is sunlight all year round.

01:03:48.760 | Yes, unless you live truly a subterranean life,

01:03:54.040 | that you are underground,

01:03:54.960 | there is sunlight during the daytime.

01:03:57.200 | - Yeah, and if there is, we have to work on that.

01:03:59.840 | To your point about it being primitive,

01:04:02.060 | I was looking at the history of this

01:04:04.780 | and it was actually very interesting to me.

01:04:06.360 | We used to have tuberculosis sanitariums

01:04:09.560 | at very high altitude and part of that treatment

01:04:11.400 | was getting out into the sun.

01:04:13.320 | At very high altitude, you have less atmosphere,

01:04:16.220 | more ultraviolet light coming in,

01:04:17.700 | more light in general coming in.

01:04:19.680 | And when I started to look at this,

01:04:20.880 | I found it was very interesting what people started to say

01:04:23.600 | and what these people were actually saying

01:04:25.760 | at the time about sunlight.

01:04:28.840 | In terms of these people, these physicians

01:04:31.600 | and these healthcare providers back in the 1800s,

01:04:34.080 | they didn't have all of the scientific accoutrements

01:04:36.320 | that we have today.

01:04:37.420 | They didn't have X-rays and things of that nature.

01:04:39.280 | But one thing that they were very, very good at,

01:04:41.600 | probably better than we are good at,

01:04:43.840 | is their power of observation.

01:04:45.960 | They were able to get a stethoscope, put it on the chest,

01:04:48.400 | listen to the space between the second heart sound

01:04:51.120 | and the opening snap and be able to say,

01:04:53.280 | this person's got severe mitral stenosis,

01:04:55.920 | this is the one you need to operate on.

01:04:57.640 | And they would do that.

01:04:58.480 | And sure enough, when they opened it up, sure enough,

01:05:00.560 | this is the one that had...

01:05:02.120 | So the power of observation was probably better

01:05:05.400 | back in the 1800s.

01:05:07.320 | So what do you have?

01:05:08.160 | You have people like Florence Nightingale,

01:05:10.360 | who is the founder of modern nursing.

01:05:14.400 | And she was there during the Crimean War,

01:05:19.320 | taking care of British soldiers.

01:05:21.920 | And she wrote down,

01:05:23.160 | I'm paraphrasing basically what she said.

01:05:24.880 | She said, look, when it comes to treating the whole patient,

01:05:28.600 | the one thing that more than anything else

01:05:31.840 | is beneficial for these soldiers to recover is fresh air.

01:05:36.280 | But she said, a very close second is direct sunlight,

01:05:40.280 | getting them out into sunshine,

01:05:42.000 | getting them out into direct sunlight.

01:05:45.280 | When I was looking at the Smithsonian Institute

01:05:48.680 | a couple of years ago, a few years ago,

01:05:50.040 | they put out their top 100 most influential Americans

01:05:54.680 | of all time.

01:05:55.600 | Well, one of them was this lady.

01:05:57.680 | She's the most translated female author in the world.

01:06:01.480 | Her name is Ellen G. White.

01:06:03.080 | And she had a third grade education,

01:06:04.520 | but she was also very interested in health, health reform.

01:06:09.280 | And she wrote at that time in the 1800s

01:06:11.880 | that we ought to be getting out into the sunlight,

01:06:13.680 | that that makes a big difference.

01:06:15.320 | Interestingly, something else that she said

01:06:17.120 | that I found really amazing,

01:06:18.360 | and this is, they're writing this before we understand

01:06:20.560 | circadian rhythm, before we understand melatonin.

01:06:23.920 | She wrote down, she's like, hey,

01:06:26.080 | this idea of keeping the lights on after nine o'clock,

01:06:30.480 | it's a wretched health-destroying habit.

01:06:32.560 | Every light should be extinguished,

01:06:34.560 | she said, after nine o'clock.

01:06:36.840 | So I know about her sayings a little bit

01:06:38.680 | because she was the founder of Loma Linda University,

01:06:41.440 | which is where I went to school.

01:06:42.680 | So, but just, we had this knowledge.

01:06:46.160 | As you said, we had hospitals that were designed

01:06:48.560 | specifically to get people out of the hospital

01:06:52.520 | and into the sunlight.

01:06:53.480 | You could see the architecture was designed for this.

01:06:56.480 | Why don't we do this today?

01:06:58.080 | I think we ought to, but I kind of have a sense.

01:07:00.800 | You asked the question, why don't we do this today?

01:07:03.680 | I have patients that I take care of,

01:07:05.120 | now that I understand this.

01:07:06.800 | I have patients that I have in the intensive care unit

01:07:09.040 | that I wanna get outside in the sunlight,

01:07:10.720 | actually try to get them out.

01:07:12.400 | It's difficult to do.

01:07:13.800 | These people are critical.

01:07:15.300 | The people that we admit to the hospitals today

01:07:18.560 | are far sicker than the people that we admitted

01:07:21.120 | to sanitariums and hospitals in the 1800s.

01:07:25.440 | You have to make sure that they don't desaturate.

01:07:27.440 | You gotta take the oxygen tank out there with them.

01:07:29.860 | You've got to make sure that they don't have a code.

01:07:32.040 | I mean, you're outside, right?

01:07:33.200 | So you're outside of the bowels of the hospital

01:07:35.820 | where your support system is.

01:07:37.040 | It's a little bit of a risk

01:07:38.600 | to get those patients out there.

01:07:39.720 | Nevertheless, I've convinced some of my hospital staff

01:07:44.660 | to do that, and I've had a number of success stories

01:07:47.440 | where we've had patients that were ready to be intubated,

01:07:50.480 | and we got them outside in the sunlight,

01:07:52.640 | and they steadily improved dramatically

01:07:54.600 | after days of getting worse, and they got better.

01:07:57.960 | There was a lady that actually contacted me.

01:08:00.320 | Her name is Amy Hahnmeier, H-O-N-M-Y-H-R,

01:08:05.200 | if you wanna look her up.

01:08:06.040 | She's on social media.

01:08:06.860 | Her son, this is a really amazing story.

01:08:10.860 | Her son basically at the age of 15 got leukemia,

01:08:14.960 | got put on chemotherapy, and this was in Minnesota.

01:08:18.620 | Fortunately, it was in the summertime,

01:08:20.420 | and he got admitted to the hospital

01:08:21.900 | with what they call neutropenic fever,

01:08:23.700 | very high fevers, very low white counts

01:08:25.780 | as a result of the chemotherapy,

01:08:27.580 | and his immune system was completely shot,

01:08:30.680 | and unfortunately, he developed a very severe

01:08:34.260 | fungal infection in his lung called mucor,

01:08:36.780 | and it just basically eats up the lung,

01:08:38.520 | goes right to the blood vessels.

01:08:40.780 | He got so bad that there was only one solution

01:08:44.500 | that they had at the time,

01:08:45.340 | and that was to take out the left lung,

01:08:48.140 | so they took out the left lung,

01:08:50.180 | and he continued to get worse.

01:08:51.420 | The right lung became infected.

01:08:53.300 | He started to get worse, had higher fevers.

01:08:55.720 | They had a meeting with the family.

01:08:57.820 | 15 years old, completely with it,

01:08:59.980 | realizing that he's dying,

01:09:02.140 | and they have to tell him that he's dying,

01:09:04.140 | so they made him what they call no-code, or DNR,

01:09:07.020 | and the staff came to him, and you can imagine,

01:09:09.980 | and I've been in this position before

01:09:11.220 | where you're trying to do everything you possibly can,

01:09:13.180 | and you just, you can't do anything else,

01:09:16.020 | so they came to him, the 15-year-old,

01:09:18.420 | and they said, "You know, this is it.

01:09:20.180 | "Do you have any basically last wishes?"

01:09:22.860 | And, you know, Amy, his mom told me

01:09:25.320 | that he'd like to play outside,

01:09:27.100 | so he told them, you know, without any knowledge

01:09:30.380 | about what we'd just been talking about,

01:09:31.700 | he just, this is his dying wish, "Take me outside.

01:09:34.960 | "I just wanna go outside,"

01:09:36.100 | and you know that nursing staff will move heaven and earth

01:09:41.100 | to do something that the patient requests to do,

01:09:44.060 | even though it's not gonna, you know, benefit them.

01:09:47.500 | They still want, this is dying wish, they're gonna do it,

01:09:49.020 | so they hooked up oxygen tanks.

01:09:51.500 | They got this 15-year-old boy in a hospital bed

01:09:58.100 | outside on BiPAP with oxygen tanks for five hours a day.

01:10:02.480 | His mom was telling me they were also using

01:10:06.420 | something called a Firefly device,

01:10:08.060 | where they were just basically shining a light onto him

01:10:10.300 | to see if it would work.

01:10:11.460 | You know how this story ends.

01:10:15.540 | He did not die in two days like they told him.

01:10:17.820 | He got better.

01:10:18.860 | His fever went away.

01:10:20.220 | His oxygen requirements came down,

01:10:22.380 | and I'm not telling you this as a proof

01:10:25.640 | that this is what happens,

01:10:26.560 | but you have to realize that he was in the hospital

01:10:28.300 | for six weeks underneath, you know, LED lighting,

01:10:33.300 | and as soon as he got outside, fever went away,

01:10:37.900 | and make a long story short, after five days,

01:10:40.060 | he came back inside.

01:10:40.940 | They repeated the CT scan, and she sent me the CT scans.

01:10:43.980 | I've seen 'em.

01:10:44.820 | We actually did a little thing on our MedCram channel on it,

01:10:48.460 | and the disease was almost gone.

01:10:52.260 | There's no explanation.

01:10:53.140 | To this day, they don't have an explanation.

01:10:54.660 | - He's still alive today. - He's still alive.

01:10:56.220 | He's getting chemotherapy.

01:10:58.300 | He went from basically, of course, he's missing a lung,

01:11:01.940 | but he still has that lung.

01:11:03.260 | He's on, he's getting the antifungal medication.

01:11:05.940 | There's no sign of the fungus anywhere,

01:11:08.740 | so this is an anecdotal story.

01:11:10.180 | It doesn't prove anything, and I don't present it as proof.

01:11:14.660 | The things that I present as proof

01:11:15.780 | is randomized control trials, epidemiological trials

01:11:18.180 | with dose-response curves.

01:11:20.220 | These are things that we can actually show the science with.

01:11:22.420 | The reason why I bring it up is because

01:11:24.980 | it shows what is it that we would need to do

01:11:27.340 | to get this type of treatment.

01:11:28.620 | It's not easy to do, but if there is a will,

01:11:32.060 | there's a way to do it.

01:11:33.220 | - I'd like to take a quick break

01:11:35.460 | and acknowledge one of our sponsors, Function.

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01:12:40.380 | that approach worked.

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01:12:43.860 | There's so many things related to your mental

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01:12:49.400 | The problem is blood testing has always been very expensive

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01:12:57.820 | It is very affordable.

01:12:59.100 | As a consequence,

01:12:59.940 | I decided to join their scientific advisory board,

01:13:02.260 | and I'm thrilled that they're sponsoring the podcast.

01:13:04.900 | If you'd like to try Function,

01:13:06.260 | you can go to functionhealth.com/huberman.

01:13:09.220 | Function currently has a wait list of over 250,000 people,

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01:13:22.040 | - It's a spectacular story by any account.

01:13:26.320 | I wanted to just touch on the fact

01:13:31.420 | that there's no replacement for sunlight.

01:13:34.160 | Getting patients outside is hard.

01:13:36.460 | And at the same time,

01:13:38.960 | most people listening to this aren't,

01:13:40.660 | fortunately, are not patients.

01:13:42.340 | Thank goodness.

01:13:44.180 | Many people, however, have relatives

01:13:47.820 | or themselves are elderly.

01:13:51.060 | As people get older,

01:13:52.080 | they tend to slow down, get outside less.

01:13:54.000 | There are many fortunate exceptions to this,

01:13:57.520 | but one of the setups that I created for myself

01:14:01.040 | that I think is certainly feasible for a lot of people

01:14:06.240 | is the following.

01:14:07.440 | Well, first of all,

01:14:08.320 | I always make it a point to get outside

01:14:09.840 | and get sunlight in my eyes,

01:14:11.280 | rain or shine.

01:14:12.460 | And regardless of where I'm traveling and et cetera,

01:14:16.720 | I do that every single day.

01:14:18.200 | If I miss a day,

01:14:19.020 | it's only because of something like a flight

01:14:21.920 | where I happen to be on a plane

01:14:23.040 | at the time of sunrise or something like that,

01:14:25.520 | in any case.

01:14:26.880 | But I have a setup that I constructed for myself

01:14:30.280 | that is basically a 10,000 lux light.

01:14:34.320 | These are available.

01:14:35.220 | I don't have any relationship to 10,000 lux light sources.

01:14:38.320 | Those 10,000 lux light sources

01:14:41.560 | tend to be short wavelength shifted.

01:14:43.600 | They tend to be very blue.

01:14:44.960 | They're white light,

01:14:45.820 | but I don't think they have power

01:14:47.120 | across the visible spectrum.

01:14:48.280 | I think they're very a red light and infrared diminished.

01:14:51.240 | They tend to be very blue and green light enriched

01:14:55.480 | and it shows up as very bright white light.

01:14:57.840 | So that's what I put in front of me when I first wake up

01:15:01.200 | if the sun isn't out yet.

01:15:03.280 | But now I've started putting a red light

01:15:06.240 | near infrared light next to it.

01:15:08.080 | And I'll spend the first couple minutes of my day

01:15:11.800 | usually as I journal or do something like that,

01:15:13.640 | or sometimes just with my eyes closed,

01:15:15.240 | just pleasantly facing in the direction

01:15:18.160 | of the 10,000 lux white light

01:15:20.480 | and the red light near infrared light.

01:15:23.680 | And I must say, again, this is anecdotal,

01:15:25.840 | but that the combination of the two,

01:15:27.720 | not only does it certainly wake you up,

01:15:29.800 | the white light will do that alone.

01:15:31.720 | We know the biological basis for that.

01:15:33.900 | But I have noticed a tremendous improvement

01:15:37.440 | in energy, mood, focus, et cetera,

01:15:40.920 | that comes from the addition

01:15:41.920 | of this red light near infrared light.

01:15:43.480 | - This is not an advertisement for red light

01:15:45.120 | near infrared light, I promise.

01:15:47.000 | Although this podcast does have a relationship

01:15:49.680 | to a medical grade red light devices.

01:15:52.220 | But I mentioned this because what I'm trying

01:15:54.480 | to simulate there is sunlight,

01:15:56.440 | but I still get outside and get sunlight.

01:15:58.440 | So I just mentioned this setup because it seems to me

01:16:01.400 | that hospitals should be able to create this setup

01:16:04.760 | for a minimum of cost.

01:16:06.560 | Certainly less costs than it takes

01:16:08.680 | to maintain a patient for one day.

01:16:10.680 | - Exactly.

01:16:11.640 | I mean, the cost of maintaining a patient

01:16:13.640 | for inpatient care is so high.

01:16:16.800 | Medical staff, the disposables,

01:16:19.600 | the actual disposing of the disposables,

01:16:23.440 | the janitorial staff, the cafeteria.

01:16:25.640 | I mean, hospital costs are outrageously high.

01:16:28.420 | Now, of course, people will hear this and think,

01:16:30.640 | well, that's exactly what hospitals want, right?

01:16:32.400 | Like the longer you stay, it's like a hotel,

01:16:34.480 | the longer that you stay,

01:16:35.560 | the longer they can charge you or your insurance.

01:16:37.340 | And I'm not a conspiracy theory type,

01:16:40.460 | but it is interesting that for many people,

01:16:43.360 | they associate going to a hospital

01:16:44.780 | with staying a long time and getting sicker.

01:16:47.560 | Sometimes they get better and go home, thank goodness.

01:16:49.600 | You're certainly a well-meaning doctor.

01:16:51.880 | The nursing staff are well-meaning people.

01:16:53.720 | - Yes.

01:16:55.080 | - Put simply, why don't hospitals include light therapy

01:16:59.480 | given the abundance of data on circadian rhythms

01:17:03.480 | and light therapy?

01:17:04.320 | And I'll just attach one more thing.

01:17:05.200 | My audience always gets upset at the duration

01:17:06.960 | of these questions/editorials,

01:17:09.080 | but this is my wheelhouse, this whole light thing.

01:17:11.660 | So I can't help myself.

01:17:12.820 | There's also something known as ICU psychosis.

01:17:15.940 | - Absolutely.

01:17:16.780 | - Which is when people who are perfectly mentally healthy

01:17:18.960 | go into a hospital because of the relationship to light

01:17:22.540 | and the disruption in circadian rhythm

01:17:24.180 | from the overhead lights,

01:17:25.220 | the checking of the patient in the middle of the night,

01:17:26.940 | the disruption in sleep, et cetera.

01:17:28.620 | People literally develop psychosis that resolves itself

01:17:32.100 | the moment they get home and get onto a normal schedule.

01:17:35.900 | And it's well-known that the patients

01:17:37.620 | that are in a hospital bed next to a window

01:17:40.560 | don't experience this to the same degree, if at all.

01:17:44.460 | So it's sort of like, I feel like we're sitting

01:17:46.920 | under an avalanche, not a waterfall,

01:17:48.700 | but an avalanche of data telling us what we need to do.

01:17:51.380 | And like, forgive me, but like, what the hell is going on?

01:17:54.220 | - Exactly.

01:17:55.060 | So I can tell you that not only do you have less likely

01:17:58.580 | to get this type of ICU psychosis,

01:18:02.620 | but the data actually shows that people who are

01:18:05.380 | in a two-bed room that are next to the window

01:18:07.980 | actually discharge from the hospital faster.

01:18:11.220 | And you say, ah, well, maybe that's the reason.

01:18:12.860 | Well, it's interesting because the financial incentives

01:18:17.020 | with hospitals is not monolithic.

01:18:19.900 | Some hospitals and their relationship

01:18:22.620 | to the insurance companies are at a situation

01:18:24.380 | where when a patient comes into the hospital

01:18:26.940 | and the physician diagnoses them,

01:18:29.000 | the insurance will pay the hospital a certain amount

01:18:32.440 | of money for that diagnosis, and that's that.

01:18:35.220 | And also there's something called

01:18:36.740 | sub-capitative arrangements where the hospital

01:18:41.100 | has a contract with an insurance company

01:18:43.260 | to take care of 30,000 people per member per month.

01:18:47.060 | And if that patient gets admitted to the hospital,

01:18:49.460 | that hospital has to take care of that patient,

01:18:51.620 | whatever the costs are.

01:18:53.280 | So it basically takes the risk now

01:18:55.780 | and puts it from the insurance company

01:18:57.460 | onto the healthcare provider.

01:18:59.220 | So in those situations, you'll see a hospital

01:19:02.340 | having an army of case managers.

01:19:05.060 | They come down every day.

01:19:06.140 | What are we doing for this patient?

01:19:07.620 | What do we need to do to get this patient

01:19:08.860 | out of the hospital?

01:19:09.680 | So they're motivated to get people out.

01:19:12.380 | And so when I say that, I'm even more bewildered

01:19:15.260 | than when you said at the beginning,

01:19:16.460 | well, if we have good data that shows that light therapy

01:19:21.020 | and light, getting people out into the sun

01:19:23.020 | actually can improve the discharge.

01:19:25.460 | We had that, as I said, that study from Brazil

01:19:28.780 | where there was a randomized controlled trial

01:19:32.180 | and they used 15 minutes of,

01:19:33.820 | they actually made this jacket

01:19:35.420 | that they put on the patients

01:19:36.500 | and they flipped it on with some patients

01:19:38.540 | and they didn't flip it on with others.

01:19:40.940 | - The jacket was a light jacket?

01:19:42.580 | - It was an LED jacket that was giving light out

01:19:45.980 | at 940 nanometers, infrared light.

01:19:48.140 | So you can't even tell if it's on.

01:19:49.620 | And as I said, the milliwatts per square centimeter

01:19:52.460 | was like 2.9.

01:19:53.620 | So you wouldn't even feel it.

01:19:55.740 | But yet these patients, when they were done,

01:19:59.040 | seven days, 15 minutes a day,

01:20:02.200 | they had better oxygen saturation.

01:20:04.360 | They could take deeper breaths, longer breaths.

01:20:08.360 | Their heart rates, their respiratory rates improved.

01:20:11.480 | Even their lymphocytes improved,

01:20:14.520 | the ones that are very important for fighting off COVID-19.

01:20:17.240 | And so at the very end of all of this,

01:20:19.240 | the average length of stay in the control group

01:20:22.640 | was 12 days, about 12 days.

01:20:24.760 | In the intervention group, it was eight days.

01:20:27.300 | How much does it cost to spend four days in a hospital?

01:20:31.800 | - It can be outrageous.

01:20:32.640 | - It's outrageous, and it's potentially possible.

01:20:36.760 | And this is why I think, really, people need to understand

01:20:38.960 | it's not just people who are wanting for their own care,

01:20:42.920 | but people who are in charge of hospitals,

01:20:45.240 | people who are in charge of healthcare in this country,

01:20:48.960 | is understanding that I believe,

01:20:51.360 | why I'm happy to talk about this,

01:20:53.160 | is I think that the lowest hanging fruit, potentially,

01:20:56.400 | after you look at that graph of deaths throughout the year,

01:21:00.640 | is encouraging sunlight in people,

01:21:04.640 | especially in those that are hospitalized and sick.

01:21:07.280 | Absolutely.

01:21:08.240 | I don't know why.

01:21:09.200 | But I think if somebody were to pick up the baton

01:21:12.000 | and decide to do a very simple study

01:21:14.320 | where you'd have to hire some nurses that would actually,

01:21:16.660 | I've actually thought about doing this study myself,

01:21:19.480 | is having a unit outside in the sun

01:21:22.040 | where people go for literally 20 to 30 minutes

01:21:24.120 | and they come back.

01:21:24.960 | You have a whole bunch of nurses there with monitoring

01:21:27.600 | so that you can make sure the patients are stable.

01:21:29.600 | And then you send them right back up.

01:21:30.680 | We send people down at the CAT scanner all the time.

01:21:32.760 | It takes 15 to 20 minutes.

01:21:33.880 | This is not something that we don't do.

01:21:35.600 | The difference is you're just sending them outside,

01:21:38.560 | hopefully it's warm, it's not too cold,

01:21:40.680 | there's nothing bad that happens,

01:21:41.880 | and you send them right back up.

01:21:42.880 | That would be a very easy study to do.

01:21:45.560 | You could randomize them

01:21:46.680 | and then see what happens to their length of stay.

01:21:48.920 | In my experience, and it's only anecdotal,

01:21:50.880 | I have not done the study, it's a world of difference.

01:21:53.720 | That's for sick people.

01:21:54.740 | If we're thinking about health maintenance

01:21:56.400 | and health improvement in healthy people

01:21:58.200 | who are not in the hospital,

01:21:59.560 | which fortunately is most people, it's very clear.

01:22:02.320 | 15 minutes a day of sunlight exposure.

01:22:04.420 | And if you absolutely can't get sunlight exposure,

01:22:09.920 | think about some artificial light arrangement

01:22:13.640 | that might be beneficial.

01:22:15.560 | I wanna make sure that we talk about

01:22:18.080 | not just sunlight exposure

01:22:19.600 | and long wavelength light exposure from artificial sources,

01:22:23.160 | but the flip side of all this,

01:22:24.360 | which is the importance of darkness at night.

01:22:28.420 | I'm aware of a study published

01:22:29.640 | in Proceedings of the National Academy of Sciences

01:22:31.760 | where they basically had kids sleep

01:22:34.440 | in either a completely black room

01:22:37.920 | or a room that had a hundred lux,

01:22:41.320 | this is very dim light, folks,

01:22:43.000 | hundred lux light source down in the corner,

01:22:46.280 | kind of like a night light,

01:22:47.440 | and then looked at morning blood glucose levels.

01:22:50.240 | And there was a significant difference

01:22:52.120 | in the direction of you don't want any light

01:22:55.440 | in the room that you're sleeping.

01:22:56.400 | Now that's hard to do,

01:22:57.720 | especially if you're traveling, hotels,

01:23:00.880 | but eye masks in particular,

01:23:03.840 | silk or even faux silk eye mask,

01:23:06.760 | which are very comfortable, can essentially provide that.

01:23:09.760 | It's very clear that it's the light exposure to the eyes.

01:23:12.920 | What, if anything, do you recommend for people

01:23:16.480 | who are basically living in an environment

01:23:19.840 | that's too bright at night

01:23:22.320 | do you yourself use like blackout curtains?

01:23:26.440 | I mean, how rigid?

01:23:28.000 | I find that this is the one

01:23:28.960 | that's a little bit harder for people.

01:23:31.320 | You have kids.

01:23:32.160 | I mean, how should we work with these data?

01:23:36.280 | And what are your thoughts about the importance

01:23:37.880 | of getting things really dark at night?

01:23:40.040 | - Yeah, that is the same question

01:23:42.440 | and the same problem that I have

01:23:44.360 | with people that do night shift

01:23:46.240 | because they go home and they're supposed to sleep

01:23:47.840 | and it's this daylight outside.

01:23:50.400 | So what do you do?

01:23:51.320 | That's where you get the aluminum foil around the windows.

01:23:54.960 | That's where you basically have to block out

01:23:57.800 | all of that light.

01:23:58.640 | And then the eye patch, of course,

01:23:59.600 | is a nice thing to do as well.

01:24:01.120 | Realizing though that even when you close your eyes,

01:24:05.840 | if there's a light source in the room,

01:24:07.080 | people think, "Well, I'll just close my eyes."

01:24:08.840 | Those photons can go through the eyes,

01:24:12.040 | just like we talked about with infrared light,

01:24:14.120 | can go through the skin.

01:24:15.360 | And I don't know if this is true or not,

01:24:18.200 | but I've heard even one or two photons of light

01:24:20.680 | hitting the back of the retina

01:24:22.240 | can cause enough signal to go to the suprachiasmatic nucleus

01:24:26.360 | that shut down melatonin production,

01:24:27.760 | or at least impair it in some way.

01:24:29.560 | - Yeah, in experimental conditions,

01:24:31.480 | that's definitely true.

01:24:32.920 | I mean, the sensitivity of the human visual system

01:24:37.280 | is extraordinary.

01:24:38.640 | I mean, your rods, the higher sensitivity photoreceptors

01:24:41.660 | in the back of your eye can detect a single photon,

01:24:45.040 | one photon.

01:24:46.480 | Most people aren't familiar with thinking

01:24:48.040 | in photon quantities,

01:24:49.760 | so that might not mean anything to them.

01:24:52.640 | Put differently, and these are wild data

01:24:54.920 | from Chuck Zeisler's lab at Harvard Medical School,

01:24:57.880 | light suppresses melatonin.

01:25:00.400 | The question is, how much light do you need?

01:25:01.880 | Because of the increase in sensitivity of the eye at night,

01:25:05.200 | this rod system and these specialized cells

01:25:08.200 | that send signals to the circadian clock,

01:25:11.680 | 15 seconds, 15 seconds of artificial light exposure

01:25:16.680 | will significantly quash your melatonin.

01:25:20.640 | - That's a whiz at night.

01:25:21.800 | - 15, yeah, right, so if you go to the bathroom,

01:25:23.920 | so then people say, "Well, what am I supposed to do?

01:25:25.320 | "How do I navigate at night?

01:25:26.480 | "And how do I make sure I'm peeing in the toilet?"

01:25:28.040 | Especially for men, right?

01:25:29.340 | And how do I not trip and fall, this kind of thing,

01:25:32.480 | and root to the bathroom or getting a glass of water?

01:25:35.480 | It's actually, you know, it's funny.

01:25:37.040 | The answer turns out to be so logical,

01:25:39.360 | but you almost have to hear it before you kind of go,

01:25:42.280 | "Oh, that makes sense."

01:25:43.380 | So perfectly fine to use your phone as a flashlight.

01:25:46.920 | And then people say, "Well, a flashlight's really bright."

01:25:49.360 | But yeah, but you're not shining the light into your eyes.

01:25:52.600 | So looking at your screen dimmed way down

01:25:55.320 | in the middle of the night

01:25:56.960 | is gonna be very detrimental to the melatonin system,

01:25:59.480 | right at the time where you want melatonin high,

01:26:01.440 | and other things too.

01:26:03.200 | But looking at a flashlight shown into the hallway

01:26:06.680 | so that you can navigate, very different scenario

01:26:09.520 | than it shining directly into your eyes.

01:26:11.600 | - Makes sense. - So you can,

01:26:12.840 | and then there are a number of different red light sources

01:26:14.920 | that are pretty good,

01:26:15.960 | like little red light lamps that are effective.

01:26:18.600 | Or you can just turn your phone to a red light mode.

01:26:21.520 | There's a way to do that.

01:26:23.200 | - Well, I remember a podcast that you had

01:26:24.760 | probably a couple of years ago,

01:26:25.880 | where you had someone, I forgot his name,

01:26:27.280 | but he said his house was very dark at night,

01:26:31.520 | and people would be afraid to go over

01:26:33.320 | because he'd be tripping all over.

01:26:34.440 | - That's my good friend, Dr. Samahir Tart.

01:26:36.400 | Now, keep in mind that Samahir is

01:26:39.040 | the head of the chronobiology unit

01:26:41.360 | at the National Institutes of Mental Health.

01:26:42.800 | So he like literally lives and breathes this stuff.

01:26:45.760 | The other thing about Samahir, which is interesting,

01:26:47.600 | is when I first met Samahir, he was very, very overweight.

01:26:51.400 | What Samahir may have relayed on that podcast,

01:26:55.680 | perhaps not, is that by changing his relationship to light,

01:26:58.600 | sunlight, and getting sunlight during the day,

01:27:01.120 | and darkness at night, and by the way,

01:27:02.360 | he lives in Baltimore at that time,

01:27:04.220 | so it's not trivial to do that,

01:27:06.740 | and changing his sleep schedule

01:27:08.500 | to one of getting into bed around nine or 10 p.m.

01:27:10.800 | and waking up earlier, as opposed to staying up late

01:27:12.760 | and sleeping the equivalent amount

01:27:14.180 | into later in the morning.

01:27:15.560 | He lost over 80 pounds effortlessly.

01:27:20.120 | His appetite just adjusted because he finally got in tune

01:27:23.520 | with his natural circadian cycles.

01:27:25.500 | - And Glenn Jeffrey's work has made me think in my mind,

01:27:29.980 | because of the presence of light in that study,

01:27:32.180 | and the fact that the glucose was less,

01:27:34.620 | it makes me wonder whether or not

01:27:36.120 | we really shouldn't be eating only when the sun is up.

01:27:38.520 | - I agree that we probably should only be eating

01:27:41.400 | when the sun is up.

01:27:42.560 | I myself, I like dinner somewhere around 6, 6.30.

01:27:45.800 | It's tough for me, but I totally agree.

01:27:48.560 | If people were willing to meet me for dinner earlier,

01:27:51.520 | I'm good.

01:27:52.420 | Now, it is true that sleep is vastly improved

01:27:54.880 | when you haven't eaten in the previous couple of hours.

01:27:56.960 | It's also true that trying to fall asleep and stay asleep

01:27:59.160 | when you have gnawing hunger in your belly is not easy.

01:28:01.920 | - No, no. - Okay.

01:28:03.260 | - Yeah.

01:28:04.100 | And I would say the other thing is too,

01:28:05.740 | is making sure that these rules

01:28:07.820 | that we're coming up with here based on physiology

01:28:10.220 | aren't laws, so that we get so anxious about following them

01:28:15.220 | that they actually become a detriment.

01:28:18.580 | There's a point where we just have to do well enough

01:28:20.820 | and then move on to the next day,

01:28:24.580 | try to do it the next day.

01:28:25.580 | - We're human. - Yeah.

01:28:27.260 | - I wanna talk about the other aspects of New Start,

01:28:30.440 | nutrition, exercise, trust, rest, et cetera.

01:28:35.120 | But before we do that, I wanna touch on something

01:28:36.920 | that I've been curious about for a long time.

01:28:40.120 | It's somewhat controversial.

01:28:42.400 | I've stated my stance on this previously,

01:28:45.680 | took some heat for it, but maybe I'll revise my stance.

01:28:49.780 | You see a lot of patients in the ICU with flu.

01:28:52.320 | Obviously, the flu can be deadly in some circumstances,

01:28:56.960 | but for most people that are healthy, generally healthy,

01:29:00.460 | first of all, how concerning is flu?

01:29:04.800 | Should I really be concerned about flu this winter season,

01:29:07.760 | even though I feel robust?

01:29:10.160 | And then the second question is,

01:29:11.760 | do you personally get the "flu shot"?

01:29:14.560 | I said on a previous podcast that I don't get it,

01:29:17.080 | and I took a lot of heat for that.

01:29:20.120 | I understand that the flu shot does protect

01:29:23.860 | against certain forms of flu, not all of them.

01:29:26.380 | That statement was kind of pushed out there

01:29:30.520 | by folks saying that I was going against CDC guidelines.

01:29:32.740 | I'm not going against CDC guidelines.

01:29:34.180 | People should do as they choose.

01:29:35.220 | They should just know what they're doing.

01:29:36.620 | I've never gotten a flu shot.

01:29:38.860 | I don't know if I've ever gotten the flu,

01:29:41.660 | but that's my personal choice.

01:29:43.060 | And it's not based on any specific fear of the flu shot.

01:29:46.440 | It's because it's never been an issue for me.

01:29:49.380 | And I'm okay with getting a cold or a flu

01:29:53.360 | every couple of years,

01:29:54.520 | feeling miserable for a week or two and bouncing back.

01:29:57.980 | I feel like that's good to develop my own antibodies,

01:29:59.940 | but maybe I'm thinking about this completely irrationally.

01:30:02.780 | So do you get the flu shot?

01:30:05.540 | Do you recommend the flu shot for healthy people?

01:30:07.820 | Do you recommend the flu shot

01:30:08.940 | for people that are metabolically challenged?

01:30:12.020 | - Yeah, it's a good question.

01:30:13.340 | I think it's, and the approach that I take

01:30:15.420 | is the approach that I take

01:30:16.900 | with any intervention in medicine.

01:30:18.660 | Every intervention in medicine has a benefit

01:30:20.720 | and every intervention has a risk, no matter what it is.

01:30:24.140 | So for me, because I work in an intensive care unit

01:30:27.260 | around sick patients all the time,

01:30:28.940 | I'm exposed to a lot of flu.

01:30:31.100 | I mean, you literally walk in and the next day they say,

01:30:33.540 | oh, by the way, that guy, yeah, he had the flu.

01:30:35.660 | So you find out after the fact.

01:30:37.700 | So for me, I've always, since I've been a physician,

01:30:39.980 | I've always gotten the flu shot every single year.

01:30:42.060 | - Do you get it multiple times per season?

01:30:44.020 | - No, just once.

01:30:44.840 | - Okay, so at the beginning of the flu season

01:30:46.100 | when they say flu shot available now.

01:30:47.860 | So it's a mix of antibodies against known strains

01:30:52.120 | of the flu.

01:30:52.960 | - Yeah, interesting.

01:30:54.180 | The way that they try to figure out or guess the way it is,

01:30:57.480 | because that's what it is, it's a guess,

01:30:58.880 | is they look six months earlier

01:31:00.280 | to see what happened in the Southern hemisphere

01:31:02.400 | and they see what was circulating there

01:31:03.880 | and then they believe that's what's gonna be circulating

01:31:06.040 | in the Northern hemisphere.

01:31:06.880 | And they do the same in the South.

01:31:08.440 | They look and see what's circulating up here

01:31:09.760 | and they try to figure out what it's gonna be there.

01:31:11.620 | So there's usually about three or four different ones

01:31:14.520 | that they try to put in there.

01:31:16.360 | Ever since 2009, they've tried to put one in there

01:31:18.680 | about 2009 because that was a really bad year.

01:31:20.760 | We mentioned that in terms of that study on sunlight,

01:31:23.880 | but in terms of the side effects as a result of that,

01:31:28.480 | it's been pretty bad.

01:31:29.560 | I mean, to give you an example,

01:31:31.000 | I had a patient recently in the intensive care unit.

01:31:33.680 | This patient came in, very poorly controlled diabetes,

01:31:36.920 | hemoglobin A1C of like 16, 17, it was very bad.

01:31:40.540 | And she developed, she got the flu

01:31:42.760 | and her immune system was not well.

01:31:45.080 | She actually also got a very bad fungal infection

01:31:48.200 | that was near fatal.

01:31:49.880 | And so that's the typical patient that we're gonna see

01:31:54.120 | who's gonna have that type of a bad reaction to the flu.

01:31:57.320 | People who are immunocompromised,

01:31:59.440 | people who are not metabolically healthy,

01:32:02.040 | these are the ones that are wide open.

01:32:03.400 | And so a flu virus is going to do a lot of damage there.

01:32:08.400 | So what does the flu vaccine do?

01:32:10.400 | It gives the immune system an advanced notice

01:32:14.960 | of what this antigen is.

01:32:16.520 | And that has two effects.

01:32:18.160 | What a lot of people believe

01:32:20.520 | is that it's gonna protect you from ever getting infected.

01:32:23.840 | That's not the case.

01:32:24.940 | You can still get infected,

01:32:26.460 | but what happens is that the symptomatology

01:32:29.240 | or the side effects of that infection

01:32:31.760 | will be greatly diminished.

01:32:33.560 | So instead of you being hospitalized, perhaps,

01:32:35.680 | maybe you're only coming down with the flu

01:32:38.220 | and you stay at home.

01:32:39.320 | A lot of people would say, I got the flu shot

01:32:41.080 | and it didn't help, I got the flu anyway.

01:32:43.000 | What we don't know is how severe that infection

01:32:45.920 | would have been in the first place.

01:32:47.560 | So that's why for people who are immunocompromised,

01:32:50.160 | I generally recommend it to get the flu shot.

01:32:52.560 | - Or people that are exposed to a lot of flu

01:32:54.320 | because like you, you work in the ICU.

01:32:56.760 | But, and if I may, do your kids get the flu shot?

01:33:01.760 | - Yeah, we give them the flu shot as well.

01:33:05.600 | It's more because they're the kids of doctors

01:33:07.640 | who might bring home the flu and more than anything else.

01:33:11.360 | But there was a point where we were not doing it.

01:33:14.480 | When they're in their teenage years,

01:33:15.680 | that's when we start actually giving them the flu shot.

01:33:17.720 | That was just a personal opinion,

01:33:18.800 | even though I know it's approved

01:33:20.560 | up down to six months of age, I believe.

01:33:22.780 | - So you started your kids

01:33:23.800 | once they were in their teen years.

01:33:25.080 | - Yeah, yeah.

01:33:26.360 | I remember one year, our son, Ryan, he got some virus.

01:33:31.360 | I don't know what it was, but he had very bad diarrhea

01:33:34.880 | and we had to take him to the emergency room

01:33:38.000 | to actually get an IV and get fluids into him.

01:33:39.600 | He was very dehydrated.

01:33:41.680 | I don't know what that was.

01:33:42.560 | I don't know if it was rotavirus,

01:33:43.880 | but something was going around that year.

01:33:45.520 | So, and he's perfectly healthy.

01:33:47.400 | So this is something that can happen

01:33:49.040 | and you just have to look at the risks and benefits.

01:33:52.240 | - So if, well, I am telling you

01:33:54.520 | that I've never gotten a flu shot.

01:33:56.360 | Am I being irresponsible as a citizen?

01:33:58.740 | I don't tend, I mean, I go places, I go to restaurants,

01:34:01.880 | I go to the gym, I've remained healthy for the most part.

01:34:06.680 | I'm in an occasional sniffle here and there.

01:34:08.120 | Every couple of years I'll get,

01:34:09.600 | it's been a long time actually, now that I think about it.

01:34:12.120 | - I think irresponsible is probably too strong of a word.

01:34:15.080 | The way I look at things is through

01:34:16.960 | what I call the Swiss cheese model.

01:34:18.280 | I don't know if you've ever heard of the Swiss cheese model.

01:34:20.000 | - I love Swiss cheese.

01:34:20.840 | - Okay, so the Swiss cheese model says this.

01:34:23.080 | Every, if I cut up a bunch of pieces of Swiss cheese,

01:34:25.960 | you'll know that every piece has a hole in it, right?

01:34:28.160 | Or maybe a couple of holes.

01:34:29.640 | And if you line up those pieces of Swiss cheese,

01:34:32.280 | those holes might be in different places.

01:34:34.600 | So if you are, let's say you're on one end of those

01:34:37.160 | multiple slices of Swiss cheese

01:34:38.920 | and little particles are coming through.

01:34:41.700 | If you have enough pieces of those Swiss cheese,

01:34:44.200 | no particles are gonna get through.

01:34:46.120 | And that's really what we look at in medicine.

01:34:48.200 | We don't just depend on one slice of Swiss cheese.

01:34:51.380 | Like in the operating room, for instance,

01:34:54.200 | we don't wanna have infections.

01:34:55.560 | So what do we do?

01:34:56.380 | We sterilize the instruments.

01:34:58.240 | But we don't just leave it there, right?

01:34:59.540 | We sterilize the skin that we're going to incise.

01:35:02.200 | We make sure that the room is the right temperature,

01:35:04.080 | the right humidity, because that has an effect.

01:35:05.900 | We make sure it's under positive pressure.

01:35:07.940 | The surgeon is wearing a mask.

01:35:09.480 | He's also wearing sterile gloves.

01:35:10.720 | So we go through, we try to do everything

01:35:13.000 | that we can possibly do so that if there is a breakdown

01:35:16.280 | in one place, we still have a bunch

01:35:17.840 | of other Swiss cheese slices in place.

01:35:20.200 | It's the same thing with the flu and new start.

01:35:22.680 | So nutrition, exercise, water, all of those things.

01:35:25.280 | And then at the end, when you've done that for yourself,

01:35:28.640 | if you wanna have extra protection,

01:35:30.160 | you wanna add on another piece of Swiss cheese,

01:35:32.000 | then you, well, you can talk to your doctor,

01:35:33.760 | see what the risks and the benefits are,

01:35:35.520 | and then make that decision

01:35:36.680 | if that's something that's right for you.

01:35:38.760 | - Are there any known risks of the so-called flu shot?

01:35:41.860 | And if so, what's the percentage risk?

01:35:44.520 | - Yeah, well, definitely there are risks

01:35:46.620 | in terms of allergies.

01:35:48.080 | So they should be asking you when you get it,

01:35:50.280 | have you ever been allergic to the flu shot before?

01:35:52.320 | I mean, you can have anaphylactic shock.

01:35:53.760 | That's one possibility.

01:35:55.000 | Of course, you can have that with anything, right?

01:35:57.480 | But specifically to the flu,

01:35:59.840 | there was actually, interestingly, one year,

01:36:03.160 | and I can't remember which year it was,

01:36:04.560 | but there was a, I think it was in Europe,

01:36:06.840 | and we actually never got it in the United States,

01:36:09.120 | but there was a rash of narcolepsy that was occurring.

01:36:12.860 | So something about the flu vaccine was causing a reaction

01:36:17.520 | that was causing an autoimmune response,

01:36:19.340 | and the antibodies, they believe,

01:36:20.720 | were acting against where hypocretin is made

01:36:26.620 | in the brain, hypothalamus.

01:36:29.600 | And so they noticed that there was an association.

01:36:32.880 | I don't know if they actually determined that it was causal,

01:36:35.540 | but they stopped that brand.

01:36:38.060 | - I would not want narcolepsy.

01:36:40.680 | I used to work in a laboratory for a summer

01:36:42.800 | that studied narcolepsy.

01:36:44.400 | It was the Laboratory Emmanuel Mignon's lab

01:36:47.040 | at Stanford School of Medicine.

01:36:48.820 | He and his colleague, Seiji Nishino,

01:36:51.600 | identified the hypocretin orexin mutation

01:36:55.400 | as the source of narcolepsy.

01:36:56.900 | And people with narcolepsy,

01:36:58.800 | people think it's just excessive daytime sleepiness,

01:37:00.960 | but anytime they have it, in the extreme examples,

01:37:05.080 | when people with narcolepsy

01:37:06.640 | have any kind of emotional activation, they fall asleep.

01:37:09.800 | And they have cataplexy too, so they can't drive.

01:37:12.320 | They become essentially paralyzed, like a sleep atonia.

01:37:16.220 | Pretty devastating disease.

01:37:18.120 | So it sounds like that particular strain of the flu shot

01:37:21.600 | in Europe was neurotoxic in some way.

01:37:24.500 | - Yeah, there was one particular strain.

01:37:25.880 | We'd never seen it before, never seen it since.

01:37:29.400 | And so, yeah, there are these one-offs, right?

01:37:32.800 | But everything has risks.

01:37:34.600 | And so the example that I give is,

01:37:36.960 | look, I'm in the ICU all day,

01:37:38.560 | and I'm seeing people occasionally with head bleeds,

01:37:41.600 | and they're on a blood thinner.

01:37:43.680 | But I don't go back to my clinic in the pulmonary office

01:37:46.600 | and then take everybody off of blood thinners

01:37:48.680 | because we know that blood thinners, epidemiologically,

01:37:51.120 | in the long run, actually save lives

01:37:53.300 | because they prevent strokes, heart attacks,

01:37:55.440 | things of that nature.

01:37:56.280 | So what we try to do is figure out

01:37:58.760 | what's the right individual for this medication,

01:38:01.560 | or what's the right medicine for this type of situation.

01:38:05.600 | And that requires training, and that requires,

01:38:09.920 | sometimes you have calculators

01:38:10.920 | that can figure out these risks.

01:38:13.140 | - In the winter months when flu levels are high,

01:38:16.720 | are you wearing a mask from the moment you walk

01:38:18.640 | into the clinic in the morning until when you leave?

01:38:21.240 | When you walk up to a new patient,

01:38:23.420 | if you know they have a flu,

01:38:25.420 | or if you know they don't have the flu, are you masked up?

01:38:29.480 | I mean, this became a big issue around the COVID discussion,

01:38:33.740 | but to what extent does wearing a conventional mask,

01:38:38.980 | or even an N95, actually protect you from flu?

01:38:42.300 | - Yeah, so the regular surgical masks

01:38:44.860 | are very good at preventing things

01:38:46.520 | from coming out of your mouth and going to other people,

01:38:49.980 | or coming onto your mouth if you happen to have one on.

01:38:52.040 | So in our clinic where we work,

01:38:54.000 | we actually look at the flu incidence,

01:38:57.620 | and then we see if it's rising,

01:38:59.600 | everybody that comes into that place,

01:39:01.200 | physicians, patients, everybody puts a mask on to reduce that.

01:39:05.720 | N95s are a little different in that

01:39:07.800 | they don't prevent viruses from coming out of somebody.

01:39:12.500 | You may notice when you put an N95 mask on,

01:39:14.720 | they may even have a valve that pops open,

01:39:16.680 | and gas can come out, respiratory air can come out,

01:39:20.680 | or comes out the sides.

01:39:22.040 | It's when you take a breath in and it seals,

01:39:24.560 | now it's filtering that air.

01:39:25.920 | So N95s are very good for people

01:39:28.720 | who don't want to get infection

01:39:30.400 | and don't have respiratory issues,

01:39:32.160 | because you're now having to breathe air in through a filter

01:39:35.920 | that takes a little bit more work.

01:39:37.240 | If someone has COPD, which is an obstructive lung disease,

01:39:42.120 | or other lung diseases,

01:39:43.240 | that might not be the best thing to have in those situations.

01:39:45.720 | So yeah, I do wear a mask.

01:39:48.400 | I was very careful.

01:39:49.520 | I know I was coming on your show this winter time,

01:39:51.440 | and I was like, there's no way I want to get the flu,

01:39:53.880 | and miss getting on to see you.

01:39:57.160 | So yeah, I wore a mask.

01:39:58.000 | - Well, thank you for avoiding bringing the flu here.

01:40:01.160 | It's wild, because ever since I started this podcast,

01:40:03.520 | we put out now two episodes a week,

01:40:05.440 | full-length episodes on Mondays

01:40:06.920 | and the shorter essential episodes on Thursdays.

01:40:09.200 | So I can't afford to get sick,

01:40:12.120 | and I haven't been sick in years.

01:40:13.720 | I take care to not get sick,

01:40:16.800 | but I'm going to think real carefully

01:40:18.520 | about this flu shot thing.

01:40:19.880 | What about hand-washing?

01:40:21.480 | Is that, so up front,

01:40:23.240 | let me give a little bit of backstory.

01:40:24.920 | The guy I worked for as a postdoc was an MD, PhD,

01:40:28.840 | and he used to joke about the fact

01:40:31.000 | that hand-washing did nothing,

01:40:32.360 | because he was, in his prior life, he was a surgeon.

01:40:35.920 | He did a, I think he did a rotation, a surgery rotation.

01:40:39.520 | He eventually became a neurologist, then a researcher.

01:40:43.160 | And I used to say, "What do you mean?

01:40:44.760 | The hand-washing does nothing."

01:40:45.840 | And he's like, "Well, have you ever seen

01:40:47.160 | what a physician does before surgery?

01:40:48.600 | You know, they wash up to their,

01:40:50.080 | up to their, basically their shoulders.

01:40:52.080 | They've got betadine, they glove in properly,

01:40:55.560 | and, you know, that's how you prevent infection.

01:40:57.320 | Washing your hands does nothing, it's a formality."

01:40:59.400 | And I thought, "There's no way that could be true."

01:41:01.760 | Then I started digging around in the literature about this,

01:41:04.160 | and it's kind of mixed.

01:41:05.920 | Like, so to what extent does washing our hands

01:41:07.840 | actually help us avoid getting infection?

01:41:09.960 | - I, you know, it's a good question.

01:41:11.280 | And I think it probably comes down to some of the studies

01:41:13.960 | are probably not good data,

01:41:15.400 | or heterogeneous enough to do a meta-analysis.

01:41:18.440 | But what's really interesting is how many times a day,

01:41:22.280 | if you were to watch yourself,

01:41:23.440 | that you touch your nose, you touch your face,

01:41:25.160 | and these are the portals for viruses

01:41:27.640 | to come into your body. - Eyes.

01:41:28.920 | - Yeah, eyes, nose, mouth, that's where they come.

01:41:31.320 | And we touch them all the time.

01:41:33.600 | You touch handles.

01:41:35.760 | I mean, if you think about it, it's almost,

01:41:38.600 | I don't know, creepy.

01:41:40.680 | - And flu, it is creepy.

01:41:41.880 | And flu and cold can survive out on surfaces for how long?

01:41:45.840 | - I'd have to look up the numbers,

01:41:47.920 | but it's longer than you might think.

01:41:50.080 | I know that when we looked at COVID,

01:41:52.000 | I know we went crazy at the beginning of the COVID pandemic

01:41:56.240 | about wiping things down.

01:41:57.400 | And really, that's not the way it seems to spread

01:42:00.800 | for COVID and more airborne things.

01:42:02.720 | But for influenza droplets, that is rotavirus, C. diff,

01:42:08.760 | that's a clostridium difficile infection of the bowel.

01:42:12.240 | That's the primary way that it actually spreads.

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01:43:57.040 | Let's talk about water and air.

01:44:00.360 | I think I, like many people, am curious

01:44:04.140 | as to how much water I drink.

01:44:07.060 | Is that influencing my susceptibility

01:44:09.660 | to infections, et cetera?

01:44:12.160 | Water on the body, water we get into, this kind of thing.

01:44:16.580 | And then air, humidity, temperature, ozone,

01:44:21.580 | anything interesting in those?

01:44:23.260 | Yeah.

01:44:24.800 | Let's talk about water.

01:44:25.640 | So the most obvious one is the internal use of water.

01:44:28.660 | And what's interesting about that

01:44:30.620 | is that we actually can do a blood test on people,

01:44:33.780 | and it's called the sodium concentration.

01:44:35.860 | One of the first things you learn as a medical student

01:44:38.380 | is that the sodium concentration in somebody

01:44:40.860 | has very little to do with how much sodium

01:44:42.940 | they take into their body.

01:44:43.980 | It has much more to do with how much water

01:44:46.300 | they take into their body.

01:44:47.260 | So the more water they take in,

01:44:48.540 | the lower the sodium concentration goes.

01:44:50.720 | But it's very well-regulated.

01:44:53.200 | There's a study that was done a number of years ago

01:44:55.340 | that looked at the chances of death,

01:44:58.380 | so mortality, and sodium concentration.

01:45:01.380 | And as sodium concentration went up,

01:45:04.460 | so did the chances of dying.

01:45:06.660 | So it's important to drink water.

01:45:08.500 | How much water?

01:45:09.940 | You know, there's this old eight-glasses-of-water thing.

01:45:13.180 | It's probably not that much,

01:45:16.420 | but it certainly is important.

01:45:19.220 | So internal use of water is well-known.

01:45:20.940 | I mean, it's a substrate that allows your kidneys

01:45:24.220 | to dump toxins, and you need to flush those things out.

01:45:28.660 | And you sweat, especially if you're exercising,

01:45:30.500 | you're gonna need to take more water in

01:45:31.740 | because you're sweating, you're breathing faster,

01:45:33.420 | you have something called insensible losses of water.

01:45:36.700 | But I think the other part of water

01:45:40.100 | that I'd like to talk about

01:45:41.220 | is not the internal use of water,

01:45:42.700 | which is pretty obvious, and the data's there,

01:45:45.540 | but the external use of water.

01:45:47.640 | And the reason why I bring that up

01:45:49.220 | is in the context of what we're talking about,

01:45:51.380 | which is illnesses, and flus, and viruses.

01:45:54.220 | One of the properties of water

01:45:55.660 | that is very, very important is its high enthalpy.

01:46:00.060 | What does that mean?

01:46:00.900 | It means it takes a lot of energy

01:46:03.260 | to raise water, the substance, one degree Celsius.

01:46:09.260 | And the opposite is also true.

01:46:10.660 | So if you put warm water on someone,

01:46:13.580 | it can transfer a lot of energy into that person

01:46:16.600 | without losing temperature.

01:46:18.780 | Why is that important?

01:46:20.220 | If you want to use,

01:46:21.660 | if you want to increase someone's body temperature,

01:46:24.140 | water is a very good way of doing it.

01:46:26.000 | If you've ever gone into a sauna, and it's a dry sauna,

01:46:29.560 | you haven't yet put the little ladle onto the heating,

01:46:33.260 | you can tolerate 170, 180 degree sauna pretty well.

01:46:38.260 | As soon as you put that water on,

01:46:40.420 | the heat just starts to come down on you.

01:46:42.300 | And that's because water is such a very good way

01:46:45.460 | of transmitting that heat.

01:46:48.100 | So why is that important?

01:46:49.900 | Let's put that away for a little bit,

01:46:51.180 | and I'll explain why that's important.

01:46:53.600 | Let's switch gears and talk about viruses

01:46:56.100 | in the immune system.

01:46:57.560 | So your immune system is divided into two components,

01:47:00.680 | an innate immune system and an adaptive immune system.

01:47:03.980 | The adaptive immune system is what we've all learned about

01:47:06.400 | in terms of vaccines and antibodies

01:47:08.900 | and all the things that the discussion

01:47:10.060 | that we've had the last four or five years.

01:47:12.360 | You see something very specific, your immune system does,

01:47:15.380 | and it makes an antibody directly against that.

01:47:17.420 | If it's slightly different,

01:47:19.020 | the antibody response is not gonna be as effective.

01:47:22.020 | So it's very highly tuned, very specific.

01:47:24.560 | That's the adaptive immune system.

01:47:27.400 | The innate immune system, on the other hand,

01:47:29.200 | is the one that goes out first, gobbles things up,

01:47:33.580 | and presents it to the adaptive immune system.

01:47:35.800 | But there's also something else in the innate immune system

01:47:38.660 | that's very important, and that is the system

01:47:41.340 | that has to do with recognizing damaged molecules

01:47:45.840 | and recognizing pathological molecules.

01:47:48.220 | There are certain pathological patterns, PAMPs,

01:47:52.320 | pathological associated molecular patterns,

01:47:54.600 | that the innate immune system recognizes

01:47:56.760 | without ever having seen it.

01:47:58.760 | And it can take those things out.

01:48:00.720 | And the greatest tool that the innate immune system

01:48:03.220 | has to take those things out is something called interferon.

01:48:06.760 | Interferon's an extremely important molecule.

01:48:11.520 | It has a very wide-ranging ability to take out viruses.

01:48:16.520 | Something that's important to understand

01:48:18.280 | is that with all of the variants

01:48:20.320 | that we've been talking about with COVID,

01:48:22.360 | with all of the different strains that we have of influenza,

01:48:26.920 | none of that matters with interferon.

01:48:29.720 | Interferon has very wide,

01:48:31.120 | and that's why it's such an important molecule.

01:48:34.040 | It's been said that the immune system is so well-designed

01:48:38.120 | that there are no viruses that can infect it

01:48:42.240 | unless they have countermeasures.

01:48:44.800 | And that is absolutely true.

01:48:46.840 | This was first seen when SARS-CoV-2 came out.

01:48:49.240 | They looked at SARS-CoV-1,

01:48:51.040 | the original one that came out in 2002.

01:48:53.800 | And sure enough, that virus, SARS-CoV-1,

01:48:57.920 | if you want to call it that, or just SARS,

01:49:00.100 | had a mechanism contained within it to neutralize

01:49:05.280 | and to suppress the secretion of interferon.

01:49:08.340 | They did some searching, and they looked at SARS-CoV-2,

01:49:11.440 | and sure enough, MAC1, which is a gene in SARS-CoV-2,

01:49:16.440 | is a gene that is specifically, I don't want to say designed,

01:49:20.660 | but it's there to get around interferon.

01:49:24.680 | That should tell you how important interferon is.

01:49:27.760 | So with that in mind,

01:49:28.880 | let's go back to our talk about water and temperature.

01:49:32.560 | There was a number of studies that had been done

01:49:34.200 | looking at temperature, interferon, and what they showed.

01:49:39.200 | This was an in vitro study where they took lymphocytes,

01:49:42.880 | they put it into a medium, and they bathed it in LPS.

01:49:47.720 | LPS is basically a molecule that is seen in bacteria

01:49:52.480 | that usually sets off the immune system.

01:49:54.520 | So you have lymphocytes, you have LPS,

01:49:56.880 | and then what they did was

01:49:57.720 | they slowly increased the temperature,

01:49:59.520 | and they measured interferon.

01:50:01.320 | Once it hit 39 degrees Celsius,

01:50:05.000 | there was a tenfold increase in interferon secretion

01:50:07.800 | from the lymphocytes.

01:50:09.500 | 39 degrees for those who are on the Fahrenheit system,

01:50:12.480 | that's about 102.2, okay, so.

01:50:15.040 | - Slight fever.

01:50:15.880 | - Slight fever, yeah, or a good fever, yeah, good fever.

01:50:19.240 | So what does this mean?

01:50:23.340 | This means that, and this gets into the whole discussion

01:50:25.900 | philosophically about fevers in general.

01:50:27.960 | - Should you block them, should you not?

01:50:28.800 | - Exactly, and I'll tell you, in the hospital,

01:50:31.480 | I'll get so many calls,

01:50:32.640 | "Hey, doctor, this patient has a fever."

01:50:34.600 | And the idea is is that the fever is part of the problem,

01:50:39.600 | and we need to fix the fever 'cause it's part of the problem.

01:50:42.620 | By the way, that was the same thought process

01:50:45.160 | in the 1918 Spanish flu pandemic that we had.

01:50:49.600 | Aspirin had just been discovered, Bayer aspirin, 1899,

01:50:53.940 | and it was great, it seemed,

01:50:56.600 | because aspirin took away fever,

01:50:58.880 | it took away the body aches, it took away the pain,

01:51:02.000 | and all of that was subscribed to the virus

01:51:04.880 | that was going on.

01:51:05.720 | They didn't even know it was a virus,

01:51:06.840 | just the influenza disease.

01:51:08.880 | And so it was being used almost excessively,

01:51:12.000 | in fact, in many cases, probably toxically.

01:51:14.940 | In these army hospitals in 1918,

01:51:17.000 | people were coming in with the flu,

01:51:18.960 | young people were coming in with the flu,

01:51:20.500 | and they were getting high doses of aspirin,

01:51:22.160 | they thought this was the way to treat it,

01:51:23.800 | and the mortality rate, the case fatality rate

01:51:25.960 | was like 6%, it might've been even higher than that.

01:51:29.760 | So getting back to water, external use of water,

01:51:35.680 | here is a way to deliver large amounts of energy

01:51:40.680 | that can be stored in water as a substance

01:51:44.640 | to the patient to elevate,

01:51:46.080 | to actually help elevate body temperature,

01:51:48.900 | to see whether or not we can improve the innate immune system

01:51:54.560 | to actually help out in that type of a situation.

01:51:57.440 | - So we're talking about hot baths?

01:51:59.040 | - Hot baths, sauna.

01:52:01.040 | - Hot shower?

01:52:01.880 | - Hot showers.

01:52:03.040 | Probably the most effective way of doing it

01:52:07.360 | is in the old term, and again,

01:52:09.760 | something that was used 100 years ago

01:52:11.320 | is hydrotherapy or hot fomentations,

01:52:13.980 | is the term that you'll find.

01:52:15.240 | If you look at the old literature,

01:52:16.640 | this is where they would get hot towels,

01:52:19.040 | linen towels, they would soak it in water,

01:52:21.360 | they would heat it up, usually in a stove,

01:52:23.040 | but you could do the same thing in a microwave.

01:52:25.760 | The big thing is that you have to make sure

01:52:27.160 | you don't burn yourself.

01:52:28.280 | - Or the house down.

01:52:29.160 | - Exactly, and so you would put a protective layer

01:52:32.400 | of a batting or cloth on the patient,

01:52:35.640 | and this would go on top of them,

01:52:37.360 | and you would basically cover them up

01:52:39.160 | until you started to see them sweat,

01:52:40.960 | and you'd do that for about 20 minutes.

01:52:42.920 | Once you start to see them sweat,

01:52:44.040 | you know that you're elevating the body temperature

01:52:45.920 | above the set point, and what that's supposed to do

01:52:49.160 | is to activate the immune system to secrete interferon.

01:52:54.080 | Look, we have studies, there was a study

01:52:55.920 | that was published a couple of years ago,

01:52:57.920 | looking at COVID, giving exogenous interferon

01:53:01.760 | to people with COVID-19 reduced hospitalizations by 50%.

01:53:06.020 | So you're getting around--

01:53:06.860 | - You can take exogenous interferon?

01:53:08.520 | - Oh yeah, absolutely.

01:53:09.360 | - You take it as a pill?

01:53:10.680 | - It's an infusion, you would digest it in the stomach.

01:53:13.360 | So this was an infusion that they gave to patients.

01:53:17.280 | - I'm surprised that I haven't heard

01:53:18.600 | of like peptide clinics selling interferon.

01:53:21.100 | Can you inject interferon subcutaneously?

01:53:25.320 | - You can, and this was actually published

01:53:27.400 | in the New England Journal of Medicine.

01:53:29.280 | It was Interferon Lambda, I believe,

01:53:31.440 | and it was a phase three trial

01:53:35.040 | looking at getting FDA approval.

01:53:37.160 | I think probably because of the fact

01:53:38.800 | that we weren't having as many hospitalized patients,

01:53:41.200 | it probably hasn't gone through,

01:53:42.120 | but in that study, it reduced hospitalizations by 50%.

01:53:45.880 | - Wow.

01:53:47.160 | For those that don't have access to interferon infusions

01:53:50.940 | or a sauna or even a bath,

01:53:54.140 | so what is it, you know, a five to 10 minute hot shower,

01:53:56.720 | then get under the blankets, this kind of thing.

01:53:58.960 | I mean, this is kind of good old mom's advice kind of stuff.

01:54:03.960 | - Isn't it interesting?

01:54:05.200 | So I'll tell you what the protocol was.

01:54:07.600 | There was, and actually this is quite interesting.

01:54:10.440 | Historically, there were a number of sanitariums

01:54:13.480 | in the Northeast of the United States

01:54:14.840 | back at that time of the century.

01:54:16.140 | And they were run by the Adventist Church

01:54:18.960 | and their way of dealing with the pandemic was different.

01:54:22.320 | They were not using drug medications.

01:54:23.960 | They were using hydrotherapy and sunlight,

01:54:25.700 | some of the things that we've been talking about here.

01:54:28.080 | And there was a guy by the name of Wells Rubel

01:54:30.440 | who was the medical director of the New England Sanitarium.

01:54:34.760 | And he said, "Let's just take a look

01:54:35.840 | "and see what's going on here.

01:54:36.760 | "Let's pool the 10 sanitariums in this area,

01:54:39.800 | "see what's gone on in terms of the way

01:54:41.460 | "we treat the patients and then look at the published data

01:54:43.940 | "from the army hospitals."

01:54:46.660 | And there was a stark difference.

01:54:47.700 | He divided it into two sections.

01:54:49.660 | The first phase of influenza is the early phase.

01:54:53.180 | And the major endpoint of that early phase

01:54:56.540 | was did they get pneumonia?

01:54:57.980 | Okay, and then from pneumonia,

01:55:00.940 | the second endpoint after that was the second phase.

01:55:03.020 | And that was, the question was, did they die?

01:55:05.700 | So where the sanitarium seemed to do a much better job

01:55:10.140 | than in the army hospitals was in that first phase.

01:55:13.780 | They had 1/6 of the people actually go to the pneumonia phase.

01:55:18.780 | So what were they doing?

01:55:19.820 | Immediately, they were doing hydrotherapy.

01:55:22.020 | Immediately, they were doing,

01:55:23.700 | which was basically increasing body temperature,

01:55:25.580 | doing fever types of treatments,

01:55:27.220 | getting them out into the sunlight.

01:55:28.580 | You can remember, maybe in your mind's eye,

01:55:31.500 | these photographs of these army hospitals

01:55:33.740 | or these army camps and the tents were outside

01:55:36.940 | 'cause they didn't have any place to put them

01:55:38.240 | in some of these cases.

01:55:39.460 | So the sunlight was good,

01:55:40.500 | but the thing that they weren't doing was the hydrotherapy.

01:55:43.220 | Once they got to the pneumonia stage,

01:55:46.580 | there was no difference

01:55:48.060 | between what the sanitariums were doing

01:55:49.620 | and the army hospitals.

01:55:50.460 | The mortality was 50%.

01:55:52.300 | Remember, this is prior to penicillin.

01:55:54.900 | This is 1918.

01:55:56.020 | This is before 1928 when we discovered penicillin.

01:55:59.380 | So once you hit pneumonia, it was really difficult to treat.

01:56:02.740 | So he actually wrote this up,

01:56:04.260 | and I actually found it in a, someone directed it to me.

01:56:07.180 | They actually showed it to me.

01:56:08.640 | It was in a, it wasn't even in a scientific journal

01:56:11.340 | that he published it in.

01:56:12.180 | It was some sort of periodical called "Life and Health."

01:56:14.900 | May 1st, 1919, I still remember it in my head.

01:56:16.980 | And he says, "Hey, this is what we did.

01:56:18.900 | "This is what they did."

01:56:19.960 | They had 1/6 of the mortality in their institution.

01:56:24.960 | And this was repeated multiple times.

01:56:27.420 | This is not done in isolation.

01:56:30.700 | Let's lead you up to the big thing here.

01:56:32.660 | There was a Nobel Prize that was given for this.

01:56:35.140 | In 1927, Jules Wagner-Jurek

01:56:39.300 | was a Austrian psychiatrist

01:56:42.740 | who noticed that in his patients that had neurosyphilis,

01:56:47.740 | that when they had a fever, their symptoms improved.

01:56:51.300 | So this is, again, prior to penicillin.

01:56:55.100 | He actually took patients with malaria,

01:56:58.700 | and he took the blood from these patients

01:57:00.860 | and carefully infected his neurosyphilis patients

01:57:04.140 | with malaria.

01:57:05.520 | And of course, you know that malaria

01:57:07.120 | causes very, very high fevers.

01:57:09.420 | He cured neurosyphilis by causing fevers from malaria.

01:57:14.420 | - Wild.

01:57:16.840 | And all he really had to do was heat them up.

01:57:20.380 | - There was many ways of doing it at the time.

01:57:21.980 | Heat closets, sometimes they would inject foreign proteins

01:57:24.980 | to create a fever.

01:57:26.060 | This was another way of doing it with malaria.

01:57:28.220 | Of course, at the time,

01:57:29.060 | they had the treatment for malaria, right?

01:57:31.060 | Quinine.

01:57:31.900 | - Well, and LPS will do this, right?

01:57:34.300 | LPS, as you mentioned, is lipid polysaccharide.

01:57:37.200 | I think they get it from yeast cell wall or something.

01:57:41.000 | - Yes, it's a foreign antigen.

01:57:42.880 | - Yeah, it's a contaminant in a lot of gray market peptides

01:57:46.720 | and things that I suggest people don't take.

01:57:49.160 | You know, there are a lot of people now

01:57:50.400 | who are interested in peptides

01:57:51.840 | and they buy them on the gray market,

01:57:53.360 | and it says not for human or animal use

01:57:56.920 | research purposes only.

01:57:58.520 | And people often say, well, why not use those?

01:58:01.720 | You know, why do people have to go through a physician

01:58:03.880 | and a compounding pharmacy

01:58:05.140 | if they're going to explore that territory at all?

01:58:08.140 | And the reason is it's very clear

01:58:10.460 | that most of the gray market peptides have LPS in them.

01:58:15.140 | So small amounts, but injected repeatedly over time,

01:58:17.520 | people start getting the systemic inflammation

01:58:19.300 | and fever response.

01:58:20.300 | - There you go.

01:58:21.780 | - You know, that's a little bit of a tangent,

01:58:23.060 | but it gets to the same mechanism.

01:58:25.140 | So when you say the use of water in this context,

01:58:30.140 | it's really about trying to heat up

01:58:32.060 | the core temperature of the body.

01:58:33.740 | - Exactly.

01:58:34.580 | - Okay, and so when we think about Russian banyas,

01:58:37.100 | which I'm a huge fan of, you know,

01:58:38.580 | there's a bunch of them in different cities.

01:58:40.780 | Whenever I'm in New York,

01:58:43.220 | I go to this place down on Wall Street, Spy 88.

01:58:46.780 | I have no relation to them.

01:58:47.860 | And they have a medium hot sauna for Russians.

01:58:51.480 | Medium hot is very hot.

01:58:52.820 | It's like a spice in certain restaurants.

01:58:55.340 | You know, you have to calibrate to the local ethnicity.

01:59:00.260 | And then they have very hot sauna.

01:59:02.340 | And what they do there, even when they're not sick,

01:59:04.380 | is they'll go from, you know,

01:59:06.100 | a moderately hot to hot to steam,

01:59:09.460 | and then back to a hot, hot sauna,

01:59:11.020 | then into cold water.

01:59:12.540 | So they're doing heat, cold contrast therapy.

01:59:14.740 | And, you know, the Eastern Europeans and Russians

01:59:17.900 | and Scandinavians have been doing this for centuries.

01:59:20.660 | - Absolutely.

01:59:21.500 | - Here, we think of it as like biohacking

01:59:23.220 | and this new domain of health,

01:59:25.020 | but this has been going on for a very long time.

01:59:26.820 | - So in my mind, anthropologically,

01:59:30.020 | I'm wondering those cultures

01:59:32.980 | that don't have access to the sunlight that we have here,

01:59:36.700 | maybe they use this as a way of supplementing that.

01:59:39.300 | 'Cause we don't see- - In winter.

01:59:40.260 | - In winter, right.

01:59:41.100 | So we don't see that.

01:59:42.060 | We don't see a lot of sauna use

01:59:43.660 | near the equator in any kind of culture.

01:59:45.140 | - Yeah, I don't know.

01:59:46.060 | I'm sure they exist down there,

01:59:47.160 | but I feel like Brazil in the summertime

01:59:49.460 | probably feels like a sauna.

01:59:51.260 | So you don't need a sauna, right?

01:59:52.920 | Whereas Siberia in winter probably feels a lot

01:59:56.740 | like the way I imagine Siberia in winter.

01:59:58.860 | If you look at probably the biggest purveyor

02:00:01.900 | of this type of therapy that we're talking about,

02:00:03.900 | hydrotherapy, was at the Battle Creek Sanitarium

02:00:06.580 | in Battle Creek, Michigan.

02:00:08.580 | And they had whole protocols for this.

02:00:10.800 | And when I looked it up,

02:00:11.780 | the general protocol for this was 20 minutes of hot

02:00:16.260 | followed by a very, very short,

02:00:19.100 | probably a minute of cold

02:00:22.240 | that involves some sort of physical rubbing

02:00:25.620 | or sort of abrasion on the chest.

02:00:30.220 | Okay, and when I saw that,

02:00:31.820 | it's like I immediately thought of what they do in Finland

02:00:34.620 | and where they hit themselves with-

02:00:36.220 | - Yeah, the Russians use these eucalyptus branches.

02:00:40.740 | - Eucalyptus.

02:00:41.580 | - And it's the, it is, it's eucalyptus branches.

02:00:44.000 | I call it, I think it's called platsa

02:00:45.460 | or something like that.

02:00:46.620 | - Yeah.

02:00:47.680 | - And yeah, it costs a little bit more,

02:00:49.900 | but if you go to one of these Russian banya's,

02:00:51.780 | you can pay someone who's skilled in this.

02:00:54.020 | They basically make you lie down

02:00:55.260 | and you cover your face and groin,

02:00:57.020 | and then they hit you with these eucalyptus branches.

02:01:00.380 | Not to smack you with them,

02:01:02.180 | but the idea is that in the sauna,

02:01:05.020 | you're gonna bring some of the additional vasodilation

02:01:09.540 | to the surface of the skin.

02:01:11.860 | So you're getting more blood flow to the periphery

02:01:13.540 | is the idea.

02:01:14.500 | I don't know if there's any truth to it, but-

02:01:16.620 | - My understanding from what I've heard and read

02:01:19.700 | is that obviously the heat part

02:01:21.660 | is to heat up the core body temperature.

02:01:23.140 | And that has a whole host of responses,

02:01:26.060 | which I'll touch on after this,

02:01:28.300 | that I read a recent article that was just amazing.

02:01:30.940 | But the cold part of it is gonna cause vasoconstriction,

02:01:34.820 | and we know this in medicine.

02:01:36.980 | We're actually taught this in medical school,

02:01:39.060 | that a cold shower, vasoconstriction,

02:01:40.980 | causes demargination of the white blood cells

02:01:43.980 | that are actually attached

02:01:45.220 | to the inside of your blood vessels,

02:01:46.900 | and it knocks them into circulation.

02:01:49.260 | So if you think about this, what is it that you're doing?

02:01:51.820 | When you're doing the heat aspect and the fever goes up

02:01:54.460 | and the temperature is basically,

02:01:56.700 | it's a non-hormonal signal to the entire body

02:01:59.660 | to start up regulation and transcription.

02:02:03.180 | And then the very last thing is the cold.

02:02:05.020 | Now, what does that do?

02:02:05.860 | Number one, it knocks those cells into circulation

02:02:08.860 | to go wherever they need to go.

02:02:10.180 | That's number one.

02:02:11.020 | And number two, vasoconstriction peripherally,

02:02:14.140 | which is what you will see,

02:02:15.660 | prevents that heat that you've just built up

02:02:17.860 | from going out to the periphery and being lost.

02:02:21.020 | So it kind of locks the heat in, in a sense,

02:02:23.580 | allowing that heat to last longer.

02:02:25.420 | - Amazing.

02:02:27.140 | Could you just repeat one more time,

02:02:28.900 | even though you said it incredibly clearly,

02:02:31.060 | this phenomenon of how the white blood cells are liberated

02:02:37.580 | by cold and constriction?

02:02:39.020 | - Yeah, so when you have,

02:02:40.500 | imagine a tube that's lined with white blood cells.

02:02:43.660 | They all have little podocytes, little things that attach.

02:02:46.700 | And what happens when you have vasoconstriction

02:02:48.420 | is it causes vasoconstriction.

02:02:49.940 | It shrinks down because of the smooth muscle in the wall.

02:02:52.940 | And you have release of these white blood cells

02:02:55.420 | into the circulation.

02:02:56.660 | And that's called demargination.

02:02:59.460 | So after a cold shower,

02:03:00.900 | you will actually be able to see,

02:03:02.500 | and this is kind of a trick question,

02:03:04.340 | does one's white blood cell count go up

02:03:06.380 | after a cold shower?

02:03:09.020 | The answer is, technically,

02:03:10.300 | you have the same number of white cells,

02:03:12.020 | but now they're just more of them in the circulation.

02:03:14.460 | So yes, the number that you get back on the lab test

02:03:17.140 | shows that it's gone up.

02:03:18.420 | - And the white blood cells,

02:03:19.500 | for those that aren't familiar,

02:03:21.020 | they essentially go out and-

02:03:22.580 | - Yeah, these are the macrophages, the neutrophils.

02:03:25.460 | These are all different branches, if you will,

02:03:28.300 | of the arm forces of your body

02:03:30.260 | that go out to try to find things and neutralize them.

02:03:33.220 | - And this is part of the innate immune response.

02:03:35.980 | This is not, so- - Yes, both actually.

02:03:37.860 | - White blood cells, right.

02:03:39.180 | White blood cells are involved

02:03:40.100 | in the adaptive immune response as well.

02:03:42.420 | Amazing, I've never heard of deliberate cold exposure

02:03:46.020 | being used to liberate white blood cells in that way,

02:03:48.700 | but it makes perfect sense.

02:03:49.820 | It sounds like it's largely mechanical.

02:03:51.580 | - It is, and it also may seem to be mechanical

02:03:54.820 | in terms of locking that heat in.

02:03:56.580 | So one of the things that I always was puzzled about

02:04:00.460 | is I don't know how many people are able

02:04:03.140 | to really get their core body temperature up to 102.2.

02:04:06.980 | I mean, it's possible.

02:04:08.260 | You'd have to really try to do it.

02:04:09.740 | And then I came across a paper that was incredible.

02:04:13.460 | And this was a paper where they actually looked at mice,

02:04:16.340 | which, by the way, I looked this up.

02:04:17.500 | They actually have the same target temperatures

02:04:19.340 | that humans have.

02:04:20.620 | And also hamsters, and again, same target temperature.

02:04:24.340 | And what they showed in this,

02:04:26.180 | they looked at the innate immune system

02:04:28.060 | and the signaling that's required

02:04:29.700 | for the secretion of interferon.

02:04:31.620 | And they looked at STAT and JAK.

02:04:33.940 | These were the two areas or signaling.

02:04:37.060 | And what they showed was essentially that,

02:04:41.460 | whereas before I had told you

02:04:42.820 | that you had to go up to 39 degrees Celsius

02:04:45.980 | to get a tenfold increase in interferon secretion,

02:04:49.420 | what they did was they looked at 36, 37, 38, and 39,

02:04:55.300 | and they saw a jump going from 37 to 38.

02:05:00.300 | So in other words, at 38 degrees,

02:05:01.980 | which is only 100.4 Fahrenheit,

02:05:04.700 | there was a dramatic increase in the signaling

02:05:07.820 | in probably six or seven different areas

02:05:10.420 | of the STAT and the JAK system signaling.

02:05:13.860 | When they did further analysis,

02:05:15.340 | they said, what's going on here?

02:05:17.020 | Is it the lack of breakdown of mRNA?

02:05:19.780 | What's actually happening?

02:05:21.140 | This is the conclusion that they came to

02:05:22.580 | after they did all the molecular studies.

02:05:25.340 | It was simply just the increase in temperature

02:05:29.180 | that was causing an increase in transcription

02:05:32.140 | in the nucleus.

02:05:33.060 | - Transcription of-

02:05:34.620 | - Of the proteins.

02:05:35.500 | - Leading to more interferon.

02:05:36.700 | - Correct.

02:05:37.540 | So we're talking about not the transcription

02:05:39.580 | of the protein interferon,

02:05:41.260 | but the transcription of the factors

02:05:42.760 | that regulates the increase in interferon, yeah.

02:05:46.220 | So it was basically transcription in the nucleus

02:05:49.920 | is actually upregulated itself by nothing else

02:05:53.020 | other than temperature.

02:05:55.580 | - I love it.

02:05:57.160 | One thing that people might wanna play with a little bit,

02:05:59.540 | although they should be careful, right?

02:06:01.420 | If you're pregnant, forget the sauna for a while.

02:06:04.180 | - Yeah, I-

02:06:05.020 | - You know, if you're-

02:06:05.840 | - Absolutely.

02:06:06.680 | - You know, everyone has different thresholds

02:06:08.160 | for heat tolerance and cold tolerance,

02:06:09.780 | but spend a little time in a Russian banya

02:06:12.740 | and you'll soon realize

02:06:13.980 | that they all wear these like wool hats.

02:06:16.380 | - Yes.

02:06:17.220 | - And you might think,

02:06:18.040 | "Oh, well, that's just gonna heat you up more."

02:06:18.880 | No, it insulates you against the heat.

02:06:20.780 | And so you can stay in much longer

02:06:22.140 | because the signal to get out,

02:06:24.060 | like that it's going too hot is a brain signal first.

02:06:27.860 | - Oh, wow.

02:06:28.700 | - Which makes sense, right?

02:06:29.540 | And your brain basically evokes something

02:06:31.820 | analogous to the gasp reflex

02:06:33.340 | when you're not getting enough oxygen, right?

02:06:35.380 | - Okay.

02:06:36.200 | - So if you go in there with a towel on your head

02:06:38.620 | or you cover your head,

02:06:40.460 | what you find is that you can sit comfortably

02:06:41.980 | at much hotter temperatures in the sauna.

02:06:43.900 | - Got it.

02:06:44.740 | - That could be a problem, right?

02:06:46.220 | 'Cause you don't wanna burn your skin.

02:06:47.460 | But the sauna actually provides a lot more degrees

02:06:50.960 | of freedom and exploration safely than does hot bath.

02:06:54.100 | Because if you get into a bath that's truly too hot,

02:06:56.260 | you'll burn your skin.

02:06:57.220 | - Correct.

02:06:58.060 | - Right, whereas in the sauna, you know,

02:06:59.300 | you might go into a very hot sauna.

02:07:01.260 | I'm very heat tolerant.

02:07:02.180 | I don't like the cold so much, but I do it anyway.

02:07:03.940 | But I'm very heat tolerant.

02:07:05.340 | But when I first hit a, you know, a 210 degree sauna,

02:07:08.820 | which is very, very warm sauna,

02:07:10.520 | if your head isn't covered, your heart starts racing.

02:07:14.660 | You feel like you want out of there.

02:07:16.360 | If you go in there wearing a, like a wool beanie cap.

02:07:19.220 | - Yeah.

02:07:20.060 | - You're like, you're fine.

02:07:20.900 | - Yeah, yeah.

02:07:21.720 | - You're fine because the brain signal

02:07:22.560 | doesn't get kicked off for a while.

02:07:23.900 | - So that's interesting because I've seen

02:07:26.060 | some old photographs of when they used to do this,

02:07:28.500 | like in mass in the big hospitals back East 100 years ago.

02:07:31.740 | And there was these treatment rooms

02:07:34.340 | and each of the treatment rooms had a little hole in,

02:07:36.300 | not a little hole, but a hole enough to put your head.

02:07:38.100 | And so it was kind of funny

02:07:39.540 | 'cause you see this long hallway

02:07:41.500 | and all of these humans heads kind of sticking out of a hole

02:07:44.680 | while the treatment was going on inside the room,

02:07:46.700 | their heads were outside the room.

02:07:48.220 | - You know, it's so amazing how humans find

02:07:51.660 | the same solutions through different portals.

02:07:54.040 | - It is true.

02:07:54.880 | - I'm fascinated by this.

02:07:55.700 | You know, every once in a while,

02:07:56.540 | I sit back from the information that we touch on

02:07:58.580 | in this podcast since we launched in 2021.

02:08:00.740 | And I think, you know, there are so many different tools

02:08:03.980 | and protocols and you're providing additional ones today.

02:08:08.540 | They almost all fall into about six to 10 batches.

02:08:13.540 | And whether one comes through

02:08:15.780 | the portal of traditional Western medicine

02:08:17.860 | or Eastern medicine or what the, you know,

02:08:20.100 | Finns or the Russians do or what they do,

02:08:22.260 | it's so interesting that, you know,

02:08:23.580 | we're talking light, temperature,

02:08:26.100 | and these things obviously relate,

02:08:27.980 | hydration, which I'm sure we'll talk about,

02:08:30.180 | mitochondria, cellular metabolism.

02:08:33.500 | I mean, you know, there isn't an infinite number

02:08:36.300 | of conceptual themes and they tend to sort of

02:08:38.420 | batch into them.

02:08:39.260 | And I think understanding those themes

02:08:40.300 | helps people make decisions.

02:08:42.420 | Like if you're on the road and you're feeling run down

02:08:44.260 | after getting off the plane

02:08:45.780 | and you're thinking you might be coming down

02:08:46.940 | with something, you get that little throat tickle.

02:08:49.300 | You know, you only have access to a hot shower.

02:08:51.360 | That's your best bet, do that.

02:08:52.580 | Like you don't need a sauna.

02:08:54.140 | Ideally, you're getting sunlight.

02:08:55.260 | You don't have sunlight.

02:08:56.100 | You can, you know, take some of the other measures

02:08:57.980 | that we were talking about before.

02:09:00.400 | Yeah, I find it fascinating that humans

02:09:02.580 | eventually converge on the same answers.

02:09:04.380 | It just sort of varies in terms

02:09:05.980 | of what you call these things.

02:09:07.220 | Exactly.

02:09:08.060 | You call it hydrotherapy.

02:09:08.900 | Yeah.

02:09:09.720 | I call it deliberate heat exposure,

02:09:10.560 | deliberate cold exposure.

02:09:11.620 | If you're, you know, in some cases.

02:09:13.260 | And people from all over the world

02:09:14.500 | and different cultures have talked to me

02:09:16.500 | in Asia, in the Middle East.

02:09:18.460 | And they say, you know what?

02:09:19.300 | My grandmother, my mother,

02:09:20.700 | they used to do this to us all the time.

02:09:22.260 | They put us in the hot sand.

02:09:23.340 | I remember someone telling me from Iraq,

02:09:25.660 | they said, if we were sick,

02:09:27.820 | they would put us into the hot sand to heat us up.

02:09:30.140 | And then you talk to somebody, you know,

02:09:31.740 | from the 1950s, grandma would say,

02:09:33.700 | oh, they put us to bed and make sure

02:09:35.500 | we're all warm with the covers and.

02:09:37.060 | Hot water bottle.

02:09:38.020 | Hot water bottle, exactly.

02:09:39.340 | I mean, in Asia, they would do something different.

02:09:41.660 | I've heard them tell it.

02:09:43.400 | It's interesting to me how all of these cultures

02:09:46.660 | that really haven't connected necessarily

02:09:48.700 | have come up with the same answers

02:09:50.620 | for a lot of these things.

02:09:52.080 | That said, there are things that purportedly

02:09:57.940 | we can take to accelerate our progression

02:10:00.820 | through an illness should we get one

02:10:03.940 | and to help avoid illness.

02:10:05.460 | One of the things I'm most interested in

02:10:07.540 | is your thoughts on MAC, N-acetylcysteine.

02:10:11.340 | My understanding is that a few years ago in this country,

02:10:13.980 | there was an FDA ban on N-acetylcysteine,

02:10:17.020 | but that the people who had already been taking

02:10:18.900 | N-acetylcysteine were so bullish about it

02:10:20.980 | that they fought back and it has remained freely available

02:10:24.060 | without a prescription.

02:10:25.460 | My understanding is that N-acetylcysteine

02:10:27.960 | requires a prescription in some countries.

02:10:30.380 | Could you tell us what the various uses

02:10:32.940 | of N-acetylcysteine are and what its potential role is

02:10:37.860 | for avoiding or even accelerating the progression

02:10:41.260 | through a viral or other type of infection?

02:10:43.860 | - Yeah, so I sometimes say N-acetylcysteine.

02:10:47.820 | It may be just my Canadian accent coming through.

02:10:50.180 | - I'm guessing, oh, I didn't realize you were Canadian.

02:10:52.640 | I'm guessing you are correct and I'm incorrect.

02:10:54.740 | - No, I think you are correct

02:10:55.740 | 'cause people have corrected me.

02:10:56.820 | So I think if I say it, if slip up, that's what happens.

02:10:59.860 | - Mom, mom, you know, ninth grade and grade nine,

02:11:02.780 | these are all Canadian.

02:11:03.780 | - That is true.

02:11:04.620 | - Yeah, so.

02:11:05.700 | - So probably the most obvious one to start with

02:11:08.300 | is the one that's actually we use all the time

02:11:10.420 | in the hospital and it's for Tylenol overdose.

02:11:13.340 | And that's because Tylenol, the metabolism of Tylenol

02:11:16.820 | depletes the liver of these reducing agents,

02:11:19.820 | glutathione, things of that nature.

02:11:21.300 | So N-acetylcysteine is going to replace that.

02:11:25.300 | And that's one of the things that's well-known.

02:11:27.780 | We actually have dosing protocols.

02:11:29.180 | We have nomograms to tell us when we should use it,

02:11:31.820 | when we shouldn't use it.

02:11:32.700 | And it's very well-documented.

02:11:34.460 | - So it supports the liver metabolism.

02:11:36.420 | - It supports liver metabolism

02:11:37.660 | and prevents the liver from going into failure.

02:11:40.220 | So people could literally die

02:11:42.260 | if we didn't give them this medication.

02:11:44.140 | - Does it also effectively treat liver failure

02:11:46.740 | due to other things like alcohol?

02:11:48.260 | - That's an excellent question.

02:11:50.380 | I would say if you asked me that question

02:11:52.020 | 20 to 25 years ago, I would have said no,

02:11:54.060 | there's no evidence.

02:11:54.900 | But now if you talk to some GI specialists,

02:11:57.500 | they'll say, yeah, there's some data

02:11:59.100 | that it actually may be beneficial.

02:12:01.280 | It's certainly not gonna hurt.

02:12:02.660 | And so in patients who have liver failure

02:12:05.220 | from one thing or another,

02:12:06.220 | they may actually recommend using that medication as well,

02:12:09.140 | N-acetylcysteine.

02:12:09.980 | - So NAC is a glutathione precursor.

02:12:12.140 | Is that right?

02:12:12.980 | - It is one that it's recharging.

02:12:14.180 | So if you wanna think about it in terms of redox,

02:12:17.500 | this is a good way to think about it,

02:12:19.180 | is think about a sulfur element

02:12:22.660 | with a hydrogen attached to it.

02:12:26.860 | That is the reduced form

02:12:29.640 | because it can donate that proton often

02:12:32.580 | and it'll be in a reduced situation.

02:12:34.580 | So it can reduce something that was oxidized.

02:12:37.640 | However, when it reduces something that was oxidized

02:12:40.060 | and it does that in a good way,

02:12:42.060 | it itself becomes oxidized.

02:12:43.620 | And instead of having an S-H, it's now S-S.

02:12:48.340 | So now it's oxidized.

02:12:50.420 | That's really important in a lot of places

02:12:53.960 | because of that S-S bond.

02:12:55.700 | So you'll know that the S-S bonds occurs in amino acids.

02:13:00.700 | It's the reason why you can perm your hair.

02:13:03.540 | You may not know that,

02:13:04.380 | but the way your hair is is because of S-S bonds.

02:13:08.300 | And then what you do is you reduce all of those S-S bonds.

02:13:11.120 | In other words, basically disconnecting them.

02:13:14.340 | And then you can curl it however you want.

02:13:16.740 | And then when you take it away,

02:13:18.460 | those S-S bonds clamp down and you have a perm.

02:13:21.740 | - All right, next episode,

02:13:22.660 | I'll show up looking like a Chia pet.

02:13:24.820 | - That's the reason why when you go to get a perm,

02:13:26.740 | that stuff smells like rotten eggs.

02:13:28.820 | It's because that's the sulfur group, yeah.

02:13:31.060 | So that's also, by the way, the same reason why,

02:13:35.620 | and this gets into a little bit other discussion

02:13:37.820 | about why I think NAC may be, I'll just call it NAC,

02:13:40.980 | is used in other areas,

02:13:42.700 | is this is also the main reason

02:13:45.340 | why we get thrombosis of platelets.

02:13:48.900 | So pulmonary artery,

02:13:51.340 | if you have the endothelial lining,

02:13:54.540 | which makes sure that the red blood cells

02:13:56.380 | as they're going through the pulmonary artery

02:13:58.260 | are not causing clots.

02:14:00.860 | If that endothelial lining would become damaged,

02:14:04.420 | it would release underneath it

02:14:05.980 | and expose a huge collection

02:14:09.020 | of something called von Willebrand's factor.

02:14:11.940 | Von Willebrand's factor is a monomer,

02:14:13.700 | but it quickly becomes a polymer.

02:14:15.660 | And the way it does that is in forming SS bonds.

02:14:19.940 | So that's a quick polymerization.

02:14:21.500 | Then of course, the next step that happens

02:14:22.940 | is that these polymers will then trap platelets

02:14:26.340 | and cause them to clump,

02:14:28.020 | and you will get something called a white clot.

02:14:30.500 | - So for those that aren't familiar

02:14:31.940 | with monomers and polymers and this kind of thing,

02:14:34.420 | basically you're taking a bead

02:14:36.300 | and you're creating the polymer,

02:14:37.820 | which is more like beads on a string.

02:14:39.340 | - Exactly, exactly.

02:14:40.500 | - And that can capture more things,

02:14:41.740 | like a big clumpy molecule.

02:14:42.940 | Big clumpy, sticky molecules aren't "bad" or "good,"

02:14:47.060 | but in this context, they're definitely bad.

02:14:48.660 | - They would be, yeah.

02:14:49.500 | So imagine now, if you will,

02:14:51.540 | the pulmonary artery in somebody who becomes infected

02:14:54.420 | with either influenza or COVID-19,

02:14:57.460 | and that causes an oxidative stress situation

02:15:02.100 | where you have the cell having more oxidative stress

02:15:06.180 | than it should, causes dysfunction of the cell,

02:15:09.100 | the cell becomes damaged, heals back,

02:15:12.500 | releases some of the von Willebrand's factor,

02:15:14.460 | and now you have clots in the pulmonary artery.

02:15:17.340 | This is something actually that we did see with COVID.

02:15:19.660 | When they did the autopsies,

02:15:20.980 | they found many times more of these specific white clots

02:15:25.980 | in these patients.

02:15:28.460 | And so I don't know if that's the mechanism

02:15:31.580 | that's occurring in influenza,

02:15:32.980 | but there was a lot of papers that were published in COVID.

02:15:35.980 | And the interesting thing about that was,

02:15:38.700 | is that, do you remember when they published,

02:15:40.740 | they had a paper that was published

02:15:42.220 | looking at blood types and COVID,

02:15:44.820 | and they said, "You know what?

02:15:46.020 | "What we're finding is is that those with type O blood

02:15:48.660 | "are just slightly less susceptible to getting COVID.

02:15:52.180 | "They have a slightly less mortality."

02:15:54.540 | - Yeah, that was a relief to me because I'm O blood.

02:15:56.780 | - Okay. - Yeah.

02:15:57.860 | - Well, the interesting thing about that is well-known,

02:16:00.120 | is that people with type O blood

02:16:01.500 | have slightly less von Willebrand's factor.

02:16:04.580 | - So does that mean in general that we clot less?

02:16:09.200 | - If that clotting is related

02:16:10.740 | to von Willebrand's factor in platelets, then yes.

02:16:12.980 | There's other ways of causing clotting cascade, but yes.

02:16:17.140 | So I found it really interesting.

02:16:18.280 | There was kind of two independent points

02:16:20.180 | that sort of connected each other.

02:16:22.340 | The other thing that was actually really interesting

02:16:24.060 | about this, and this will lead to the conversation

02:16:25.620 | about NAC and why I was using it in actually patients

02:16:28.620 | with COVID-19 and influenza,

02:16:30.340 | and we'll talk about that study too,

02:16:33.020 | is ACE2.

02:16:35.820 | So ACE2 is the receptor for the spike protein

02:16:38.140 | for SARS-CoV-2, true.

02:16:40.540 | But let's take it one step further.

02:16:42.800 | That ACE2, what is it actually there for?

02:16:45.060 | Why is it even there?

02:16:45.900 | It's not there to be a receptor for spike protein.

02:16:49.000 | The actual job that ACE2 does is it converts angiotensin-2,

02:16:54.000 | which is a pro-oxidant, into angiotensin-1,7,

02:16:57.100 | which is an antioxidant.

02:16:58.340 | So let's go back to the beginning of our discussion again.

02:17:01.660 | Here's the mitochondria.

02:17:03.020 | Here is the mitochondria is doing what it needs to do,

02:17:05.620 | and it's producing oxidative stress.

02:17:07.780 | And it's got all these different enzymes

02:17:09.340 | that are there to lessen the heat from that engine,

02:17:13.620 | catalase, glutathione peroxidase, superoxide dismutase,

02:17:17.460 | melatonin, as we discussed at the beginning,

02:17:19.800 | and angiotensin-1,7.

02:17:22.280 | So now what happens?

02:17:25.040 | You've got these patients that have obesity.

02:17:27.420 | You have these patients that have cancer.

02:17:31.580 | Heart disease, dementia.

02:17:32.980 | These are people whose engines are running hot.

02:17:35.700 | They're barely making it

02:17:37.340 | because of all of the oxidative stress damage

02:17:39.340 | that has occurred.

02:17:40.180 | Now what happens?

02:17:41.000 | This virus comes in, spike protein, hits the ACE2 receptor,

02:17:45.600 | and now that thing that was in balance

02:17:47.760 | is now out of balance

02:17:48.740 | because you're no longer taking a pro-oxidant

02:17:51.180 | and making an antioxidant.

02:17:52.920 | So now the analogy is that you're in a car,

02:17:56.420 | and the heat in the engine's barely,

02:17:59.780 | I mean, it's coming up, right?

02:18:01.140 | And you're barely making it,

02:18:02.060 | and now you approach a hill called COVID-19,

02:18:05.100 | and you're going up that hill.

02:18:06.080 | You're gonna burn out.

02:18:07.340 | Your engine's gonna overheat.

02:18:08.900 | And that's what was happening with these patients.

02:18:10.740 | Remember they were coming in happy hypoxics,

02:18:12.980 | they were calling them?

02:18:14.180 | They were there, they looked, they were fine,

02:18:15.420 | but they were severely hypoxic.

02:18:19.100 | What I believe what was happening,

02:18:20.420 | and there's some data to show this is the case,

02:18:22.940 | is that as the virus went into the lungs,

02:18:26.380 | and I believe this also happens with influenza,

02:18:30.020 | the virus was getting into the pulmonary circulation.

02:18:33.220 | And as it was going down,

02:18:34.380 | it was binding to the very rich ACE2 receptors

02:18:37.500 | and all of these pulmonary endothelial cells.

02:18:39.940 | And it was causing these enzymes to stop working,

02:18:43.220 | and now the oxidative balance was being knocked out.

02:18:45.960 | These cells were becoming damaged, they were peeling off.

02:18:48.580 | Von Willebrand's factor was coming into circulation,

02:18:51.220 | and this polymerization was occurring,

02:18:53.540 | and these white clots were occurring,

02:18:54.820 | and that was leading to hypoxemia.

02:18:56.980 | How do we stop that from happening?

02:18:58.980 | Well, certainly one way of doing it

02:19:00.780 | is to make sure that the redox balance

02:19:02.980 | in these cells are maintained.

02:19:05.740 | And one way of doing that is light and melatonin

02:19:08.420 | and all the things that we just talked about.

02:19:10.220 | But another way of doing it, in addition,

02:19:12.860 | would potentially be in preventing those sulfide bonds

02:19:15.060 | from forming and causing polymerization.

02:19:18.580 | And that's where you have NAC,

02:19:20.100 | which is basically, it would go through to those SS bonds

02:19:23.920 | that are causing the polymerization and break them off.

02:19:27.500 | - I see.

02:19:28.420 | So I started taking NAC at, I think it's 600 milligrams

02:19:32.100 | or even 900 milligrams three to four times per day,

02:19:35.260 | which is a very high dose,

02:19:36.720 | but restricted to times when I felt like

02:19:39.140 | I might be coming down with an infection

02:19:41.540 | or I was traveling in the winter months, I still do this,

02:19:45.900 | or if I had any kind of low-level congestion.

02:19:50.660 | And my understanding is that it's a mucolytic.

02:19:53.860 | - Yes, because mucus, again,

02:19:55.960 | the reason why mucus is so thick

02:19:57.780 | is because of those SS bonds.

02:19:59.900 | So when you put NAC in there,

02:20:01.900 | it breaks it off and now it's liquidy.

02:20:04.700 | - It's used to treat cystic fibrosis

02:20:06.900 | and to counteract the buildup of fluid in the lungs,

02:20:10.700 | as I understand.

02:20:11.660 | - Yeah.

02:20:12.700 | - So it will make your nose run a bit

02:20:15.700 | if you have a little low-level congestion.

02:20:17.160 | But what I love about it, and I don't have any really,

02:20:19.940 | to be clear, folks,

02:20:20.780 | I don't have any relationship to any company that sells NAC.

02:20:23.580 | I'm not paid by the big NAC or anything similar,

02:20:27.700 | - Or Big Mac.

02:20:29.340 | - Certainly not by Big Mac, but by Big Mac either.

02:20:32.240 | But I don't like conventional decongestants.

02:20:36.940 | I like steam, but I don't like taking over

02:20:39.700 | the counter decongestants

02:20:40.780 | of the sort of conventional commercial type

02:20:44.260 | because they tend to be very drying.

02:20:46.260 | They sometimes have a little bit

02:20:47.320 | of a stimulant quality to them.

02:20:48.700 | I just don't like them.

02:20:50.020 | And I find that NAC, in addition to increasing glutathione,

02:20:53.820 | which can only be a good thing,

02:20:56.300 | is a great decongestant.

02:20:58.620 | You do have to keep blowing your nose quite a lot.

02:21:00.420 | If you take it right before you go to sleep

02:21:01.620 | and you sleep on your back,

02:21:02.940 | you can wake up like feeling more congested.

02:21:04.900 | So you have to kind of understand what it's doing.

02:21:07.140 | That's why we're talking about it in this way.

02:21:08.940 | But I find that it's helped me move through periods

02:21:13.220 | of sort of exposure to colds, maybe flus,

02:21:17.860 | but certainly colds, much faster.

02:21:19.820 | And actually there are data to support

02:21:21.220 | that it can prevent contracting the flu virus.

02:21:23.700 | - Well, not necessarily contracting it,

02:21:26.180 | but certainly having the symptoms of it.

02:21:27.700 | So this was a, this is like the best study

02:21:30.100 | you could ever imagine, right?

02:21:31.220 | So this is a multi-centered, double-blinded,

02:21:34.260 | placebo-controlled trial, right?

02:21:36.060 | So you're eliminating a lot of the confounders.

02:21:38.320 | And what they did was in a winter season,

02:21:40.780 | so I think it was over three to six months,

02:21:43.340 | people were taking 600 milligrams of NAC twice a day.

02:21:47.460 | And what they did was they looked to see

02:21:49.140 | how many people got infected and what their symptoms were.

02:21:52.020 | And while it did not reduce the number of infections

02:21:55.540 | from influenza, there was a significant reduction

02:21:59.300 | in the symptoms of influenza.

02:22:02.300 | So infections, no, it doesn't reduce,

02:22:04.160 | but symptoms dramatically.

02:22:05.180 | And which symptoms specifically?

02:22:07.160 | It's the most annoying symptoms.

02:22:08.620 | So the one that dropped the most was the runny nose

02:22:11.580 | and the sore throat.

02:22:12.980 | That was what it was best at reducing.

02:22:15.740 | There's been some question about NAC

02:22:17.780 | because it's so good for cells, right?

02:22:20.540 | 'Cause it replenishes.

02:22:22.840 | There are some studies in vitro in cells

02:22:26.000 | that are designed to be models for cancer

02:22:31.000 | that NAC can actually cause the propensity

02:22:34.760 | for some of these cells to grow and expand.

02:22:39.760 | I think that probably needs to be taken

02:22:41.600 | with a little bit of grain of salt

02:22:42.960 | because these were in models that are designed

02:22:46.240 | for cancer cells to grow.

02:22:47.440 | So the same thing would happen if you were to give nutrition

02:22:50.840 | to cancer cells on a Petri dish, right?

02:22:52.800 | That doesn't necessarily mean

02:22:53.680 | that nutrition causes cancer.

02:22:55.760 | - Yeah, you raise a really important point around this.

02:22:57.960 | I mean, the joke that was told to me years ago

02:23:01.280 | is a drug or a compound is a substance

02:23:05.000 | that when injected into an animal

02:23:07.440 | creates a scientific paper.

02:23:09.800 | Meaning it's very easy to see things change

02:23:13.040 | when you add, when you do a dose response curve

02:23:15.280 | of just about anything.

02:23:17.360 | And some people might say, well, thank goodness,

02:23:19.480 | are any compounds doing anything that's real

02:23:22.040 | or is it all placebo?

02:23:23.000 | I think there are real effects of compounds.

02:23:25.600 | The context is really important.

02:23:27.760 | Do you take NAC continuously given your job

02:23:31.520 | or do you increase your dosage

02:23:33.920 | when you know you're coming into contact with flu patients?

02:23:37.600 | - I do exactly as this paper was doing.

02:23:40.520 | In a winter season when I know

02:23:42.240 | that things are gonna be elevated and high

02:23:44.600 | and I'm gonna be seeing a lot of influenza patients,

02:23:47.680 | I do take 600 milligrams twice a day.

02:23:50.080 | But I try not to do it for more than three months.

02:23:51.880 | I don't know the long-term effects,

02:23:53.240 | but I think three months is probably good enough.

02:23:55.200 | - Yeah, I know people take it continuously.

02:23:56.680 | I've never taken it continuously.

02:23:58.160 | I sort of enjoy the fact that there are certain compounds

02:24:02.440 | out there like NAC that I personally can observe a benefit

02:24:07.120 | from if I take it for short periods

02:24:08.760 | and slightly higher doses, and then I stop.

02:24:12.480 | And I have the, you know, an unfounded theory

02:24:15.680 | that it helps punctuate the effectiveness

02:24:20.120 | because there is down regulation

02:24:22.640 | of pretty much every mechanism you could possibly imagine.

02:24:25.440 | - Yeah, I mean, there's so many redundancies

02:24:27.120 | that are built into the system.

02:24:28.640 | But in this situation, I don't know what the mechanism is,

02:24:32.520 | but I believe that with influenza,

02:24:34.200 | there is a tilting of the scale toward oxidative stress.

02:24:39.160 | And NAC in that sense can be very helpful.

02:24:41.840 | - And as I recall in the study that you described

02:24:44.660 | where people took this 600 milligrams of NAC twice a day,

02:24:48.220 | the reduction in severe symptoms,

02:24:52.700 | or was it the number of people

02:24:54.180 | that experienced severe symptoms went from somewhere

02:24:56.740 | in the high 70%, maybe 78% or something like that.

02:25:00.740 | I'm not quite exact on the numbers here, folks,

02:25:04.540 | to about 28%, is that right?

02:25:06.820 | - Yeah, so that's about a 50% absolute risk reduction,

02:25:11.820 | which if you do the math,

02:25:13.100 | it's a number needed to treat of two,

02:25:15.260 | which is extremely low and very amazing.

02:25:18.460 | - And you're getting an increase in glutathione to boot.

02:25:22.960 | - Yeah, yeah. - So, yeah, wonderful.

02:25:25.300 | Other things that have been shown to improve symptomology

02:25:29.420 | or perhaps even immune system function,

02:25:32.860 | maybe we could talk about zinc.

02:25:34.580 | - Yeah.

02:25:35.420 | - I take what most people would consider

02:25:37.420 | very high levels of zinc,

02:25:38.660 | and I've been doing it for a long time,

02:25:40.100 | and I'm gonna continue to do it,

02:25:42.020 | 'cause I do my blood work and it works for me.

02:25:44.300 | I think there is actually good data for zinc.

02:25:46.620 | Some people might disagree,

02:25:48.620 | but I think the studies that I've seen

02:25:51.500 | seem to show that zinc supplementation can be beneficial.

02:25:55.620 | The theoretical, of course,

02:25:57.100 | and I'm sure you're familiar with it,

02:25:58.380 | is the copper deficiency,

02:25:59.700 | and if you're checking that, then that's fine.

02:26:02.220 | The recommendations that I have seen

02:26:04.260 | is 40 milligrams of elemental zinc.

02:26:06.660 | So you have to be careful when you look up zinc

02:26:08.740 | on your bottles to tell you how many milligrams,

02:26:10.940 | but it's the entire molecule that they're measuring,

02:26:13.000 | so you've gotta, it'll also say how many milligrams

02:26:16.380 | of elemental zinc that is equivalent to,

02:26:19.260 | and the recommendation that I've heard from people

02:26:21.620 | is 40 milligrams, but I don't,

02:26:24.540 | if you're checking your copper levels,

02:26:26.020 | then you should be fine, yeah.

02:26:26.940 | - Well, it's never charted out by body weight either,

02:26:29.420 | so I weigh, you know, 215 pounds,

02:26:31.540 | so what's the risk of copper depletion?

02:26:34.240 | - Blood deficiencies and things of that nature, yeah.

02:26:39.100 | - Okay, I'll get my copper levels checked.

02:26:41.460 | - I believe it's in my blood panel.

02:26:44.520 | It is in my blood panel, and I don't have a flag there,

02:26:47.240 | but I'll keep an eye on it.

02:26:48.400 | - Yeah, liver, I believe,

02:26:49.460 | also is involved with copper as well.

02:26:52.120 | - So what is zinc doing to improve immune system function?

02:26:56.080 | - There's a couple of enzymes that use zinc as a cofactor,

02:26:59.200 | and I believe that that's what it's related to.

02:27:03.480 | I can't remember exactly which ones they are,

02:27:05.320 | but zinc is used as a cofactor

02:27:07.440 | in some of the enzymatic reactions of the immune system, yeah.

02:27:11.320 | - Why doesn't somebody market an interferon inhaler

02:27:15.300 | or a nasal spray?

02:27:16.420 | - You know, actually, they are looking at that.

02:27:19.420 | When I was researching this for the intravenous interferon,

02:27:24.420 | I remember seeing something about interferon

02:27:28.060 | in terms of a nasal spray.

02:27:29.340 | I haven't seen that yet, though.

02:27:31.060 | - Someone out there who's industrious can create one.

02:27:35.380 | - It doesn't make you feel very nice.

02:27:37.460 | I mean, when these patients, for instance,

02:27:40.500 | well, this might be material to understand, too.

02:27:43.380 | For many years, we had hepatitis C that was incurable,

02:27:46.700 | and interferon actually is the cure.

02:27:49.580 | There was a point where we used to give infusions

02:27:52.580 | of interferon to cure people with hepatitis C,

02:27:55.040 | but when we gave them the treatment, they felt horrible,

02:27:57.860 | felt like they had the flu, and it's for good reasons,

02:28:00.180 | because when you have high levels of interferon,

02:28:03.540 | you do have the flu, it feels like that.

02:28:05.300 | - It's worth touching on this,

02:28:06.980 | so much of the symptomology when we have a flu or a cold

02:28:11.780 | or what have you is the immune system doing its thing,

02:28:15.140 | the fever, the congestion, and we think of that

02:28:20.140 | as the illness, but it's often the byproduct

02:28:23.100 | of the body trying to extrude or kill.

02:28:25.660 | - Exactly, nobody likes congestion,

02:28:28.380 | so I don't mind treating that,

02:28:30.580 | but I think out of all of those symptoms

02:28:32.500 | that you mentioned there, the one that I think

02:28:35.540 | is probably the most beneficial to keep is the fever.

02:28:38.500 | - What about these cocktails that I see,

02:28:44.180 | eucalyptus oil, oregano oil, all this stuff,

02:28:47.220 | is it completely worthless?

02:28:49.100 | - No, it's not completely worthless.

02:28:51.540 | So let's talk about the science,

02:28:53.380 | let's talk about the actual data.

02:28:56.060 | We don't have, I don't have a randomized control trial

02:28:58.140 | to give you like I did with light,

02:28:59.660 | but there was a study that was done,

02:29:02.060 | and the reason why they were looking at this,

02:29:03.620 | this was a bunch of oncologists that were looking

02:29:05.700 | to see if there was something that could improve

02:29:08.100 | the immune system when people were getting chemotherapy,

02:29:11.140 | and they did an in vitro study, so this is in vitro,

02:29:13.800 | but they were able to show that just a very small amount

02:29:16.660 | of eucalyptus oil had a tremendous impact

02:29:19.740 | on phagocytosis on the innate immune system.

02:29:23.700 | They actually-- - Phagocytosis, folks,

02:29:25.180 | sorry for interrupting, but is it a gobbling up

02:29:27.460 | of bad stuff by good cells?

02:29:30.220 | - Yeah, exactly.

02:29:31.220 | So they had these beads, and the paper showed

02:29:35.100 | that these beads, and they were fluorescent,

02:29:37.100 | and you could see in the cells

02:29:39.140 | that had not yet gotten the eucalyptus oil

02:29:42.220 | that there was a number of beads outside,

02:29:43.820 | and these cells were just kind of moseying around,

02:29:46.140 | and they had both light microscopy and electron microscopy,

02:29:49.660 | and a few of these beads had gotten eaten up inside,

02:29:53.620 | and then they showed the next slide.

02:29:56.140 | It was like a transformation with the eucalyptus oil,

02:29:58.180 | so instead of these nice rounded cells,

02:30:01.060 | they were like all of these things just coming out,

02:30:03.780 | like little podocytes, like reaching for things,

02:30:06.340 | and then a few hours later, it showed all of the beads

02:30:09.740 | that were outside were now inside.

02:30:12.100 | So there was something in the eucalyptus oil itself

02:30:15.020 | that was stimulating the innate immune system

02:30:18.520 | to gobble this stuff up.

02:30:20.540 | And again, we go back to the folksy type of old stuff.

02:30:24.500 | The main ingredient in Vicks VapoRub is eucalyptus oil.

02:30:29.300 | - Could I have a theory that it's not going to be

02:30:34.300 | very kind to eucalyptus trees or koalas

02:30:37.860 | or anything related to eucalyptus,

02:30:39.620 | which is that maybe the eucalyptus oil is a mild irritant

02:30:44.620 | at the cellular level.

02:30:47.020 | You inhale it, you get this menthol-like odorant.

02:30:52.020 | It's kind of caustic, and the immune system reacts to it

02:30:55.900 | by activating phagocytes to go gobble up more stuff.

02:30:59.100 | - It could very well be.

02:31:00.260 | In that line of discussion, it's very imperative

02:31:04.980 | to understand that eucalyptus oil is never recommended

02:31:08.160 | to be taken internally.

02:31:10.540 | There's actually been reported deaths

02:31:12.420 | from taking too much eucalyptus oil.

02:31:14.180 | So I just put that out there, that if people think

02:31:16.400 | that it's gonna work and more is better.

02:31:18.860 | Usually the way it's used and the way it has been used,

02:31:21.920 | historically, is, and for instance, in hydrotherapy,

02:31:25.560 | they would put maybe a few drops of that

02:31:28.580 | or rub it onto the skin and allow it to sink.

02:31:30.940 | And it's extremely potent.

02:31:32.340 | If you go online to buy eucalyptus essential oil,

02:31:36.780 | that should not really be taken internally.

02:31:38.540 | It's not designed for that.

02:31:40.300 | It's extremely potent, and putting it maybe on your,

02:31:44.140 | sometimes I'll do that, put it on the upper lip,

02:31:46.140 | so I'm inhaling it.

02:31:47.660 | It actually can be actually very soothing.

02:31:50.580 | In fact, one of the things that I found very soothing,

02:31:53.060 | and there are actually some data in the literature on this,

02:31:55.620 | is if you get a cold and you're congested,

02:31:58.100 | it's just heating up some hot water on the stove,

02:32:01.380 | putting a towel over your head and just inhaling that steam.

02:32:04.180 | It tends to open things up and decrease the congestion.

02:32:08.460 | And I've been known to put a couple of drops

02:32:10.180 | of eucalyptus oil into that,

02:32:11.700 | and that's actually been beneficial as well.

02:32:13.560 | - Great, don't ingest eucalyptus oil, folks.

02:32:17.100 | I'll take it as a personal insult,

02:32:19.460 | but I'm not gonna take responsibility if you do it anyway.

02:32:22.640 | That's a great segue to error.

02:32:25.980 | I've heard conflicting things vis-a-vis,

02:32:29.660 | should we sleep with an air humidifier?

02:32:33.500 | Should we sleep with a cold room under warm blankets?

02:32:37.540 | Lowering core body temperature

02:32:40.420 | definitely helps us fall asleep,

02:32:41.920 | but that's under conditions

02:32:43.280 | where we're not combating an illness.

02:32:45.580 | I have had the experience several times now,

02:32:48.120 | to the extent that I really believe it's a real effect,

02:32:50.220 | where if a room is extremely cold,

02:32:52.820 | even if I'm under warm blankets,

02:32:54.600 | breathing that cold air at night,

02:32:56.260 | I'll often get some respiratory stuff going on,

02:32:59.580 | probably 'cause of a drying out of the respiratory pathways.

02:33:02.340 | - Yeah, that's very possible.

02:33:04.280 | So let's talk about air, 30,000 foot level.

02:33:09.460 | First of all, don't inhale anything

02:33:11.600 | that's not either a medicine designed for your lungs

02:33:14.500 | or air itself.

02:33:15.680 | So it goes without saying, but smoking,

02:33:18.480 | cigar smoking, vaping. - Vaping, sorry folks.

02:33:21.980 | Vaping might be better for you than smoking,

02:33:23.620 | but it's still terrible for your lungs.

02:33:25.760 | That vaping community hates me

02:33:27.740 | because they want me to say it's not carcinogenic,

02:33:29.980 | but the data show that it can cause popcorn lung.

02:33:33.860 | I mean, it's just not good.

02:33:35.500 | - No, right before COVID hit,

02:33:37.940 | I can't tell you how many young kids

02:33:40.420 | were being admitted to my ICU on ventilators.

02:33:42.940 | It was a little different at that time

02:33:45.020 | because it was so expansive

02:33:46.300 | that people were making vitamin E oil

02:33:48.520 | to cut the nicotine in,

02:33:49.980 | and they were making basically garage,

02:33:52.860 | out of their garage brand vapes and selling it.

02:33:55.500 | And these kids were ending up in the ICU.

02:33:58.820 | - This is totally unrelated to COVID.

02:34:00.580 | - This is totally unrelated to COVID.

02:34:02.620 | And to be fair, totally unrelated to the brand of vaping,

02:34:06.840 | the brand names.

02:34:07.820 | So this was off-label stuff,

02:34:09.180 | people making their own thing and selling it.

02:34:10.820 | It was crazy.

02:34:11.980 | But let's talk about briefly the brand.

02:34:15.340 | So yeah, we're starting to understand now

02:34:17.260 | that vaping doesn't have as many toxins that smoking does,

02:34:21.020 | but it's not a healthy choice.

02:34:24.540 | And it contradicts us to the thought process

02:34:26.980 | is that it really doesn't get people off of nicotine.

02:34:31.460 | In fact, there's higher concentrations of nicotine

02:34:34.220 | in the vape than in regular cigarettes,

02:34:37.740 | very high concentrations.

02:34:39.380 | - Incidentally, what are your thoughts on non-smoked,

02:34:42.100 | non-vaped, non-dipped, non-snuffed nicotine?

02:34:45.340 | - So nicotine gum, nicotine pouches,

02:34:48.300 | I mean, will raise blood pressure, vasoconstrictor,

02:34:51.220 | but definitely increases alertness

02:34:53.180 | while causing relaxation, outcome clean.

02:34:55.960 | I occasionally will take a milligram or two,

02:34:58.500 | which is very low, of nicotine gum.

02:35:01.860 | Yeah, but never smoke or vape or dip or snuff it.

02:35:05.540 | - I use it all the time in my patients

02:35:07.460 | who I'm trying to get off of smoking.

02:35:08.920 | So, and that's a safer alternative,

02:35:11.340 | especially for the lungs, right?

02:35:12.860 | 'Cause this is not, they're not irritants

02:35:15.100 | that are going into the lungs.

02:35:16.020 | So no problem with that,

02:35:17.540 | especially if it's used to get them off of smoking.

02:35:20.500 | It's something that we use all the time.

02:35:22.300 | - Do you use nicotine?

02:35:23.500 | - No.

02:35:24.320 | - No. - Yeah.

02:35:25.160 | - There's a massive expansion in the number of people

02:35:27.780 | taking nicotine pouches now.

02:35:29.860 | - Yeah, and it's something that affects the brain,

02:35:32.080 | as you know, it affects the pregnant women,

02:35:36.460 | affects a number of aspects of the nervous system.

02:35:39.660 | We have receptors called nicotinic receptors for a reason,

02:35:42.820 | because that's the neurotransmitter.

02:35:44.580 | So yeah, it has an effect.

02:35:46.860 | - It is highly habit-forming/addictive.

02:35:50.960 | It does seem that at least in people 60 and older,

02:35:56.180 | there may be some mild cognitive sparing

02:35:59.020 | or enhancement due to nicotine use.

02:36:00.860 | I think that's an area that needs further exploration.

02:36:03.460 | - Yeah, I'm not familiar with that data,

02:36:05.540 | but certainly something to look into.

02:36:07.380 | - Yeah, I'm not gonna try and convince you

02:36:09.180 | to get on nicotine.

02:36:10.340 | I'll also say that it doesn't just hit

02:36:12.460 | the nicotinic receptors,

02:36:13.540 | it'll also hit the muscarinic acetylcholine receptors.

02:36:16.700 | And that's one reason why if you do take nicotine gum

02:36:19.820 | or use nicotine gums or pouches,

02:36:21.260 | what you'll notice is when you don't use it,

02:36:22.820 | you'll feel as if your throat is mildly irritated

02:36:26.260 | and then you take it and it relaxes it.

02:36:29.180 | - Interesting.

02:36:30.020 | - And this is one of the more subtle,

02:36:32.620 | but powerful ways in which it is habit-forming,

02:36:36.100 | is that people feel like they're more verbally fluid,

02:36:38.380 | they can breathe easier when they're taking nicotine,

02:36:40.740 | but it's a vasoconstrictor.

02:36:41.980 | So for those interested in performance-enhancing effects,

02:36:45.020 | it's pushing you in the opposite direction.

02:36:48.220 | Anyway.

02:36:49.060 | - So in terms of air,

02:36:49.880 | we've talked about what should not be in the air,

02:36:52.420 | but there's actually some data that's really surprising

02:36:55.060 | that I found during the pandemic that was interesting to me

02:36:58.460 | that should be in there that maybe isn't in there.

02:37:00.740 | And that's the fresh air associated with going outside.

02:37:03.880 | So what is out there in the air?

02:37:05.780 | What should be out there?

02:37:07.100 | Obviously clean air.

02:37:08.580 | People who live next to freeways and pollution,

02:37:11.380 | those are bad things.

02:37:12.200 | We've talked about that.

02:37:13.720 | But the Japanese seem to have a corner on this research.

02:37:17.420 | It's really interesting stuff.

02:37:19.340 | You've heard of forest bathing.

02:37:21.220 | So there was a number of studies

02:37:22.740 | where they've taken these CEOs in Tokyo

02:37:25.800 | and they took them up to the Hinoki Cypress forests.

02:37:29.380 | - Sounds beautiful.

02:37:30.220 | - It is.

02:37:31.040 | And what they found was,

02:37:32.860 | they did actually very controlled research

02:37:34.820 | where they checked blood levels

02:37:36.460 | and they did blood tests

02:37:38.460 | and they had them walk around for three days

02:37:40.780 | in the forest, forest bathing.

02:37:43.420 | And they actually took air samples

02:37:45.100 | and they found that there's these substances

02:37:47.340 | called phytoncides, which are given off by the trees,

02:37:51.460 | not just Hinoki Cypress trees,

02:37:53.760 | but just about any kind of tree.

02:37:54.940 | So fir trees, oak trees, all sorts of pine trees.

02:37:59.660 | And that these substances interact with our bodies

02:38:03.660 | and specifically again, the innate immune system.

02:38:07.140 | They were actually able to look at chromogranin A,

02:38:09.380 | which is a substance that's in some of these

02:38:11.860 | white blood cells that are, you know,

02:38:14.680 | fighting white blood cells that fight infections.

02:38:17.300 | And they were able to show

02:38:18.420 | that when they were in that environment,

02:38:21.740 | there were definite changes in the immune system

02:38:24.420 | toward the positive.

02:38:25.660 | And that these changes lasted for seven days.

02:38:28.960 | So they did another aspect of the study.

02:38:30.820 | So there was a multiple publications

02:38:32.300 | that this group in Japan did.

02:38:33.940 | They took these same guys and they took them down

02:38:36.280 | to a hotel in Tokyo, out of the Hinoki Cypress forests.

02:38:40.820 | And they infused the same phytoncides

02:38:43.660 | from these Hinoki Cypress trees.

02:38:45.540 | They basically took the oil from these trees

02:38:47.740 | and infused it in the hotel room.

02:38:50.140 | And they found very similar results

02:38:52.360 | to what they were getting out there

02:38:53.720 | when they're walking in the forest.

02:38:55.140 | So that would seem to indicate that there was something

02:38:57.580 | that this was what was being made responsible.

02:39:00.740 | The one difference, which was interesting,

02:39:02.940 | between when they were up there walking around

02:39:05.140 | in the forest and when they were down in Tokyo

02:39:07.460 | in the hotel room with the infuser,

02:39:09.140 | is the urinary cortisol levels were lower

02:39:13.160 | when they were walking in the forest

02:39:14.980 | than when they were in the hotel.

02:39:16.320 | And that's, as you know, a symbol of basically stress.

02:39:19.860 | So there is something that, there was a je ne sais quoi,

02:39:23.340 | I guess the French would say.

02:39:24.440 | There's something gestalt about walking in the forest

02:39:28.560 | that's different than just infusing the Hinoki Cypress.

02:39:32.600 | But I thought that was an interesting thing.

02:39:34.180 | And it kind of goes along again

02:39:36.620 | with what we were talking about at the beginning.

02:39:38.420 | When you're out there in nature, in the forestry,

02:39:41.660 | in the green, walking green spaces, we have this evidence.

02:39:44.700 | These leaves reflect a lot of infrared light,

02:39:47.640 | which we've already talked about.

02:39:48.800 | But there's also something else in the equation as well.

02:39:51.880 | And it kind of leads just a bigger picture

02:39:53.480 | and a bigger philosophy of life.

02:39:55.580 | And that's the reductionism of science.

02:39:57.280 | We always try to reduce something to an active ingredient

02:39:59.720 | to try to figure out what it is.

02:40:01.780 | But there is actually something to be said

02:40:03.120 | for getting these things in the environment

02:40:06.120 | that we would normally be getting them in.

02:40:08.240 | I think that's interesting.

02:40:09.700 | - Someone made the comment recently

02:40:11.720 | that so much of modern health,

02:40:15.840 | or our attempts at being healthier in modern times,

02:40:19.600 | perhaps the better way to put it,

02:40:21.100 | is about trying to bring the out of doors indoors.

02:40:24.120 | - That's correct.

02:40:24.960 | We exercise in gyms, whereas we used to,

02:40:27.760 | carry buckets of fruit and soil.

02:40:30.520 | And we are talking about some artificial light.

02:40:35.080 | There's no replacement,

02:40:36.980 | but ways to supplement artificial light, excuse me,

02:40:41.200 | ways to supplement sunlight with artificial light.

02:40:43.920 | We're just indoors a lot more.

02:40:45.960 | And no one's suggesting that we all run around

02:40:48.160 | in loincloths outside all the time.

02:40:50.880 | But there really does seem to be many factors

02:40:55.460 | within outdoor environments.

02:40:57.500 | So many, both known and unknown,

02:41:00.380 | seems that the reductionist approach to science,

02:41:02.960 | while I've made it my profession for many decades,

02:41:07.140 | it makes sense why no one thing seems to solve

02:41:12.680 | all the issues that we're after,

02:41:16.000 | that we need to experience these things in combination.

02:41:18.800 | Maybe nature is just the best way to do that.

02:41:21.120 | - Yeah, and I can't help but think of some studies

02:41:23.640 | that have been done in the past

02:41:25.040 | where this has really highlighted it.

02:41:27.300 | There was some evidence,

02:41:28.760 | they believed that people with lung cancer

02:41:31.180 | would do better if they had,

02:41:33.000 | 'cause they noticed that people with lung cancer did better

02:41:35.320 | when they had diets that were rich in vitamin E

02:41:37.960 | and vitamin A derivatives.

02:41:39.880 | So they said, "Oh, reductionist science.

02:41:41.200 | "Let's go ahead and get vitamin E, vitamin A.

02:41:42.860 | "Let's package it.

02:41:43.700 | "Let's give them some high doses.

02:41:44.620 | "Maybe this will solve lung cancer or help lung cancer."

02:41:48.040 | They had to stop the study early

02:41:49.320 | because they did worse than the control subjects.

02:41:52.240 | - Important to point that out,

02:41:54.640 | that the high-dose supplementation is not the same

02:41:56.800 | as ingesting something in the context of a food.

02:42:00.520 | - And we didn't discuss it directly,

02:42:03.640 | but we kind of alluded to it with lights,

02:42:05.760 | and indoor light and artificial light.

02:42:07.600 | So what do we get?

02:42:09.280 | The human body, since its existence,

02:42:12.560 | has always had blue lights in the presence of red lights.

02:42:16.360 | And altogether, the entire biological spectrum.

02:42:19.760 | And now what we've done is we've essentially created

02:42:23.240 | an indoor environment where we have efficient lights,

02:42:28.160 | which are supposed to be,

02:42:29.760 | more efficient would imply that it's equivalent.

02:42:32.360 | But realize that LED lights,

02:42:34.920 | or the LED lights that are commercially available

02:42:36.800 | for us to buy, are energy efficient

02:42:39.640 | because they're not broadcasting, if you will,

02:42:43.520 | in the infrared or in the ultraviolet.

02:42:45.440 | It's a very specific, narrow range of visible light.

02:42:49.320 | We alluded to this.

02:42:50.360 | - Oftentimes there's no red light in there either.

02:42:53.080 | - Exactly.

02:42:53.920 | - They are really blue, green, yellow,

02:42:56.680 | sometimes even UV light.

02:42:59.320 | - Right.

02:43:00.160 | - I mean, the fluorescent lights in a department store,

02:43:02.080 | for instance, or in a pharmacy.

02:43:04.720 | I haven't done the spectral waveform analysis,

02:43:07.880 | but those who have, it's published, it's out there.

02:43:11.200 | There are a lot of data

02:43:12.120 | in environmental occupational health stuff,

02:43:15.040 | would show that the emission spectra

02:43:19.600 | are severely tilted toward short wavelengths.

02:43:23.840 | And there's hardly any red light in there.

02:43:25.200 | Whereas a candle, for instance,

02:43:26.640 | or a fire roaring, fire roaring candle,

02:43:28.520 | people ask that, sorry to interrupt,

02:43:29.600 | is almost all orange and red light.

02:43:31.960 | - Right.

02:43:32.800 | - And then people say,

02:43:33.640 | "Well, won't that wake me up at night?"

02:43:35.000 | And a lot of people are surprised to know this.

02:43:36.960 | I'll just ask you, and it's not a trick question,

02:43:39.720 | but how many lux do you think come from

02:43:43.320 | like a really bright candle or a roaring fireplace?

02:43:48.320 | Or the brightest moonlit night on a full moon?

02:43:52.080 | - Since you asked it that way,

02:43:53.320 | I'm gonna try to guess the other direction

02:43:55.080 | and say like 50.

02:43:56.200 | - So somewhere between one and 10 would be high level.

02:44:00.840 | - Okay, wow.

02:44:01.680 | - And then I started, and I was like,

02:44:02.520 | there's no way that could be, right?

02:44:04.440 | How could it be?

02:44:05.280 | It's like this roaring fireplace or the moon that lights up.

02:44:08.400 | So it turns out that if you're at a campfire

02:44:11.240 | and we're facing one another around the campfire,

02:44:13.000 | I can see your face across the campfire,

02:44:14.640 | I can see the front of your body.

02:44:16.240 | And so it looks like it's so bright, it must wake me up.

02:44:19.940 | But no, you have no trouble going back to your tent

02:44:21.560 | and falling asleep or your cabin.

02:44:23.220 | If you turn away from that bright campfire,

02:44:27.200 | you need a flashlight to navigate

02:44:28.760 | even the shortest distance,

02:44:30.220 | which tells you that it's not very bright at all.

02:44:32.440 | It's very concentrated,

02:44:34.400 | but the fall off of that brightness

02:44:36.560 | is really what indicates just how dim it really is.

02:44:40.880 | But if we think about an LED coming off a wall panel

02:44:43.960 | to adjust temperature in a hotel room,

02:44:45.940 | it has something like 100 to 400 lux.

02:44:50.560 | And yet we think of it as a dim nightlight.

02:44:53.320 | And so this is sneaky stuff.

02:44:56.580 | It's really diabolical because that wall nightlight

02:45:00.880 | or thermostat light messes up our glucose regulation

02:45:05.720 | as shown in really good peer reviewed studies.

02:45:07.960 | - Absolutely.

02:45:08.800 | And then the other aspect of it,

02:45:09.700 | and I actually, I think I learned this from you,

02:45:11.680 | is that the photoreceptors

02:45:14.040 | are in the lower portion of our retina.

02:45:16.000 | Or sorry, the lower portion of our retina.

02:45:18.840 | And so the type of light

02:45:22.760 | that's gonna affect your circadian rhythm

02:45:24.720 | is gonna be much more likely to do that

02:45:26.480 | if it's coming from up above

02:45:27.720 | or at the same level than down below.

02:45:30.040 | - That's right.

02:45:30.880 | And the Scandinavians, my stepmom is Scandinavian,

02:45:34.280 | understood this intuitively.

02:45:35.960 | And so in the evening, they don't have a ceiling light.

02:45:38.640 | They turn off the ceiling lights

02:45:40.520 | and then they only use desk sort of table level

02:45:44.000 | or even floor lights.

02:45:46.760 | Now, candles along the floor would be the ultimate,

02:45:48.920 | but it's super dangerous.

02:45:49.960 | And we just had a bunch of fires here

02:45:51.400 | and those were outdoor fires at first anyway.

02:45:54.120 | And the reason we're riffing

02:45:58.680 | in a kind of light bio improv here

02:46:03.360 | is that when you step back

02:46:04.800 | and you just look at it logically,

02:46:06.960 | we have dim days, as you pointed out before,

02:46:09.520 | we have bright evenings and nights,

02:46:11.800 | and it's all short wavelength at night.

02:46:14.720 | It's terrible.

02:46:15.800 | I'm beginning to think that many, many, many

02:46:18.920 | of the problems that we have

02:46:20.480 | in terms of our metabolic health,

02:46:22.760 | sure that has to do with food,

02:46:24.320 | certainly has to do with lack of exercise

02:46:26.400 | and a number of things, screens, et cetera.

02:46:29.440 | But I'm convinced that the light piece

02:46:32.560 | is at least one of the top three,

02:46:35.320 | if not the top two major factors

02:46:37.280 | in determining the kind of obesity metabolic crisis.

02:46:39.760 | - I completely agree with you.

02:46:41.240 | The one thing I was gonna add to that too are the windows.

02:46:44.880 | So you're aware, of course, in California we have,

02:46:49.400 | we need efficiency and we have these windows

02:46:53.200 | called low E glass,

02:46:54.760 | and they're specifically designed

02:46:56.400 | to filter out infrared lights.

02:46:59.680 | So the way you can tell whether or not your window

02:47:02.120 | is filtering that out is just stand in it

02:47:04.840 | when the sun is on it.

02:47:06.080 | If there is a lot, if you can feel the warmth of that sun,

02:47:10.280 | then you know that it's one of the old windows

02:47:12.080 | that's allowing that to come in.

02:47:13.200 | If you don't feel it, that's a low E glass.

02:47:16.000 | And so what we've done is we've created

02:47:17.800 | this environment inside.

02:47:19.640 | We've gotten rid of the incandescent bulbs.

02:47:22.960 | We have LED bulbs.

02:47:24.320 | We've gotten rid of the regular window.

02:47:26.120 | It's all for energy efficiency,

02:47:27.480 | which is a reasonable thing to do.

02:47:28.800 | We need energy efficiency.

02:47:30.600 | But no one's asked what the human collateral damage is

02:47:35.600 | to this type of efficiency.

02:47:40.600 | Yeah, and we shouldn't have to take vacations

02:47:42.720 | to expensive sunny places to overcome this stuff.

02:47:45.520 | That's not the right way to think about it.

02:47:47.200 | The way is to try and weave it into our lives

02:47:48.840 | at low expense or no expense,

02:47:50.960 | getting outside, for instance, opening windows.

02:47:54.440 | In cars, it's the worst.

02:47:57.000 | So what's wild is if you go to the Pacific Northwest

02:48:00.240 | in the fall or winter when it's really hard to get light,

02:48:03.160 | I think Seattle's the northernmost city

02:48:04.960 | in the contiguous US.

02:48:06.040 | It's so dark up there.

02:48:07.240 | And you get into an Uber.

02:48:08.840 | They have tinted windows.

02:48:10.320 | It's so crazy.

02:48:11.520 | Like, it's so wild,

02:48:13.400 | especially since the research on this stuff

02:48:14.960 | is being pioneered largely

02:48:16.120 | out of the University of Washington in Seattle.

02:48:18.600 | Like, we've got a number of things exactly backwards.

02:48:21.320 | And light in our relationship to light

02:48:23.360 | is one of the ways in which we do.

02:48:25.200 | The problem, I think, is when we start talking like this,

02:48:27.240 | people think, oh, well, we're all supposed to have

02:48:29.680 | atriums and skylights and be outside all day.

02:48:32.040 | And it's like, yeah, actually, that would be great

02:48:33.920 | and dimmer and darker at night.

02:48:35.760 | So taking small steps towards adjusting

02:48:38.160 | toward bright days and very dim and dark nights is key.

02:48:43.080 | We didn't talk about incandescent bulbs.

02:48:44.880 | It used to be until about 15 years ago

02:48:47.560 | that the quote-unquote low-efficiency bulbs

02:48:49.760 | that were present in all our homes,

02:48:51.480 | the bulbs that would burn out pretty often,

02:48:53.640 | we know that the incandescent bulbs

02:48:56.680 | are more full-spectrum.

02:48:59.720 | They have a lot of red and orange emission.

02:49:01.840 | You see them as wider, but they look a little warmer.

02:49:04.280 | It has that warm, those are great.

02:49:07.480 | Those are great.

02:49:08.320 | They're harder to find now.

02:49:09.160 | Actually, they were illegal for a short while.

02:49:11.600 | I don't think anyone was gonna come to your house

02:49:12.880 | and arrest you, but you couldn't get them.

02:49:14.560 | They were banned.

02:49:15.520 | And now they're available again, is my understanding.

02:49:17.640 | - Oh, I haven't seen them,

02:49:18.920 | but I know that in new constructions,

02:49:21.480 | they're not even putting in sockets.

02:49:23.520 | They're putting in receptacles that can only be replaced

02:49:26.040 | with other LEDs.

02:49:27.600 | So in new constructions, that's what's going on.

02:49:30.000 | We'll see what happens.

02:49:33.400 | I believe there is a movement right now

02:49:35.520 | based on the new administration

02:49:37.600 | to see if we can change some of those rules

02:49:39.640 | and maybe get some rule changes.

02:49:41.120 | I believe it's with the Department of Energy.

02:49:43.640 | - Do you know who are really the smartest about this stuff,

02:49:46.600 | that if you wanna know where self-directed human health

02:49:53.520 | is gonna be in five years, you know where you can look?

02:49:56.760 | - Tell me.

02:49:58.200 | - You talk to the people who are really good

02:49:59.820 | at maintaining aquaria and reptiles.

02:50:04.280 | - Ah, yes.

02:50:05.400 | - Because those animals literally die

02:50:07.840 | under conditions of pure blue light.

02:50:09.620 | Like if you've ever had fish tanks,

02:50:10.920 | I'm a fish tank, you don't wanna send me down this path,

02:50:13.400 | but there's a very famous fish tank designer.

02:50:15.760 | I was a huge fan of his.

02:50:16.880 | Unfortunately, he died of pneumonia when he was 60,

02:50:19.720 | Takashi Amano.

02:50:21.280 | There's museums in Japan about him.

02:50:22.760 | He developed this thing called aquascaping,

02:50:24.280 | which is about plants and lighting more than the fish,

02:50:27.140 | although there's fish in it.

02:50:28.040 | And everyone, I've been involved in aquascaping

02:50:30.640 | in one level or another for a while now.

02:50:33.120 | Super geeky, I know, but the whole principle

02:50:36.160 | is that you're trying to create

02:50:37.080 | full spectrum light, plants, air.

02:50:39.960 | You're trying to create the right conditions

02:50:41.320 | for these fish and other aquatic elements

02:50:43.960 | like plants to thrive.

02:50:45.820 | And anyone that understands how to maintain reptiles

02:50:49.320 | or understands how to, which I'm not into,

02:50:50.960 | I don't like scaly things except fish, or aquaria,

02:50:55.760 | they know you can't have a dearth of long wavelength light

02:51:00.760 | or all the fish get sick.

02:51:02.920 | The plants die.

02:51:04.520 | They just can't do it.

02:51:05.600 | Now, there are deep sea plants where the red light,

02:51:07.440 | long wavelength light doesn't get down to the bottom.

02:51:10.040 | And forgive me for going off on this.

02:51:11.720 | Maybe I should just do a solo episode,

02:51:13.260 | but what's amazing is the intrinsically photosensitive

02:51:16.560 | cells of the eye that set our circadian rhythms

02:51:19.120 | and that do all this.

02:51:20.560 | The "reason" why the peak of the portion

02:51:25.560 | of the visible spectrum is where it is for those cells

02:51:31.920 | is because it's the wavelength of light

02:51:34.440 | that can go deep into water.

02:51:36.860 | If you've ever been snorkeling,

02:51:37.880 | you only see reds down to about 10 meters or so.

02:51:41.080 | You swim down a little bit lower

02:51:42.520 | and you need to bring a light with you.

02:51:44.280 | Now, of course, the fish that are red

02:51:45.480 | are still red down there.

02:51:46.440 | You just can't see it because of the lack of reflectance

02:51:48.440 | of long wavelength light.

02:51:49.360 | So we are walking around in the evening,

02:51:54.360 | basically being exposed to what our eye and brain

02:51:59.000 | think is daytime, just as our retinal sensitivity

02:52:02.280 | is going up.

02:52:03.740 | And then all day we're in this and it's not bright enough.

02:52:07.040 | So anyway, I'll stop now.

02:52:08.560 | But it has me activated, as you can imagine,

02:52:12.560 | because you hear about all the mental health issues,

02:52:14.880 | the physical health issues.

02:52:16.520 | I think they're all downstream, as you pointed out,

02:52:18.240 | of mitochondrial dysfunction.

02:52:20.360 | Put differently, mitochondrial function is downstream

02:52:22.640 | of proper relationship to light.

02:52:24.160 | - Absolutely.

02:52:25.000 | - Which you so beautifully illustrated.

02:52:26.140 | And I learned a ton that I hadn't known before about that.

02:52:29.000 | Okay.

02:52:31.640 | If I continued on Aquaria, we won't do that.

02:52:34.920 | We'll be here.

02:52:35.760 | This will be the longest podcast episode ever.

02:52:37.800 | I'd love to talk a little bit about two more things.

02:52:42.680 | We will return to New Start.

02:52:47.720 | But I want to know about long COVID.

02:52:49.520 | Is long COVID a real thing?

02:52:52.720 | - Oh yeah.

02:52:53.560 | - And what is long COVID?

02:52:56.480 | What can be done about long COVID?

02:52:58.520 | How do you know if, like most people by now

02:53:01.960 | have had COVID at a high level or a low level.

02:53:04.160 | - Yeah.

02:53:05.000 | - How do you know if you have long COVID?

02:53:06.880 | - Long COVID is defined as having symptoms

02:53:10.000 | of a number of different types of symptoms.

02:53:14.280 | Typically it's fatigue, could be headaches,

02:53:16.480 | could be all sorts of things.

02:53:18.600 | Even loss of taste and smell

02:53:21.640 | for more than 12 weeks after the infection.

02:53:24.400 | So we're talking a good three months.

02:53:26.620 | The thing about long COVID in my experience

02:53:30.160 | and what I've seen is that it's very heterogeneous

02:53:33.520 | and it can be due to many different things.

02:53:35.520 | So it's been very difficult to put together

02:53:39.160 | exactly what the issue is.

02:53:42.000 | But I'll tell you, as a physician, as a pulmonologist,

02:53:47.000 | one of the cardinal symptoms of long COVID

02:53:52.320 | is shortness of breath.

02:53:54.240 | And so because I'm a lung doctor

02:53:58.640 | and people believe that shortness of breath

02:54:01.080 | always has to do with the lungs,

02:54:02.760 | I get a lot of consults for people

02:54:05.400 | who have shortness of breath, long COVID

02:54:07.920 | after they were infected months ago.

02:54:10.640 | And so a lot of these people came to me

02:54:12.160 | and one of the things I had to do is research this topic.

02:54:15.560 | And as it turns out, one of the,

02:54:20.160 | not for everybody, but for many people with long COVID,

02:54:23.440 | guess what's at the center of long COVID?

02:54:27.280 | And actually we have research to show this,

02:54:29.220 | mitochondrial dysfunction.

02:54:30.480 | The thing that gets them COVID

02:54:33.800 | is the thing that keeps them actually having long COVID.

02:54:36.320 | So there was a study that was done looking at metabolism

02:54:40.120 | and they showed, it was one of these plots

02:54:42.280 | where they looked at up-regulation and down-regulation

02:54:44.880 | of metabolism in the mitochondria.

02:54:47.280 | And they looked at the enzymes of glycolysis,

02:54:51.160 | if you can remember back all those enzymes,

02:54:53.240 | and they looked at the enzymes of beta-oxidation,

02:54:56.040 | so fatty acid, basically, oxidation.

02:54:58.880 | And it was pretty well shown

02:55:01.000 | that there was a significant down-regulation

02:55:04.200 | in people with long COVID

02:55:05.320 | versus people who had COVID that didn't have long COVID

02:55:08.320 | that had a down-regulation in beta-oxidation.

02:55:11.840 | So they were not able to very well utilize

02:55:15.440 | and metabolize fatty acids in the mitochondria.

02:55:19.240 | Why is this the case?

02:55:20.720 | Well, based on what we talked about earlier,

02:55:22.960 | one of the, certainly one of the possibilities here

02:55:25.280 | is that they were infected with COVID.

02:55:27.180 | It down-regulated for many of the systems in their body,

02:55:30.360 | oxidative stress mechanisms,

02:55:33.160 | caused damage to their mitochondria.

02:55:35.440 | And we don't know why,

02:55:37.040 | but perhaps the areas of the mitochondria

02:55:39.720 | that were damaged most

02:55:40.560 | had to do with beta-oxidation and fatty acids.

02:55:42.680 | So you'll talk to people who have been infected with COVID,

02:55:46.080 | and they said, "We gain weight

02:55:47.840 | after we're infected with COVID,

02:55:49.440 | and I have all these symptoms."

02:55:51.440 | First of all, when someone comes to you like that

02:55:53.080 | as a physician, you have to make sure

02:55:55.360 | that you're ruling out all of the obvious things.

02:55:57.760 | So I'm getting an echocardiogram

02:55:59.160 | to make sure they didn't have some sort of cardiac issue.

02:56:01.760 | I'm getting pulmonary function tests

02:56:03.200 | to make sure they didn't get scarring in their lungs

02:56:05.600 | and to have restrictive lung disease.

02:56:08.640 | So I'm ruling out all of these things.

02:56:10.000 | And so about a month or two later,

02:56:12.680 | I've got all these tests back, and I'm going over it.

02:56:14.480 | And for the ones where everything is negative,

02:56:16.380 | 'cause there were some where I actually discovered

02:56:17.920 | they had blood clots, and we had to treat them for that.

02:56:20.320 | But for people who have everything negative,

02:56:22.280 | and they're still complaining.

02:56:23.600 | I remember one gentleman in particular.

02:56:25.560 | He had eight out of 10 shortness of breath,

02:56:28.260 | and he couldn't sleep very well.

02:56:30.460 | And this had been going on for over a year.

02:56:32.980 | And we ruled out pulmonary embolism.

02:56:34.820 | We ruled out congestive heart failure.

02:56:36.320 | We ruled out interstitial lung disease

02:56:38.340 | with all of the tests.

02:56:40.240 | And it was about this time

02:56:41.080 | that I was coming out to this idea about light

02:56:43.900 | and looking at these studies about the mitochondria.

02:56:46.160 | And I had this idea, because there was nothing else left.

02:56:49.460 | I had this idea that if there was some way

02:56:52.000 | we could regenerate the mitochondria,

02:56:55.180 | but instead of it being damaged.

02:56:56.320 | Because you know, when you have damaged mitochondria,

02:56:59.120 | that creates just more oxidative stress

02:57:01.160 | and damages it even more.

02:57:02.200 | So in other words, we have to basically get his body

02:57:04.900 | into a situation where he was generating new mitochondria

02:57:09.140 | so we could get rid of these issues with metabolism.

02:57:11.780 | So I had this idea, and I don't know if it worked this way,

02:57:14.680 | but I actually got him to do intermittent fasting.

02:57:18.300 | And this whole idea about how intermittent fasting

02:57:21.580 | allows the body to generate things at night.

02:57:25.780 | Because you're now, the body knows

02:57:27.900 | what it needs to downregulate and break up.

02:57:31.060 | You just have to give it the opportunity.

02:57:32.500 | This is how I understood it.

02:57:33.940 | The innate immune system looking at pathological

02:57:36.920 | molecular patterns and also damaged molecular patterns.

02:57:40.900 | So PAMPs and DAMPs, D-A-M-P.

02:57:43.540 | If we were to allow the immune system

02:57:44.980 | to do what it needs to do, it would find these areas

02:57:47.420 | that are not working well, tear them down,

02:57:49.500 | destroy those cells, and then allow regeneration

02:57:52.460 | of new cells with hopefully brand new virgin mitochondria.

02:57:56.360 | So that was the first thing I did.

02:57:57.520 | He vowed that he would never eat after 5.30,

02:58:00.160 | after I explained all this to him.

02:58:01.580 | I took a clinic visit and we explained all of this.

02:58:04.180 | The other thing I did was told him to get out and sun.

02:58:06.780 | Now this may sound dismissive.

02:58:10.460 | Can you imagine, you've got long COVID,

02:58:11.900 | you've been suffering, and you go to a physician

02:58:13.660 | and they tell you, well, I want you to stop eating

02:58:15.740 | after 5.30, I want you to get outside more.

02:58:18.020 | Like, is he taking me seriously?

02:58:19.980 | Does he really believe that I have a condition?

02:58:22.500 | But I took the time to explain why I was thinking

02:58:25.420 | about these things and going through the studies.

02:58:27.280 | So he did it.

02:58:28.700 | And I saw him back a month later.

02:58:31.200 | He was amazed, I was amazed.

02:58:36.300 | He said that his gastroesophageal reflex disease

02:58:41.260 | completely went away after he stopped eating after 5.30.

02:58:44.860 | His shortness of breath went from an eight out of 10

02:58:47.220 | to a three out of 10.

02:58:48.780 | And he said it doesn't even bother him anymore.

02:58:51.300 | This is after a year of having this type of symptoms.

02:58:56.300 | So that really took me a pause.

02:58:58.040 | Now, I'll tell you the first thing.

02:58:59.620 | That doesn't happen to all of my patients with long COVID.

02:59:02.340 | But it tells me that when you're dealing with long COVID,

02:59:06.580 | you're dealing with people who have had an infection

02:59:11.220 | that has caused damage to the system.

02:59:14.540 | And some of the studies from what I've reviewed,

02:59:16.920 | sometimes people have residual virus still in the system.

02:59:20.820 | There was a study that was done looking at

02:59:22.140 | to see whether vaccination of COVID-19

02:59:24.860 | would work after patients with long COVID.

02:59:27.320 | There was some benefit.

02:59:29.420 | It wasn't big, but it was some.

02:59:30.980 | And it may be that you're just stimulating

02:59:33.660 | the immune system again to fight off this remaining virus

02:59:37.260 | that's still in the system.

02:59:38.620 | But we have data that shows that the type of inflammation

02:59:45.500 | that we get with spike protein,

02:59:47.060 | it's actually a toll-like receptor four type of inflammation.

02:59:49.500 | There's a study that looked at this.

02:59:51.140 | And they were actually able to show and demonstrate

02:59:53.660 | that infrared light, coming back to that again,

02:59:56.100 | can actually mitigate the inflammation

02:59:58.540 | from toll-like receptor-mediated inflammation,

03:00:01.580 | which is exactly the inflammation mediated in COVID-19.

03:00:05.540 | So short answer to your question, or that's a long answer,

03:00:08.400 | but the short answer is yes,

03:00:09.540 | I do believe that long COVID is something,

03:00:11.580 | and I believe people are suffering with it.

03:00:13.820 | It's a very heterogeneous disease,

03:00:17.460 | and it's hard to just pin one thing on everything

03:00:19.920 | and have it work for everything.

03:00:21.740 | That being said, I don't see a lot of downside

03:00:24.580 | in instituting some of these things that we think may work,

03:00:27.620 | sunlight as being one of those things.

03:00:30.020 | People who are sick with COVID and long COVID

03:00:33.460 | tend to be sick and they stay indoors.

03:00:35.680 | And so there may be an exacerbation of the process.

03:00:37.820 | The last thing they wanna do is to get outside,

03:00:40.580 | but it may actually be beneficial.

03:00:42.280 | - Yeah, I would imagine that pretty much everything

03:00:45.540 | that you've shared with us today would be beneficial.

03:00:48.260 | My understanding is that some of the heterogeneity

03:00:51.140 | of even just the COVID response in various people

03:00:54.900 | who got it in addition to the heterogeneity

03:00:58.100 | and long COVID symptoms could be due to the fact

03:01:00.440 | that the distribution of ACE2 receptors

03:01:03.700 | is very widespread in the body.

03:01:05.440 | SARS-CoV-2 binds to the ACE2 receptor.

03:01:10.620 | It's a primary receptor site, as I understand.

03:01:13.500 | And I remember early in the pandemic

03:01:18.380 | asking on social media,

03:01:19.900 | are there ACE2 receptors in the brain and on neurons?

03:01:22.580 | And people were like, no, there's no ACE2 receptor.

03:01:24.380 | It turns out the olfactory neurons

03:01:27.220 | are chock-a-block full of ACE2 receptor

03:01:30.500 | and they are bonafide CNS neurons, their brain neurons.

03:01:35.500 | And you lose them.

03:01:38.140 | Fortunately, those can replenish over time

03:01:40.420 | in an activity-dependent way.

03:01:42.260 | But yeah, when I hear that some people got COVID

03:01:45.060 | and it was no big deal, other people got COVID

03:01:47.060 | and they felt like they had brain fog for six months

03:01:50.020 | and are still coping with it,

03:01:51.260 | probably has to do with the extent to which the virus

03:01:53.900 | was able to bind to ACE2 receptors in one person's brain

03:01:57.620 | versus someone else.

03:01:58.460 | Maybe their blood-brain barrier,

03:02:00.740 | it didn't get in there at all.

03:02:01.900 | - Right, yeah, as I recall from the,

03:02:05.060 | from the, and this is actually kind of interesting

03:02:07.180 | about olfactory, is that the nurse cells

03:02:10.060 | that are next to those neurons in the olfactory

03:02:12.620 | are the ones that have a lot of ACE2 receptors.

03:02:15.740 | And that's, so what happened is these nurse-supporting cells

03:02:18.900 | that were helping with the, you know,

03:02:20.940 | whatever they do to support the neurons were dying off

03:02:23.220 | and that's why they were losing a sense of smell.

03:02:24.900 | And so when the nurse cells came back and replenished,

03:02:28.300 | people didn't smell exactly the same

03:02:30.460 | because it wasn't exactly in the same,

03:02:33.060 | didn't come back in the same way.

03:02:34.820 | There was, and this has been used for years

03:02:37.420 | in ear, nose, and throat circles,

03:02:39.740 | is something as, this sounds kind of silly,

03:02:43.140 | but smelling sticks.

03:02:45.300 | There's actually a protocol that is used

03:02:47.460 | that these markers that are manufactured in Europe,

03:02:50.260 | where they have a different, different-

03:02:52.580 | - Yeah, orange, lemon, chocolate.

03:02:54.140 | - Exactly. - Yeah.

03:02:54.980 | - And smelling these things actually over,

03:02:57.940 | there was a randomized crossover placebo-controlled trial

03:03:00.820 | that actually showed that they were able

03:03:02.020 | to regain their sense of smell

03:03:03.900 | by training their sense of smell with these sticks.

03:03:06.780 | - It makes sense because the olfactory neurons

03:03:09.500 | are replenished, not just regenerate,

03:03:12.260 | but they turn over in an activity-dependent way.

03:03:16.340 | And so it requires electrical activity

03:03:18.140 | and their electrical activity is dictated by smell.

03:03:21.060 | - Smell, got it.

03:03:22.460 | - And so certain clusters of olfactory neurons

03:03:24.700 | and the brain neurons that they connect to

03:03:26.660 | or reconnect to in this case

03:03:28.420 | are going to be activated by different smells.

03:03:30.300 | And so the smell training-based protocols

03:03:32.900 | for bringing your sense of smell back

03:03:34.940 | intentionally includes a variety of smells.

03:03:39.780 | You don't just want to smell a lemon,

03:03:41.020 | you want to smell lemon, coffee, this.

03:03:43.780 | People always say, "Do I need foul smells too?"

03:03:46.220 | In kind of an unfortunate way,

03:03:49.580 | the neurons that detect noxious odors and bad odors

03:03:53.660 | tend to not die off as readily.

03:03:56.820 | - Oh, I see.

03:03:57.660 | - But it makes sense because those are the cells

03:03:59.460 | that actually preserve your innate aversion reflex.

03:04:03.540 | - Right.

03:04:04.380 | - They're the ones that can,

03:04:05.740 | our ability to detect smoke in the air,

03:04:08.760 | something very relevant to the recent history here in LA,

03:04:11.260 | or ammonia, things that are potentially hazardous for us,

03:04:15.980 | the detection thresholds are incredibly low.

03:04:18.700 | We're just so sensitive.

03:04:19.940 | - This is like the fifth cranial nerve, isn't it,

03:04:21.380 | that does that?

03:04:22.580 | - Well, yeah, so the trigeminal,

03:04:24.340 | it's involved in some of the protection

03:04:28.220 | of the nasal epithelium and whatnot.

03:04:31.260 | But this is a direct line

03:04:33.820 | through the olfactory pathway to the amygdala,

03:04:36.820 | a fairly direct line.

03:04:38.140 | - That's right, it bypasses the thalamus.

03:04:40.160 | - Right, so, right.

03:04:41.200 | All of olfaction bypasses the thalamus,

03:04:42.840 | but the learning of odors is,

03:04:45.200 | your odor maps are gonna be slightly different

03:04:48.160 | than mine based on your experience.

03:04:49.640 | But when it comes to the representation of smoke,

03:04:52.920 | vomit, feces, and rotting bodies, all the dangerous stuff,

03:04:57.920 | our pathways look pretty similar.

03:05:00.920 | - Got it.

03:05:01.760 | - Got it, to be blunt.

03:05:04.880 | Given your expertise in lungs,

03:05:07.220 | and a number of people I know have mold issues.

03:05:12.220 | They claim or they believe

03:05:14.680 | that mold has infiltrated their lungs.

03:05:17.880 | Some doctors tell them they're crazy.

03:05:20.480 | Some doctors tell them that they're not crazy

03:05:22.960 | about that idea.

03:05:24.600 | Is mold toxicity a real thing?

03:05:27.780 | Can it be treated?

03:05:28.920 | Maybe we do an entire episode about this another time,

03:05:31.280 | but is it a real thing?

03:05:33.800 | And what is the kind of primary treatment

03:05:35.960 | for mold toxicity?

03:05:37.400 | - It is a real thing.

03:05:39.000 | And mold is a substance

03:05:42.320 | that can have multiple different effects on the body.

03:05:46.440 | Let me give you an example.

03:05:48.320 | There's a fungus called aspergillus.

03:05:51.360 | And there's two ways that aspergillus

03:05:54.000 | can affect the human body.

03:05:55.680 | One is if it just sets up shop in your lungs

03:05:59.040 | and it doesn't invade, you could become allergic to it.

03:06:02.760 | And so the symptoms are allergic.

03:06:04.320 | Actually, there's a condition

03:06:05.200 | called allergic bronchopulmonary aspergillosis.

03:06:07.840 | - So it's kind of like an autoimmune situation.

03:06:10.100 | - Exactly, and so you have symptoms of asthma.

03:06:12.320 | You have symptoms of inability to breathe.

03:06:15.680 | And the primary treatment, ironically, there is steroids,

03:06:18.680 | because you need to reduce the inflammation,

03:06:21.040 | but also antifungals to get rid of the thing

03:06:23.840 | that's inciting in the first place.

03:06:25.740 | That's as opposed to invasive aspergillosis.

03:06:29.200 | That's where the fungus comes in and starts to invade

03:06:32.640 | and create a cavitary lesion,

03:06:34.520 | usually with a fungus ball sitting in the middle of it.

03:06:36.840 | Oh yeah, it's pretty bad.

03:06:38.400 | Sometimes it's so bad that you actually have to do surgery

03:06:40.760 | to cut out that thing 'cause you can't cure it.

03:06:43.160 | The way that this often happens

03:06:47.880 | is mold and fungus are in the air all the time.

03:06:52.680 | So here's this understanding of there's germ theory

03:06:57.120 | and there is terrain theory.

03:06:59.560 | And today, and I almost hate to even get into it,

03:07:02.960 | but people think it's one or the other.

03:07:05.620 | And I can tell you as a physician, it's both.

03:07:08.080 | There are certain diseases,

03:07:09.440 | it doesn't matter what your terrain is,

03:07:11.800 | it's gonna, like Neisseria meningitidis,

03:07:14.080 | if you get that, it's gonna cause a bad meningitis,

03:07:17.360 | no matter how healthy you are, okay?

03:07:20.200 | There was just, I remember reading

03:07:22.280 | about a young Japanese star, I think, or Taiwanese star,

03:07:26.960 | just recently here, that died of influenza.

03:07:30.080 | 48 years old, no medical problems.

03:07:32.680 | So it's possible, no matter how good your terrain is,

03:07:35.920 | you could get a bad bug, a bad germ, and it could kill you.

03:07:38.960 | On the other hand, there are certain bugs

03:07:40.820 | that are just sitting out there and they will go in

03:07:43.160 | and your immune system will just kick it out

03:07:44.880 | like it's nothing, why?

03:07:46.080 | Because your terrain is good.

03:07:47.920 | Because, so I can talk about different types of infections

03:07:51.880 | that could do that.

03:07:53.120 | So that's where we are with molds.

03:07:56.240 | So typically, you're breathing in all sorts of molds

03:08:00.240 | and fungus spores all the time.

03:08:02.780 | But if your immune system is good,

03:08:05.080 | it'll just kick it out and won't have a chance to survive.

03:08:07.360 | Where you have a problem is if you have a situation

03:08:10.980 | where your immune system is compromised.

03:08:13.680 | To give you an example of that practically,

03:08:15.800 | there are some biological medications that people get

03:08:19.880 | when they have rheumatoid arthritis.

03:08:22.120 | Before we, if we get to that point

03:08:24.000 | where you have rheumatitis so bad

03:08:25.380 | that we have to put you on a biologic,

03:08:26.920 | that means there's an antibody there

03:08:28.440 | that's suppressing the immune system

03:08:30.480 | so that you don't have the symptoms

03:08:31.960 | of rheumatoid arthritis.

03:08:33.340 | That's actually suppressing your immune system.

03:08:35.400 | In those patients, we'll always check them for tuberculosis

03:08:39.560 | because certain people walking in the population

03:08:41.840 | will have an inactivated tuberculosis.

03:08:44.200 | They're infected, but their immune system has walled it off.

03:08:47.060 | Then we put them on a biologic and the tuberculosis pops up.

03:08:51.000 | So all of that to say that, yes, it is possible.

03:08:53.700 | If you have mold in your house

03:08:55.800 | versus if you don't have mold in your house,

03:08:57.360 | that just increases the burden of mold that you're inhaling.

03:09:00.440 | And to the degree that it's gonna match

03:09:02.480 | against your immune system,

03:09:05.820 | that could depend on whether or not it jumps in

03:09:09.080 | and actually causes a problem.

03:09:10.320 | So we're coming up, this is the time of year

03:09:12.920 | where we're coming up to the Super Bowl.

03:09:14.200 | So it's the question about terrain theory

03:09:17.760 | versus germ theory.

03:09:20.040 | And the question is, whoever wins the Super Bowl,

03:09:22.120 | did they win the Super Bowl

03:09:23.940 | or did the other team lose the Super Bowl?

03:09:26.200 | And that's, who knows?

03:09:28.860 | So this is where this thing, it's not or, it's and.

03:09:32.900 | And really what determines whether or not you get infected

03:09:35.140 | is how good is your immune system

03:09:37.220 | and how virulent is the burden

03:09:39.260 | of a pathogen that's going in.

03:09:41.260 | - The reason I asked, is it a real thing,

03:09:43.020 | is that people that I know

03:09:44.460 | who believe they have a mold infection or they did

03:09:49.480 | do seem to have symptoms that last a long time.

03:09:52.420 | And there doesn't seem to be any general agreement

03:09:56.460 | about what specific treatment to use for this,

03:09:59.900 | unless maybe they need surgery or something.

03:10:02.580 | So do you give people antifungals?

03:10:05.400 | Is there anything over the counter that can help?

03:10:08.480 | Will the sauna protocols and steam protocols

03:10:10.660 | we were talking about earlier help?

03:10:11.700 | I would imagine a lot of warm, moist air

03:10:14.140 | is exactly what fungus loves.

03:10:15.780 | - Yes, it does.

03:10:18.940 | If someone came to me with a mold complaint

03:10:22.860 | or thinking they had mold,

03:10:24.380 | there are a number of tests that you can do

03:10:25.620 | to see whether or not there's antibodies to those things.

03:10:27.880 | And you can see whether or not that may or may not be there.

03:10:29.880 | It's not definitive.

03:10:31.420 | But if somebody actually truly has mold

03:10:34.220 | growing in their lungs,

03:10:35.540 | we should be able to see that on a CAT scan.

03:10:37.460 | We should be able to identify it.

03:10:39.220 | We should be able to go and biopsy it.

03:10:40.760 | We should be able to go in and collect it.

03:10:42.340 | And if that's exactly what grows out on the culture

03:10:44.680 | after we take a biopsy or a culture,

03:10:47.180 | then we can tailor antifungals for that particular thing.

03:10:51.340 | In the sense, though, that someone may be having symptoms

03:10:54.220 | of some sort of infection or something,

03:10:56.140 | and there's nothing on the CAT scan,

03:10:58.740 | it's harder to really isolate exactly which one it would be

03:11:01.460 | and what would be the right treatment.

03:11:02.820 | Although, there are some syndromes known as RADS,

03:11:07.820 | or reactive airways disease,

03:11:10.300 | where you can have an exposure

03:11:12.380 | to something that's so egregious

03:11:15.780 | that even though you don't get exposed to that thing again,

03:11:18.220 | it can still cause persistent difficulty with breathing.

03:11:22.340 | It's very similar, by the way, to asthma.

03:11:26.340 | So, for instance, let's say someone's working in a vat,

03:11:29.660 | and there's a chemical that's spilled,

03:11:31.700 | and they get an incredible amount

03:11:33.500 | of inhalation of that chemical.

03:11:35.780 | It's well-known that these people can go on

03:11:37.960 | and have these types of problems,

03:11:39.500 | even though their lungs may image correctly,

03:11:43.660 | and they may never be exposed to that chemical again.

03:11:46.300 | - Let's talk about the T in New Start, trust.

03:11:50.760 | You talked about higher power, you talked about community,

03:11:57.500 | you talked about connection generally and specifically.

03:12:02.140 | I've always been struck by how the belief system

03:12:06.540 | can impact our physical health.

03:12:09.500 | We recently had Dr. Ellen Langer

03:12:11.740 | on the podcast from Harvard,

03:12:12.860 | who's done incredible studies, really,

03:12:14.820 | about how beliefs can shape our physical health

03:12:18.260 | in any number of different ways.

03:12:19.980 | What is your clinical observation of people who are ill,

03:12:26.020 | severely ill, mildly ill,

03:12:29.740 | and the role that trust in, fill in the blank,

03:12:33.960 | you can fill in the blank,

03:12:35.940 | has in terms of the severity of their symptoms

03:12:39.580 | and the rate at which they recover,

03:12:41.520 | and hopefully they do recover?

03:12:42.740 | - Yeah, they do.

03:12:43.680 | Some of the times, sometimes they don't,

03:12:46.100 | and we can't help that, but we do the best that we can.

03:12:49.060 | No, it does help quite a bit.

03:12:50.740 | So people who have a network,

03:12:55.740 | people that have faith, people that have community,

03:12:59.940 | have that strength that allows them

03:13:03.020 | to get through those very difficult times.

03:13:06.500 | There's been a number of studies that have looked at this.

03:13:08.780 | You'd think that this area is kind of nebulous

03:13:10.820 | and hard to study.

03:13:11.660 | No, there's actually some pretty good data on this.

03:13:14.980 | And I think back to a number of studies that have been done

03:13:18.340 | and where they looked at thankfulness

03:13:20.340 | and the mind-body connection.

03:13:22.300 | People who are more thankful have less somatic complaints,

03:13:27.300 | for instance, than those that are not.

03:13:29.760 | So they actually did an experiment

03:13:31.520 | where they had people write out letters.

03:13:33.460 | They thought about some mentors in their past,

03:13:35.500 | and they wrote out letters to thank them.

03:13:37.860 | And it was interesting,

03:13:38.900 | because not all of the people that wrote the letters

03:13:41.300 | were able to actually deliver those letters

03:13:43.380 | to those recipients, but it didn't matter.

03:13:46.020 | What they found in the study

03:13:47.020 | was just simply the thought of writing out those letters

03:13:50.620 | actually had a change in the endpoints in those studies.

03:13:54.220 | There was another study that was done

03:13:55.460 | that was very telling to me.

03:13:57.300 | It was a survey that was done of 1,500 people.

03:13:59.620 | It was published out of Texas.

03:14:02.120 | In this particular case,

03:14:03.140 | they wanted to limit the population of the recipients.

03:14:07.580 | So these were just Christians in this case,

03:14:09.780 | just because of the heterogeneity.

03:14:11.740 | They wanted to see if they can get an endpoint.

03:14:13.880 | And what they did was they asked people in this survey,

03:14:18.720 | how do you forgive?

03:14:20.100 | Forgiveness has to do a little bit

03:14:21.380 | about faith and trust as well.

03:14:24.300 | And there was basically two major types of forgiveness.

03:14:27.560 | There was forgiveness that was conditional,

03:14:30.220 | and there was forgiveness that was unconditional.

03:14:33.180 | And what I mean by that is that people

03:14:35.360 | that would forgive conditionally would be,

03:14:37.220 | if someone did something to somebody,

03:14:38.900 | they might forgive them if they came back and apologized,

03:14:41.380 | or they showed some sort of remorse.

03:14:43.540 | Those are the people that forgave conditionally.

03:14:46.660 | The other people who forgave unconditionally

03:14:48.880 | were the ones that would just forgive

03:14:50.420 | regardless of what that other person would do.

03:14:51.860 | They would just forgive them,

03:14:52.900 | and it would be off their mind.

03:14:54.060 | They would just go on their way.

03:14:56.460 | What they found was really interesting

03:14:57.900 | between those two populations.

03:14:59.140 | Now, this was an associative study,

03:15:00.580 | but they found that when they looked at anxiety

03:15:04.260 | at the end of life in terms of dying,

03:15:08.980 | well-being, somatosensory complaints,

03:15:12.340 | all sorts of, a whole list of different things,

03:15:14.700 | they found that people who forgave conditionally,

03:15:18.780 | the ones that would wait for someone to come back to them,

03:15:21.520 | had higher marks in those cases.

03:15:23.860 | In other words, they had more anxiety.

03:15:25.780 | They had more somato complaints.

03:15:28.580 | They were less feeling of well-being.

03:15:32.980 | And so they found that that was really interesting.

03:15:34.420 | Well, they didn't stop there.

03:15:35.320 | They wanted to figure out what was going on.

03:15:37.500 | And they asked the question,

03:15:39.500 | okay, well, what is the biggest determinant

03:15:41.900 | that determines whether or not somebody forgives

03:15:45.740 | conditionally versus unconditionally?

03:15:48.460 | And I think the odds ratio on this statement

03:15:50.820 | was like a two or three, which is getting up there.

03:15:53.380 | It's almost, you could say that the likelihood ratios

03:15:55.820 | are high enough to say causation, but not quite,

03:15:57.940 | but it was high, and it came down to this statement.

03:16:00.780 | And the statement was,

03:16:03.840 | do you feel like you have been forgiven by God?

03:16:06.920 | If they felt like they were forgiven by God,

03:16:11.460 | they were much more likely to forgive unconditionally.

03:16:14.900 | If they had ever felt that they were forgiven by God.

03:16:17.340 | If they feel like they were forgiven by God, yes,

03:16:19.400 | for whatever it was that they had done.

03:16:21.340 | So this was really interesting to me

03:16:24.940 | because oftentimes I will have patients

03:16:29.500 | in my intensive care unit who are very anxious.

03:16:33.700 | They know that, I mean,

03:16:34.780 | anybody who gets admitted to the hospital

03:16:36.740 | starts to think about the mortality.

03:16:38.260 | Just imagine if you get admitted to the intensive care unit.

03:16:41.460 | A lot of my patients are not able to communicate.

03:16:44.340 | They're mentally out.

03:16:45.780 | But there are a few that can.

03:16:47.900 | And those, you can tell, become very anxious.

03:16:51.260 | So this is an area that I have to sort of

03:16:54.300 | delicately ask about

03:16:56.420 | because you don't know people's faith structure.

03:16:58.700 | You don't know who they are.

03:17:00.380 | I'm a graduate of Loma Linda University,

03:17:02.780 | and our motto, and it's a Christian institution,

03:17:05.980 | is to make man whole.

03:17:08.220 | And part of that is not just the physical,

03:17:10.680 | not just the mental,

03:17:12.520 | but also the spiritual aspect of that.

03:17:14.280 | So we make no excuses about that.

03:17:17.380 | But it's important to also understand

03:17:19.300 | that not everybody wants to have

03:17:21.580 | a spiritual component to their care.

03:17:22.940 | So you have to approach it in a way that you're almost,

03:17:26.260 | do you give me permission to do this?

03:17:27.740 | And you have to watch for things.

03:17:29.340 | It's not an easy thing to do,

03:17:30.620 | but you wanna help if someone wants to be helped.

03:17:33.180 | So oftentimes, I will talk to them about this very issue,

03:17:36.940 | and I will say, you know, is there something on your mind

03:17:40.840 | that you need to get off your chest?

03:17:42.300 | You would be surprised about how many times

03:17:44.300 | people have this issue.

03:17:46.140 | It's because they've done something

03:17:48.300 | to somebody in their past,

03:17:50.220 | and they don't feel like they're forgiven.

03:17:52.420 | And if you have the opportunity to do that,

03:17:55.580 | to actually give them that ability

03:17:57.660 | in their belief structure,

03:18:00.940 | to tell them that they are forgiven,

03:18:02.900 | there's a world of difference.

03:18:05.660 | And it's quite, actually, it's quite amazing.

03:18:08.340 | It's interesting to me that in all hospitals,

03:18:14.260 | not just hospitals with an affiliation

03:18:18.340 | to a particular branch of religion,

03:18:21.100 | you have chaplains.

03:18:22.400 | Yeah.

03:18:23.240 | You have different people associated often

03:18:26.560 | with different religions that people can call upon,

03:18:28.760 | which I find amazing, right?

03:18:30.360 | In this quote-unquote modern time, you know,

03:18:34.200 | of modern medicine.

03:18:35.680 | Right.

03:18:36.840 | As far as I know, every major hospital has this.

03:18:40.000 | It doesn't matter how cutting edge

03:18:41.420 | or how small a community hospital,

03:18:43.840 | which by the way, many community hospitals are excellent.

03:18:46.720 | Yes.

03:18:47.560 | I should point that out.

03:18:48.380 | The words community hospital juxtaposed

03:18:50.120 | to, you know, a cutting edge research institution.

03:18:52.920 | You know, there's actually a debate

03:18:54.080 | as to like which one you would prefer to go to,

03:18:56.200 | depending on your needs.

03:18:57.640 | But they all have, generally, as far as I know,

03:19:02.640 | have access to people with whom patients

03:19:07.640 | and family of patients and friends of patients can pray.

03:19:10.560 | And that's not a coincidence.

03:19:13.120 | I think that there's a deep understanding

03:19:15.000 | of some sort of relationship there.

03:19:19.020 | And certainly there's good science

03:19:22.140 | to support everything you just said.

03:19:24.060 | And your clinical experience, in my mind,

03:19:26.180 | goes along with that.

03:19:28.780 | You know, science, as you said, is very reductionist, right?

03:19:31.060 | But people in two groups, one prays, one doesn't.

03:19:33.020 | You know, that's sort of, that's the way science is done.

03:19:35.540 | Of course.

03:19:36.380 | But ultimately, the real world clinical implications

03:19:40.140 | are what really resonate.

03:19:43.780 | So thank you.

03:19:44.940 | Absolutely.

03:19:45.780 | Thank you for that.

03:19:46.860 | I have one final question.

03:19:48.220 | Yeah.

03:19:49.060 | And it might get you in trouble.

03:19:49.880 | Okay.

03:19:50.720 | But I'm going to ask anyway.

03:19:51.560 | Let's say I or someone that I care about

03:19:55.260 | is admitted to the hospital.

03:19:57.060 | What are the things to do or ask that we're not told

03:20:00.660 | that can facilitate better care that are within bounds?

03:20:05.220 | Now, I will go on record since these days

03:20:07.820 | I'm in the habit of just kind of saying it all.

03:20:10.540 | I'm aware that families of donors to hospitals

03:20:16.580 | get special care.

03:20:18.060 | This is, I will just tell you there's,

03:20:19.580 | you go to a hospital, there's a code language.

03:20:21.340 | I happen to know it for several hospitals.

03:20:23.460 | There's a code language of,

03:20:25.380 | this is a quote unquote special patient.

03:20:27.260 | This will anger some listeners, but it's true.

03:20:29.940 | This is the way the world works.

03:20:31.180 | Not only some listeners, but some physicians.

03:20:32.860 | Some physicians too, right?

03:20:34.140 | So there's a code language that differs by hospital

03:20:37.700 | and I know it for several hospitals.

03:20:39.420 | And I don't want to get into that.

03:20:42.340 | It's one of the more complicated aspects of medicine

03:20:46.180 | and hospitals as businesses and things like that.

03:20:49.380 | I'm gonna get some angry calls about this.

03:20:51.260 | Now, the point of asking this is that

03:20:53.980 | most people are not donors to hospitals.

03:20:56.540 | They're not going to be flagged as a special patient

03:21:00.860 | that gets the room with the window,

03:21:03.020 | that gets sunlight in the morning,

03:21:04.700 | that gets the room alone without somebody next to them

03:21:07.100 | who's coughing all night and on and on.

03:21:11.300 | So are there specific things that people should mention

03:21:16.040 | or ask for in order to get the best possible care

03:21:18.780 | when admitted to a hospital?

03:21:20.820 | Sorry, I got to put you on the spot.

03:21:22.180 | - No, this is excellent.

03:21:23.660 | This is an excellent question.

03:21:25.160 | Some of the things you can control,

03:21:27.940 | some of the things you can't control.

03:21:29.240 | Getting a bed is just completely out of your controls.

03:21:31.940 | If you're in the emergency room,

03:21:33.980 | you can ask when you're gonna go upstairs,

03:21:35.740 | you're gonna get a bed when there's gonna be a bed.

03:21:37.900 | And sometimes I can't even get patients upstairs.

03:21:40.460 | - And they're triaging, right?

03:21:41.660 | - They're triaging.

03:21:42.500 | - This person's at risk of dying.

03:21:44.260 | This person is miserable.

03:21:46.000 | - Right.

03:21:47.140 | - And you're less miserable, you're gonna wait.

03:21:49.260 | Is that how it works?

03:21:50.160 | Okay. - Potentially.

03:21:51.160 | I think in terms of where you are in the hospital

03:21:56.080 | and the care that you're going to get,

03:21:58.400 | I believe that the number one thing that you can do

03:22:01.160 | to make sure that you're getting the appropriate care

03:22:03.820 | is to, in as many ways as possible,

03:22:06.960 | communicate to the physician, usually not directly,

03:22:10.720 | that you are familiar with the disease

03:22:12.960 | that the patient is being admitted for

03:22:14.460 | and you're gonna ask some tough questions.

03:22:16.560 | Yelling at the nurse is not gonna help you.

03:22:21.280 | Saying insulting things to the nurse or the doctor

03:22:24.840 | or the staff is not gonna help.

03:22:26.060 | It's gonna make things worse.

03:22:27.400 | I think the number one way,

03:22:28.740 | and I can tell you that in terms of as me as a physician,

03:22:31.180 | if I'm speaking to a patient and we have a family member

03:22:34.700 | that is asking me intelligent questions about something,

03:22:37.340 | that's gonna put me up on my game.

03:22:39.620 | That's gonna make sure that I know

03:22:41.100 | I'm gonna be ready for rounds

03:22:42.400 | because you're not gonna be glossing over things.

03:22:44.500 | They're gonna be asking some tough questions.

03:22:45.940 | I gotta know what I'm doing.

03:22:47.580 | And that's kind of what I've been doing

03:22:51.640 | for the last 10 years, 12 years,

03:22:53.860 | in terms of the teaching that I do.

03:22:55.660 | We have a website called MedCram.com

03:22:59.020 | where we put up, if you go to your doctor

03:23:02.540 | and you get a CBC back, right?

03:23:04.520 | How do you interpret that CBC?

03:23:06.460 | - Can you explain CBC to people?

03:23:07.740 | - So CBC is a complete blood count

03:23:09.620 | and it's the blood test that you get back

03:23:11.460 | when you get your blood test.

03:23:12.660 | There's a metabolic panel that you get back.

03:23:14.900 | How do you know what's going on with those things?

03:23:17.640 | What about an EKG?

03:23:18.620 | You have these smart watches

03:23:20.420 | that can actually measure your heart rate.

03:23:22.640 | How can you interpret what's going on there?

03:23:25.500 | We've put courses together to educate people.

03:23:27.900 | We even have courses on diseases.

03:23:30.420 | Congestive heart failure.

03:23:31.660 | What kind of questions do you need to ask

03:23:33.460 | in congestive heart failure?

03:23:34.840 | What are the things that you need to watch out for?

03:23:36.380 | What are the medicines that could put you on?

03:23:37.740 | What are the side effects of those medicines?

03:23:39.980 | I think if, and you don't have to be that educated actually

03:23:43.820 | or even know that much,

03:23:44.780 | but if you can show that you're asking the right questions

03:23:47.660 | to a physician, they're gonna ask you,

03:23:50.140 | are you in the medical field?

03:23:51.220 | You're like, no, I just know about this disease

03:23:53.300 | and I have these questions

03:23:54.180 | about when are you gonna start to do this?

03:23:55.500 | When are you gonna start to do this?

03:23:56.600 | When is this happening?

03:23:57.580 | And when's the next?

03:23:59.100 | I think that more than anything puts those people

03:24:01.740 | who are taking care of you on alerts

03:24:04.100 | to know that you're intelligent,

03:24:05.500 | you're gonna be asking some questions

03:24:07.340 | and they're gonna need to make sure that they focus on

03:24:09.460 | and answering those questions effectively.

03:24:11.580 | I think that's the number one thing.

03:24:13.260 | I love it.

03:24:14.100 | And thank you for stepping right in the line of fire

03:24:15.940 | with that one and not trying to dodge it.

03:24:17.740 | So it speaks to the kind of person you are.

03:24:22.220 | It speaks to the spirit behind your work,

03:24:27.220 | which is so clearly in service to helping people.

03:24:31.380 | You know, it's such a cliche thing.

03:24:32.620 | We hear, you know, helping people, I wanna help people,

03:24:34.540 | but it's very clear that you wanna help people.

03:24:36.780 | You do this in your social media,

03:24:37.980 | you do this through your online teaching.

03:24:41.340 | We'll, by the way, provide links to all these sources.

03:24:44.500 | And you're doing this in so many ways.

03:24:46.060 | And of course, in your clinical practice.

03:24:48.180 | And, you know, for all those reasons,

03:24:50.940 | and also for coming here today to take time out

03:24:53.240 | of your very busy professional and family schedule,

03:24:57.140 | and you have your own self-care, right?

03:24:58.420 | If you're not healthy,

03:24:59.240 | you can't take care of other people's health.

03:25:01.660 | I just wanna say on behalf of myself

03:25:03.120 | and everyone listening and watching, thank you so much.

03:25:05.220 | I learned a ton.

03:25:07.220 | And I know everyone else listening did as well.

03:25:09.820 | It's all actionable in service to basic health

03:25:13.740 | and improving health, and in service to avoiding illness.

03:25:17.820 | Those are not the same thing necessarily,

03:25:19.700 | although they go hand in hand,

03:25:21.220 | and to moving through illness

03:25:22.780 | should one contract an infection.

03:25:25.420 | And, you know, just a treasure trove of knowledge.

03:25:29.040 | So thank you so much.

03:25:30.740 | I'd love to have you back again.

03:25:32.220 | - I would love to come back.

03:25:33.060 | Thanks. - I look forward

03:25:33.900 | to seeing you online, but even more so in person.

03:25:36.540 | So thank you so much, Dr. Shwelt.

03:25:39.600 | You're a real gem.

03:25:40.700 | - Thank you so much.

03:25:42.140 | - Thank you once again for joining me

03:25:43.460 | for today's discussion with Dr. Roger Shwelt.

03:25:46.020 | To learn more about his work

03:25:47.220 | and to find links to him on social media and YouTube,

03:25:50.020 | please see the show note captions.

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03:27:49.860 | You simply go to hubermanlab.com,

03:27:51.580 | go to the menu tab in the top right corner,

03:27:53.460 | scroll down to newsletter and enter your email.

03:27:55.980 | And I should emphasize

03:27:56.820 | that we do not share your email with anybody.

03:27:59.540 | Thank you once again for joining me

03:28:00.860 | for today's discussion with Dr. Roger Schwelt.

03:28:03.740 | And last, but certainly not least,

03:28:05.700 | thank you for your interest in science.

03:28:07.820 | [upbeat music]

03:28:10.400 | (upbeat music)

How to Enhance Your Immune System | Dr. Roger Seheult

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