Using Your Nervous System to Enhance Your Immune System

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

00:00:02.260 | where we discuss science and science-based tools

00:00:04.900 | for everyday life.

00:00:05.900 | I'm Andrew Huberman,

00:00:10.360 | and I'm a professor of neurobiology and ophthalmology

00:00:13.060 | at Stanford School of Medicine.

00:00:15.280 | Today, we are discussing the immune system,

00:00:18.220 | and we are also discussing the nervous system,

00:00:20.600 | which is the brain, spinal cord,

00:00:22.140 | and the connections of the brain and spinal cord

00:00:23.940 | with all the organs of the body.

00:00:25.720 | We are also going to discuss how the nervous system

00:00:29.260 | can be used to activate and control the immune system.

00:00:33.680 | Now, about 10, 20 years ago,

00:00:35.940 | somebody said that the mind could control the immune system.

00:00:40.020 | It'd probably get laughed out of most academic conferences,

00:00:42.920 | and certainly the work wouldn't be published

00:00:44.500 | in quality journals.

00:00:45.520 | But nowadays, there are dozens, if not hundreds,

00:00:49.020 | of quality peer-reviewed studies on how the mind

00:00:53.100 | and how the nervous system can control activation

00:00:56.580 | of the immune system.

00:00:58.180 | This is a wonderful growing body of research.

00:01:00.820 | And just to give you a hint of where we are headed with this,

00:01:04.180 | just this last week, there was a paper published in Nature,

00:01:07.900 | which is the apex journal for scientific publishing,

00:01:11.040 | premier journal, extremely stringent.

00:01:13.720 | A paper published in Nature from Chufu Ma's lab

00:01:17.500 | at Harvard Medical School explored how acupuncture

00:01:21.440 | can reduce inflammation in the body.

00:01:24.580 | And I will describe this study in a bit more detail later,

00:01:28.060 | but what they discovered was that by stimulating the body

00:01:32.660 | in particular ways at particular sites on the body,

00:01:36.420 | they were able to liberate certain cells and molecules

00:01:41.000 | that enhance the function of the immune system

00:01:43.920 | and potentially can be used to combat

00:01:45.700 | different types of infection.

00:01:47.540 | And just to give you another little hint,

00:01:49.620 | they found that a particular type of organ tissue

00:01:53.260 | called fascia, some of you may have heard of fascia,

00:01:55.580 | fascia surrounds our muscles.

00:01:57.940 | Just to look at it,

00:01:58.780 | you might think it's a kind of useless tissue.

00:02:00.340 | It's sort of like a dense bag

00:02:02.100 | in which the muscles are contained.

00:02:04.000 | Well, it turns out that those dense bags

00:02:06.100 | are much smarter than we thought.

00:02:07.400 | They don't have a mind of their own,

00:02:08.580 | but by stimulating the fascia

00:02:10.860 | in a particular location on the body,

00:02:13.260 | there's a pathway leading out of that fascia

00:02:16.500 | directly to an organ called the adrenal medulla,

00:02:20.400 | I'll explain what all this means,

00:02:21.600 | that could liberate particular chemicals

00:02:23.300 | that had a potent anti-inflammatory effect.

00:02:26.940 | So what we're basically saying is that the nervous system

00:02:29.900 | acts as a set of highways

00:02:31.820 | between the different tissues of your body,

00:02:33.780 | calling into action the immune system,

00:02:36.340 | liberating particular molecules

00:02:38.000 | that can reduce inflammation and lead to faster healing.

00:02:42.380 | And I will explain how all of that works

00:02:44.400 | as well as some other non-acupuncture methods

00:02:47.660 | for activating and enhancing

00:02:49.700 | the function of the immune system.

00:02:51.020 | So today we're going to be talking

00:02:52.220 | all about healing with the mind

00:02:55.100 | in a completely non-mystical, non-abstract sense.

00:02:59.020 | Before we begin, I'd like to emphasize that this podcast

00:03:01.980 | is separate from my teaching and research roles at Stanford.

00:03:04.900 | It is, however, part of my desire and effort

00:03:07.160 | to bring zero cost to consumer information

00:03:09.220 | about science and science-related tools

00:03:11.540 | to the general public.

00:03:13.040 | In keeping with that theme,

00:03:14.240 | I'd like to thank the sponsors of today's podcast.

00:03:17.260 | Our first sponsor is Roca.

00:03:19.580 | Roca makes eyeglasses and sunglasses

00:03:21.940 | that are absolute superb quality.

00:03:24.860 | I've spent a lifetime working on the visual system.

00:03:27.260 | And I can tell you that one of the major issues

00:03:29.680 | our visual system has to contend with

00:03:31.800 | is how to see things clearly in bright environments

00:03:34.980 | or dimmer environments, et cetera.

00:03:37.420 | Roca clearly understands the science of the visual system

00:03:40.100 | because one thing that's wonderful about their sunglasses

00:03:42.380 | is that you can be in a very bright environment

00:03:45.060 | and then walk into a shadowed environment

00:03:47.020 | and you don't even notice the transition.

00:03:48.860 | Everything is still seen with crystal clarity.

00:03:52.580 | Their eyeglasses as well allow you to see things

00:03:54.980 | regardless of how bright or dim internal lighting is.

00:03:58.740 | I wear readers at night.

00:03:59.780 | I wear sunglasses during the day.

00:04:01.620 | And Roca eyeglasses and sunglasses are particularly nice

00:04:04.300 | because they're very lightweight.

00:04:05.960 | I often forget that they're even on my face.

00:04:08.480 | They also don't slip off if you get sweaty.

00:04:10.820 | They were actually designed to be used

00:04:12.580 | while running or cycling.

00:04:14.220 | And so I can use them while exercising.

00:04:15.900 | They also have a great aesthetic.

00:04:17.100 | So you can go from exercising to dinner or to work

00:04:20.220 | without having to change from one set of glasses

00:04:22.260 | to the next.

00:04:23.540 | If you'd like to try Roca glasses,

00:04:25.040 | you can go to roca.com.

00:04:26.740 | That's R-O-K-A.com and enter the code Huberman

00:04:29.700 | to save 20% off your first order.

00:04:32.280 | Today's episode is also brought to us by Athletic Greens.

00:04:35.820 | Athletic Greens is an all-in-one

00:04:37.620 | vitamin mineral probiotic drink.

00:04:40.060 | I've been taking Athletic Greens since 2012.

00:04:42.780 | And so I'm delighted that they're sponsoring the podcast.

00:04:45.660 | The reason I started taking Athletic Greens

00:04:47.660 | and the reason I still take Athletic Greens

00:04:49.280 | once or twice per day

00:04:50.860 | is because it allows me to cover

00:04:52.300 | all of my basic nutritional bases.

00:04:54.440 | It's got the vitamins and minerals

00:04:56.560 | that make sure that no matter what I'm eating,

00:04:59.060 | I'm covering all of my micronutrient bases.

00:05:01.420 | And it has the probiotics.

00:05:03.060 | And probiotics we now know

00:05:04.800 | are essential for a healthy gut microbiome

00:05:06.980 | and a healthy gut microbiome we know

00:05:09.180 | is essential for many important biological functions

00:05:12.340 | related to human health,

00:05:13.620 | like metabolic needs, endocrine function,

00:05:15.920 | immune function, and so on.

00:05:17.800 | With Athletic Greens, I can mix that up with water.

00:05:20.040 | I usually add some lemon or lime juice.

00:05:22.160 | It tastes delicious.

00:05:23.300 | I like it very much,

00:05:24.140 | and I'll drink it once early in the day

00:05:25.700 | and once again later in the afternoon.

00:05:28.040 | If you'd like to try Athletic Greens,

00:05:30.400 | you can go to athleticgreens.com/huberman.

00:05:33.240 | And if you do that, you can claim a special offer.

00:05:35.620 | They'll give you five free travel packs,

00:05:37.280 | which make it very easy to mix up Athletic Greens,

00:05:39.380 | whether you're in the car or on a plane or on the move.

00:05:42.300 | And they'll give you a year supply of vitamin D3K2.

00:05:46.180 | There is now a lot of data showing that vitamin D3

00:05:49.260 | is important for many biological functions

00:05:51.560 | that impact our immediate and long-term health.

00:05:53.840 | And most people do not get enough vitamin D3,

00:05:56.240 | even if they're getting a lot of sunshine.

00:05:57.820 | And K2 is also important,

00:06:00.100 | or has been shown to be important for heart health

00:06:03.120 | and for blood lipid function, et cetera.

00:06:05.420 | So again, if you'd like to try Athletic Greens,

00:06:07.440 | you can go to athleticgreens.com/huberman

00:06:10.540 | to get the Athletic Greens, the five free travel packs,

00:06:12.960 | and the year supply of vitamin D3K2.

00:06:15.840 | Today's episode is also brought to us by Inside Tracker.

00:06:19.140 | Inside Tracker is a personalized nutrition platform

00:06:21.700 | that analyzes data from your blood and DNA

00:06:24.520 | to help you better meet your immediate

00:06:26.100 | and long-term health goals.

00:06:28.060 | I've long been a fan of getting regular blood work done

00:06:30.980 | for the simple reason that many of the things

00:06:33.560 | that impact your immediate and long-term health

00:06:35.880 | can only be analyzed from a quality blood test.

00:06:38.500 | There's just simply no other body surface marker

00:06:41.940 | that you can look at somebody or yourself and say,

00:06:43.940 | ah, you know, I know that my blood lipids

00:06:45.780 | or my cholesterol are good,

00:06:47.220 | or that my hormone levels are X, Y, or Z.

00:06:49.540 | We really need numbers on those things

00:06:51.240 | to know where they sit.

00:06:53.260 | The problem with a lot of blood tests, however,

00:06:55.180 | is you get all those numbers back.

00:06:56.700 | You don't know what to do with that information.

00:06:58.760 | Inside Tracker has solved that problem.

00:07:00.340 | They have a very easy to use dashboard

00:07:03.460 | where when you get your numbers back,

00:07:05.900 | it can tell you, for instance,

00:07:07.460 | where your numbers are high or low or on target,

00:07:10.220 | and they can suggest very specific dietary interventions,

00:07:14.420 | supplemental interventions, and behavioral interventions

00:07:17.260 | that can allow you to bring those numbers

00:07:19.020 | to where you would like them to be.

00:07:20.380 | So they've simplified the whole process.

00:07:21.960 | And in terms of getting the blood test,

00:07:23.500 | you can go to a local center to get the blood drawn,

00:07:25.580 | or they can even send somebody to your house.

00:07:27.300 | They've made the whole thing very, very easy

00:07:28.980 | from start to finish.

00:07:30.440 | If you'd like to try Inside Tracker,

00:07:32.320 | you can visit insidetracker.com/huberman

00:07:35.420 | to get 25% off any of Inside Tracker's plans.

00:07:38.700 | You just use the code Huberman at checkout.

00:07:41.640 | Okay, let's talk about the immune system

00:07:44.380 | and the nervous system and how the two interact

00:07:47.260 | and how you can control your immune system

00:07:49.720 | to serve you better.

00:07:51.700 | We are going to talk a lot of mechanistic science,

00:07:55.380 | a little bit of detail.

00:07:56.240 | You learned some new language around the immune system,

00:07:59.500 | names of the different cell types and so forth,

00:08:01.300 | but I promise to make it all very clear

00:08:03.180 | regardless of your background.

00:08:04.900 | We are also going to discuss a lot of tools.

00:08:07.420 | And I think many of you are probably here

00:08:09.160 | because you want to know what you can do

00:08:11.060 | in order to boost or enhance the function

00:08:13.460 | of your immune system.

00:08:14.560 | That's a very reasonable question to ask.

00:08:17.580 | I want to begin by just acknowledging that

00:08:21.860 | if one were to put that question into the internet,

00:08:24.640 | you would get back a lot of answers.

00:08:27.200 | And there is now a sort of generic form of that answer

00:08:30.620 | that deserves our respect,

00:08:32.460 | but is not going to be the topic of conversation today.

00:08:35.340 | I just want to tip my hat to it, however,

00:08:38.620 | and list off a few of the things that we know

00:08:41.780 | set us up to be healthier than we would be

00:08:44.940 | if we didn't do these things.

00:08:45.900 | So the first of course,

00:08:47.020 | is the foundation of all mental and physical health,

00:08:49.100 | which is to get adequate sleep, meaning enough sleep,

00:08:52.280 | whatever it is for you that you require to get deep sleep.

00:08:55.500 | So it's got to be of high quality

00:08:57.340 | and to time that sleep correctly,

00:08:59.620 | meaning you can't sleep during the day one day

00:09:01.280 | and at night the next day

00:09:02.220 | and expect your system to function well.

00:09:04.060 | Talked a lot about that before on this podcast.

00:09:05.840 | You need a relatively consistent sleep schedule

00:09:08.620 | most of the time, about 80% of the time,

00:09:11.480 | or even better would be 90% of the time.

00:09:13.360 | But the realities of life make it that

00:09:16.040 | we can't always go to bed at the same time

00:09:18.020 | and wake up at the exact same time.

00:09:20.140 | So we need sleep.

00:09:21.540 | We do need sunshine.

00:09:22.700 | Why do we need sunshine?

00:09:23.700 | Because it sets our rhythm into a regular state

00:09:26.820 | where the genes in all of our cells

00:09:29.520 | can be expressed at the correct times.

00:09:31.260 | We're sort of a factory of cells, if you will,

00:09:33.320 | and that factory can only run properly

00:09:35.060 | if it knows when certain things should be active

00:09:37.960 | and when certain cells should not be active.

00:09:40.100 | And the best way to coordinate all of those activities

00:09:42.840 | of all the cells is to get sunshine in your eyes

00:09:45.680 | in the morning and again in the evening

00:09:47.940 | and not to get too much bright light in your eyes

00:09:50.180 | in the middle of the night.

00:09:51.520 | That's just foundational.

00:09:53.860 | And then any lists that you'll find

00:09:55.860 | on any number of websites on the internet would say,

00:09:58.220 | okay, get good sleep, get sun, get exercise.

00:10:03.040 | How much exercise?

00:10:04.160 | We should all be getting 150 to 180 minutes

00:10:06.660 | of zone two cardio.

00:10:08.420 | That's cardiovascular exercise

00:10:10.440 | where we can just barely hold a conversation

00:10:12.820 | or maybe not per week.

00:10:15.480 | We should be eating well.

00:10:16.660 | We're always told we have to get good nutrition.

00:10:19.220 | What good nutrition means to you is going to be different

00:10:21.660 | than what it means to somebody else.

00:10:22.940 | But we acknowledge that food intake

00:10:26.460 | and quality of food in particular,

00:10:28.600 | avoiding processed foods, that's going to be important.

00:10:31.260 | Social connection is important.

00:10:32.660 | Hydration is important.

00:10:33.860 | You're starting to get the picture.

00:10:37.340 | We can take all that, acknowledge it as useful

00:10:40.860 | and foundational for mental and physical health.

00:10:43.640 | But of course, there are many people who still struggle

00:10:46.100 | with getting ill too often or with not being able to heal

00:10:51.100 | from physical injuries and wounds or from various bacterial

00:10:55.660 | and viral infections quickly enough

00:10:57.700 | or deal with chronic disease.

00:10:59.180 | And so today is really about how you can take all

00:11:01.740 | of that information, acknowledge it and follow it.

00:11:05.020 | But in addition to that, there are things

00:11:07.220 | that you can do to leverage your nervous system

00:11:09.800 | in order to enhance the function of your immune system

00:11:12.860 | in very robust ways.

00:11:14.760 | So that's where I'd like to shift the conversation to.

00:11:17.380 | The first topic we have to attack is the question

00:11:21.060 | of what is the immune system and how does it work?

00:11:23.760 | I think many of you have heard of antibodies

00:11:27.140 | or killer cells or the various organs of the body

00:11:30.500 | that are involved in the immune system,

00:11:31.840 | like the bone marrow, the spleen, the thymus

00:11:34.060 | and the lymph nodes.

00:11:36.260 | I'd like to just take a moment

00:11:37.380 | and do a sort of brief immune system 101.

00:11:42.380 | Really simple, cover the basic elements of the immune system

00:11:45.780 | so that everyone listening or watching this

00:11:49.120 | can get a clear sense of how the immune system functions

00:11:52.660 | and what its basic parts are.

00:11:55.160 | For some of you, this might be too basic.

00:11:57.340 | It might be a little bit of background

00:11:58.940 | that you already know.

00:11:59.960 | I think for most of you, this information will be new.

00:12:02.540 | And I promise you, you don't need a biology

00:12:05.340 | or medicine background in order to understand this.

00:12:07.260 | It's actually really simple

00:12:09.540 | because it is truly elegant in design.

00:12:12.540 | You have three main layers of defense for your health.

00:12:17.540 | These are the three things that are constantly at work

00:12:21.580 | to protect you from invasion and illness,

00:12:25.540 | from bacteria, from viruses and from parasites.

00:12:30.240 | And the first of those three is a physical barrier

00:12:34.140 | that we call your skin.

00:12:36.100 | And that might seem kind of obvious,

00:12:37.460 | but everything about you is contained in this compartment

00:12:42.300 | that is boundaried by your skin.

00:12:45.300 | And your skin is a very important aspect

00:12:48.100 | of your immune system.

00:12:49.780 | If you've ever had a cut,

00:12:51.080 | you essentially have a breach of the boundary

00:12:53.900 | that is your immune system.

00:12:55.860 | And you would notice a number of things would happen.

00:12:57.960 | You might get some swelling around that cut.

00:13:01.220 | You might get a scab.

00:13:02.740 | Likely you would get a scab over time.

00:13:05.520 | If it got dirty, there were some bacteria that got in there.

00:13:07.860 | You might see some accumulation of white blood cells,

00:13:10.100 | what's called pus.

00:13:10.940 | I know it's kind of gross, but that's what that is.

00:13:13.220 | It might take on a yellow tint

00:13:15.020 | because of the accumulation of some dead cells there.

00:13:18.060 | But basically your skin is the primary barrier

00:13:20.720 | through which you keep things from the outside

00:13:23.140 | that could harm you from getting to the inside.

00:13:26.900 | Now, still in category one,

00:13:30.600 | your body and your external surface,

00:13:32.760 | you have openings to that surface, right?

00:13:36.300 | You're not just a round or a body-shaped,

00:13:40.960 | completely covered up with skin, you have openings.

00:13:43.460 | What are those openings?

00:13:44.300 | Well, let's start at the top and work our way down.

00:13:47.140 | A primary site of potential infection are your eyes.

00:13:51.100 | You have your ears, you have your nostrils,

00:13:52.960 | you have your mouth, okay?

00:13:54.120 | Those are going to be the primary sites

00:13:56.200 | by which things can get into your system.

00:13:58.900 | And you need to put things into your system.

00:14:00.260 | You need to drink and eat

00:14:01.300 | and you need to get light into your system.

00:14:02.820 | That's why you have those openings.

00:14:04.620 | But bad things, meaning things that can harm you,

00:14:07.780 | can get into those systems.

00:14:10.120 | And then of course, along the back of your throat,

00:14:13.540 | all the way down to your stomach and your digestive system,

00:14:18.180 | and through your intestines and out your rectum,

00:14:20.260 | you have a tube that you are basically a series of tubes.

00:14:24.400 | I've said that before in this podcast,

00:14:25.780 | and this is one such tube by which you extract nutrients

00:14:28.460 | from the outside environment.

00:14:30.120 | But all along that tube,

00:14:32.460 | including your nose and your mouth, it's lined with mucus.

00:14:37.140 | And while mucus might seem kind of gross to some of you,

00:14:39.320 | the more you learn about mucus,

00:14:40.380 | the more you realize that mucus is really, really cool.

00:14:43.420 | Because mucus essentially acts as a filter,

00:14:46.140 | as a trap for bacteria and viruses.

00:14:49.420 | And it has certain ways of scrubbing

00:14:52.240 | or killing those bacteria and viruses.

00:14:55.160 | Now, the mucus is constantly being turned over.

00:14:58.860 | And as we'll talk about later,

00:15:00.060 | the chemistry of that mucus is really important

00:15:03.120 | in order to make sure that certain things

00:15:06.060 | don't make it into your system

00:15:07.200 | and other things are allowed to move through your system

00:15:09.400 | and you can extract nutrients from them.

00:15:11.540 | So the reason I'm talking about this first category

00:15:14.680 | of a barrier for immune system in such detail

00:15:17.440 | is I'd like you to envision yourself as a human, of course,

00:15:21.140 | but as a human that is a clear entity from everything else,

00:15:25.500 | and you have to bring in the right things

00:15:26.920 | and you have to keep out the wrong things or kill them.

00:15:30.400 | Now, inevitably, bacteria, viruses, and parasitic infections

00:15:35.400 | are going to make their way into our body.

00:15:39.540 | But whether or not they are killed off

00:15:41.560 | or whether or not they take over and cause us harm

00:15:44.520 | is going to be determined by layers two and three.

00:15:48.060 | So layers two and three are the so-called

00:15:51.240 | innate immune system and the adaptive immune system.

00:15:54.620 | So the innate immune system is what I would call

00:15:57.120 | the second layer of defense, it's very fast.

00:15:59.480 | So whether or not it's bacteria, virus, or parasite,

00:16:02.880 | what happens when you have something enter your body,

00:16:06.880 | maybe you swallowed it, maybe it got in through your eyes,

00:16:09.380 | maybe you shook somebody's hand

00:16:12.040 | who is carrying a particular kind of illness

00:16:14.560 | and then you wiped your eyes.

00:16:16.200 | And I've talked about on this podcast before,

00:16:17.840 | very soon after we meet another person,

00:16:19.840 | usually within 30 seconds, believe it or not,

00:16:22.200 | most people wipe that person's chemicals

00:16:24.660 | somewhere on their face or on their body surface.

00:16:26.980 | This has been demonstrated over and over again.

00:16:29.740 | If you want to learn more about that,

00:16:30.800 | we did an episode all about chemical signaling

00:16:32.780 | where you can learn about it.

00:16:33.620 | I know it sounds weird and you might say, I don't do that,

00:16:36.180 | but indeed you do most of the time, most everybody does.

00:16:41.180 | Okay, so this innate immune system is this rapid response.

00:16:45.220 | When something enters our system

00:16:47.580 | and our body doesn't recognize it, it's not food,

00:16:50.980 | it's not clean air,

00:16:52.860 | it's something that's either a bacteria virus or parasite.

00:16:57.160 | And the innate immune system involves the release

00:17:00.980 | of particular cells that are waiting dormant,

00:17:03.980 | ready to attack whatever this invader is.

00:17:06.620 | And some of these cell types you've heard of before,

00:17:09.480 | the most typical one are the so-called white blood cells.

00:17:12.740 | So the white blood cells will actively go

00:17:15.120 | to the site of invasion and will start to encapsulate

00:17:18.700 | or try and surround that given invader.

00:17:23.020 | The other names of these different cell types are things

00:17:25.060 | like neutrophils, macrophages, natural killer cells,

00:17:28.900 | just a few of the many types of immune cells.

00:17:31.580 | So there's kind of like an ambulance system,

00:17:33.980 | but rather than go and try and heal something

00:17:36.180 | like a paramedic would, they go there and they try

00:17:38.420 | and surround and kill whatever this invader is.

00:17:41.440 | They work in concert with two other assistants

00:17:47.900 | and those assistants are called the complement proteins.

00:17:51.180 | Complement proteins exist in the blood.

00:17:54.200 | And what they do is they travel to sites

00:17:56.800 | where there's an invasion and they mark certain things

00:18:00.820 | for being engulfed and eaten.

00:18:03.180 | So they sort of put an eat me tag on it.

00:18:06.680 | They basically put a chemical tag onto invaders

00:18:10.220 | that then allows those white blood cells, neutrophils,

00:18:13.340 | macrophages and natural killer cells to say,

00:18:15.940 | ah, I need to basically wrap, you'll kill this thing

00:18:19.580 | and then wrap it in a body bag and send it off,

00:18:21.500 | kill that thing, wrap it in a body bag and send it off.

00:18:23.520 | And I'm using the analogy of the body bag,

00:18:25.460 | but in a sense it is one, it's the right one rather,

00:18:29.380 | because these cells that come in and kill things,

00:18:31.780 | the way they do that is actually to engulf

00:18:34.340 | the invading bacteria virus or parasite.

00:18:36.700 | So they actually surround it.

00:18:38.060 | And when you see pus or you see infection

00:18:40.900 | maybe a cut on the skin or something like that,

00:18:45.420 | or even in an ingrown hair that gets some bacteria in it,

00:18:49.720 | that pus and that the white part,

00:18:52.000 | I know it's kind of gross to talk about,

00:18:53.220 | but those are the white blood cells.

00:18:54.980 | And those are the dead, oftentimes it's dead cells,

00:18:58.360 | and that's the dead invader sitting there.

00:19:00.420 | So it's trying to create an isolated compartment

00:19:02.660 | 'cause it wants to keep it in that part of the body.

00:19:05.000 | So you've got the innate immune system.

00:19:06.960 | The compliment comes through blood

00:19:09.100 | and helps it by tagging certain things

00:19:11.360 | with an eat me signal.

00:19:12.860 | And then there are the cells that are either damaged

00:19:16.740 | from the injury or from the parasite

00:19:19.100 | or are suffering because of the bacteria

00:19:21.820 | or the virus itself.

00:19:23.360 | And the cells of your body

00:19:26.140 | will also release an alarm signal,

00:19:28.860 | which is not an eat me signal, but a help me signal.

00:19:31.720 | And those help me signals come in the form

00:19:34.040 | what we call cytokines.

00:19:35.740 | And the cytokines are things like interleukin-1,

00:19:38.460 | interleukin-6, tumor necrosis factor alpha.

00:19:41.620 | You may have heard of these things

00:19:42.900 | if you are at all curious about

00:19:45.580 | or been learning about the health space,

00:19:47.460 | online health space, especially in the last few years.

00:19:49.560 | Inflammation is all the buzzword now.

00:19:51.940 | Everyone's talking about inflammation,

00:19:53.040 | inflammation, inflammation.

00:19:54.300 | What do we mean when we say inflammation?

00:19:56.380 | Well, inflammation is a physical response,

00:19:58.800 | but it's also a chemical response.

00:20:01.060 | And many times the markers of inflammation

00:20:04.660 | that are measured in people or an animal model,

00:20:08.380 | excuse me, where this research is done

00:20:10.060 | are things like interleukin-1, interleukin-6,

00:20:14.060 | tumor necrosis factor alpha.

00:20:15.720 | So when those go up in the blood,

00:20:17.340 | it's a sign that somewhere there's a cell

00:20:19.500 | that's saying, help me, help me,

00:20:20.840 | and it's secreting these things,

00:20:22.020 | which calls in those neutrophils, macrophages,

00:20:25.060 | natural killer cells, and white blood cells, okay?

00:20:27.820 | And it might help to remember all this,

00:20:29.860 | but by just telling people that what interleukin means

00:20:34.200 | is to communicate, right?

00:20:36.540 | So the interleukin is shouting out, help me,

00:20:38.500 | the complement proteins are coming in and saying,

00:20:40.540 | eat this, and tagging the invader with an eat me signal.

00:20:44.300 | And then the killer cells and the white blood cells

00:20:46.840 | are doing the job of trying to kill off that thing.

00:20:49.300 | That's the innate immune system.

00:20:51.140 | So your skin and your mucus lining,

00:20:54.940 | plus your innate immune system

00:20:57.700 | are a beautiful two-layered set of defenses

00:21:02.260 | against various kinds of invaders and infections.

00:21:05.580 | And then there's the third type,

00:21:07.080 | which is the adaptive immune system.

00:21:09.020 | And you'll notice that leading up until now,

00:21:11.300 | I haven't said the word antibody at all.

00:21:14.060 | And that's because it is the job,

00:21:16.180 | not of the skin or the mucus or the microbiome

00:21:20.480 | or the innate immune system to produce antibodies

00:21:23.820 | that can recognize specific invaders,

00:21:25.840 | but rather it is the job of the adaptive immune system

00:21:29.140 | to create antibodies against bacteria, viruses,

00:21:33.740 | and even parasites and even physical intruders

00:21:37.520 | to your system.

00:21:38.880 | So the adaptive immune system has this incredible ability

00:21:43.320 | to show up at the site of invasion

00:21:45.960 | or infection or inflammation.

00:21:47.520 | It's called there by various cues,

00:21:50.420 | including the cytokines that we've talked about earlier.

00:21:53.380 | And what it does is it actually attaches to

00:21:58.380 | and creates a sort of an imprint of the shape

00:22:02.680 | of whatever invader happens to be there.

00:22:05.400 | So if that particular invading bacteria or virus

00:22:09.580 | has a contour that's kind of rippled or kind of spiky

00:22:12.680 | or whatever shape it happens to have,

00:22:15.120 | it creates an imprint of that.

00:22:17.520 | And then using that imprint in concert with some other cells

00:22:22.520 | creates antibodies that are specific

00:22:25.420 | to recognize that invader should the body

00:22:28.240 | ever have that invader inside of it again.

00:22:31.160 | Now that's why it's called the adaptive immune system.

00:22:33.760 | And in many ways, it creates a memory of a prior infection

00:22:38.760 | so that these antibodies can be made anytime

00:22:42.560 | that same invader comes back again, all right?

00:22:45.060 | And so this is the basis of what we call immunity.

00:22:47.840 | This is the basis of what we call an enhanced ability

00:22:51.580 | to combat certain types of infections.

00:22:54.060 | And it's really a wonderful, and I mean,

00:22:56.080 | just I can't even state how incredible this really is

00:23:00.800 | that all of our bodies have this capacity, right?

00:23:03.640 | We have something called leukocytes.

00:23:06.960 | These are essentially white blood cells.

00:23:09.720 | We have red blood cells and white blood cells,

00:23:11.600 | and they both are derived from the same type of origin cell.

00:23:15.320 | It's a stem cell.

00:23:16.520 | When you hear stem cell,

00:23:17.360 | a stem cell just means a cell that can become

00:23:20.200 | many different types of other cells.

00:23:23.280 | We sometimes hear about stem cells

00:23:25.080 | in terms of people that are getting injections of stem cells

00:23:27.840 | or the potential therapeutic effects of,

00:23:30.760 | or potential of stem cells,

00:23:31.920 | but we all harbor certain stem cells within us as well

00:23:35.220 | that can become lots of different cell types.

00:23:37.000 | And there's one particular type of stem cell,

00:23:39.120 | which is the hemopoietic stem cell,

00:23:41.040 | which can give rise to red blood cells

00:23:42.960 | and white blood cells.

00:23:44.380 | And in general, these reside in the marrow,

00:23:46.960 | at least in adults.

00:23:49.180 | So in our bone marrow,

00:23:50.360 | we have this ability to make certain cells

00:23:53.160 | that can go out when they are called out chemically,

00:23:57.400 | they're called out to sites of infection

00:23:59.020 | and create antibodies and then maintain those antibodies

00:24:02.840 | in our system or have a memory of that particular infection

00:24:06.960 | so that if the infection comes back again,

00:24:09.040 | we can kill it off immediately.

00:24:10.620 | And it doesn't have to pass through these multiple stages

00:24:13.680 | of first the innate response,

00:24:15.080 | then the adaptive response, taking some time.

00:24:17.600 | Now, there are a lot more details

00:24:18.740 | to the adaptive immune system,

00:24:20.360 | but I just want to emphasize a few points

00:24:23.600 | that might be relevant.

00:24:25.400 | First of all, the name of the antibodies that are created

00:24:30.400 | sometimes come in the form of IgM and IgG,

00:24:35.500 | things of that sort.

00:24:36.760 | This isn't a full deep dive immunology class,

00:24:39.520 | but Ig stands for immunoglobulin, okay?

00:24:43.420 | So the immunoglobulins are part

00:24:45.200 | of the adaptive immune response in creating antibodies.

00:24:48.740 | If you hear IgM, the IgM is the first of the adaptive

00:24:55.580 | immune responses, and it tends to come on earlier.

00:24:58.760 | So if somebody is immunopositive for IgM

00:25:02.000 | for a particular type of viral or bacterial invader,

00:25:05.380 | that means that it was a fairly recent infection.

00:25:08.040 | Later, one creates the adaptive immune system,

00:25:12.160 | I should say, creates an IgG,

00:25:14.080 | which is the more stable form of the specific antibody

00:25:16.980 | that's going to recognize a given invader.

00:25:19.840 | So IgG tends to come up a little bit later.

00:25:21.880 | So just to recap, something gets into your system

00:25:26.040 | through your eyes, through some hole in your skin,

00:25:30.040 | a cut through your mouth.

00:25:31.720 | Sexually transmitted diseases come in

00:25:35.120 | through the mucus membranes that are on the genitalia

00:25:39.160 | or in the genitalia.

00:25:40.520 | Sexually transmitted disease, airborne disease,

00:25:44.760 | gets into the mucus, somehow gets into the bloodstream.

00:25:47.900 | Then there's the innate response,

00:25:50.320 | which is a more general response of trying to contain

00:25:52.960 | and combat the infection or invader.

00:25:55.240 | And then the adaptive response is the one

00:25:57.000 | that generates the antibodies.

00:25:58.240 | First, the IgM response, the immunoglobulin M response,

00:26:02.520 | and then the immunoglobulin G response, IgG response.

00:26:07.000 | So how do we keep these three barriers

00:26:11.640 | or these three defense systems to infection tuned up?

00:26:14.920 | Well, leaving aside the list of things

00:26:17.640 | that I mentioned before that generally enhances

00:26:20.180 | their function, things like sleep and sunlight

00:26:22.200 | and good nutrition, et cetera,

00:26:23.440 | the sort of generic things for good health.

00:26:26.680 | One of the key ways we can do that is to keep

00:26:29.100 | that mucus lining in really good shape.

00:26:32.040 | And what does that mean?

00:26:32.860 | Well, the mucus lining needs to turn over quite often,

00:26:36.380 | and it needs to be the correct chemistry

00:26:38.600 | to be a trap for the bad stuff

00:26:41.440 | and for it to be permeable to the good stuff,

00:26:45.560 | to the nutrients that we need.

00:26:47.240 | And it is now very clear from hundreds if not thousands

00:26:50.360 | of studies that the best way to do that

00:26:51.980 | is to maintain a healthy so-called microbiome.

00:26:55.340 | The microbiome being these little bacterial organisms

00:26:58.700 | that are good for us that live all along our mucus pathways

00:27:03.600 | and even in our eyes.

00:27:05.020 | Now, just to be really clear,

00:27:07.420 | it's not just about the gut microbiome.

00:27:09.560 | We actually have a microbiome in our eyes.

00:27:11.880 | We have one that's specific to our mouth.

00:27:13.520 | We have a nasal specific microbiome.

00:27:16.320 | There's one all along the gut and the species of microbiota

00:27:19.960 | that live all along the digestive tract differ

00:27:22.680 | from the mouth to the throat, to the stomach,

00:27:25.480 | intestines, and to the rectum.

00:27:27.160 | It's well established that there are healthy microbiota

00:27:29.720 | that live all along that length

00:27:31.240 | and they differ along that length.

00:27:33.740 | There's also a urethral microbiota

00:27:36.760 | and there's a vaginal microbiota

00:27:38.640 | that promotes health of that environment as well.

00:27:41.160 | So how is it that one can maintain the healthy microbiota

00:27:45.540 | and not favor growth of harmful bacteria

00:27:48.940 | or allow that mucus lining to become too permeable

00:27:52.820 | to the bad stuff that can come in from the environment?

00:27:55.740 | Well, as far as we know,

00:27:57.960 | there are three main ways to do that.

00:28:00.680 | The first two are purely structural and mechanical.

00:28:04.920 | It's very clear now from work,

00:28:07.840 | some of which was done at Stanford, but elsewhere as well,

00:28:11.220 | that the nasal microbiome is particularly good

00:28:15.680 | at scrubbing bacteria,

00:28:18.840 | at preventing certain types of infections.

00:28:21.180 | So this is a reminder that whenever possible,

00:28:24.920 | unless eating or speaking, you want to be nasal breathing,

00:28:28.680 | not breathing through your mouth.

00:28:30.120 | Your nose is a much better filter

00:28:33.040 | for viruses and bacteria than is your mouth.

00:28:36.500 | The mouth contains certain structural features,

00:28:38.940 | even organs and cell types that can protect

00:28:42.180 | against incoming infection,

00:28:43.840 | but you don't want to be a mouth breather

00:28:46.740 | for a variety of reasons.

00:28:48.060 | And there's a terrific book called "Jaws, a Hidden Epidemic,"

00:28:51.600 | which was written by my colleagues,

00:28:52.740 | Sandra Kahn and Paul Ehrlich at Stanford

00:28:54.940 | and Stanford Medicine with a forward by Jared Diamond

00:28:57.420 | and Robert Sapolsky.

00:28:58.720 | So it's really a lot of heavy hitters on that book

00:29:00.440 | that talks about the increase in infection

00:29:04.040 | that one gets when breathing through the mouth

00:29:07.580 | as opposed to the nose.

00:29:08.640 | Now, of course, during hard exercise,

00:29:10.480 | one reads through the mouth, that's not necessarily bad.

00:29:13.240 | When one is eating or speaking,

00:29:14.640 | that's not necessarily bad at all.

00:29:16.400 | I guess it depends on what you're saying, it was a joke.

00:29:18.860 | But in general, when possible,

00:29:20.920 | you want to be breathing through your nose.

00:29:22.640 | Many people have trouble breathing through their nose

00:29:24.660 | because of so-called deviated septums

00:29:26.480 | or chronically collapsed sinuses.

00:29:28.780 | The best way to dilate those sinuses

00:29:30.800 | is actually to breathe through your nose.

00:29:32.200 | So it can take a little bit of time,

00:29:33.440 | but there is some plasticity to the sinuses.

00:29:36.820 | And so be a nose breather, not a mouth breather,

00:29:39.600 | you will combat more of the infections

00:29:42.540 | that you are constantly confronted with.

00:29:44.080 | I should mention that we are always bombarded

00:29:46.240 | with different types of bacteria, viruses,

00:29:48.040 | and parasites in our environment.

00:29:49.560 | And the goal, of course, is to reinforce your immune system

00:29:53.360 | so you can keep these things at bay and not get sick.

00:29:56.460 | There's actually a paper that was published in Cell Report,

00:30:00.320 | Cell Press Journal, excellent journal,

00:30:01.780 | that showed that the nasal microbiome,

00:30:04.180 | it has particular species of microbiota

00:30:08.040 | that are good at fighting off infection.

00:30:10.360 | There has not been a direct link

00:30:12.800 | between particular patterns of nasal breathing

00:30:15.420 | and the nasal microbiome yet,

00:30:17.180 | but oxygenation of that environment

00:30:19.100 | by breathing through your nose

00:30:20.480 | turns out to be quite important overall

00:30:22.960 | for enhancing it as a filter.

00:30:24.920 | So don't just think of your nose

00:30:26.520 | as something to smell foods and to bring in air.

00:30:28.800 | It's also an active filter for things that could invade you.

00:30:33.680 | The other way to try and keep out bad things

00:30:37.880 | and to avoid getting sick is the advice that your mother

00:30:40.440 | and certainly my mother gave me,

00:30:42.240 | which is to not touch your eyes

00:30:45.440 | after touching other people or touching other surfaces.

00:30:49.440 | And as I mentioned earlier,

00:30:51.480 | we tend to do this subconsciously.

00:30:53.720 | But the reason to avoid doing that

00:30:55.180 | is the eyes are a primary entry point

00:30:58.080 | for a lot of bacteria and viruses.

00:31:00.340 | You're constantly lubricating the surface of your eyes

00:31:02.400 | with the so-called lacrimal glands and tears

00:31:04.920 | and things of that sort.

00:31:06.680 | If you've ever noticed when you wake up in the morning,

00:31:08.240 | you have some sleep in your eyes,

00:31:10.120 | you're the kind of crusty stuff

00:31:11.240 | in the corners of your eyes or on your eyelashes,

00:31:14.440 | that sleep, that crust are actually dead bacteria

00:31:19.140 | that you've successfully battled during the night.

00:31:22.960 | That's what that is.

00:31:23.800 | It's not the accumulation of some healthy tissue.

00:31:26.640 | It's the accumulation of your healthy mucous membranes

00:31:30.080 | and tears and other things that are specifically combating

00:31:34.200 | those bacteria.

00:31:35.380 | So I know that sounds a little bit gross,

00:31:37.040 | but that's what that is.

00:31:37.880 | So you're wiping away the casualties of a battle

00:31:41.320 | that you fought at night.

00:31:43.040 | So during the daytime, you don't want to introduce viruses

00:31:45.820 | and things to your eyes as much as possible.

00:31:48.080 | It is a primary site of entry.

00:31:49.660 | This is why people wear goggles in surgical units

00:31:52.880 | and things of that sort to try and avoid getting things

00:31:56.800 | into their eyes.

00:31:57.840 | Very, very important.

00:31:59.000 | And then the third way to keep a healthy line of defense

00:32:03.720 | for your entire mucus tract

00:32:07.200 | is to enhance the proliferation of good gut microbiota.

00:32:12.160 | The best way to enhance the quality of your gut microbiome

00:32:16.000 | and the mucus lining that serves as this protective layer

00:32:20.020 | all along your body is to ingest two to four servings a day

00:32:24.520 | of fermented foods, low sugar fermented foods.

00:32:27.160 | I've talked about this before a bunch of times on the

00:32:29.000 | podcast, but these are data from my colleague,

00:32:31.140 | Justin Sonnenberg's lab at Stanford Med.

00:32:33.600 | And there, I just wiped my eyes.

00:32:35.120 | Yep, you got me.

00:32:36.040 | But that a paper published in the journal Cell,

00:32:40.480 | which is a absolutely spectacular journal really points

00:32:44.400 | to the fact that when people eat fermented foods,

00:32:48.400 | two to four servings per day,

00:32:50.160 | it helps reduce the activity of certain cytokines.

00:32:53.500 | Now, you know what those are, right?

00:32:54.900 | Cells make cytokines to call out,

00:32:56.360 | help me, help me, to reduce the amount of cytokines,

00:33:01.160 | the so-called inflammatome.

00:33:02.400 | Now that doesn't render those cells more vulnerable.

00:33:04.440 | The reason they saw a reduction in IL-6 and IL-1

00:33:08.120 | and some of these other cytokines is because when people

00:33:10.400 | have a healthy gut microbiome,

00:33:12.320 | there are fewer cells in the body being infected

00:33:15.080 | from outside infections and therefore less of a reason

00:33:18.060 | for cells to be crying out help

00:33:19.460 | because they are thriving, not suffering.

00:33:22.600 | So don't wipe your eyes, keep your hands clean,

00:33:26.240 | everyone tells you that, right?

00:33:27.240 | But keep your hands clean, don't wipe your eyes.

00:33:29.120 | Be a nasal breather, not a mouth breather,

00:33:31.200 | unless you're speaking, exercising, or eating.

00:33:33.840 | And keep a healthy gut microbiome by eating two

00:33:37.280 | to four servings a day of quality,

00:33:39.720 | low sugar fermented foods, things like sauerkraut,

00:33:41.960 | things like natto, if you can access that.

00:33:44.880 | I've tried it before, it's interesting.

00:33:47.480 | It's sort of an acquired taste.

00:33:48.920 | Kimchi, pickles, again, low sugar sources are going

00:33:52.080 | to be the sources that are going

00:33:53.720 | to be most effective for this.

00:33:55.880 | So now you're armed with three ways to enhance the function

00:33:59.520 | of your immune system and combat infection that is,

00:34:03.240 | I like to think, separate from the typical type

00:34:05.240 | of information that you get, such as, you know,

00:34:07.840 | get good sleep, good nutrition,

00:34:09.300 | good social connection, et cetera.

00:34:10.520 | All that stuff still holds true,

00:34:11.800 | but these three other points I think can really

00:34:15.080 | make a substantial difference in terms

00:34:16.680 | of bolstering the immune system, your immune system.

00:34:20.720 | I do want to mention, because these names are going

00:34:22.960 | to come up several times during this episode,

00:34:25.740 | that while interleukins like IL-6

00:34:28.920 | and IL-1 encourage inflammation,

00:34:32.180 | they are these help me signals that call in cells

00:34:34.700 | to gobble up invaders, there are some interleukins

00:34:38.000 | that are anti-inflammatory.

00:34:39.440 | And the one that I'd like to highlight in particular,

00:34:41.500 | because it will come up again in a little bit,

00:34:43.520 | is interleukin 10.

00:34:45.200 | So not all of the IL, insert number,

00:34:48.940 | not all of the interleukins are inflammatory,

00:34:51.440 | some are anti-inflammatory.

00:34:53.880 | So that's important point to keep in mind as we go forward.

00:34:56.380 | Next, I'd like to talk about what's called

00:34:58.280 | sickness behavior.

00:34:59.700 | And indeed, there is a category of behavior

00:35:02.580 | that we call sickness behavior that is very informative

00:35:06.820 | as to the things that we can do to avoid getting sick.

00:35:10.920 | Now, this notion of sickness behavior goes back

00:35:13.260 | several decades or more, and it's a very interesting way

00:35:17.440 | of looking at the function of the immune system,

00:35:20.480 | because what it does is it bridges us from this thing

00:35:24.400 | that we're calling the immune system,

00:35:25.600 | where it's T cells and B cells and cytokines and leukocytes,

00:35:30.220 | and it starts taking us into the realm

00:35:31.720 | of the nervous system, because of course,

00:35:33.480 | the nervous system controls behavior.

00:35:35.640 | So sickness behavior is a suite of responses

00:35:40.040 | that we tend to all undergo when we are feeling sick.

00:35:44.180 | So this is going to vary from person to person,

00:35:47.640 | but there's some general categories of things

00:35:49.360 | that we all do and that happened to all of us

00:35:52.180 | after we are wounded or sick or dealing with an infection

00:35:55.320 | of any kind.

00:35:56.160 | And by examining sickness behavior in some detail,

00:35:59.500 | it can be really informative as to routes

00:36:02.440 | that we can take to health.

00:36:03.980 | So the main thing about sickness behavior

00:36:06.960 | is that it tends to involve a slowing

00:36:09.540 | of our usual levels of activity.

00:36:11.540 | People start to feel lethargic or they feel like

00:36:14.500 | the activities that previously they could do

00:36:17.420 | with relative ease are very difficult for them

00:36:20.540 | or somewhat overwhelming.

00:36:22.400 | The other thing you start to see is that people

00:36:24.440 | and animals, by the way, stop grooming.

00:36:27.360 | They stop taking care of themselves,

00:36:28.880 | not necessarily stop showering,

00:36:30.300 | although oftentimes that's the case,

00:36:31.640 | but they will stop doing their hair.

00:36:34.280 | They'll stop putting on makeup, you know,

00:36:36.820 | depending on whether or not they did that before,

00:36:38.880 | they might stop.

00:36:39.720 | Animals will stop licking and grooming themselves.

00:36:43.040 | People will stop taking care of their cosmetic appearance.

00:36:46.760 | Now it's not just because they don't care how they look

00:36:49.760 | when they're sick.

00:36:50.600 | It's because there's this overall suppression

00:36:53.280 | of certain kinds of activities and an enhancement

00:36:55.860 | of other kinds of activities.

00:36:57.040 | And this is really important.

00:36:59.240 | Sickness behavior is actually a motivated state.

00:37:02.980 | It's a state that's designed to accomplish certain things.

00:37:06.720 | One of the other features of sickness behavior,

00:37:09.580 | in addition to being lethargic, loss of grooming,

00:37:12.120 | will be a loss of appetite, right?

00:37:15.800 | Oftentimes people who have a great appetite normally

00:37:18.360 | just won't feel hungry at all.

00:37:20.280 | And there are several theories as to why this would be.

00:37:22.620 | One prominent idea in the literature

00:37:25.720 | is that it's to discourage vomiting and diarrhea,

00:37:29.960 | which of course can be infectious to other people.

00:37:33.360 | So that's a theory.

00:37:35.120 | I don't know that that's ever been tested directly,

00:37:37.540 | but that's one idea.

00:37:39.240 | The other idea is that it's simply to harbor more resources

00:37:43.400 | for sake of repair.

00:37:44.840 | And I want to talk about that

00:37:46.200 | because we are all told to get extra sleep

00:37:50.140 | when we aren't feeling well or to rest.

00:37:52.440 | But just like any good two or three-year-old

00:37:55.680 | constantly asks why, why?

00:37:58.260 | Good scientists, good people who are interested

00:38:02.400 | in health information should always be asking why?

00:38:05.240 | Why should I get more sleep?

00:38:06.240 | What happens in sleep

00:38:07.880 | that I should get more sleep when I'm sick?

00:38:09.500 | Why shouldn't I just push through this?

00:38:11.140 | And there are a couple of reasons for this

00:38:13.280 | that have been established in the literature.

00:38:15.160 | The first is that there does seem to be something useful

00:38:18.520 | about slowing circulation when we are ill.

00:38:21.840 | One idea that has some data to support it

00:38:24.340 | is that when we slow our circulation, our blood circulation,

00:38:28.520 | so not running around so much or running at all,

00:38:30.900 | but rather lying down, getting extra rest,

00:38:34.460 | maybe sleeping, maybe even just remaining still

00:38:37.240 | is that the lymphatic system,

00:38:39.380 | which carries a lot of the immune-related cells and fluids

00:38:42.560 | is able to ramp up its levels of activity.

00:38:45.560 | So this is interesting, right?

00:38:46.880 | So reducing circulation of the blood,

00:38:49.240 | but increasing circulation of the lymphatic system.

00:38:52.840 | You've all probably been familiar with the lymphatic system.

00:38:55.920 | When you're combating an infection,

00:38:57.640 | your lymph nodes can get sore.

00:38:59.340 | You've got lymph nodes behind your ears and your groin,

00:39:01.320 | your armpits, around your throat,

00:39:02.920 | around near your thyroid, in your throat, et cetera.

00:39:06.560 | So that's the other reason.

00:39:08.900 | Now, some people, when they get sick,

00:39:11.840 | get psychologically go into a very vulnerable state

00:39:16.800 | where they really, really want people,

00:39:19.160 | other people to take care of them.

00:39:20.860 | You've probably witnessed this,

00:39:22.840 | or you feel this way yourself.

00:39:25.300 | About 50% of people have that response.

00:39:27.660 | They really want to be taken care of.

00:39:29.360 | Now, when you think about it from an adaptive perspective,

00:39:32.000 | this makes sense, right?

00:39:33.480 | A member of our species is ill,

00:39:36.100 | and they more or less will cry out for help

00:39:39.460 | in one form or another

00:39:40.840 | to the other members of their species to take care of them.

00:39:44.200 | And of course, this will be especially apparent

00:39:46.720 | in cases where people are young enough

00:39:48.880 | or incapacitated enough

00:39:50.120 | that they can't actually get resources on their own.

00:39:52.720 | If you've ever been really sick,

00:39:53.720 | just getting up and going to the fridge or to the restroom

00:39:55.880 | can feel like a monumental task.

00:39:59.920 | So about 50% of people report or describe seeking of help

00:40:04.920 | and support when they are sick.

00:40:06.660 | But you could also imagine

00:40:08.560 | how this would be a very non-adaptive response

00:40:11.800 | because it increases the opportunity

00:40:14.040 | to spread infection to the caretaker.

00:40:16.380 | So that's an interesting consideration.

00:40:19.200 | Another 50% of people seem to have the opposite response

00:40:24.720 | when they're sick.

00:40:25.560 | So somehow, regardless of how they were

00:40:28.140 | prior to getting ill,

00:40:29.800 | the sickness behavior that's engaged

00:40:32.200 | by these neural circuits in the brain,

00:40:34.040 | they are indeed neural circuits in the brain,

00:40:35.760 | create a stay away from me.

00:40:37.640 | I don't want to be bothered.

00:40:38.640 | I want to be left alone.

00:40:39.660 | I don't want to be taken care of, right?

00:40:41.240 | It's not stubbornness.

00:40:42.720 | It's literally a lack of interest or a disinterest

00:40:46.840 | in social connection when one is sick.

00:40:48.640 | And you see this in animals too.

00:40:50.160 | Some animals will seek out other members of their species.

00:40:52.920 | Others, like my unfortunately now passed away bulldog,

00:40:56.320 | Costello, when he was sick,

00:40:57.360 | I always knew because he would go around

00:40:59.160 | in the back of the house and he would just hide there.

00:41:00.720 | He would just take himself away from everybody else.

00:41:03.600 | He did not want to be taken care of.

00:41:05.400 | And it was just a natural response to him.

00:41:07.480 | I don't think he was trying to prevent me

00:41:08.840 | from getting whatever it was that he had.

00:41:11.140 | So if ever somebody doesn't want to be taken care of,

00:41:14.400 | or if they do want to be taken care of,

00:41:15.640 | realize that people tend to fall into these two bins naturally

00:41:19.400 | and animals tend to fall into these bins,

00:41:21.880 | regardless of what species they are, it's about 50/50.

00:41:24.840 | And again, this sickness behavior is a motivated state.

00:41:28.480 | It's designed to slow circulation of the blood,

00:41:31.580 | increased circulation of the lymph

00:41:33.520 | and the other killer cells in the body,

00:41:36.320 | reduce the probability of infecting others

00:41:38.900 | by reducing its thought, diarrhea and vomit,

00:41:42.020 | but also breathing on others, interacting with others.

00:41:45.240 | And in some cases it will activate this,

00:41:48.300 | I don't want to call it a regressed state,

00:41:50.040 | but many people feel somewhat more if they are adults,

00:41:54.060 | they feel more childlike when they are ill

00:41:56.380 | and they want to be taken care of very badly.

00:41:58.340 | Some of it might be learned,

00:41:59.300 | some of it might be innate, we don't know,

00:42:02.620 | but the sickness behavior is very interesting

00:42:05.040 | for a couple of reasons.

00:42:06.080 | First of all, it mimics another state

00:42:09.120 | that has been described in the neuroscience literature,

00:42:11.760 | which is major depression.

00:42:13.540 | And in both sick individuals,

00:42:17.760 | sick from bacterial viral infection,

00:42:20.160 | and in people with major depression,

00:42:21.720 | it's been shown that there are robust increases

00:42:24.760 | in the levels of interleukin-6

00:42:27.720 | and tumor necrosis factor alpha.

00:42:29.800 | So there is an idea now circulating that depression

00:42:33.580 | involves these inflammatory cytokines being very active.

00:42:37.580 | And we know that illness

00:42:39.380 | involves inflammatory cytokines being very active.

00:42:42.180 | So if you think about it,

00:42:43.020 | the similarity between major depression and being sick

00:42:45.940 | ought to be able to point us in a direction of interventions

00:42:49.940 | that could help us either prevent illness

00:42:52.660 | or move through illness more quickly.

00:42:55.100 | But as we head in that direction,

00:42:58.160 | because indeed that's the case,

00:43:00.020 | I just want to emphasize that sickness behavior

00:43:02.720 | is what provides this bridge between the immune system

00:43:06.220 | and the nervous system.

00:43:07.720 | And what we'll soon see also is that healthy behavior,

00:43:11.400 | behavior that allows us to avoid infection

00:43:13.660 | also points to a clear bridge

00:43:16.320 | between the nervous system and the immune system.

00:43:18.800 | That it isn't just that we have a brain and body

00:43:21.220 | and our organs, and then we have an immune system.

00:43:23.040 | That's true, but they're interacting all the time.

00:43:25.920 | And this is going to lead us to a place

00:43:27.960 | where it's going to be very clear

00:43:29.920 | and not at all surprising how certain patterns of thinking

00:43:33.500 | and certain behaviors that we can elect to take

00:43:36.740 | can help enhance our immune system function and vice versa.

00:43:40.680 | There are two other features of sickness behavior

00:43:43.180 | definitely worth pointing out.

00:43:45.260 | One is a theory, which is that the reduced appetite,

00:43:48.680 | in particular appetite for protein-rich foods when sick

00:43:53.320 | is thought to be an attempt,

00:43:56.660 | a subconscious attempt of the organism

00:43:59.580 | to reduce the amount of iron that it's taking in.

00:44:02.860 | Now, typically the amount of iron intake

00:44:05.460 | that's recommended or more or less is for men,

00:44:09.460 | it's about eight milligrams per day.

00:44:11.760 | For women, it's anywhere from 18 to 27 milligrams per day,

00:44:14.740 | depending on whether or not they're pregnant,

00:44:16.220 | lactating or menstruating, et cetera.

00:44:18.860 | The ranges can vary.

00:44:20.080 | But, and indeed it's true that if iron levels in the blood

00:44:24.620 | go too high, like over 45 milligrams per day,

00:44:28.900 | can be very toxic to the system.

00:44:30.900 | But the theory that's prominent in the biology literature

00:44:34.740 | and in the health literature is that the reduction

00:44:37.020 | in appetite is actually an attempt to reduce iron intake

00:44:41.180 | specifically because many bacteria

00:44:44.220 | and other forms of infection seem to thrive

00:44:46.860 | when levels of iron in the blood are high.

00:44:49.860 | Now, I don't want to see anyone take this to extreme

00:44:51.860 | and suddenly do an iron deprivation diet

00:44:53.680 | in order to get well.

00:44:55.940 | But it's an interesting theory that I'd be remiss

00:44:58.160 | if I didn't mention, because it makes good sense.

00:45:01.540 | Iron is actually attached to hemoglobin

00:45:04.780 | and red blood cells in the bloodstream.

00:45:06.760 | Normally that can help us quite a lot.

00:45:10.220 | It's also in muscle.

00:45:11.340 | I should mention that iron can be sequestered into muscle

00:45:14.340 | and iron serves a lot of important health promoting roles,

00:45:19.100 | but by reducing appetite and thereby reducing iron intake,

00:45:24.100 | it does reduce the capacity of certain things,

00:45:27.120 | including infections to travel

00:45:29.300 | in certain compartments within the body.

00:45:31.580 | So again, that's just theory,

00:45:33.320 | but I think many of you are probably familiar

00:45:35.580 | with not having an appetite when you're sick.

00:45:38.480 | The other thing that's very typical

00:45:42.940 | of people with major depression is loss of appetite.

00:45:46.160 | Not always, but often loss of appetite.

00:45:47.820 | So here again, we have loss of appetite

00:45:49.720 | in sickness behavior, loss of appetite in major depression.

00:45:52.560 | And perhaps not surprisingly,

00:45:55.220 | one of the major symptoms of sickness behavior

00:45:58.140 | and major depression that map more or less onto one another

00:46:01.880 | is loss of libido or interest,

00:46:04.260 | not just in social interactions,

00:46:05.720 | but in sex and reproduction.

00:46:07.280 | And so again, if you think about sickness behavior

00:46:09.780 | and depression, they are very, very similar.

00:46:12.900 | Okay, so sickness behavior and major depression

00:46:15.720 | have certain core features in common.

00:46:19.280 | We need to therefore ask ourselves why and how

00:46:24.520 | does being sick influence the way that we think

00:46:27.160 | and perceive our environment and impact our appetite,

00:46:32.160 | whether or not we want to be cared for more

00:46:34.420 | or cared for less.

00:46:35.400 | Again, people tend to diverge

00:46:36.780 | into two different bins there.

00:46:39.040 | And believe it or not,

00:46:40.340 | the pathway for this has been identified.

00:46:43.760 | When we have an infection someplace in our body,

00:46:47.280 | and it could be up in our head,

00:46:48.600 | you know, it could be a sinus infection,

00:46:50.340 | it could be an ear infection,

00:46:51.920 | or I should also mention many of these same mechanisms

00:46:55.740 | can also be the consequence of a wound

00:46:57.780 | or an injury to the body,

00:46:59.380 | you know, a back injury or a slipped disc,

00:47:02.660 | or I guess it's called a herniated disc

00:47:04.700 | is the way that you hear it described.

00:47:07.700 | When we have that, we can be kind of irritable.

00:47:10.080 | We don't want to do certain things

00:47:11.760 | and we just want to be left alone.

00:47:13.900 | Things are harder, how, why?

00:47:16.140 | Well, there's a known pathway,

00:47:18.920 | which is the so-called vagus nerve

00:47:21.820 | that connects the body and the brain,

00:47:24.340 | signals to particular brain sites

00:47:26.940 | to engage this category of motivational state

00:47:30.980 | that we call sickness behavior.

00:47:32.540 | Many of you have probably heard of the vagus,

00:47:35.780 | V-A-G-U-S, vagus.

00:47:37.480 | The vagus nerve is a very extensive nerve pathway.

00:47:40.960 | It's the 10th cranial nerve

00:47:42.080 | comes out of the back of the brainstem,

00:47:45.920 | heads into the body and branches out extensively

00:47:49.400 | to innervate or connect to many of our organs,

00:47:53.180 | including our lungs, our heart, our gut, et cetera.

00:47:55.420 | And all of those organs are able also

00:47:57.780 | to send neural signals back up to the brain.

00:48:00.440 | We sometimes hear the vagus

00:48:02.860 | as the route to calming ourselves down.

00:48:06.600 | Unfortunately, that's more or less a myth

00:48:08.920 | that I don't know how it got propagated.

00:48:10.960 | You have lots of different pathways in the vagus.

00:48:13.060 | Usually vagal stimulation

00:48:14.560 | actually creates more arousal and alertness,

00:48:17.160 | although it does have multiple pathways.

00:48:19.180 | But there have now been many studies of the vagus

00:48:23.520 | in various contexts, including in sickness behavior.

00:48:25.900 | And it's very clear that the vagus nerve

00:48:29.040 | is the fast pathway by which an infection in the body

00:48:33.640 | is signaled to the brain

00:48:34.840 | to a particular location in the brain

00:48:36.200 | called the hypothalamus,

00:48:37.400 | which harbors a lot of different types of neurons.

00:48:40.180 | Neurons, for instance, in the preoptic area

00:48:42.280 | that increase body temperature and fever, right?

00:48:45.240 | That's one of the most important things

00:48:46.560 | is to increase body temperature in order to,

00:48:49.100 | it's the body's attempt to kill off this invader

00:48:52.900 | because many viruses and many bacteria

00:48:57.020 | don't survive well at elevated heat.

00:48:59.220 | That's the function of a fever.

00:49:00.520 | A fever actually has a functional role.

00:49:02.140 | So in biology, we like complicated words.

00:49:04.940 | So we call anything that increases body temperature

00:49:07.800 | or creates a fever.

00:49:09.560 | Pyrogen, many years ago in my undergraduate years,

00:49:14.100 | I was working on pyrogens, injecting something called

00:49:17.680 | lippy polysaccharide into the belly,

00:49:21.660 | which then gives you a fever.

00:49:22.860 | The way it does that is LPS causes an inflammation response

00:49:26.980 | in the gut.

00:49:28.000 | The gut doesn't know what is happening.

00:49:29.620 | The stomach cells don't know what's happening.

00:49:31.500 | So they just start secreting the IL-6, the IL-1,

00:49:35.860 | all those cytokines, the killer cells migrate into the gut.

00:49:38.740 | That's why you sometimes get a stomach ache

00:49:40.280 | when you don't feel well, you have a flu

00:49:41.920 | or something like it.

00:49:43.300 | So a neural signal, electrical signals get sent up

00:49:46.300 | to the hypothalamus.

00:49:47.340 | The hypothalamus says,

00:49:48.180 | "Oh, I don't know what's going on out there,

00:49:49.840 | but there's a signal something's going on.

00:49:51.500 | Let's just heat up the body.

00:49:53.140 | Let's just start cooking whatever it is out there."

00:49:56.060 | And of course, you don't want fever to go too high

00:49:57.800 | because you can kill brain cells,

00:49:59.540 | but within a particular range,

00:50:02.480 | the fever is a functional and adaptive response, okay?

00:50:06.780 | So if you're taking drugs to try and lower the fever,

00:50:09.720 | that might make you feel more comfortable,

00:50:11.140 | but actually that's limiting the response

00:50:14.020 | that your body is creating

00:50:15.060 | in order to try and kill off that invader.

00:50:17.900 | And again, you don't want fever to go too high.

00:50:20.900 | This is going to vary depending on age.

00:50:23.420 | You can look up online

00:50:24.340 | what the tolerable ranges are for fever,

00:50:27.220 | but when you're trying to lower body temperature,

00:50:29.780 | when you have a fever,

00:50:31.380 | unless you're heading into dangerous levels of heating up,

00:50:34.820 | that's actually the wrong way to take your system

00:50:36.860 | if you do indeed want to kill off that invader.

00:50:40.180 | Okay, so the vagus nerve is the quick response.

00:50:42.300 | It also sends input to areas of the brain

00:50:46.700 | that change your perception of the outside world.

00:50:49.200 | One of the most obvious of these,

00:50:51.860 | obvious once I tell it to you, is photophobia, right?

00:50:56.060 | I love bright sunshine.

00:50:57.460 | I love bright lights when I want to be alert.

00:51:00.140 | We all have different levels of light sensitivity,

00:51:02.940 | but most people, when they are sick,

00:51:05.780 | when there's an inflammation response in the body,

00:51:08.420 | they feel like bright lights are kind of aversive.

00:51:10.640 | They get a well-described kind of classical photophobia.

00:51:14.060 | And that's mediated by a pathway that goes from your eye

00:51:17.820 | to an area of your thalamus

00:51:20.880 | called the anterior nucleus of the thalamus.

00:51:24.040 | This is work that was done by Clifford Saper

00:51:25.980 | at Harvard Medical School.

00:51:27.860 | It's really beautiful work.

00:51:30.000 | And then from there up to the outer lining of the brain,

00:51:34.580 | which is the meninges,

00:51:36.020 | just sort of on the outside of the brain

00:51:38.020 | where the brain starts to interface

00:51:39.420 | with some of the other connective tissues.

00:51:41.380 | We'll talk more about these later.

00:51:43.040 | It can actually create a photophobia and a headache

00:51:46.540 | when one is ill.

00:51:47.500 | So here's the pathway.

00:51:49.580 | Some invader gets into your system

00:51:51.900 | 'cause you wiped your eyes or it got in through your mouth.

00:51:53.940 | You didn't listen to your mother

00:51:55.100 | and got in through your eyes.

00:51:57.100 | You're feeling sick.

00:51:58.200 | Something's going on there.

00:51:59.980 | You have a stomach ache

00:52:00.860 | because of all the inflammation there.

00:52:03.180 | The signal goes up from your vagus nerve.

00:52:05.540 | You're heating up with a fever.

00:52:07.320 | You've got photophobia

00:52:09.240 | because you've activated this pathway

00:52:12.160 | by which what would normally be tolerable light

00:52:15.240 | is triggering this thalamic nucleus, the anterior thalamus.

00:52:19.080 | That's projecting up to the meninges.

00:52:20.800 | You've got a headache in response to looking at light.

00:52:23.120 | It's basically triggering an overall pathway

00:52:25.320 | to get you to go into a quiet, dark place and rest.

00:52:28.400 | And the last element I'd like to talk about is the rest.

00:52:31.420 | There's something that gets triggered

00:52:33.440 | from the body to the brain to the hypothalamus.

00:52:35.940 | And we think we know which hypothalamic area it is.

00:52:38.460 | It's the supraoptic nucleus, we think.

00:52:40.740 | Supraoptic 'cause it's right above

00:52:42.260 | your so-called optic chiasm.

00:52:43.900 | If you want to look up where that is,

00:52:45.100 | it's right above the roof of your mouth.

00:52:46.780 | And there are nuclei there that promote the desire to sleep

00:52:51.780 | even during the daytime,

00:52:54.280 | what would normally be the active phase

00:52:55.740 | of your circadian cycle.

00:52:57.800 | Now, that is really interesting

00:53:00.060 | because what's happening here

00:53:01.500 | is you've got multiple pathways that are saying,

00:53:04.560 | "Avoid light, reduce your amount of behavior,

00:53:08.880 | heat up all the things that are making you sick."

00:53:11.200 | This is sickness behavior,

00:53:12.200 | and it's going from your body to your mind

00:53:15.600 | to make you do the right thing.

00:53:18.040 | Now, there's also a slow pathway

00:53:20.560 | that's purely mediated by the blood,

00:53:23.080 | so-called humoral factors, not 'cause they're funny,

00:53:25.660 | but humoral factors are factors of the blood.

00:53:28.720 | As you have an infection for many hours or days,

00:53:34.540 | the amount of IL-6 and IL-1 and tumor necrosis factor

00:53:39.540 | and other inflammatory cytokines is starting to increase

00:53:42.960 | such that the total amount in your circulation

00:53:46.540 | gets high enough and is communicated to the brain.

00:53:49.740 | And it tends to enter the brain

00:53:52.400 | through a particular type of tissue

00:53:54.260 | that's really interesting called choroid, C-H-O-R-O-I-D.

00:53:58.880 | Choroid is really interesting.

00:54:00.640 | It's kind of this fluffy tissue that sits in your ventricles.

00:54:04.260 | The ventricles are the spaces in your brain,

00:54:06.120 | and the spaces in your brain

00:54:07.520 | have what's called cerebral spinal fluid in them.

00:54:09.900 | The cerebral spinal fluid

00:54:10.760 | contains a number of important things,

00:54:12.400 | but the choroid starts releasing and responding

00:54:16.080 | to these cytokines, the inflammatory cytokines,

00:54:19.640 | and then the brain actually starts to experience

00:54:23.320 | all sorts of changes in terms of inflammation to neurons.

00:54:27.340 | Your memory tends to get poor.

00:54:29.040 | Your cognition tends to get poor.

00:54:31.280 | These are transient things most often.

00:54:33.960 | Eventually these things will pass,

00:54:35.580 | but this is deep into sickness

00:54:36.960 | when you're really feeling lousy.

00:54:38.320 | You can't read, you can't watch a movie,

00:54:39.880 | you can't do anything.

00:54:40.720 | So if you ever get sick

00:54:42.160 | and you just can't be bothered by anything,

00:54:44.620 | it's probably because you've had that fast response

00:54:47.380 | from the body, and you've also had this slower response

00:54:50.320 | where you literally have a set of tissues in your brain

00:54:52.920 | that are sending out these inflammatory signals,

00:54:56.260 | and now your whole brain is starting to cope

00:54:58.880 | or is trying to cope with this infection.

00:55:00.880 | So you've got a slow pathway and a fast pathway.

00:55:03.280 | That all sounds really terrible.

00:55:06.480 | So now I'd like to talk about what you can do

00:55:09.160 | to reduce the probability of getting sick,

00:55:12.500 | and there are actually things that one can do

00:55:16.600 | as you start to get sick and once you're sick

00:55:19.120 | to accelerate the healing process by flipping the equation.

00:55:23.320 | Up until now, we've been talking about how the body

00:55:26.200 | activates certain areas in the brain to create sickness

00:55:28.960 | behavior that's very much like depression.

00:55:30.920 | You're probably all familiar with this

00:55:32.080 | from any time you've had a cold or a flu

00:55:33.640 | or something really lousy or an injury.

00:55:35.900 | Now let's flip the equation and ask,

00:55:39.080 | what can we do with our nervous system

00:55:41.880 | in order to enhance the function of our immune system

00:55:45.120 | in order to be able to heal and recover

00:55:47.280 | from illness and injury more quickly?

00:55:49.560 | So let's say you are in that unfortunate circumstance

00:55:52.600 | of waking up one day or coming home

00:55:57.000 | and you've got that tickle in your throat,

00:55:59.980 | or when you breathe, your nasal passages

00:56:02.600 | don't feel the same way.

00:56:03.760 | You've got a little bit of a headache.

00:56:04.820 | You're feeling kind of off.

00:56:06.160 | We all know what we should do.

00:56:08.320 | We should all hydrate, drink some water and go to sleep.

00:56:12.080 | Right, that's what we are all told.

00:56:14.360 | But there are actually things that you can actively do

00:56:18.200 | in order to get your immune system

00:56:20.400 | to deploy a more robust response

00:56:23.860 | at that early phase of potential infection.

00:56:27.700 | Let's focus first on the rest component.

00:56:31.740 | Yes, of course, we are all told

00:56:34.520 | that we should take a hot shower and go to sleep

00:56:36.720 | and get nine or 10 hours of sleep,

00:56:38.700 | but there's an interesting way of looking at sleep

00:56:42.280 | specifically for its role in enhancing the immune system.

00:56:47.080 | And there's a wonderful review.

00:56:49.540 | I'll put the review in the captions

00:56:52.220 | that looked specifically at the literature

00:56:55.020 | surrounding sleep that is different

00:56:59.240 | because it occurs in support of the immune system.

00:57:02.720 | So normally when we go to sleep,

00:57:04.140 | we have slow wave sleep predominantly

00:57:05.640 | in the early phase of the night.

00:57:06.920 | And then over time, as we sleep longer and longer,

00:57:09.160 | we get more so-called REM, rapid eye movement sleep.

00:57:11.520 | Talked all about this on the episodes on sleep.

00:57:14.200 | Of course, you have slow wave sleep and REM sleep

00:57:16.200 | throughout the night always,

00:57:17.440 | but it's the fraction of slow wave sleep to REM sleep

00:57:19.580 | that shifts and they have different functions, et cetera.

00:57:22.860 | There is some evidence that the sleep

00:57:26.260 | associated with an infection,

00:57:29.120 | in particular early stage of infection,

00:57:31.660 | is associated with elevated levels of serotonin in the brain

00:57:36.220 | that either through an adaptive mechanism

00:57:39.140 | or for whatever reason, the brain,

00:57:41.500 | the neurons in the brain of the so-called raffae nucleus

00:57:43.920 | start releasing more serotonin.

00:57:46.740 | And that that serotonin and its related pathways

00:57:50.300 | can help enhance some of the immune system function

00:57:53.820 | that could combat the infection.

00:57:56.160 | There is starting to be some data,

00:57:59.540 | and I emphasize starting

00:58:00.920 | because it's not a very robust literature yet,

00:58:03.480 | looking at whether or not supplementing precursors

00:58:06.520 | to serotonin like 5-HTP,

00:58:09.240 | which can be taken in a supplement form,

00:58:12.480 | or consuming foods that increase serotonin naturally.

00:58:17.480 | So these would be any foods

00:58:19.300 | that contain high levels of tryptophan.

00:58:20.780 | You can look up what those are.

00:58:21.960 | So white meat, turkey, for instance,

00:58:25.160 | certain complex carbohydrates

00:58:27.480 | can often be rich with tryptophan.

00:58:30.440 | That consuming those foods can enhance

00:58:33.040 | the amount of serotonin that's available

00:58:34.660 | in the brain and blood,

00:58:35.980 | and thereby lead to the particular quality of sleep

00:58:39.200 | that allows for more deep healing,

00:58:41.440 | or for, when I say deep healing,

00:58:43.240 | I mean for a more robust immune response.

00:58:46.160 | Now, again, those are still emerging data.

00:58:49.880 | What is very clear, however,

00:58:52.040 | is that during sleep, and in particular during sleep,

00:58:55.200 | that's associated with the early stage

00:58:56.920 | of any kind of viral or bacterial infection,

00:58:59.620 | the so-called glymphatic system

00:59:02.480 | is much more active than it would be normally.

00:59:05.020 | What's the glymphatic system?

00:59:06.400 | The glymphatic system

00:59:07.400 | is actually a relatively recent discovery.

00:59:10.500 | I mentioned lymph and the lymphatic system earlier.

00:59:14.000 | The glymphatic system, with a G,

00:59:16.520 | is a system in the brain by which debris

00:59:20.080 | that accumulates throughout the day,

00:59:22.240 | but in particular debris that accumulates

00:59:24.940 | under conditions of neuroinflammation

00:59:27.200 | and inflammation of the body,

00:59:29.840 | is cleared out or is washed out of the brain.

00:59:33.080 | And the activity of this glymphatic system

00:59:36.280 | is extremely important

00:59:38.200 | for the recovery from infection of any kind.

00:59:41.780 | And it's now becoming clear,

00:59:43.880 | is important for recovery from traumatic head injury

00:59:46.820 | and maybe even from psychological trauma.

00:59:48.880 | So the glymphatic system can be thought of

00:59:52.320 | more or less as a plumbing system

00:59:53.680 | that runs through the ventricles,

00:59:55.160 | but also mainly through the lining

00:59:57.620 | that sits between the brain and the skull

00:59:59.680 | and some of the other tissues and things of that sort.

01:00:03.020 | The choroid is involved as well.

01:00:05.160 | Brain imaging reveals that the glymphatic system

01:00:07.220 | is very active during deep sleep

01:00:08.640 | and there's this kind of washout of the glymphatic system.

01:00:11.400 | And I'm aware of some studies that are ongoing now

01:00:14.440 | where augmenting the serotonin system

01:00:17.240 | through either supplementation of tryptophan or 5-HTP

01:00:21.680 | or even serotonin itself, these are laboratory studies,

01:00:24.600 | is being looked at for its capacity

01:00:26.080 | to increase the amount of circulation

01:00:28.520 | in the glymphatic system.

01:00:29.980 | And the idea is that it might, and I want to underscore,

01:00:32.600 | might potentially lead to more rapid recovery

01:00:35.600 | from injury and illness and potentially ramp up, if you will,

01:00:40.040 | the activity of the immune system.

01:00:41.820 | So it essentially is a ramping up

01:00:43.620 | of the activity of the immune system.

01:00:45.300 | Now, regardless of whether or not you decide to,

01:00:48.660 | for instance, supplement with 5-HTP before sleep or not,

01:00:52.060 | I'll talk about what that might look like in a moment,

01:00:54.260 | there is a way that you can increase the activity

01:00:56.440 | of your glymphatic system under normal circumstances.

01:01:00.160 | Because of the mechanics of the glymphatic system,

01:01:03.560 | it turns out that if you elevate your heels

01:01:06.720 | by about 12 degrees, it doesn't have to be exactly 12,

01:01:10.000 | as you sleep by putting maybe a rolled pillow

01:01:12.000 | or two pillows underneath your feet,

01:01:13.800 | by having the head below your legs,

01:01:17.460 | it seems that there's more glymphatic washout

01:01:20.080 | or clearance during sleep.

01:01:21.960 | And this is without taking any compound

01:01:23.600 | to adjust the serotonin system.

01:01:25.160 | So I would say, if you're not feeling well,

01:01:27.420 | yes, take the hot shower.

01:01:28.600 | Yes, get into bed and go to sleep,

01:01:30.640 | but elevate your feet to try

01:01:31.960 | and increase the activity of the glymphatic system.

01:01:34.660 | Some might even consider that if you have to be awake,

01:01:41.100 | that you might want to be awake with your feet elevated

01:01:43.960 | above your head.

01:01:45.000 | Now, that might not be practical for the workplace,

01:01:47.960 | but it might be practical for a short nap during the day

01:01:50.640 | or something of that sort.

01:01:51.780 | The glymphatic system is not just active during sleep,

01:01:54.280 | it's also active during certain phases of waking,

01:01:56.400 | in particular, when we are in a deep state of relaxation.

01:02:00.000 | So as many of you probably know, I'm a big proponent

01:02:03.200 | of self-hypnosis

01:02:04.800 | because of the quality scientific literature on this.

01:02:07.260 | If you're interested in self-hypnosis,

01:02:08.840 | you can go to Reveri, R-E-V-E-R-I.com.

01:02:11.960 | Reveri is a cost-free app for Apple and Android

01:02:15.960 | that was developed by my colleague, David Spiegel,

01:02:18.080 | and others at the Stanford University School of Medicine

01:02:20.380 | based on quality studies and peer-reviewed data,

01:02:23.240 | showing that deep states of relaxation

01:02:25.580 | can be used to improve pain management,

01:02:28.960 | improve transition time to sleep,

01:02:30.720 | and a number of other things.

01:02:32.400 | You can select the various sort of outcomes

01:02:36.040 | that you're seeking using Reveri.

01:02:37.920 | It's a great thing that,

01:02:39.320 | especially for people that are challenged

01:02:40.860 | with meditation could use

01:02:42.320 | because you just listen to the script,

01:02:43.560 | involves deep relaxation.

01:02:45.080 | I would suggest using that script,

01:02:47.640 | or the script for sleep,

01:02:48.800 | but with feet elevated to increase activity

01:02:50.800 | of the glymphatic system.

01:02:52.040 | Now, if you do decide that you want to test out

01:02:56.000 | this serotonin hypothesis on your own,

01:02:58.180 | obviously check with a doctor.

01:02:59.540 | I'm not a doctor, I'm a professor,

01:03:00.920 | so I'm professing things, not suggesting things.

01:03:02.720 | But 5-HTP is a supplement that I've talked about before

01:03:06.620 | on this podcast that I actually do not recommend

01:03:10.360 | for most people for sake of sleep,

01:03:12.400 | because it can disrupt the normal architecture of sleep

01:03:16.240 | and create a deep sleep early in the night,

01:03:18.540 | and then a spontaneous waking

01:03:19.980 | with some trouble to get back to sleep.

01:03:21.760 | And that's because of the way that the serotonin system

01:03:23.840 | and the melatonin system interact.

01:03:25.920 | However, under conditions where one is feeling

01:03:28.880 | like they might have an infection

01:03:30.200 | or an early stage of illness,

01:03:32.540 | in that case, 5-HTP might be a useful supplement

01:03:35.800 | in order to access these states of sleep

01:03:38.200 | that are not typical.

01:03:39.720 | They're not the typical deep sleep that you would achieve

01:03:42.820 | when you're feeling healthy.

01:03:43.880 | These are states of sleep that are specifically there

01:03:47.140 | in order to try and repair some of the immune system

01:03:50.420 | related inflammation that's occurring.

01:03:52.560 | If you'd like to explore the 5-HTP approach

01:03:55.700 | and you feel it's right and safe for you,

01:03:57.780 | and you've talked to your doctor,

01:03:59.560 | it's 300 to 500 milligrams taken about 30 to 60 minutes

01:04:03.420 | before going to sleep for the night.

01:04:06.360 | That's the typical protocol.

01:04:08.580 | Not incidentally,

01:04:10.440 | increasing serotonin is also one typical approach

01:04:15.740 | for the treatment of major depression.

01:04:17.080 | This is the basis for things like SSRIs,

01:04:19.960 | selective serotonin reuptake inhibitors,

01:04:21.840 | like Prozac and Zoloft and so forth.

01:04:26.440 | The 5-HT approach is a much milder approach

01:04:29.860 | than prescription drug, of course,

01:04:31.520 | but will allow more serotonin to be synthesized

01:04:36.240 | and/or released.

01:04:37.400 | Now, for those of you that are interested

01:04:39.900 | in learning more about the glymphatic system,

01:04:41.660 | it's a fascinating system,

01:04:43.140 | and you might want to do a deep dive there

01:04:44.820 | in terms of the behavioral protocols

01:04:46.360 | and what's known about it.

01:04:47.200 | There's a wonderful article called "The Glymphatic System,"

01:04:51.320 | a beginner's guide.

01:04:52.560 | This is a scientific article.

01:04:54.180 | The first author is Jessen is the last name, J-E-S-S-E-N.

01:04:59.480 | If you put in Jessen, the glymphatic system,

01:05:01.960 | a beginner's guide,

01:05:02.800 | you can access the full-length manuscript easily online.

01:05:05.300 | It'll show up immediately in your search.

01:05:08.240 | And in a really interesting way,

01:05:11.120 | the glymphatic system has now also been tied

01:05:14.480 | to the iron deposition system.

01:05:17.220 | Earlier, we were talking about iron

01:05:18.640 | and how, of course, getting enough dietary iron

01:05:21.080 | is important, but if levels of iron are too high,

01:05:23.960 | it isn't good for a number of reasons.

01:05:27.120 | There's a very interesting article

01:05:28.920 | that just came out last year

01:05:30.360 | called "Dysfunction of the Glymphatic System Might Be

01:05:34.140 | Related to Iron Deposition in the Normal Aging Brain."

01:05:38.000 | So we're starting to see these links

01:05:39.920 | between iron levels being too high,

01:05:42.640 | the glymphatic system not being active enough,

01:05:46.360 | and so forth, leading to sickness behavior,

01:05:49.760 | inflammation, and maybe even damage to neurons

01:05:52.480 | associated with aging.

01:05:54.080 | We can flip that on its head and say that

01:05:56.440 | increasing the activity of the glymphatic system,

01:05:58.920 | feet elevated during deep sleep,

01:06:01.440 | maybe even feet elevated above the head,

01:06:05.160 | while awake during a nap or doing a reverie script

01:06:09.400 | once a day or something of that sort,

01:06:11.400 | could increase the activity of the glymphatic system,

01:06:13.740 | lowering iron to a point that's probably below

01:06:18.880 | the typical intake during periods of infection,

01:06:22.720 | perhaps, perhaps I should say,

01:06:24.840 | can enhance the glymphatic system and vice versa.

01:06:27.480 | And then you've got this specialized sleep

01:06:30.440 | that's related to sickness behavior

01:06:32.700 | that seems to have heightened levels of serotonin

01:06:35.480 | that might be augmented by increasing, excuse me,

01:06:39.840 | that might be augmented by ingesting 5-HTP.

01:06:42.920 | Again, not on a regular basis.

01:06:44.880 | I don't suggest that people take compounds

01:06:47.060 | that increase serotonin unless it's prescribed to you

01:06:49.120 | for depression or something,

01:06:50.700 | but not doing it by supplement with tryptophan or 5-HTP

01:06:55.180 | on a regular basis, but only under conditions where,

01:06:57.720 | as I mentioned, you might be starting to feel sick

01:07:00.080 | or you're coming down with something

01:07:01.140 | or you're combating some sort of infection.

01:07:03.500 | So if we consider the advice that we typically get

01:07:06.680 | when we're not feeling well of take a hot shower,

01:07:08.600 | get into bed and go to sleep,

01:07:10.360 | and we've now touched on ways to potentially increase

01:07:14.420 | the efficacy of the sleep part through the glymphatic

01:07:17.120 | and the serotonin system.

01:07:18.480 | What about the take a hot shower part?

01:07:20.120 | Is that good advice?

01:07:20.940 | Well, it turns out it is,

01:07:21.780 | and there's actually a way to do even better.

01:07:24.080 | There's a study, very interesting study.

01:07:27.780 | The title reveals where I'm going with this.

01:07:29.640 | It's effect of a single finish sauna session

01:07:33.500 | on white blood cell profile and cortisol levels.

01:07:36.280 | In this case, it was done in athletes and non-athletes,

01:07:38.440 | which is kind of nice.

01:07:40.340 | This involves taking athletes and non-athletes

01:07:44.240 | and exposing them to sauna.

01:07:46.000 | It wasn't particularly hot.

01:07:47.720 | It was 96 degrees, which isn't cool, but it's not really hot.

01:07:50.960 | Nowadays, you hear about people doing very, very hot sauna.

01:07:53.840 | The humidity of the sauna, if you want to know,

01:07:55.480 | is 15 plus or minus 3%,

01:07:57.200 | but basically what they found was that just

01:07:59.640 | one 15-minute sauna session

01:08:01.280 | could really increase white blood cell profiles

01:08:03.520 | and could adjust cortisol levels in ways

01:08:05.960 | that were beneficial for combating infection.

01:08:08.760 | And now there are many other studies like this.

01:08:11.060 | Now, this should immediately make sense

01:08:12.940 | based on what we said before about fever.

01:08:14.540 | Heating up can actually help combat infection.

01:08:17.780 | But for those of you that have listened

01:08:18.920 | to the episodes on temperature,

01:08:20.820 | what you probably know is that when you get into a sauna

01:08:22.920 | or any kind of hot environment,

01:08:24.320 | your body is also going to be actively pushing

01:08:26.540 | to cool itself off.

01:08:28.160 | So there's probably an increase in heat,

01:08:30.720 | there is an increase in heating,

01:08:32.280 | that then afterwards your body will cool off,

01:08:34.320 | maybe even with a dip below baseline.

01:08:36.400 | I do want to provide a cautionary note

01:08:38.520 | that if you are already running a fever,

01:08:40.880 | getting into a sauna could take your body temperature

01:08:43.240 | into dangerously high levels,

01:08:44.740 | dangerously meaning you can kill neurons.

01:08:46.480 | And once you kill neurons, they do not come back.

01:08:48.960 | So please don't kill your neurons.

01:08:50.720 | I don't recommend getting into a sauna

01:08:53.900 | if you're already running a fever.

01:08:55.180 | So this would be something to do

01:08:56.900 | at the initial stage of an infection

01:08:58.600 | or if you're feeling a little bit off.

01:09:00.340 | So this is kind of a ramping up or a super protocol

01:09:04.020 | of the typical advice of take a hot shower

01:09:05.740 | and get into bed, that is good advice.

01:09:07.160 | Now we're talking about a hot sauna, probably showering off

01:09:11.440 | and then getting into bed, maybe augmenting serotonin.

01:09:14.320 | I know many people don't have access to sauna.

01:09:16.520 | So in that case, a very hot bath or shower,

01:09:19.600 | don't scald yourself of course,

01:09:21.100 | but as hot as you can comfortably tolerate

01:09:23.600 | or right at that edge of what you can tolerate

01:09:26.200 | would be a good idea.

01:09:27.360 | Some people I've heard are creating saunas

01:09:29.280 | in their bathrooms by running hot water

01:09:31.320 | and creating a ton of steam.

01:09:32.440 | Anything that really heats you up

01:09:35.520 | but not to dangerously high levels is going to be beneficial.

01:09:39.100 | If you have access to a sauna, terrific.

01:09:41.240 | This again was only 15 minutes.

01:09:44.820 | They'd had a cool off session.

01:09:47.800 | Would you get more of an increase?

01:09:50.160 | People always want to know if you did it twice as much,

01:09:51.920 | would you get twice increase?

01:09:53.380 | Those data don't really exist yet.

01:09:54.760 | However, if you are interested

01:09:56.360 | in maximizing the effects of sauna,

01:09:58.600 | it is clear that a cool off period is important.

01:10:01.540 | So it's not that a 15 minute sauna is good

01:10:04.320 | and a 30 minute sauna is better.

01:10:05.880 | If you are going to take that route of exploring more,

01:10:09.080 | it does seem that doing a 15 minute heating period

01:10:12.400 | followed by a five to 10 minute cooling period

01:10:14.600 | and then getting back into the heat can be beneficial.

01:10:18.600 | And this is interesting.

01:10:19.580 | It gets to the mechanisms by which the hypothalamus

01:10:23.400 | that areas, the areas of the hypothalamus that is

01:10:25.980 | that generate increases in body heat.

01:10:28.220 | The activation of those neurons occurs as you heat up.

01:10:32.560 | And then were you to just stay in that heated environment,

01:10:35.500 | they would actually shut off

01:10:36.680 | and some other neurons would be handling the job,

01:10:38.720 | so to speak.

01:10:39.640 | But by getting in and out of the heated environment,

01:10:42.180 | you actually force that system to send repeated pulses

01:10:45.420 | of these cortisol lowering

01:10:47.800 | and white cell stimulating signals to the body.

01:10:51.320 | Some of you have probably heard the phrase,

01:10:53.000 | feed a fever, starve a cold.

01:10:55.200 | I don't know who first said that.

01:10:57.920 | I couldn't find the citation, but we hear this

01:11:01.380 | and we can speculate that the reason that phrase,

01:11:05.440 | feed a fever, starve a cold came to be

01:11:08.140 | is because of the adaptive function of fever

01:11:10.740 | that increases in body temperature make it challenging

01:11:14.320 | for intruding viruses and bacteria to survive.

01:11:19.120 | Even though of course, highly elevated body temperatures

01:11:22.080 | pose a danger to the host organism, to you.

01:11:24.600 | Feeding, eating does cause an increase in body temperature

01:11:31.000 | through the so-called thermogenic effect of food.

01:11:33.440 | So I can understand the logic of feed a fever.

01:11:36.700 | It would mean that when you have a fever,

01:11:38.660 | it's your body's natural attempt to heat up

01:11:41.240 | and kill some invading thing.

01:11:44.100 | And by eating,

01:11:45.040 | you would further increase your body temperature.

01:11:47.900 | Why you would want to starve a cold, I don't know, however.

01:11:51.180 | Maybe it's because when your nasal passages are congested,

01:11:55.240 | it's uncomfortable to eat or something of that sort.

01:11:58.020 | So the feed a fever part makes sense to me

01:11:59.900 | that the starve a cold part is still mysterious to me.

01:12:02.860 | I couldn't find any logical reason why that would be good.

01:12:06.820 | There are communities out there that believe that fasting

01:12:09.800 | is a viable way to combat certain types of infection.

01:12:14.720 | Fasting, in particular prolonged fast,

01:12:18.340 | do increase the amount of adrenaline,

01:12:21.500 | also called epinephrine in the brain and body.

01:12:24.260 | And as we will next explain, epinephrine,

01:12:27.900 | adrenaline does have a powerful effect

01:12:31.020 | on the various inflammatory cytokines

01:12:33.220 | and on the immune system in general.

01:12:35.340 | So let's talk about a behavioral protocol

01:12:38.140 | that anyone can use.

01:12:39.160 | It doesn't involve any equipment.

01:12:40.660 | You don't need a sauna.

01:12:42.220 | You don't need anything at all that has been demonstrated

01:12:45.620 | in excellent peer reviewed research

01:12:47.540 | to enhance the function of the immune system

01:12:49.940 | and actually allow people to combat infection

01:12:52.900 | in very dramatic ways.

01:12:54.740 | Next, I'd like to do an in-depth analysis of a study

01:12:58.860 | that has achieved some prominence out there,

01:13:01.740 | not just in the scientific literature, but on the internet,

01:13:05.060 | because it relates to how particular types of breathing

01:13:09.480 | can impact the immune system

01:13:11.580 | and the ability to combat infection.

01:13:14.620 | The title of this paper is voluntary activation

01:13:17.820 | of the sympathetic nervous system

01:13:19.580 | and attenuation of the innate immune response in humans.

01:13:23.980 | This is a paper that was published in PNAS,

01:13:27.220 | which is the Proceedings

01:13:28.060 | of the National Academy of Sciences USA.

01:13:30.080 | It's a very prestigious journal.

01:13:32.180 | For those of you that know PNAS,

01:13:34.500 | you know that there are certain papers published in PNAS

01:13:37.580 | or there used to be that were not peer reviewed.

01:13:39.340 | In recent years,

01:13:40.180 | I think all of them have moved to peer reviewed papers.

01:13:42.300 | So this is a peer reviewed, very high quality study.

01:13:46.340 | And I just want to describe the basic contour of the study.

01:13:50.140 | I'll explain the findings,

01:13:51.340 | and then I want to go in depth

01:13:52.660 | and explain the mechanistic basis for these findings

01:13:55.780 | and the protocol that we can all export from these findings.

01:14:00.040 | So here we go.

01:14:01.820 | First of all, a couple of terms

01:14:04.480 | so that everybody is on the same page.

01:14:06.380 | The sympathetic nervous system

01:14:09.040 | is one division of our nervous system.

01:14:11.460 | It's a set of neurons down the middle of our spinal cord

01:14:14.680 | and in our brain that generally lead

01:14:17.900 | to a heightened state of arousal and alertness.

01:14:20.980 | It's associated with epinephrine release in the brain

01:14:23.520 | and adrenaline release in the body.

01:14:25.640 | It's the so-called fight or flight system

01:14:27.820 | when it's really active,

01:14:29.380 | but it's the system that's active when we are wide awake.

01:14:33.240 | And we already talked about the innate immune system.

01:14:37.820 | That's that first line of defense

01:14:39.620 | after the skin barrier, of course,

01:14:42.100 | whereby some infection comes into the body

01:14:44.620 | and there's this rapid response of increasing inflammation.

01:14:48.660 | And that's also about the time that you first feel lousy.

01:14:52.060 | So when you start to feel like,

01:14:52.900 | oh, I think I've got something.

01:14:54.140 | I don't feel right, a headache.

01:14:55.620 | I feel nauseous, I'm heating up.

01:14:57.840 | I don't feel good.

01:14:58.680 | That's the innate immune system kicking in.

01:15:02.900 | That's what they did in this study.

01:15:05.220 | And by the way, I should say they,

01:15:07.700 | this is the first author is Cox, K-O-X,

01:15:10.840 | last author, last name Pickers, P-I-C-K-K-E-R-S.

01:15:15.540 | What they did was they exposed human subjects

01:15:20.160 | to an endotoxin by, in other words,

01:15:23.700 | they injected people with E. coli.

01:15:26.300 | There's a bacteria which makes people,

01:15:29.400 | all people feel terrible.

01:15:31.300 | See nauseous, fever, vomiting, diarrhea, very unpleasant.

01:15:36.300 | These people voluntarily signed up for this study.

01:15:39.060 | However, some of the subjects in this study

01:15:43.580 | performed a behavioral protocol

01:15:47.140 | that can best be described as cyclic hyperventilation.

01:15:50.700 | My lab works on these types of breathing protocols.

01:15:53.180 | This is not work that my lab did,

01:15:54.620 | but basically subjects hyperventilate

01:15:57.800 | followed by breath retention, by breath holds.

01:16:00.100 | And I'll explain exactly what they did.

01:16:02.180 | They also looked at other forms of behavioral protocols,

01:16:05.560 | but let's focus on that one.

01:16:07.020 | So they're comparing controls

01:16:09.820 | that do just sort of a basic meditation

01:16:12.080 | versus people that do this intense breathing

01:16:14.400 | followed by some breath holds.

01:16:15.840 | I'm just paraphrasing here.

01:16:18.440 | In the intervention group, the breathing group,

01:16:20.480 | plasma levels of anti-inflammatory cytokine IL-10.

01:16:24.540 | So this is a cytokine that lowers inflammation,

01:16:27.720 | increased after endotoxin administration.

01:16:32.120 | And that was triggered by an increase

01:16:35.800 | in epinephrine and adrenaline.

01:16:37.060 | So in other words,

01:16:37.900 | doing a particular pattern of breathing

01:16:39.500 | allowed an anti-inflammatory cytokine to be turned on,

01:16:42.340 | whereas that was not the case in the subjects

01:16:45.420 | that did not do this particular breathing protocol.

01:16:49.860 | And they discovered that levels of pro-inflammatory

01:16:53.700 | TNF alpha, tumor necrosis factor alpha,

01:16:56.380 | IL-6, interleukin-6, and interleukin-8,

01:16:59.420 | which you should all be familiar with now,

01:17:01.240 | as pro-inflammatory cytokines

01:17:03.620 | were lower in the intervention group,

01:17:05.560 | whereas these IL-10 levels

01:17:07.760 | that are anti-inflammatory went up.

01:17:09.560 | Finally, flu-like symptoms

01:17:12.640 | were lower in the intervention group.

01:17:14.480 | So this is an amazing finding, right?

01:17:16.740 | These are human subjects.

01:17:18.320 | One group of subjects is doing this breathing protocol.

01:17:21.280 | The other group of subjects is just meditating.

01:17:23.420 | They both, both sets of subjects

01:17:25.320 | have been injected with E. coli.

01:17:28.520 | So you know everyone's getting the same amount

01:17:31.520 | placed into their system.

01:17:33.480 | This is very, very interesting.

01:17:35.720 | And it leads to the question that every good scientist,

01:17:38.960 | two-year-old, or health information seeker asks,

01:17:41.280 | which is why, how?

01:17:43.500 | How in the world does this work?

01:17:44.760 | Why does this work?

01:17:45.960 | Well, to make a long story short-ish,

01:17:49.720 | because I am going to go into depth here,

01:17:52.000 | the reason it works is because

01:17:53.960 | the sympathetic nervous system,

01:17:55.880 | the so-called stress part of our nervous system,

01:18:00.780 | it's not really called that,

01:18:01.640 | but the part of our nervous system that triggers stress

01:18:04.120 | from mild stress to severe stress, even to panic,

01:18:07.420 | causes the release of adrenaline and epinephrine

01:18:11.360 | in the brain and body.

01:18:13.040 | And under normal circumstances,

01:18:15.260 | when we have some sort of invading infection,

01:18:18.480 | our body is able to push back on that,

01:18:20.960 | to resist it by engaging the stress response.

01:18:23.920 | So what's happening here is there's a behavioral protocol

01:18:27.940 | involving the nervous system,

01:18:29.440 | 'cause all behaviors are generated

01:18:30.640 | from the nervous system, of course,

01:18:32.360 | a behavioral protocol that people are deliberately employing

01:18:36.200 | that allows them to activate the sympathetic nervous system,

01:18:39.800 | which in turn allows them to activate the normal pathways

01:18:43.580 | by which immune system function is enhanced, okay?

01:18:48.320 | Now, the reason I'm underscoring this

01:18:50.480 | is that the common interpretation of this study

01:18:53.260 | is that somehow it blocks the normal immune response,

01:18:57.880 | but that's not really what's happening here.

01:18:59.740 | Yes, there's a reduction in inflammatory cytokines

01:19:03.500 | and there's an increase in anti-inflammatory cytokines,

01:19:06.380 | but that's not really the same thing

01:19:08.300 | as blocking the immune response.

01:19:10.580 | This could just as easily be viewed

01:19:12.460 | as enhancing the immune response

01:19:14.080 | and combating the intruder, in this case, E. coli.

01:19:18.100 | So let's parse this study a little bit more closely.

01:19:21.920 | First of all, what is this magical pattern of breathing?

01:19:24.880 | Some of you may recognize this

01:19:26.300 | as so-called Wim Hof breathing.

01:19:28.100 | Wim, of course, the Dutchman,

01:19:29.780 | I think his occupation online used to be listed as Daredevil,

01:19:32.660 | believe it or not, on Wikipedia.

01:19:34.060 | That's a pretty cool occupation.

01:19:37.340 | Wim is best known for his activities with cold exposure.

01:19:42.340 | He holds multiple world records for that,

01:19:44.980 | swimming under icebergs and other incredible feats

01:19:48.460 | that you definitely don't want to try

01:19:50.780 | unless you're extremely skilled

01:19:52.380 | and really know what you're doing as he does,

01:19:54.700 | but also for the use of breath work.

01:19:56.860 | The breathing that is so-called Wim Hof breathing

01:20:00.400 | is very similar, not exactly the same,

01:20:02.340 | but very similar to Tummo breathing

01:20:05.380 | as it's been described historically.

01:20:07.380 | In the science and physiology community

01:20:09.720 | and in my laboratory, because I run a university laboratory,

01:20:12.540 | we refer to it as cyclic hyperventilation,

01:20:14.620 | which just means repeated deep breaths in and out,

01:20:17.900 | and then there are these retention.

01:20:19.340 | So I'm, because I'm here in the hot seat anyway,

01:20:23.100 | I might as well demonstrate it for you

01:20:24.860 | so you know what this looks like.

01:20:26.120 | There are variations on this.

01:20:27.380 | So with respect to Wim, with respect to Tummo practitioners,

01:20:31.080 | with respect to the cyclic hyperventilators everywhere,

01:20:34.100 | this is one general theme of it.

01:20:35.980 | It involves 20 to 30 deep inhales

01:20:40.380 | and then exhales through the mouth,

01:20:42.820 | followed by a exhale of all one's air and a breath hold.

01:20:47.740 | That's the retention.

01:20:49.780 | And then at some point, 15 to 60 seconds later,

01:20:53.300 | repeating the 25 or 30 breaths,

01:20:55.460 | and then again, a breath hold with lungs empty.

01:20:59.020 | There are variations on this,

01:21:00.440 | but in our laboratory and in this particular study,

01:21:04.460 | it looks something like this, okay?

01:21:05.940 | I'm not going to do the whole thing right now,

01:21:07.360 | but it goes something like this.

01:21:09.100 | [inhales and exhales]

01:21:12.260 | Okay, so let's assume I did that for 30 breaths.

01:21:20.900 | I can already feel myself perspiring a little bit.

01:21:23.820 | You're heating up, that's the release of adrenaline.

01:21:26.220 | It's caused by that breathing pattern.

01:21:27.560 | And then exhaling all of one's air,

01:21:28.980 | no speaking in between like I'm doing.

01:21:30.860 | [exhales]

01:21:33.020 | And then sitting, lungs empty,

01:21:37.780 | until one feels the impulse to breathe,

01:21:39.820 | and then repeating for several rounds,

01:21:42.100 | two or three or even four rounds.

01:21:43.720 | Now, some people will also introduce

01:21:45.900 | a big inhale and breath hold at the end

01:21:48.420 | and find that indeed they can hold their breath

01:21:50.740 | much longer than they normally would be able to,

01:21:53.000 | because the trigger to breathe is normally activated

01:21:56.580 | by increases in carbon dioxide.

01:21:59.240 | In our blood, we have neurons in our brain stem

01:22:01.540 | and in our various regions of our brain, actually,

01:22:04.220 | that respond to when carbon dioxide is too high

01:22:07.200 | and trigger the reflex to breathe.

01:22:08.700 | But when we exhale deeply,

01:22:10.940 | we blow off a lot of carbon dioxide

01:22:12.820 | so we don't feel that impulse to breathe come quite as soon.

01:22:15.820 | Basically, this study looked at people doing

01:22:21.020 | these cyclic hyperventilation with retention,

01:22:24.400 | 25 or 30 breaths, then the retention,

01:22:26.700 | 25 or 30 breaths, then retention, 25 or 30 breaths,

01:22:29.520 | then the retention.

01:22:30.360 | So three rounds of 25 to 30 breaths

01:22:32.360 | followed by exhale hold in between of various duration,

01:22:37.160 | but in general, 15 to 60 seconds is typical.

01:22:40.940 | What happened physiologically?

01:22:43.400 | This is one of the reasons I like this study.

01:22:46.280 | What happened physiologically?

01:22:47.780 | Well, a couple of things.

01:22:49.460 | Of course, blood oxygenation drops.

01:22:52.740 | You would expect that based on hyperventilation

01:22:55.360 | and especially based on the exhale

01:22:56.820 | of so much carbon dioxide.

01:22:58.100 | We could explain why that is,

01:22:59.200 | but blood levels of oxygen drop.

01:23:03.540 | The pH, the alkalinity of the body goes way up.

01:23:08.540 | This is very interesting.

01:23:10.100 | If you look up this paper,

01:23:11.380 | you can look at figure one, panel C.

01:23:13.500 | The pH goes way up.

01:23:14.700 | People become alkaline.

01:23:15.800 | You've heard before of alkaline water.

01:23:18.220 | I hate to say this.

01:23:19.060 | I probably lose some friends for this,

01:23:20.540 | but yeah, don't waste your money on drinking alkaline water.

01:23:24.100 | You can't really shift the alkalinity of your body.

01:23:27.380 | There are cases where some compartment in your body

01:23:30.300 | needs to be more alkaline than the rest.

01:23:31.920 | Your gut is a different alkalinity

01:23:33.500 | than other areas of your body, et cetera,

01:23:35.780 | but ingesting high alkaline water

01:23:38.260 | isn't going to shift your overall alkalinity.

01:23:41.300 | If someone can send me a quality reference

01:23:43.120 | that shows different,

01:23:44.900 | then I'm happy to revise that statement,

01:23:46.420 | but in any case, doing that pattern of breathing

01:23:49.720 | that I just described greatly increases the pH.

01:23:52.500 | Greatly, I should say,

01:23:53.700 | it doesn't send it off into dangerous levels.

01:23:55.320 | It takes it from 7.4 to 7.6,

01:23:57.400 | which is a significant increase in alkalinity.

01:24:01.220 | So as pH levels,

01:24:03.460 | for those of you who remember high school

01:24:04.580 | or college chemistry,

01:24:06.060 | as the numbers on the pH go down,

01:24:08.700 | you're becoming more acidic.

01:24:10.140 | As they go up, you're becoming more alkaline, okay?

01:24:12.980 | Or more basic.

01:24:14.060 | So the subjects went from 7.4 to 7.6 during the breathing,

01:24:18.900 | and then afterwards it returned to normal.

01:24:20.660 | But that shift in alkalinity

01:24:22.780 | is thought to be important here.

01:24:24.920 | So what's going on here?

01:24:25.860 | How is the breathing leading to these shifts in,

01:24:30.660 | or I should say reduction in inflammatory cytokines

01:24:35.060 | and an increase in the liberation

01:24:38.740 | of these anti-inflammatory cytokines?

01:24:41.220 | Well, the authors make some good arguments

01:24:43.420 | as to why it's not the shift in pH per se,

01:24:47.740 | or the shift in carbon dioxide levels in the blood,

01:24:51.980 | but rather it's the release of epinephrine.

01:24:54.580 | There's some good reason to believe why that's the case.

01:24:57.700 | It's beyond the scope of this discussion,

01:24:59.140 | but that it's actually the release of epinephrine,

01:25:02.260 | AKA adrenaline,

01:25:03.780 | that's causing this reduction in inflammation.

01:25:07.140 | And that's actually supported

01:25:10.580 | by something that you've probably experienced before,

01:25:13.340 | which is if you've ever worked, worked, worked,

01:25:15.140 | worked really hard,

01:25:16.020 | or you've been a caretaker for somebody else

01:25:18.180 | or studying for exams and people around you are getting sick

01:25:21.540 | and you're just powering through it

01:25:23.660 | and you're not getting sick, but then you stop,

01:25:25.900 | you turn in your final exam,

01:25:27.520 | you stop taking care of somebody else,

01:25:29.880 | or you finally stop and rest or you go on vacation

01:25:32.300 | and then you get sick.

01:25:34.020 | Well, you've just experienced the effect

01:25:37.860 | that adrenaline, epinephrine can have

01:25:40.120 | in activating your immune system

01:25:42.000 | by way of the nervous system

01:25:44.000 | in order to keep fighting and combating infection.

01:25:47.680 | And that brings us to a larger theme,

01:25:49.440 | which is that stress and combating infection or a wound

01:25:52.940 | is not one unique system.

01:25:56.460 | It's the same stress system

01:25:57.740 | that you use to combat psychological stress.

01:26:00.080 | So when you're very, very stressed,

01:26:01.800 | at least in the short term,

01:26:03.620 | because you release so much adrenaline and epinephrine,

01:26:06.640 | you're actually better able to combat infections

01:26:09.300 | and you reduce inflammation

01:26:10.680 | and the whole feeling lousy response, right?

01:26:12.580 | Remember, reduced flu-like symptoms here.

01:26:14.780 | So this pattern of breathing is actually a very useful tool.

01:26:18.060 | And I confess, I use this pattern of breathing

01:26:19.920 | anytime I am at the initial stages

01:26:22.560 | of getting some sort of bug.

01:26:23.760 | If I feel like I've been running myself ragged

01:26:26.400 | or if I somehow, for whatever reason,

01:26:28.440 | have a tickle in my throat

01:26:29.720 | or I have that kind of sensation in my nose,

01:26:31.900 | like I might've caught a bug of some sort,

01:26:35.300 | I will do this pattern of breathing.

01:26:37.740 | I've been doing it consistently,

01:26:39.300 | gosh, for the last four years or more.

01:26:41.680 | Now, this is just anecdotal reports,

01:26:45.140 | but I find that it allows me, indeed,

01:26:47.880 | to either have those early symptoms disappear

01:26:51.700 | or it allows me to just kind of push through

01:26:54.540 | and harder longer.

01:26:55.740 | I don't suggest people continue to push through

01:26:59.260 | exposure to infections.

01:27:00.580 | Obviously, you don't want to infect other people,

01:27:03.080 | nor do you want to crash

01:27:04.340 | and suddenly get a massive illness of some sort

01:27:07.220 | because you stopped doing this breathing.

01:27:09.100 | But I do think it's a useful tool.

01:27:10.780 | It's a purely behavioral intervention

01:27:13.140 | that has been shown here.

01:27:15.160 | And now there are additional studies on the way

01:27:17.800 | to enhance the function of your immune system

01:27:21.140 | and to reduce inflammation.

01:27:22.700 | And this is, to me, one of the most concrete examples

01:27:26.060 | of a zero cost tool that bridges the activation

01:27:31.060 | of the nervous system through breathing

01:27:33.840 | with the immune system by way of releasing adrenaline

01:27:38.180 | and thereby reducing the terrible effects

01:27:41.660 | or feelings of lousiness from a,

01:27:45.600 | in this case, an E. coli infection.

01:27:48.020 | Now, I'd like to focus on a couple of important points

01:27:52.220 | that I haven't heard discussed broadly elsewhere,

01:27:55.800 | which is that the hyperventilation

01:27:58.620 | and the breath retention are both important.

01:28:01.640 | So you can't simply hyperventilate to get this effect

01:28:06.700 | at the level of epinephrine release

01:28:09.180 | and reduction in inflammatory cytokines.

01:28:11.820 | It's been shown before that the hyperventilation phase

01:28:15.220 | and the hypoxia, which is a kind of low oxygen saturation

01:28:19.900 | due to the breath retention,

01:28:21.980 | they both combine to increase epinephrine adrenaline levels.

01:28:26.080 | So you have to do the 25 or 30 breaths

01:28:30.000 | and then the retention, 25 or 30 breaths,

01:28:32.200 | then the retention, meaning that the exhale

01:28:34.100 | with the breath hold in order to get the full effect.

01:28:36.700 | I also want to provide a critical cautionary note.

01:28:39.780 | Don't do this anywhere near water or while driving a car.

01:28:43.700 | These things might seem kind of obvious,

01:28:45.580 | but obviously in the off chance that you black out

01:28:49.700 | or something like that, it could be disastrous.

01:28:51.260 | So please be careful.

01:28:53.340 | And again, don't try and push the breath hold.

01:28:56.540 | The moment you feel the impulse to breathe, just breathe.

01:28:58.940 | And it did seem that the three rounds

01:29:01.020 | of 25 to 30 breaths with interventions, excuse me,

01:29:04.360 | with breath hold retentions in between

01:29:06.600 | was the ideal protocol.

01:29:08.500 | There's one last very interesting feature of this study

01:29:11.580 | that I want to emphasize.

01:29:12.940 | And that was that they actually measured

01:29:15.460 | the so-called catecholamine concentrations.

01:29:17.980 | Catecholamines are things like dopamine, epinephrine,

01:29:20.660 | norepinephrine, these are chemicals in your nervous system

01:29:25.220 | and body that promotes states of alertness.

01:29:28.580 | Dopamine of course, part of the reward and motivation

01:29:31.140 | pathways.

01:29:32.720 | They explored the levels of these molecules in blood,

01:29:36.100 | in plasma, during and after this breathing protocol.

01:29:41.100 | And as interesting, as I mentioned before,

01:29:43.180 | epinephrine showed robust increases compared

01:29:45.500 | to the control group.

01:29:46.520 | Norepinephrine, significant increases occurred

01:29:49.480 | in the breathing group, but in the cyclic hyperventilation

01:29:53.660 | retention breathing group, of course, but less so.

01:29:57.900 | And dopamine levels actually dropped somewhat.

01:30:01.600 | But this is very interesting because there's a new

01:30:04.860 | and emerging literature, largely from ISA, A-Y-S-A,

01:30:09.860 | Rolle's lab in Israel.

01:30:13.380 | What her laboratory has shown is that motivational state

01:30:18.380 | and mindset has a powerful impact on various aspects

01:30:24.340 | of the immune system that were thought to be independent

01:30:27.220 | of the brain and mind and thinking.

01:30:29.380 | So this brings us back to something that we discussed

01:30:32.840 | at the very beginning of this episode,

01:30:34.220 | which is that 20, 30 years ago,

01:30:37.140 | the idea that you could heal the body with the mind

01:30:39.420 | was considered kind of quackery.

01:30:41.500 | I think that there was an intervening period up until now

01:30:45.300 | where people might've said, sure, if you're stressed out,

01:30:48.100 | it's going to make things worse.

01:30:49.180 | I mean, I think everyone agrees that stress

01:30:50.920 | makes everything worse at some level.

01:30:54.280 | Outcomes to neurodegeneration, performance

01:30:57.240 | in physical endeavors and mental endeavors.

01:31:00.480 | If stress is too high for too long,

01:31:04.360 | people experience different challenges

01:31:07.460 | and essentially every major psychiatric disorder,

01:31:09.880 | everything suffers.

01:31:11.020 | But in the short term, stress can actually be beneficial

01:31:13.880 | in the ways that we just described.

01:31:15.180 | And stress, if we break it down,

01:31:18.220 | is really a neurochemical state, right?

01:31:20.840 | It's the release of these catecholamines.

01:31:23.280 | And what ISA roles as laboratory has shown

01:31:26.720 | is that when the so-called dopamine system,

01:31:29.880 | and at several episodes I described

01:31:31.240 | there are multiple dopamine systems,

01:31:32.720 | but the so-called mesolimbic reward pathway

01:31:35.260 | involving areas like the nucleus accumbens, et cetera,

01:31:38.800 | when the reward system that's associated with dopamine

01:31:43.540 | and norepinephrine is activated,

01:31:45.980 | you see incredible effects, including for instance,

01:31:51.760 | highly significant reduction in tumor size in cancers.

01:31:55.920 | Now, why would that be?

01:31:57.520 | How is it that mindset, dopamine and tumor growth

01:32:02.520 | are somehow linked?

01:32:03.600 | We now know how this occurs,

01:32:06.200 | largely through the incredible work of ISA roles and others.

01:32:09.180 | So now I'd like to turn our focus to how it is specifically

01:32:13.120 | that certain mindsets impact the immune system

01:32:17.280 | in ways that we can actually point

01:32:18.460 | to specific biological pathways

01:32:20.160 | and also specific protocols related to mindset.

01:32:23.720 | I guess a simple way to frame all this would be to say

01:32:27.640 | that most of us are aware that yes, indeed,

01:32:30.160 | you can worry yourself sick.

01:32:32.340 | We've been told that.

01:32:33.180 | You're going to worry yourself sick.

01:32:35.120 | And actually there was a paper published in Science,

01:32:37.800 | again, one of the top three journals out there,

01:32:39.920 | the top three really being Nature, Science and Cell,

01:32:43.120 | and then other, of course, excellent journals exist.

01:32:45.520 | But this was a paper that came out in Science last year.

01:32:49.440 | First author is Kataoka, K-A-T-A-O-K-A,

01:32:53.520 | describing psychogenic stress and fever.

01:32:58.480 | So this was looking or asking the question,

01:33:01.360 | are there areas of the brain that actually underlie

01:33:05.060 | this notion that we can worry ourselves sick?

01:33:07.960 | And they discovered a new pathway

01:33:09.840 | and they were able to both activate this pathway

01:33:12.660 | independent of worry and stress and see illness occur.

01:33:16.240 | And they were able to inhibit this pathway,

01:33:18.160 | block activity in this neural pathway

01:33:20.220 | and prevent psychogenic fever

01:33:22.840 | and the worrying of oneself sick.

01:33:26.120 | So they were able to do this in a very controlled way.

01:33:29.760 | I'll just mention the pathway

01:33:30.920 | in case you want to look it up in more detail.

01:33:34.260 | This is a corticolimbic pathway.

01:33:37.520 | So for just to orient us,

01:33:39.980 | the cortex is more or less the outer shell of the brain.

01:33:42.720 | It's involved in thinking and sensation

01:33:44.560 | and perceptions and learning

01:33:46.520 | and maintenance of a lot of memories are stored there.

01:33:49.040 | We all hear that you learn and remember in the hippocampus.

01:33:52.760 | That's the initial side of learning and memory.

01:33:55.040 | But then that information, believe it or not,

01:33:56.620 | is passed off to the cortex where it's stored

01:33:58.460 | in kind of a long-term hard drive type storage.

01:34:01.840 | So the corticolimbic pathway is one in which your thoughts,

01:34:06.840 | your prior experiences can literally in a structural way

01:34:11.200 | feed down onto the areas of the brain

01:34:13.720 | that control very basal processes,

01:34:15.800 | including temperature regulation.

01:34:17.080 | So this is a corticolimbic hypothalamic pathway.

01:34:20.320 | We talked earlier about the hypothalamus

01:34:21.680 | as controlling temperature

01:34:22.660 | and a lot of sickness-related behavior, right?

01:34:25.160 | Remember, vagus up to the hypothalamus

01:34:26.840 | and all the sleep more, less appetite, fever, okay?

01:34:30.000 | That's all in the hypothalamus.

01:34:31.400 | This is a top-down corticolimbic hypothalamic pathway,

01:34:36.400 | and it has a fancy name.

01:34:38.040 | It's the dorsopeduncular cortex, dorsotonia tecta.

01:34:42.880 | The short of that is the DPDTT.

01:34:44.880 | So let's just call it the DPDTT

01:34:46.920 | to the dorsomedial hypothalamus.

01:34:49.800 | Not a lot of Ds.

01:34:51.160 | It shouldn't mean anything.

01:34:53.320 | Doesn't really matter what we call it,

01:34:55.160 | but what's important is conceptually,

01:34:59.040 | it's a pathway that originates in sites of the brain

01:35:02.400 | that are associated with thinking,

01:35:04.800 | with emotion and with prior history,

01:35:07.440 | and feeds directly into an area of the brain

01:35:09.380 | that's involved in basic physiological

01:35:11.460 | subconsciously controlled processes.

01:35:13.640 | So that's incredible, right?

01:35:15.240 | And it points to a physical pathway

01:35:18.300 | by which the way we think about something

01:35:20.600 | changes something core about our physiology.

01:35:23.720 | Now, in some ways that shouldn't be surprising, right?

01:35:25.680 | If you think about something that excites you,

01:35:27.360 | your heart rate can increase.

01:35:28.820 | You think about something that terrifies you,

01:35:30.040 | your heart rate can increase.

01:35:31.060 | So the idea that thinking controls our physiology

01:35:33.560 | is not a new concept at all,

01:35:35.280 | but somehow human beings,

01:35:38.420 | we have been challenged with the idea

01:35:41.360 | that we could actually think ourselves into being sick.

01:35:44.640 | But this paper from Kataoka shows that

01:35:48.160 | if you expose somebody to a psychological stress,

01:35:52.320 | you can actually activate this pathway and create a fever.

01:35:56.440 | And how did they do that?

01:35:57.280 | Well, you can do this by exposing subjects

01:35:59.720 | to a very stressful real event

01:36:02.920 | and you cue it through associative learning.

01:36:05.040 | So maybe like my pilot V5s, which I love so much,

01:36:07.960 | we could traumatize me to the pilot V5

01:36:10.280 | if I had some horrible experience happen to me

01:36:11.880 | while I'm looking at and concentrating on the pilot V5,

01:36:14.480 | then you take away the horrible experience,

01:36:15.980 | you give me the pilot V5,

01:36:17.220 | and I start to experience a lot of the symptoms

01:36:19.880 | associated with that terrible event.

01:36:22.360 | They were able to do this

01:36:23.320 | using sickness-inducing stimuli and so forth.

01:36:26.600 | They did all the various derivations

01:36:29.280 | and identified this pathway that when activated,

01:36:33.100 | even in the absence of some horrible event,

01:36:35.160 | could create fever and illness-like behavior and so forth.

01:36:39.800 | And if they blocked certain stations

01:36:42.540 | along this neural pathway, they could block that effect.

01:36:44.560 | So this is really concrete evidence, proof, if you will,

01:36:48.320 | that there are dedicated pathways in the mammalian brain,

01:36:51.280 | your brain and mine,

01:36:52.760 | that allow us to turn thoughts into illness.

01:36:55.620 | That's kind of a depressing idea.

01:36:58.240 | What about the inverse?

01:36:59.520 | What about turning thoughts into health?

01:37:02.260 | Well, that's the work of ISA roles.

01:37:05.600 | They explored the well-established psychological phenomenon

01:37:10.600 | that when cancer patients or very ill people

01:37:15.600 | or people who are suffering from very debilitating injuries,

01:37:18.600 | when they had or when people had or reported a sense of hope,

01:37:23.600 | their rates of recovery were much higher, right?

01:37:26.660 | Sounds very subjective.

01:37:29.640 | But what is a sense of hope?

01:37:32.040 | A sense of hope is a sense of the future.

01:37:34.840 | A sense of the future is tightly associated

01:37:36.960 | with the dopamine system.

01:37:38.640 | Dopamine, again, being this molecule of reward

01:37:40.940 | and motivation and movement,

01:37:42.880 | but movement and motivation are about things

01:37:47.880 | that are beyond the confines of our skin

01:37:49.800 | and are about the future.

01:37:51.400 | And so what they've discovered and through other studies

01:37:54.120 | from other groups have discovered is that stimulation

01:37:57.360 | of the dopamine pathway,

01:37:58.520 | either simply by thinking about a future,

01:38:02.120 | ideally a positive future,

01:38:04.380 | but thinking about a positive future leads to activation

01:38:07.060 | of this so-called mesolimbic reward pathway

01:38:09.560 | and could reduce the size of tumors,

01:38:11.720 | could accelerate wound healing,

01:38:13.560 | could greatly accelerate the passage from a state of illness

01:38:18.340 | to a state of health and wellbeing.

01:38:21.200 | So there are many, many studies now starting

01:38:24.020 | to wick out related to this.

01:38:27.240 | There's also the idea that augmenting the dopamine system

01:38:30.700 | can increase the rate of healing.

01:38:33.200 | And so there are individuals out there who opt, for instance,

01:38:36.680 | to take things that increase dopamine.

01:38:38.820 | Now, obviously drugs of abuse would not be a good idea

01:38:42.220 | in this context, even though they increase dopamine,

01:38:44.240 | they lead to big crashes,

01:38:45.300 | they have addictive properties, et cetera.

01:38:48.000 | I've talked before on this podcast about things

01:38:50.000 | like L-tyrosine, take it anywhere from 500

01:38:53.440 | to 750 milligrams, can increase dopamine

01:38:57.420 | because tyrosine is a dopamine precursor, of course,

01:39:00.100 | things like micuna purines, which are L-DOPA,

01:39:02.060 | the immediate precursor to dopamine.

01:39:04.200 | Some of these will lead to somewhat of a crash

01:39:06.460 | in certain individuals,

01:39:08.420 | other people tolerate them a little bit better.

01:39:10.560 | Again, you have to talk to your doctor,

01:39:11.820 | you have to figure out what's right for you.

01:39:13.120 | If you have bipolar or mania or schizophrenia,

01:39:16.200 | these things are, I would not recommend them at all.

01:39:19.240 | I'm not recommending them all,

01:39:20.360 | I'm just mentioning them for potential exploration

01:39:22.600 | if it's safe and right for you.

01:39:24.200 | But the point is this, the dopamine system,

01:39:27.420 | when activated, can accelerate healing.

01:39:30.140 | It can accelerate the recovery from injury of all kinds.

01:39:34.160 | And that shouldn't come as a mystery

01:39:37.420 | or a surprise result to us.

01:39:39.460 | It's because this reward pathway

01:39:41.920 | and the fact that it's related to a sense of the future

01:39:45.160 | seems to liberate entire systems within the body

01:39:48.400 | that make inflammatory cytokines go down

01:39:52.760 | and anti-inflammatory cytokines go up,

01:39:55.580 | exactly as was demonstrated in the beautiful PNAS study

01:40:00.300 | where breathing, cyclic hyperventilation,

01:40:04.000 | was used to increase epinephrine, increase norepinephrine,

01:40:07.600 | and to augment the catecholamine system.

01:40:10.760 | So I think that the bridges between these studies

01:40:14.560 | are really relevant.

01:40:15.400 | In one case, I'm talking about potentially

01:40:17.160 | taking an over-the-counter compound

01:40:19.340 | to increase dopamine to accelerate healing.

01:40:21.240 | In another case, we're talking about using breathing.

01:40:24.340 | There's also the use of cold water exposure

01:40:27.620 | to increase dopamine.

01:40:28.540 | I talked about this several episodes ago,

01:40:30.260 | but it's been shown that cold water,

01:40:32.000 | immersing oneself in cold water up to the neck or so,

01:40:34.960 | how cold?

01:40:35.800 | Well, it depends on what you can tolerate,

01:40:37.000 | but uncomfortably cold,

01:40:38.280 | but not so cold that you become hypothermic.

01:40:40.160 | But where it's challenging to get in,

01:40:42.840 | but you can stay there for three to 10 minutes or so,

01:40:46.240 | has been shown to lead to very significant doubling or more

01:40:51.560 | of baseline dopamine levels and epinephrine levels

01:40:54.640 | that go on for several hours.

01:40:56.840 | This may be the basis for why people will do cold showers

01:41:01.180 | or ice baths and then get into a sauna,

01:41:03.080 | so what's called contrast, cold heat contrast therapy,

01:41:06.860 | as a way to augment these neurotransmitters.

01:41:09.300 | Today, we've been talking about how these neurotransmitters

01:41:11.160 | can be used to enhance the function of the immune system.

01:41:14.900 | And so just keep in mind that anytime you're talking about

01:41:17.820 | increasing neurotransmitter levels,

01:41:19.300 | that can be done pharmacologically through supplementation,

01:41:22.140 | or it can be done behaviorally through exposure

01:41:24.500 | to cold water, for instance,

01:41:26.300 | or it can be done even just simply by breathing

01:41:29.180 | in a particular way,

01:41:30.060 | cyclic hyperventilation followed by retention.

01:41:32.860 | The catecholamines, noradrenaline, dopamine,

01:41:36.380 | and norepinephrine are the bridge of activation

01:41:39.740 | for the immune system and the nervous system.

01:41:42.340 | They are the way that the nervous system calls out

01:41:44.460 | to the immune system.

01:41:46.780 | Aha, we have a problem, we need to counter this.

01:41:49.260 | So you can think of them, them meaning dopamine,

01:41:53.020 | epinephrine, and norepinephrine,

01:41:54.860 | as being able to deploy larger amounts of immune cells,

01:41:59.860 | all the types of immune cells that we talked about

01:42:02.060 | at the beginning of the episode.

01:42:04.080 | Okay, so thus far, we've been discussing

01:42:06.940 | how one can prevent getting sick

01:42:09.860 | or when one starts to feel ill,

01:42:12.700 | how one might be able to shorten the course

01:42:14.660 | of that infection by ramping up the activity

01:42:17.380 | of the immune system.

01:42:18.940 | But what about when you're already experiencing symptoms,

01:42:22.400 | the runny nose, stuffed up nose, congestion, headache,

01:42:26.580 | et cetera?

01:42:27.820 | Well, there are many ways to address that

01:42:30.380 | at the symptom level.

01:42:31.560 | You're probably aware of all the over-the-counter

01:42:34.040 | medications, many of which focus on the epinephrine system.

01:42:39.040 | Things that are of the Sudafed variety prevent

01:42:43.140 | or reduce congestion because of the way

01:42:46.020 | that they cause release of epinephrine.

01:42:48.500 | And some of the effects on dilating the bronchioles

01:42:52.160 | and dilating the nasal passages and so forth.

01:42:54.500 | I'm not going to speak to whether or not

01:42:57.460 | those are good or bad choices.

01:42:59.140 | They do have a couple of effects that are not so great

01:43:02.120 | for the course of treating the underlying cause,

01:43:05.620 | which are, first of all, they can cause dehydration.

01:43:09.120 | So you have to make sure that you're hydrating well

01:43:10.860 | both fluids and electrolytes.

01:43:13.540 | And they also can interfere with sleep

01:43:16.800 | because as I've talked about in the episodes on sleep,

01:43:20.320 | one of the hallmarks of deep sleep and in particular REM

01:43:22.960 | sleep is that epinephrine adrenaline levels are low.

01:43:27.160 | This is what allows you to have intense,

01:43:29.800 | often very emotionally laden dreams during REM sleep

01:43:33.740 | and not act those out.

01:43:36.340 | And low adrenaline epinephrine during REM sleep

01:43:40.080 | is basically a signature, a neurochemical signature

01:43:43.320 | of the REM sleep state, which is so vital

01:43:45.080 | for emotional and physical repair and so forth.

01:43:48.120 | So the fact that they can inhibit sleep,

01:43:50.440 | the fact that they can cause dehydration,

01:43:52.520 | the fact that they can make people feel kind of lightheaded

01:43:54.360 | and jittery makes them not terrific choices

01:43:57.360 | for a number of people.

01:43:59.000 | There is an interesting alternative choice.

01:44:01.120 | And when I say alternative, I do mean alternative.

01:44:04.080 | The choice that I'm referring to is spirulina,

01:44:06.620 | which is actually a form of algae.

01:44:09.000 | Years ago, I think when I first heard about spirulina,

01:44:12.000 | it sounded very much of the kind of 1970s, '80s

01:44:15.220 | health food store variety.

01:44:17.260 | It seemed really kind of mystical and wacky,

01:44:19.920 | but actually now there are some really nice studies

01:44:22.400 | and some data and also an understanding of the mechanism

01:44:25.200 | by which spirulina can have potent effects

01:44:27.960 | in reducing what's called rhinitis,

01:44:29.880 | which is a fancy word for congestion of the nose

01:44:33.400 | and inflammation of the nose.

01:44:34.780 | Basically, anytime you hear a word that includes itis,

01:44:39.780 | at least if it's in the medical or health context,

01:44:41.800 | it generally means inflammation of some tissue.

01:44:44.160 | So rhinitis just being inflammation of the nasal passages,

01:44:48.620 | but that's one of the most uncomfortable symptoms

01:44:50.480 | of any kind of infection.

01:44:52.040 | So there are two studies I'd like to highlight

01:44:54.300 | just very quickly.

01:44:55.140 | One is the effects of spirulina on allergic rhinitis.

01:44:58.200 | And the other is a clinical comparison

01:45:00.000 | to the efficacy of spirulina platensis,

01:45:03.000 | that's a technical name,

01:45:06.600 | and cetirizine for the treatment of allergic rhinitis.

01:45:10.600 | These looked at humans, so this is not a mouse study,

01:45:13.560 | this is a study on humans.

01:45:14.820 | Both sexes, so males and females,

01:45:18.760 | in one case looking at 100 plus subjects, 129 subjects,

01:45:22.240 | the other 65 subjects, so a decent number of subjects,

01:45:24.680 | randomized trial, double-blind.

01:45:27.440 | Both cases saw significant decreases in nasal obstruction,

01:45:32.440 | improved ability to smell, improved sleep,

01:45:37.520 | daily working, inflammatory cytokines were reduced as well,

01:45:42.280 | reduction in nasal itching,

01:45:44.420 | all the stuff that you'd like to experience, I can imagine,

01:45:47.520 | after taking two grams, two grams, not milligrams,

01:45:50.560 | but two grams of spirulina,

01:45:52.740 | sometimes had to be taken for a short while

01:45:55.180 | before the effect kicked in.

01:45:56.720 | So that's pretty impressive, I would say,

01:45:59.440 | but it doesn't really speak to mechanism,

01:46:01.280 | but in exploring the underlying mechanisms

01:46:03.720 | for spirulina's effects on reducing rhinitis,

01:46:08.240 | it's interesting to find that spirulina

01:46:10.680 | actually can inhibit the formation and/or activity

01:46:14.800 | of so-called histaminergic mast cells, M-A-S-T, mast cells.

01:46:19.520 | We haven't talked a lot about mast cells,

01:46:21.580 | but they are a very interesting cell type

01:46:23.760 | in the immune response.

01:46:25.560 | Essentially, what they are are little packets of histamine,

01:46:29.480 | and when we have some sort of injury

01:46:34.480 | or irritant, rather, to the skin,

01:46:38.440 | so a mosquito bite, for instance,

01:46:40.240 | or poison oak or poison ivy,

01:46:42.100 | something that causes an itch

01:46:44.800 | or something that causes inflammation internally,

01:46:47.040 | doesn't just have to be on the skin,

01:46:48.540 | these mast cells are these little bubbles

01:46:50.400 | that contain histamine that go to that site

01:46:52.800 | and release their histaminergic contents

01:46:56.160 | and cause swelling and inflammation of whatever cells

01:47:00.220 | are affected locally.

01:47:01.640 | That's cause, you might think,

01:47:03.000 | well, why would I want to have a mechanism in my body

01:47:04.960 | that would cause swelling and inflammation?

01:47:06.720 | Ah, well, then those cells in turn send out cytokine signals

01:47:11.080 | that recruit the very cell types that we were talking about

01:47:14.960 | way back at the beginning of the episode,

01:47:17.600 | the cells that are characteristic

01:47:19.440 | of the innate immune system that come in,

01:47:21.700 | the macrophages and the other types of cells

01:47:24.240 | that will come in and gobble up the foreign invaders

01:47:26.920 | or will help sequester and move away,

01:47:29.840 | say, the poison from a bite or from whatever irritant.

01:47:34.000 | Again, it doesn't just have to be at the skin surface.

01:47:36.880 | I'm describing an example at the skin.

01:47:39.720 | For instance, if you've ever had hives of any kind,

01:47:43.140 | that almost certainly involved mast cells.

01:47:47.040 | So when you take an antihistamine, antihistamine,

01:47:49.680 | in order to deal with seasonal allergies, for instance,

01:47:53.360 | you're dealing, you're, excuse me,

01:47:55.760 | you're taking a compound that's reducing histamines

01:47:58.680 | in mast cells, and spirulina has also been used

01:48:01.320 | quite effectively as a way to treat seasonal allergies

01:48:04.900 | and some of the symptomology equally on par

01:48:07.560 | with some of the major prescription

01:48:09.040 | and over-the-counter drugs for that.

01:48:11.360 | One cautionary note, spirulina does,

01:48:13.960 | can carry some side effects for people

01:48:16.600 | that have a genetic mutation

01:48:19.080 | leading to something called PKU.

01:48:20.320 | These people know who they are.

01:48:21.400 | They're very sensitive to phenylalanine.

01:48:24.600 | The same people cannot drink any sort of

01:48:26.920 | nutris read or diet soda for reasons that they understand.

01:48:30.080 | It can be quite dangerous.

01:48:30.960 | It's a rare genetic disorder, but nonetheless,

01:48:33.280 | spirulina can be an issue for those people.

01:48:36.380 | For most people, the side effect profile is pretty minimal.

01:48:40.280 | And just to be clear, I don't have any relationship

01:48:42.040 | to spirulina company or anything.

01:48:43.720 | I just find it interesting that there are these compounds

01:48:46.440 | that sound rather, forgive the phrase,

01:48:49.040 | but rather new-agey because they come from algae,

01:48:53.480 | from a plant.

01:48:54.320 | But when you look at the underlying mechanism,

01:48:55.660 | it makes perfect sense.

01:48:56.960 | So that's often what we like to point out here

01:48:59.440 | is that if there are these so-called alternative therapies,

01:49:02.460 | alternative because most people haven't heard of them,

01:49:05.000 | it's always nice if they map to a specific logical mechanism

01:49:08.000 | and framework by which that compound would work

01:49:09.840 | as opposed to just some anecdote of,

01:49:11.480 | "Oh, I hear spirulina is great for allergies."

01:49:13.480 | Well, now we know why.

01:49:14.540 | It inhibits mast cells and histaminergic mast cells

01:49:17.280 | in particular.

01:49:18.760 | Earlier, I mentioned a new and very exciting study

01:49:22.340 | published as a full article in Nature.

01:49:24.520 | Full article means that it is a major finding.

01:49:28.440 | At the journal Nature, they have letters,

01:49:30.660 | which are important findings.

01:49:32.060 | They're still very high stringency

01:49:34.000 | for getting a letter in Nature published.

01:49:36.560 | But the full articles,

01:49:38.760 | generally there's only one or two per issue

01:49:41.880 | in the weekly edition of Nature.

01:49:44.680 | And just last week, there was a very exciting article

01:49:47.720 | published from Chufu Ma's lab at Harvard Medical School.

01:49:51.360 | Chufu, I've known for a number of years,

01:49:53.320 | his group has done phenomenal work

01:49:54.760 | on the mechanisms of itch and pain

01:49:57.480 | and discovering some of the receptors and pathways

01:49:59.520 | for itch and pain.

01:50:00.360 | And more recently, they've been exploring

01:50:02.400 | the mechanistic basis of acupuncture.

01:50:05.620 | And the title of the article is,

01:50:07.600 | "A Neuroanatomical Basis for Electroacupuncture

01:50:10.680 | to Drive the Vagal Adrenal Axis."

01:50:13.120 | And while that's a mouthful,

01:50:15.160 | now most all of you are probably familiar

01:50:18.520 | with what I mean when I say vagal adrenal axis.

01:50:21.480 | Vagal, meaning of the vagus,

01:50:23.480 | and adrenal of the adrenal glands.

01:50:25.260 | And so perhaps we should not be surprised,

01:50:27.920 | although excited nonetheless,

01:50:30.200 | that Wen-Chufu's lab looked at stimulation

01:50:35.200 | of the body with so-called electroacupuncture.

01:50:38.640 | So these are needles

01:50:39.800 | where a small bit of electrical current,

01:50:41.560 | low level of electrical current,

01:50:43.140 | is passed into the needle and therefore into the body.

01:50:47.500 | They located sites on the body

01:50:50.140 | that can increase inflammation

01:50:52.460 | by way of releasing inflammatory cytokines.

01:50:55.080 | These areas included the abdomen.

01:50:57.600 | And they found areas on the body,

01:50:59.160 | such as the lower limbs or the hind limbs in this case,

01:51:03.580 | that can stimulate the vagal adrenal reflex

01:51:07.340 | and can lead to reduced inflammation.

01:51:10.740 | And what was really interesting is that they figured out

01:51:14.400 | that it was activation of nerve endings

01:51:17.200 | that resided in the fascia.

01:51:19.080 | I mentioned earlier what fascia is,

01:51:20.560 | but just to remind you,

01:51:21.440 | the fascia is a really thick sheath of tissue

01:51:25.180 | that surrounds muscle.

01:51:26.920 | If ever you've heard of rolfing,

01:51:28.560 | rolfing is a form of very intense massage.

01:51:31.400 | I've never had this done, but I've heard about this.

01:51:33.200 | It involves, among other things,

01:51:37.040 | actually separating the muscle away from the fascia somewhat.

01:51:40.800 | So it's a very, very deep tissue massage.

01:51:43.460 | Actually, a good friend of mine who had this done

01:51:47.040 | told me that it was probably the most challenging experience

01:51:50.840 | that physical experience that he'd ever been through

01:51:52.820 | going through this rolfing procedure.

01:51:54.220 | Maybe some of you have been rolfed, as they say,

01:51:57.120 | and can report to the experience

01:51:59.000 | whether or not it was pleasant or unpleasant

01:52:00.580 | or you felt benefits or not.

01:52:02.100 | In any case, this study isn't about rolfing per se,

01:52:04.920 | but it is about the fascia.

01:52:06.520 | And so what they discovered is

01:52:08.320 | there's a specific population of neurons.

01:52:10.500 | Those neurons have a name, as they often do in science.

01:52:13.120 | Name isn't important, but if you want to look it up,

01:52:15.200 | it's the Prok R2 neurons, P-R-O-K R2 neurons.

01:52:20.200 | And they send a connection deep into the limb fascial tissue.

01:52:25.460 | Okay, and then they send another connection.

01:52:27.880 | The connections we're referring to

01:52:29.480 | are axons, neurons have axons.

01:52:30.880 | So a wire in one direction

01:52:33.160 | that goes into the deep fascial tissue of the lower limb

01:52:37.800 | and near the calf and thigh.

01:52:39.440 | And then they send another wire up into the spinal cord

01:52:44.020 | and to a region of the hindbrain

01:52:46.860 | in the back of your brain, kind of near your neck,

01:52:48.400 | called the medulla, in the medulla oblongata.

01:52:51.140 | That neuron also has a name called the DMZ, doesn't matter.

01:52:53.520 | And that neuron connects to the adrenal gland

01:52:56.800 | to release our good old friends, the catecholamines,

01:52:59.800 | noradrenaline, adrenaline, and dopamine, or norepinephrine,

01:53:04.080 | epinephrine, and dopamine.

01:53:06.300 | And their release causes a reduction in inflammation,

01:53:11.300 | even in response to an injection

01:53:13.640 | of something called lipopolysaccharide,

01:53:15.160 | which can actually induce fever.

01:53:16.360 | So what is all this saying?

01:53:17.260 | This is saying that activation of the deep fascial tissue

01:53:21.440 | causes a chain of neural reactions that leads eventually

01:53:26.580 | to the release of norepinephrine, noradrenaline, adrenaline,

01:53:30.200 | and dopamine, and once again, lowers inflammation,

01:53:33.440 | very much like the breathing study

01:53:35.880 | that we talked about earlier

01:53:37.000 | in the pattern of cyclic hyperventilation with retention,

01:53:39.660 | leading to reductions in inflammation.

01:53:41.720 | I can't tell you how happy this makes me.

01:53:43.320 | I had nothing to do with this work,

01:53:44.620 | but the reason it makes me happy

01:53:45.840 | is because I have a particular fondness

01:53:49.320 | for when practices that have existed for many centuries

01:53:53.240 | or even thousands of years, such as acupuncture,

01:53:55.760 | such as respiration work, start to converge

01:53:59.960 | with some of the hardcore mechanistic science.

01:54:02.740 | And the reason this excites me

01:54:04.580 | is not because we want to take science

01:54:06.320 | and erase the previous tools and methods

01:54:09.340 | of these ancient practices, not at all.

01:54:11.660 | And it certainly isn't the case

01:54:12.900 | that we just want to name things

01:54:14.800 | or rename things with modern science.

01:54:17.140 | What's very exciting is when we can discover mechanism

01:54:20.840 | that explains why certain practices work.

01:54:23.640 | First of all, that validates those as legitimate practices,

01:54:28.440 | maybe even insurance will start to cover them,

01:54:31.240 | whereas maybe they previously had not.

01:54:33.080 | I don't know what the current status is

01:54:34.520 | for insurance coverage of acupuncture.

01:54:36.720 | I'm guessing there are places that do it,

01:54:38.440 | maybe others that don't.

01:54:40.400 | I personally am not somebody who receives acupuncture.

01:54:43.360 | I have in the past,

01:54:44.200 | but it's not that I'm a particular fan of it,

01:54:47.360 | but I think that there are a number of people

01:54:48.720 | that have benefited from it, so I think that's wonderful.

01:54:51.600 | Breath work and respiration work is something

01:54:54.240 | that I've cultivated as a practice over the years.

01:54:56.400 | I mentioned earlier how I use it to push back

01:54:58.880 | on incoming infections and so forth.

01:55:00.720 | And now that doesn't sound like total,

01:55:04.320 | like just a figment of my imagination.

01:55:05.960 | There's actually a published mechanism to explain it.

01:55:09.080 | But the most exciting thing to me about all this

01:55:11.600 | is that practices that traditionally have been shrouded

01:55:15.080 | in complicated language or were the unique domain

01:55:17.480 | of the practitioners and relied on phrases

01:55:21.180 | like the meridians or the chakras,

01:55:23.840 | of which I think is perfectly valid language,

01:55:25.820 | but doesn't inform mechanism.

01:55:27.320 | And then in a separate community,

01:55:29.980 | the community I come from, the community of scientists,

01:55:32.380 | have used language like our two neurons,

01:55:35.880 | medulla oblongata, vagal adrenal axis,

01:55:38.320 | and basically no one can communicate with one another

01:55:40.720 | because the language is shrouding.

01:55:41.960 | What we're now starting to see is that at their convergence

01:55:46.560 | is a common mechanism.

01:55:48.120 | And with that understanding, what's going to be

01:55:51.060 | really terrific is as new protocols start to emerge.

01:55:55.060 | So in understanding mechanisms and pathways

01:55:57.340 | and in being able to understand the base set of practices

01:56:01.340 | like breathing, like electroacupuncture and so forth,

01:56:04.120 | we can now start to daydream in a very realistic way

01:56:07.980 | about the development of new protocols,

01:56:10.280 | more effective protocols,

01:56:11.660 | protocols that perhaps one can do at home without needles,

01:56:14.780 | perhaps protocols such as the breathing

01:56:17.240 | that you can do anywhere, anytime,

01:56:18.820 | and be confident that you're actually impacting

01:56:21.560 | the IL-6 and the IL-8 pathways,

01:56:23.620 | reducing those and increasing IL-10.

01:56:25.780 | So we are no longer wandering around in the fog,

01:56:29.160 | hearing about these magical techniques

01:56:31.140 | without understanding why they work,

01:56:32.540 | nor are we just seeing a bunch of science

01:56:34.900 | that is descriptive but not mechanistic

01:56:38.020 | or pointing to specific protocols.

01:56:39.700 | So I'm just delighted.

01:56:41.340 | Again, I had nothing to do with this work,

01:56:42.800 | but really terrific work, Chufu and colleagues.

01:56:47.800 | And I also want to acknowledge a journal

01:56:50.220 | as prominent as nature for featuring this upfront

01:56:53.580 | because I think it really does mark the beginning

01:56:55.580 | of a new path in medicine.

01:56:58.920 | And just to underscore that point a little bit further,

01:57:02.220 | the National Institutes of Health, of course,

01:57:03.880 | has a cancer institute, an eye institute

01:57:05.780 | that deal with trying to combat cancer

01:57:07.460 | and to cure blindness and so forth.

01:57:10.420 | And now they have what's called NCCIH,

01:57:12.800 | which is complementary health.

01:57:14.560 | And so there are good tax dollars being put

01:57:18.060 | to the kinds of explorations that we're talking about

01:57:20.120 | that undoubtedly are going to lead to better treatments

01:57:23.260 | for immunological diseases, neurological diseases,

01:57:26.480 | the convergence of the immune system and the nervous system,

01:57:29.020 | very exciting times.

01:57:30.480 | And I hope that by learning about some of this new

01:57:32.660 | and emerging science and hearing about some of the protocols

01:57:35.780 | that are either zero cost or low cost,

01:57:38.720 | certainly for respiration, that's the case,

01:57:41.220 | or for the use of heat or cold,

01:57:43.100 | or maybe even electroacupuncture,

01:57:45.020 | if you have access to that,

01:57:46.380 | that we can really see that we're starting to evolve

01:57:50.060 | as a field of health and medicine and science

01:57:52.280 | and ancient practices,

01:57:53.260 | and that they're really starting to converge

01:57:54.920 | and have a vector, as we say,

01:57:56.400 | in a new and more exciting direction.

01:57:59.140 | Once again, we've covered a lot of information.

01:58:01.220 | Today, we learned about the immune system,

01:58:02.780 | the adaptive immune system, the innate immune system,

01:58:05.320 | and the nervous system and how those interact.

01:58:07.660 | And throughout, we discuss protocols that can allow you

01:58:10.700 | to tap into this relationship

01:58:12.480 | between the nervous system and immune system,

01:58:14.620 | and hopefully avoid and/or shorten the course

01:58:18.240 | of any illnesses, injuries, or inflammation

01:58:21.220 | that you might encounter.

01:58:22.960 | If you're enjoying and/or learning from this podcast,

01:58:26.660 | please subscribe to our YouTube channel.

01:58:28.700 | And also on YouTube, please leave us a comment.

01:58:31.860 | One of the best forms of comments you can give us

01:58:34.060 | are suggestions for future topics and future guests to have

01:58:38.060 | on the Huberman Lab Podcast.

01:58:39.940 | Please also subscribe to our podcast on Apple and Spotify.

01:58:43.720 | And on Apple, you can also leave us up to a five-star review

01:58:46.460 | and leave us a comment there as well if you like.

01:58:49.700 | In addition, please check out our sponsors

01:58:51.540 | that we mentioned at the beginning of each episode.

01:58:53.620 | That's the best way to support this podcast.

01:58:56.500 | And we have a Patreon.

01:58:58.100 | It's patreon.com/andrewhuberman.

01:59:00.540 | And there, you can support the podcast

01:59:02.440 | at any level that you like.

01:59:04.500 | A few times during this episode

01:59:06.000 | and in many previous episodes, I mentioned supplements.

01:59:09.160 | Not everybody needs to take supplements,

01:59:10.780 | but many people find benefit from them.

01:59:13.000 | A key thing if you're going to take supplements

01:59:14.800 | is to know that the quality of the supplements

01:59:16.780 | that you're taking is very high.

01:59:19.220 | And that's not always the case with many supplement brands.

01:59:21.500 | That's why we partnered with Thorne, that's T-H-O-R-N-E.

01:59:25.340 | Thorne supplements are known to be

01:59:26.640 | of the very highest quality,

01:59:27.960 | and the specificity of the ingredients is very high as well,

01:59:31.660 | meaning what they list on the bottle

01:59:32.820 | is actually what's contained in that bottle.

01:59:34.860 | They've worked with the Mayo Clinic,

01:59:36.060 | all the major sports teams.

01:59:37.200 | So trust is very, very high with Thorne products.

01:59:40.480 | If you'd like to see the supplements that I take,

01:59:42.040 | you can go to thorne.com/u/huberman.

01:59:47.040 | And there, you can see all the supplements that I take.

01:59:49.240 | You can get 20% off any of those supplements.

01:59:51.540 | And if you enter the Thorne site through that portal,

01:59:53.800 | you can get 20% off any of the supplements that Thorne makes.

01:59:57.000 | That's T-H-O-R-N-E.com/u/huberman

02:00:02.000 | to see the supplements that I take

02:00:04.940 | or get 20% off any of the supplements that Thorne makes.

02:00:08.120 | If you're not already following Huberman Lab on Instagram,

02:00:10.920 | please do so.

02:00:12.140 | There, I teach neuroscience and health-related topics

02:00:15.000 | sometimes, but not always overlapping

02:00:16.840 | with the content of the podcast.

02:00:19.340 | We are also Huberman Lab on Twitter.

02:00:22.380 | And last but not least,

02:00:24.580 | thank you for your interest in science.

02:00:26.360 | (upbeat music)

02:00:28.940 | (upbeat music)

Using Your Nervous System to Enhance Your Immune System | Huberman Lab Podcast #44

Chapters