How to Enhance Your Immune System | Dr. Roger Seheult

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology at Stanford School of Medicine my guest today is Dr Roger schwell Dr Roger schwell is a board-certified medical doctor in pulmonology which is the understanding and treatment of conditions that impact the respiratory system such as colds flu and other viruses mold infections asthma and more Dr schwell is also board certified in sleep medicine he does his clinical work in the Intensive Care Unit at lalinda University and he is actively involved in medical and public health education through his terrific online Channel called medc today we discuss how to avoid getting colds flu and other viruses and how to treat them to minimize discomfort accelerate healing and avoid long-term consequences during today's episode we discuss long covid as well as the use of sun and red light to stimulate mitochondrial and their metabolic Health across the entire brain and body that opens up a broader discussion about phototherapy which is the use of light to control health and temperature and other levers for improving brain and bodily function Dr schwell emphasizes that sun and red light therapy have a long and wellestablished medical history and their mechanisms of action are known and therefore it's not just biohacking as many people think we also discussed the sometimes controversial topic of the flu shot and if and when you should get one Dr schel as you'll see here is worldclass at making medical Concepts and the actionable items related to health exceptionally clear as a consequence I'm certain that you'll truly appreciate the knowledge that he shares in your efforts to be and stay healthy at any age in fact by the end of today's episode you'll be armed with the real knowledge on how to best get over nasty infections of the sinuses lungs and throat faster should you happen to get one and even better how to avoid them alt together before we begin I'd like to emphasize that this podcast is sep from my teaching and research roles at Stanford it is however part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme this episode does include sponsors and now for my discussion with Dr Roger schel Dr Roger schel welcome thank you so much Andrew for having me I discovered you because you were putting out and continue to put out incredible information about how to stay healthy amidst infectious diseases Airborne in ious diseases skin contact based infectious diseases and on and on and nobody likes to be sick and you've provided me tremendously valuable information about how to avoid getting sick and in many cases how to accelerate the progression from sick to healthy again it's been uh tremendously helpful for getting me back into life as it were let's talk about some of the things that one can do to avoid getting sick when in the presence of airborne viruses in particular colds and flu and other viruses as it were if you were to think about the the major pillars of remaining healthy especially when one is exposed to colds and flu from kids for in your case also in the Intensive Care Unit where people are coming in specifically because they're sick often with infections like colds and flu or worse you need to take specific precautions to avoid getting sick what do you think of as the fundamental layer of keeping a healthy immune system to avoid getting sick and then we'll talk about how to get over and move through being sick more quickly yes well the question is how do you avoid getting sick in terms of uh infectious diseases and as it turns out the answer to that is is actually the same in terms of avoiding getting sick for anything and it sort of goes to the pillars as you call it in my mind there's a there's actually a physician that I know very well just outside of uh Stanford actually in a place called wear wear University Dr Neil nedley and he's actually coined this this pneumonic called New Start um and and each of those letters to me in my mind is something that I go to when I want to improve health uh in in people in general so the and starts for nutrition and we can talk about nutrition and what that does to the human body obviously you know as natural as possible staying away from processed foods that's something there um exercise is e and uh when I'm talking about exercise I'm talking about the understanding that we have regarding exercise not to build muscle necessarily be stronger I'm talking about exercise in terms of health and that has more of a a j hook type of of picture what I mean by J hook is if you're not doing any exercise you're going to have higher levels of inflammation as soon as you start to do some exercise even mild to moderate exercise the amount of inflammation your body starts to come down but as you start to do more and more exercise you do have to be careful in terms of your General Health this is exactly what happens with athletes um they have to be very careful that when they're doing that type of elite athletic exercise that they're not sick on the day of performance and so that that's an issue so I'm referring to just you know mild to moderate exercise is good um the next one would be W water so this is something that's really interesting obviously it seems pretty you know obvious but not only the use of internal water but external water so in that area we can talk about sauna cold plunge things of that nature that can actually help with our immune system that's a whole interesting area of discussion it involves the innate immune system it involves interferon there's a lot of history and data that goes back over hundred years on how that's been used start St so s is sunlight I've been a real proponent of getting people outside into the Sun and we can talk a lot about that there's a lot of interesting research not only in terms of sunlight in terms of influenza but also covid and just about any natural disease lot of interesting information there t t uh stands for the old term called Temperance which you may recall is a is a term that we use to prevent us from taking in toxins into our body that's a whole another discussion so staying away from things that would make you sick a is air and when I talk about air it's not just what we focus on which is keeping bad things out of the air so having fresh air but there's a whole discussion to be had in terms of air that has good qualities in it so there's a whole area of research that looks at for instance fdes which are chemicals that come off of trees you may have heard of forest bathing they've done a lot of research in Japan on this and getting out into nature there are actual chemicals that are in the air that you can breathe that actually have an impact on your inate immune system finally R we're getting to R R and at the end R is rest now this is goes without saying but people who have good sleep habits are going to have much better immune systems whether you're talking about the the antibody response after a vaccine uh versus just um the number of times per year you're sick there's very good data very good research that shows that getting seven eight hours of sleep a night is going to be very beneficial for your immune system has to do with cortisol and beta receptors and all sorts of things and the last t which is trust and uh for some it is is trust in a higher power trust in God these are the sorts of things that can help us uh relieve stress if someone else is is helping you if someone else is there tea would also include Community people that are around you these are some of the less um tangible ways of measuring but when someone ask me a question what can I do to avoid getting sick and as you just asked me in terms of influenza there's a lot of specific things we can talk about but that's where I start out with the pillars of Health I'd like to take a quick break and thank our sponsor ju ju makes medical grade red light therapy devices now if there's one thing that I have consistently emphasized on this podcast it is the incredible impact that light can have on our biology now in addition to sunlight red light and near infrared light sources have been shown to have positive effects on improving numerous aspects of Cellar and organ Health including faster Muscle Recovery improved skin health and wound healing improvements in acne reduced pain and inflammation even mitochondrial function and improving Vision itself what sets juv lights apart and why they're my preferred red light therapy device is that they use clinically proven wavelengths meaning specific wavelengths of red light and near infrared light in combination to trigger the optimal seller adaptations personally I use the ju whole body panel about three to four times a week and I use the ju handheld light both at home and when I travel if you'd like to try ju you can go to ju spelled jv.com huberman chuve is offering an exclusive discount to all huberman lab listeners with up to $400 off ju products again that's ju spell jv.com huberman to get up to $400 off today's episode is also brought To Us by eight sleep eight sleep makes Smart mattress covers with cooling Heating and sleep tracking capacity now I've spoken before on this podcast about the critical need for us to get adequate amounts of quality sleep each night now one of the best ways to ensure a night sleep is to ensure that the temperature of your sleeping environment is correct and that's because in order to fall and stay deeply asleep your body temperature actually has to drop by about 1 to 3° and in order to wake up feeling refreshed and energized your body temperature actually has to increase about 1 to 3° eight sleep makes it very easy to control the temperature of your sleeping environment by allowing you to program the temperature of your mattress cover at the beginning middle and end of the night I've been sleeping on an eight Sleep mattress cover for nearly 4 years now and it has completely transformed and improved the quality of my sleep eight sleep recently launched their newest generation of the Pod cover called the Pod 4 ultra the Pod 4 ultra has improved cooling and heating capacity I find that very useful because I like to make the bed really cool at the beginning of the night even colder in the middle of the night and warm as I wake up that's what gives me the most slow wave sleep and rapid eye movement sleep it also has a snoring detection that will automatically lift your head a few degrees to improve your air flow and stop your snoring if You' like to try an eight Sleep mattress cover go to 8sleep.com huberman to save up to $350 off their pod 4 ultra eightsleep currently ships in the USA Canada UK select countries in the EU and Australia again that's 8sleep.com huberman let's start off with one of my favorite topics would be the s in New Start let's talk about sunlight listeners of this podcast or anyone that's heard me on social media know that I'm you know as big a proponent of getting morning sunlight in one's eyes as one could possibly be without repeating himself 10 million times per year uh it's a daily activity that we just know has such an outsized positive effect on the whole setting of the Circadian rhythm and thereby improved daytime mood focus and alertness and nighttime sleep but the way you describe sunlight goes beyond just getting morning sunlight in one's ey so if we want to parse this s sunlight in new start how are you thinking about sunlight is it sunlight on the skin is it also midday light not just morning sunlight is it a certain amount of sunlight and then maybe we can also talk about some of the underlying mechanisms yeah exactly so when you talk about sunlight and I'm a big believer I'm board certified in sleep medicine and I and I I'm cheering you on when you talk about these things because it's so important that light into the retina does have an effect on the Circadian rhythm supermatic nucleus it does have an effect on mood goes to the per cular nucleus in the brain and has an effect there those are well known and very important um what I'm talking about when I'm talking about sunlight is an aspect of light that is not very well known in terms of its visible effects so we we know about the visible effects of light these are photons that are coming into the eyes that we can see what I'm discussing and what I'm talking about is the is the effect of sunlight on the human body the skin penetrating into the human body now this at first sounds kind of uh woooo I guess we could say but the the point that I want to make here is understanding that when we look at the sun we are seeing about 38% of that energy coming from the sun is in the visible spectrum there's a whole another 52% of the photons coming from the Sun in the infrared spectrum and on the other end on the ultraviolet side this is the part we have no problem understanding because we know that ultraviolet B light comes into our skin and it's high energy so it's able to actually move the bonds on these uh cholesterol derivatives in order to make vitamin D so we know that so now what do we say when I say hey I want to go outside to get some vitamin D we know that we're going outside to get this light that we can't see that's very imperative to giving us something called vitamin D which is hormone in our body and it's very very important on the other side of that though on the infrared side is is something that there's new science new data that is coming out that is showing that it's actually very very important and so that I I would point to a an article that really changed my my thinking on this and really open my eyes no pun intended there was an article that was published in 2019 uh in melatonin research by Scott Zimmerman and Russell Ryder and the the name of that article was melatonin Optics of the human body the Optics of the human body and what Scott Zimmerman and Russell Ryder set out to show is that in fact fact um infrared light because of its very long wavelength um it can penetrate through into the skin actually very deep and we're not talking about how long a a path length goes through you have to remember that that this type of long wavelength can scatter and it can can scatter throughout up to they say up to 8 cm according to this this data a single Photon a single Photon can bounce around it's it's a very low energy Photon uh but low energy photons because they're very long in wavelength can penetrate very deeply a good way of thinking about this is you you know you pull up to a stop sign and a car pulls up next to you and they're playing this really loud music right what do you hear in your car it's very low frequency sound and the reason why that's what you hear is because low frequency sound is the only kind of sound coming out of that guy's radio that's able to penetrate not only his car but go into your car and shake the steering wheel on your car it's it's the same thing like for instance if you were to go to the Grand Canyon and there's a storm coming storm very far away what's the first thing that you're going to hear it's low rumbling it's because that low frequency energy is able to penetrate very deeply um there's a astrophysicist in Europe uh in England actually Bob Fosbury he sent me a photograph of his hand in front of a infrared light source and it was almost like uh uh the first guy who took a X-ray of his hand Ren rigan guess is his name and uh he said he looked at his hand he says I almost like saw my own death cuz he could see the bones in his hand through the X-ray well Bob Fosbury who's at the European space agency and is well tuned into this type of of understanding he put his hand in front of a infrared light sensor or infrared light source and took a infrared light photograph and the light comes through the hand it illuminates the entire hand uh and this is of course a lot more than a few millimeters and the mind in thing about it was you could not see any bones it was either penetrating through the bone or it was going around the bone and very clearly you could see that infrared light is able to go much more than just skin deep it penetrates through your clothes you you can actually test this out on a on a on a summer day or even on a winter day if the Sun is out wear a few clothes of uh layers of clothing go outside close your eyes and move around and see if you can feel where the sun is you can and the reason is is because it's that infrared radiation that's able to penetrate through the clothes penetrate through your skin actually activate the heat sensors in your body and actually go much deeper than that that's actually in a straight line after it does that it hits something and then it bounces around a couple of more times maybe a few hundred more times and so the point of that paper the Optics of the human body is that we have this understanding or this idea that light simply hits our skin and that's where it ends and that's not the case why that's important is because of the effect of this type of infrared light has on mitochondria and that's really the mind-blowing aspect of this is that mitochondria are like engines in your in your cells right they're like engines in your car the engine in your car Burns fuel makes Locomotion and in the process of making that Locomotion it creates heat and that heat if not dealt with can shut down your engine well in the mitochondria you've got this process occurring making ATP which is basically the currency of energy in in the cell and in the process of doing this it makes oxidative stress oxidate reactive oxygen species if you don't deal with those reactive oxygen species that could shut down the mitochondria and um and and quite truly just about every single chronic disease that we have in this country whether it's diabetes hypertension heart disease dementia uh all of those they all has have at the root of them mitochondrial dysfunction and this this goes to a much bigger picture of the mitochondrial Theory of Aging we know that after 40 years the output of mitochondria which is ATP drops by about 70% 70 70 can you imagine being in your house and somehow the energy production to your house drops by 70% can you imagine what an impact that would have on just about every function that goes on in your house this is exactly what's happening in the cell and so what does this have to do with sunlight well here's what they've shown that the mitochondria actually make on site melatonin in orders of magnitude higher concentration that is made in the pineal gland really yes so they've actually done the work where they have serotonin they are actually labeling the carbon in serotonin and showing that that melatonin in orders of magnitude higher concentration are being made on site in the mitochondria okay I have to ask about this yes most people including me are familiar with melatonin secretion from the pineal gland correct being suppressed by light via some neural circuit Pathways that go from eye to supermatic nucleus to there there's a a circuitous Loop to the you know uh the brain stem and then up uh um to the pineer so light suppresses melatonin release from the pineal we know that yes in that context melatonin is the hormone of darkness and causes sleepiness correct what is the role of melatonin in the context that you are describing because if indeed infrared and long other long wavelength light is causing the production of melatonin from the mitochondria in the rest of the body I'm assuming that's not to increase our levels of sleepiness that is correct and I do know that melatonin is a powerful antioxidant yes so I'm guessing that next you're going to tell me that it is combating or the reactive oxygen species that are produced as a function of mitochondrial uh metabolism absolutely okay absolutely so the the mitochondria make melatonin on site this is not being secreted into the blood it's being used on site so this is not being used as a secondary Messenger to tell the body anything about circadian rhythm this is a extremely powerful as you know extremely powerful antioxidants it's actually one of the most powerful antioxidants in the human body it actually upregulates the glutathione system by regulation so what this melatonin does is it's able to mop up these reactive oxygen species let's let's back up a little bit there reactive oxygen species what are they so if you if you let's get let's get nerdy let's get into the details in the mitochondria the way it works is that you burn fuels you burn carbohydrates proteins and fats and as a result of that you make these very reduced agents nadh fadh2 they go to the electron transport chain and as just as the Colorado River as it goes down through various different dams and then dumps out into the Gulf of California the same thing happens with these very highly charged and electronegative electrons they as they start to fall down and get trans erred from one uh enzyme to another they cause the out out production or the out transfer of protons into the in membrane space the problem is though is when you finally get done with these electrons they've been completely spent there's nothing else to accept them and the only thing that can actually do that is something so Electro negative that it would actually take these electrons and that's oxygen and that's the reason why we breathe oxygen it's it's because we need an electron acceptor for these spent electrons it's very near and dear to my heart as a pulmonologist and critical care specialist I we need to have oxygen if you don't have oxygen things shut down very quickly for those that aren't familiar with these biochemical Pathways maybe one way for them to think about it is that free electrons are not a good thing in this system you don't want electrons floating around and in these biochemical steps that convert energy into the stuff that cells can use more readily to move and do everything that we do right electrons are kicked off oxygen can work with those free electrons I'm trying to use language here that you know divorces us from the from the uh you know the classic biochemical pathway so that more people can grasp it because it's really a beautiful mechanism it so if you have a a positive charge to effectively work with the the free negative charge then um the system is is stabilized or at least isn't pushed in in the direction of inflammation these is many people have heard of free radicals exactly and that's what we're referring to you want to you want to offset the free radicals correct and to the biochemists out there and the biologist I'm using the term offset Loosely um okay so melatonin in the context of how sunlight can activate melatonin within cells maybe it's um worth pointing out to people that when the pineal gland releases melatonin to make you sleepy that's an endocrine or hormone type mechanism hormones act on local tissues and more distant tissues in the body corre phermones act between bodies right right in the context that you're describing melatonin is acting within cell correct okay so let's let's think of the let's think of this dichotomy the mitochondria always needs to have antioxidants otherwise it's going to become damaged like if these free radicals are produced the very next molecule that they bump into it's going to change it and if that's the mitochondria the mitochondria is going to be damaged so it needs a cooling system just like your car has a cooling system for heat the mitochondria needs a cooling system for oxidative stress what's the cooling system during the day sunlight comes in activates these uh it upregulates melatonin which does that well when there is no sunlight what is the cooling system then it's the system that we've always known about and the reason why we've always known about it is because we can draw blood samples it's much easier to detect melatonin in the blood because we've developed techniques first to detect things in the blood but what we're talking about now is how do we detect things not only intracellular but intra organel that's much more sophisticated yet now we do have the technology to show and the amount of melatonin we're talking about is 20 times higher than we're picking up in the blood so at night the system is melatonin is secreted from the pineal gland it goes into the blood diffuses into the cell diffuses into the mitochondria and does the job do you think that that role of melatonin from the pineal at night is part of the reason why sleep is so restorative absolutely it's probably no coincidence then that when we fall asleep it's at least correlated with and in many ways caused by the reduction in core body temperature like it's very unusual for melatonin levels to be high when body temperature is high yeah these things normally are coordinated at night I'm not aware that it actually drops body temperature but it might I I'm just not aware of the literature but what you're describing is amazing I mean first of all most people's minds including mine are going to be blown by the fact that long wavelength light can actually go through clothing yes and skin and so you can imagine that if you have a minimum of clothing on whatever is appropriate for that context and you get some sunlight on your skin even on a cloudy day yes some of this should be coming through we could talk about that it's more UV light short wavelength light that's going to break through thick cloud cover correct uh cloud cover because it's water vapor and water vapor does absorb infrared it will be substantially less but much more than being inside and on a clear day or partially cloudy day uh we're getting a lot of red light long wavelength light and infrared and near infrared light coming through absolutely I think a lot of people don't realize that because in this age of of red light devices and infrared light devices um of which I own one and I love and I use um but people forget that the uh the primordial and arguably I'll I'll say the best source of red light and near infrared light and infrared light of the sort that we're talking about right now is going to come from the sun right I mean there's there's no device that can replace the sun 100% okay 100% yeah okay great so how does this keep us safe from infection as long as we're here yeah um what else is it doing to offset the 70% reduction in mitochondrial function because what we're talking about now is um the role of melatonin within cells to um lower temperature and reduce these uh reactive oxygen species yes does that somehow offset the reduction in mitochondria that normally occurs it does and so there's a so the increase in melatonin from infrared uh radiation going into the mitochondria is one aspect there's a whole host of other aspects that occur there is cytochrome 4 oxidase again one of those enzymes in the electron transport chain can absorb infrared light there's nitric oxide what what the whole effect of this is and the bottom line is is that when you have red light to near infrared light getting in that deep there is a increase in the efficiency of the mitochondria so this is the key point because if in fact with the theory of mitochondrial aging that we're having a decrease in the efficiency of the mitochondria as we get older if there is something that we can do to reverse that or to at least prevent that from happening that can have a tremendous impact in our health overall so two points one uh one point about infrared and its characteristic and then number two let's actually get to some data because we're we're saying a bunch of things but what we really need is evidence-based stuff okay so the first thing there's one other thing that I should mention about the effect of infrared light especially in nature and that is is that not only can It penetrate through clothes you may remember the Sony cam uh night vision thing uh back in the 90s where Sony came up with a night vision camera that you could take pictures at night and some enterprising youth probably a man fig figured out that you could use it during the day and you could see through clothes and presumably they took that off the market they took it off the market pretty quick yes um but there's one other thing that's really important to understand too and that is that believe it or not but the leaves on trees and grass anything with chlorophyll is highly reflective of infrared light what that means is that if you go out outside on a sunny day versus going outside on a sunny day surrounded by Green green spaces you're going to get probably two three four times more infrared light in that environment than you would without that environment if you you could you could check this out you go to Google and just type in infrared photography and click images and you will see any kind of infrared filtered light when it shows a tree or grass it it looks like it's lit up like it's got snow on it it's bright white it's very reflective on a hot summer day if you go outside and touch some object that's in the sun it's going to be extremely hot touch a leaf it's it's not hot at all it's because it's reflecting that light in fact the coolest place in a garden on a hot summer day is where it's under a tree because all of that all of that infrared light is being reflected off so and and just to jump ahead here but we know from years and Decades of data that people who live in green spaces have reduced diabetes reduced hypertension reduced mortality just living in green spaces is it possible to tease away the effect from the other things associated with living in green spaces because fortunately our audience is train to think scientifically and they'll know well it's not necessarily causal right people live in green spaces tend to walk more they tend to perhaps eat more fruits and vegetables and on and on so so uh getting on to that uh there was a study that was just done in Louisville Kentucky four square miles they measured everybody in that four square miles h R hscrp what's hscp it's basically it's a surrogate marker for inflammation in the body and then they did this they did something incredible they brought in 8,000 plus trees mature trees and they planted those trees in that four square mile area took them about a year two to three years later they went out nothing the the income of these people living in this four square mile area did not change the presumably they did not do any exercise programs in this area everything was the same the only thing they did was plant trees and they went out and they rechecked everybody's highly sensitive CRP levels they drop by 133% wow and that's about on the order almost on the order of Doing exercise three times a week I should mention that um crpc reactive protein has been associated with a number of blinding eye diseases um uh associated with inflammation and basically um everything bad you can imagine in every organ of the body heart attack uh esia yeah this kind of thing um incredible yeah so let's let's actually look at some data so we've talked about you know any astute person listening to this is like okay so you talked about a lot of observational stuff is there any Interventional stuff so I I uh turned to Glenn Jeffrey who's um he's in the department of Opthalmology you you know him well actually at uh University College London and he's done some really interesting experiments in the last two to three years looking at red light one of them was uh the first one he did was he took um older subjects who had difficulty with color sensitivity in their vision and he exposed them to 670 nanometer which is red it's visible light for just three minutes in the morning it only worked in the morning in this case which is interesting and he showed that there was a 177% increase in color sensitivity that lasted for days now why would that be again you should know that the retina is the the one tissue in the human body that has the highest concentration of mitochondria and if you understand what's going on in light and I know you do but our audience might not is when you have visible light coming in to the retina it is causing a photochemical reaction that requires a tremendous amount of energy vesicles budding off things uh diffusing electrical conductions and it has to happen very very quickly otherwise what you see is going to be there as a blur so this is constantly being updated so it's no surprise that you know mitochondria is so uh concentrated there so what's actually going on there what we believe is going on is that this red light is actually stimulating these mitochondria to produce more ATP and it's improving the sensitivity but the the the cord or the the Pella resistance was his next study which he did where he took 30 subjects he gave them 75 gram of glucose and in a blinded way so they couldn't tell what was if the light was on or off he exposed their backs to the same 670 nanometer lights and he he monitored their glucose over time uh over the next two hours basically multiple points and what did he find he found that those that were exposed to red light and didn't know it had lower glucose concentrations so he surmised that the mitochondria were working more efficiently they were using up more energy and this is the reason why the glucose didn't Peak as high but he couldn't be sure unless he also monitored for the output of metabolism so what happens when the mitochondria is working it's making carbon dioxide so he also measured carbon dioxide and sure enough those subjects that had the intervention of the red light had statistically significantly higher carbon dioxide levels on exhalation awesome too bad the guys in England that's a joke about for my British friends uh yeah it tends to be very overcast there but the does come out in England as well so so here we have basically this is a randomized controlled intervention trial which showed that red light's doing this and there's a whole host of other uh other trials that show the same thing so when I started to see this in my patients and and what caused me to even do this you might ask what's a pulmonary Critical Care doc talking about mitochondria in the eye what really spur me on to look at this was when I was in the middle of something called the co pandemic and I was seeing patients in my IU that were that were dying and what were they dying of covid but what were they in there for they had things like diabetes hypertension dementia um all of these things which have at the root of them mitochondrial dysfunction so what we have is is an epidemic I believe of mitochondrial dysfunction and how are we going to repair that I think sunlight is one of the ways to do it so I started looking around at the evidence um there was a study that was done Oxford and the University of leadon in the Netherlands where they looked at about 10,000 subjects they just drew their blood and they said let's just check triglycerides and insulin sensitivity and then what they did was they looked over the previous 10 days at the weather report and they were able to show that by the hour the more sunlight that there was in the previous seven days that actually predicted an improvement in insulin sensitivity and a reduction in triglycerides that fast over a 7-Day period of time there was another study that was done this was in Sweden uh so this was an epidemiological study but maybe actually showed some causation they looked at Swedish women it was about 30,000 Swedish women living in uh Sweden at the time of course and they divided them into three groups those that avoided the sun those that got moderate sun exposure and those that got a lot of sun exposure Ure and what they showed after following them for 20 years so a long period of time was that those women that were out in the sun not only had lower all cause mortality but they also had lower cardiovascular mortality and what's really interesting is they had lower cancer mortality and it was in a dose response curve which suggests Bradford Hill criteria that there was maybe some causation here what was really interesting about that study is that they looked at smoking so what was the difference here it wasn't a small difference it was actually such a large difference that the sunlight made that they were able to show that those women in Sweden who were in this study who went out into the sun avidly and smoked had the same mortality as those women who avoided the Sun and didn't smoke the first thing that hit my mind was is what do we what do we do to people here in this country that want to smoke we tell them to go outside I'm not encouraging people to smoke clearly the best outcomes are going to be from not smoking um and from getting sunlight but it is a remarkable study I mean this is certainly I smoking would be under the te for temperance that would be where I would put a new start we we would not want to do that but it that same study was repeated basically again University of Edinburgh they did a biobank study 10 times the amount of people 400,000 repeated the study showed exactly the same both men and women uh except this time they actually measured UVA so they used uh ultraviolet a radiation as a surrogate for infrared and for sunlight in general they found exactly the same thing reduction in mortality such so is the evidence that even dermatologists are starting to rethink there was an article that was published in the journal of investigative Dermatology by Richard Weller and uh the name of that article was published last year it was titled uh sunlight time for a rethink and he said look there are societies that are seeing this and they're already saying that there's a potential benefit for getting out into the sun yeah the um dermatologist that I hosted on this podcast Dr Teo solmani um also happens to be a Derm oncologist so his specialty is skin cancer anwers and um I was surprised to learn but you know we've talked about several times Now offline as well too and I I was surprised to learn that the sunlight induced cancers of the skin while they do exist that's real right get too much UV exposure you're going to um age your skin more rapidly you're uh going to increase the likelihood that you'll get a skin cancer however this was really surprising to me according to him there is no evidence that sunlight induces the deadly types of cancers like melanoma those are more genetically determined yeah yeah that's not to say that sunlight can't damage skin but it is really interesting that more and more data and clinical trials included are pointing to exactly what you're saying which is that more sunlight exposure is beneficial and the risks of sunlight exposure can largely be offset by limiting your exposure to excessive UV and it's pretty easy nowadays with any app um a lot of zeroc cost apps out there I can put uh links to one or two in the show note captions that I like that have no affiliation to whatsoever by the way um we'll tell you when the UV index is highest it's in the middle of the day typically and so it's possible to get plenty of sunlight on your skin without exposing yourself to excessive UV yeah and I even take it a step further because we we know that a single layer of clothing can actually is pretty good at blocking ultraviolet lights right but remember what we talked about infrared infrared can penetrate through so if someone is fair skin and they're concerned about getting skin damage wear a broad rimmed hat put a put a a long sleeve shirt on but get outside because that's where the infrared especially if you're around uh you know Green uh green uh shrubs and and and leaves and things because those are a lot of infrared light we know that green spaces are are are beneficial in terms of that and we talked about you know Louisville Kentucky that there's a benefit there just by putting the tree there I love those data I'd like to take a quick break and thank our sponsor ag1 ag1 is an all-in-one vitamin mineral probiotic drink with adaptogens I've been taking ag1 daily since 2012 so I'm delighted that they're sponsoring this podcast the reason I started taking ag1 and the reason I still take ag1 is because it is the highest quality and most complete foundational nutritional supplement what that means is that ag1 ensures that you're getting all the necessary vitamins minerals and other micronutrients to form a strong foundation for your daily Health ag1 also has probiotics and prebiotics that support a healthy gut microbiome your gut microbiome consists of trillions of microorganisms that line your digestive tract and impact things such as your immune system status your metabolic 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pack in terms of your original question which is uh getting back to influenza or flu or things so there's a St there's a great study that I always love to talk about uh in terms of this and it was U actually done by Harvard it was a Harvard Kennedy School uh um which is not the medical school this is the public policy politics school and what they did was they looked at this very question of influenza and why do we always get it in the winter time and what's what's potentially beneficial for it and the problem is is that we always have this influenza season which is in the wintertime we can talk about why that might be I would suggest to you that it's because that's when we have the shortest day of the year but we also have other things that happen at that time right what else is happening we're having parties at that time there's there's Thanksgiving there's new years it's cold you know does the does the temperature have anything to do with it uh we're also inside because it's cold so what is it that's actually doing it well 2009 was a banner year because 2009 was the year that we had the H1N1 pandemic and that was a boon for us the reason is is because not because of the deaths that we had but from scientific standpoint this epidemic actually peaked in the summertime and it was in areas where the humidity was sometimes high and sometimes it was low and sometimes the temperature was high sometimes the temperature was low sometimes the sun was out sometimes it was cloudy in other words we uncoupled the influenza virus in 2009 from it being in the winter time and all of those things that were associated so now we have all of these data points and so Harvard went to work at looking at all these data points they looked at solar uh radiation data at that time and they were actually able to look specifically where that person came from and what was the solar radiation in that particular area and what they came up with was abs absolutely they said quote sunlight strongly protects against getting influenza it was a amazing study um I'm reminded of a study that was published in covid this was published in 2021 and it was looking at this very question is it temperature is it humidity or is it sunlight so what they did was they looked at the Autumn surge of covid in the winter time in Europe in Autumn actually and they asked this question when there was the surge date in this country whatever country it was in Europe when did it happen and what were the things that caused it to happen so they put all the data out there for temperature and it was a flatline there was temperature did not predict which country how the country got uh covid-19 when the surge started to happen they did the same thing for humidity Flatline when they got to Latitude it was a perfect correlation in other words as the sun in the wintertime started to peel back off of the Northern Hemisphere and started to sink below the equator and when there was a critical period of time that the day shortened to the point where at first Finland got a the shortest day or short enough day and then and then Germany and then further on what it showed was l ude actually perfectly predicted when the surge dates would happen starting off with Finland and ending up with Greece at the bottom wow do you see influenza at the equator you do see certainly influenza at the equator but what's really interesting about that is that if you look at for instance uh the the influenza mortality in the United States obviously in the northern hemisphere what you will see is you will see it Peak generally one to three weeks after the shortest day of the year which is around now in in December and January now if you look at Australia what do you think you'd see the inverse exactly it's it's actually in Australia the influenza season Peaks late June early July so if you now now go look at something like the Singapore Singapore is I think within 100 miles of the Equator you will see that in Singapore there are there is influenza Peaks and troughs but it's not seasonal it's just almost random is it not the case that um in hospitals and other um recovery Wards as it were uh that there used to be classically there was a uh a habit of putting people out into the sun like sun decks on the roof of hospitals and things of that sort I'm smiling because you you're absolutely correct you're absolutely correct and and as I started to go through this and look at this I started saying to myself we need to get people out in the sun and then I realized not only am I not the only one saying this but certainly this was being done 100 years ago 150 years ago just as a speculation why do you think we've migrated away from this frankly basic biochemical cellular understanding of how the Sun can benefit us I mean I feel like so much attention has been paid to how the Sun can damage our skin and quote unquote give us skin cancer that perhaps we overshot the Mark I think it has to do with scientific reductionism and what I mean to say by that is we've had a lot of data that shows that ultraviolet lights can cause cancer and so we've assumed that anything that has ultraviolet light can cause cancer there's this complete dismissal of the fact that this ultraviolet light is packaged for the entire existence of human nature along with infrared lights and and if you it's it's a beautiful thing when you start to look at this because you start to realize that the infrared we we never get blue light or ultraviolet light ever without the presence of infrared lights unless it comes from an artificial Source exactly so this is really the first time in human history that we've had this preponderance of short wavelength AKA blue uh and green light in the absence of red light in fact maybe maybe we should just spend a couple of moments talking about what kind of sunlight exposures you recommend for people Depending on time of year yeah and then after that I'd like to talk to you briefly about this shift away from incandescent bulbs to uh indoor lighting with LEDs but just to make sure that um I don't move us along before uh providing some of the key uh takeaways yes how much sunlight should we get each day in the shorter days of winter and in the fall and and when should this be done in the Jeffree study it was cleared that there was circadian regulation as you mentioned getting that sunlight excuse me getting that red light infrared light into one's eyes early in the day was important if I'm living a standard life of of work and job and people are managing kids and all sorts of things sometimes it's hard to get into the sunlight because you're just following a schedule how much time each day do you recommend independent of anything get you know related to getting sunlight in one's eyes for circadian rhythm setting right so how much time what time of day yeah and what frequency across the week excellent question and and you've hit on on exactly the issue uh based on Glen Jeff's studies based on another study that was actually done in Brazil it was actually an Interventional study in covid that showed that just 15 minutes a day for 7 days was enough to actually get people with covid out of the hospital faster this was a randomized placebo control double blinded amazing study 940 nanometers so when I talk to Glen Jeffrey about this he says he sees it in humans he sees it in bees he sees it in insects it's all the same the mitochondria behave exactly the same when you say 940 nanometers you're talking about long wavelength light coming from an artificial Source correct okay yeah that was 940 and it was actually very low it was about 2.9 mowatt per square centimeter so low energy most people yes um are not going to own a a red and far in a red a far red or an infrared light so yes um I just want to emphasize again for people you can get that wavelength and all the other relevant wavelengths from the Sun exactly that's your that's your red light therapy exactly and this is what I'm trying to say it's like this is not like some powerful laser that they were using this is 2.9 Ms I mean sunlight all of sunlight is about 100 Mills per per centimeter squared by time it reaches at through the atmosphere through the atmosphere so 130 uh when it hits the Atmosphere by the time it hits you it's about 100 if you're looking at just in for red light we're talking about 20 uh Mill per square cm and so this was 2.9 at a very specific wavelength so something that's completely doable okay and so what they did it was 15 minutes a day for seven days and what uh what Glenn Jeffrey was telling me is that Roger it he says Roger it doesn't matter if I do if it's in insects if it's in bees if it's in humans once you hit a certain point 15 20 minutes diminishing marginal utility the the the the Improvement after that point is so minimal that you only need about 15 to 20 minutes that's why he was able to do his experiment in the eye about 3 minutes was all that was necessary so is this 15 minutes outside in the first three hours of your of your conventional day as I call it because people would say well the sun comes up later this conventional Day meaning after the sun after the sun has crossed the Horizon has R I don't think it matters I don't really think it matters I think it what would what would matter is if there's a lot of ultraviolet light which would be when the sun is high and for people who are skin sensitive that could be an issue but if you're covering up it doesn't matter and here's the issue the issue is is that when you need it the most in the winter time is when it's the hardest to get so you really have to make a concerted effort and for a lot of people and this is this is what happens probably right after November and probably going through to mid January is this is what happens people get up in the morning they go to their car they get into their car they drive to work the sun's not up yet they get to their work the sun comes up but they're inside then what happens is they get done with work the sun is already down they come home from work and so there literally is weeks on end that occur where they're not even getting 15 minutes of sunlight and I think this is the reason why we have the influenza surge at this time uh if you look to see the EPA did a study and they looked at Americans 93% of our time is spent inside 86 inside a building 6 to 7% inside of a vehicle and this is a relatively new thing I mean certainly when I was growing up yeah if I came home and had a snack after school I was getting kicked out of the house to go outside you know it was it was uh routine for parents to tell kids they had to go outside yeah and I think there's also um it's also the case as you mentioned that um we're working later or at least on devices later into the evening yeah which means there's more exposure to short wavelength light from devices and artificial sources absolutely absolutely so my recommendation which is what the original question was is take your lunch break outside it's something as simple as getting outside even if it's at lunchtime yes the ultraviolet is probably the highest at that point but if that's the only time that you're going to get sunlight take it now for some you know we can say this I can say this I live in Southern California I'm blessed by 300 and some odd days of sunlight every year what do you do you do when you're in Boston what do you do if you're in New York what if you do if you're in England in Sweden and these places where there isn't a lot of light well there's a study that was done looking at infrared lamps right so you've got to be careful there because if the infrared lamps are too high in amplitude this result from infrared light in the body is something known as a basic response and that's really important to understand don't come into this if you're going to get a red light therapy and think that more is better because more may not be better um you actually could do detriment if you have the red light at too high of a level so I would match it to what we're getting from the Sun as you said the sunlight is your best infrared or red lamp so there was a study that was done looking at well-being and they did a red lamp Red Light lamp infrared light so it was coupled with 850 I think was the nanometer so that is definitely in the infrared Spectrum can't see that cannot see it and they had it set up at a desk that some guy was sitting in front of for 4 hours a day for 8 weeks and they did the study and they they did it in the summertime and they did it in the winter time and this is really telling there was no effect on the subject when they looked at those that had it in the summertime I would say probably because they were getting plenty of infrared light elsewhere it was only they only showed a statistically significant effect in the wintertime and so if you look at influenza I would even go beyond that look at a chart of the United States throughout the entire year and look at all of the natural causes of death not just influenza and pneumonia look at cardiac disease look at look at uh kidney disease Alzheimer's disease all of those deaths go up all at the same time and they all go up about 1 to 3 weeks after the shortest day of the year and they all come down and they all are at the nator about 1 to 3 weeks after the longest day of the year when you see that and you you just start to just digest what you're seeing there and then you start to understand that infrared light from the sun which we have filtered out with LEDs and all this we can get to that all of that's gone that we're spending 93% of our our time indoors put that all together and the fact that infrared light helps the mitochondria and the fact that the mitochondria is at the sort of the core of all of these chronic diseases that we're battling it it it really wakes you up and you start to realize that maybe the lowest hanging fruit that we can do right now today for literally no money is simply to just work on getting more sun exposure in the winter time two questions one um it's hard to attach a single number to this but uh what fraction of the Obesity epidemic that we observe in the United States do you think um is caused by altered interactions with sunlight or you know artificial light and its consequences or put differently let let me put it let me phrase the question differently If This Were if we were designing an experiment and I wanted to wager the hypothesis that exposure to 15 minutes a day of sunlight could help reduce um you know adapost tissue Etc independent of caloric intake I know this is kind of a heretical idea yeah independent of additional exercise and all that and I designed the experiment with you and we said okay people are going to go outside for 15 minutes a day they're going to wear short sleeves if they can or just simple long sleeve clothing they're going to get this long wavelength light from the sun 15 minutes a day yeah based on what you told us about the the light shown on the back and the lowered glucose response yes independent of all other variables what percentage Improvement in um uh sort of the overall all metrics of obesity and metabolic disease do you think we you would predict if we were just going to you know we bet a sushi dinner for instance you know I guess another way of asking the question is is at what level would I be really surp if it was 50% I would be surprised right same yeah if it was 20 to 30% I think that would probably be where it is but that's significant that's still significant okay so that's that's very helpful um I think a lot of people hearing about the role of sunlight and long wavelength light in particular its potential influ inuence on improving overall immune system function metabolic Health Etc might think that this sounds a little bit kind of biacky because the moment we get into red lights that's sort of like cold plunges it's kind of immediately associated with kind of uh biohacking people say it's Bro Science this kind of thing I just wanted to remind people that in the early 1900s a Nobel Prize was given for the use of phototherapy which is what we're describing for the treatment of Lupus so the idea that um that specific wavelengths of light can be used in order to treat cellular health or offset uh cellular disease is not a new idea at all and you mentioned this earlier but I just wanted to underscore that for people um the other way of looking at all this is that it's it's primitive so some people will say oh this is biohacking right other people say well this is just primitive like get sunlight of course but you you made a very key point which is that the way we interact with light and it in particular with sunlight nowadays is so disrupted compared to how it was just 10 15 especially 20 years ago I would just encourage people to pay attention for one week to how much time you're actually getting outside now a few people will already be getting a lot of time outside but just pay attention how much time each day do you actually get outside yeah without sunglasses onh and just measure your total exposure to outdoor time let alone sunlight I I think that's just an important experiment for people to do and because when one does that you start to realize my goodness I'm hardly getting outside at all yeah there was a study that was done uh looking at just this except they actually used watches that uh was able to detect how much light it wasn't infrared light but just Total light and the the name of the the study was basically you know dark days and bright nights and and that is associated with higher mortality we know of course about Bright Nights not being good so not having a dark room to sleep in these are things that can impair melatonin that's associated with all all sorts of of bad things but the dark days was something that um we really had not seen and it was very interesting they actually could show by the hour that if you were having light coming in exactly what that did to your mortality and mortality went up dramatically as you were still in in daylight about midnight but right around 7 o'clock in the morning 8:00 in the morning if you were out there and you're getting light now instead of uh light being a liability it was now a benefit and it dropped dramatically I also want to point out that when it's raining out or when it's very cold out even when it's dark and cloudy quote unquote dark and cloudy there's far more photons coming through the cloud cover during the day than at night people I can't tell you if I had a dollar for every time somebody said to me online and in person there's no sunlight where I live listen go outside on the shortest day of the year yeah go outside folks and look at how bright it is at 10:00 a.m. or even 2:00 p.m. compare that to the middle of the night there is sunlight unless you live in a cave there's Sun sunlight all year round it's just it's just striking so this morning you know it's uh for Southern California it's pretty overcast today there it's a Misty Rain a little bit more and I didn't want to go outside and get my sunlight this morning but I know I was going to be in studio all day and so I went downstairs and I put on a beanie cap and a hoodie and I just got outside with sunglasses and um got some sunlight in my eyes you know it's it's really bright outside even when it's raining yeah it's really bright outside even when it's storming and I think people somehow they think that if it's not a clear sunny day there's no sunlight to be had correct and they many uh gems that you're providing us today but one key take takeaway is I want people to understand there is sunlight all year round yeah I yes unless you live truly a Subterranean life that you are underground there is sunlight during the daytime yeah and if there is we have to work on that um to your point about it being primitive you know um I was looking at the history of this and it was actually very interesting to me you know we used to have uh tuberculosis sanitariums at very high altitude and part of that treatment was getting out into the the Sun at very high altitude you have less atmosphere more ultraviolet light coming in more light in general coming in and when I started to look at this I I found it was very interesting what people started to say and what what these people were actually saying at the time about sunlight um you know in terms of these these people these Physicians and these healthc care providers back in the 1800s they didn't have all of the scientific accoutrements that we have today they didn't have x-rays and things of that nature but one thing that they were very very good at probably better than we are good at is their power of observation they they were able to get a stethoscope put it on the chest listen to the the space between the second heart sound and the opening snap and be able to say this person's got severe mitro stenosis say this is the one you need to operate on and they would do that and and sure enough when they opened it up sure enough this is the one that had you know so the power of observation was probably better back in the 1800s so what do you have you have people like Florence Nightingale who is the the founder of modern nursing and she was there uh you know in um uh there during the uh the Crimean War taking care of British uh soldiers and she wrote down I'm paraphrasing basically what she said she said look when it comes to treating the whole patient the one thing that more than anything else is beneficial for these these soldiers to recover is fresh air but she said a very close second is direct sunlight getting them out into Sunshine getting them out out into into direct sunlight um when I was looking at this the Smithsonian Institute a couple years ago a few years ago put out their top 100 most influential Americans of all time one of them was this lady she's she's most translated female author in in the world her name is Ellen G white and she had a third grade education but she was also very interested in health health reform and she wrote at that time in the 1800s that we ought to be getting out into the sunlight that that's makes a big difference interestingly something else that she said that I found really amazing and this is they're writing this before we understand circadian rhythm before we understand melatonin she wrote down she's like hey this idea of keeping the lights on after after 9:00 it's a wretched Health destroying habit every light should be extinguished she said after 9:00 so I know about her sayings a little bit because she was the the founder of lumaland University which is where I went to school so but uh just we had this knowledge as you said we we had hospitals that were designed specifically to get people out of the hospital and into the sunlight like you could see the architecture was designed for this why don't we do this today I think we ought to but I I kind of have a sense you asked the question why don't we do this today I have patients that I take care of now that I understand this I have patients that I have in the Intensive Care Unit that I want to get outside in the sunlight I actually try to get them out it's difficult to do these people are critical um the people that we admit to the hospitals today are far sicker than the people that we admitted to sanitariums and and hospitals in the 1800s you you have to make sure that they don't desaturate you got to take the oxygen tank out there with them you've got to make sure that they don't have a code I mean you're outside right so you're outside of the the bowels of the hospital where your support system is it's a little bit of a risk to get those patients out there nevertheless I've convinced um some of my hospital staff to do that and I've I've had a number of success stories where we've had patients that were ready to be intubated and we we got them outside in the sunlight and they steadily improved dramatically after days of getting worse and uh and they got better there was a lady that actually contacted me her name is Amy hanm H NM yhr if you want to look up she's on social media her son this is a really amazing story her son contract basically at the age of 15 got uh leukemia got put on chemotherapy and this was in Minnesota fortunately it was in the summer time and he got admitted to the hospital with what they call neutropenic fever very high fevers very low white accounts as a result of the chemotherapy and his immune system was was completely shot and unfortunately he developed a very severe fungal infection in his lung called mucor and it just basically eats up the lung goes right to the blood vessels he got so bad that they there was there was only one solution that they had at the time and that was to take out the left lung so they took out the left lung and he continued to get worse the right lung became infected he started to to get worse had higher fever they had a meeting with the family 15 years old completely with it realizing that he's dying and they have to tell him that he's dying so they made him what they call no code or DNR and uh the staff came to him and you can imagine and I've been in this position before you've trying to do everything you possibly can and you just you can't do anything else so they came to him the 15-year-old and they said you know this is it do you have any basically last wishes and you know Amy his mom told me that he'd like to play outside so he told them you know without any knowledge about what we've just been talking about he just this is his dying wish take me outside just I just want to go outside and and you know that nursing staff will move Heaven and Earth to do something that the patient requests to do uh even though it's not going to you know benefit them they still want this is dying wish they're going to do it so they they hooked up oxygen tanks they uh they they got this this 15-year-old boy in a in a hospital bed outside on BiPAP with auction tanks for 5 hours a day um his mom was telling me they also uh using something called a firefly device where they were just basically Shining Light onto him to see if it would work you know how the story ends he did not die in two days like they told him he got better his fever went away his oxygen requirements came down and and I'm not telling you this as a as a as a proof that this is what happens but you have to realize that he was in the hospital for six weeks under underneath you know LED lighting and as soon as he got outside fever went away and make a long story short after five days he came back inside they repeated the CT scan and she sent me the CT scans I've seen them we actually did a a little thing on our our megc channel on it and um it was the disease was almost gone there's no explanation to this day they don't have an explanation still alive today still alive he's getting chemotherapy he he went from basically and of course he he's missing a lung but he still has that lung he's on he's getting the the antifungal medication there's no sign of the fungus anywhere so this is an anecdotal story it doesn't prove anything and I don't I don't I don't present it as proof the things that I present as proof is randomized control trials epidemiological trials with with dose response curves these are things that we can actually show the science with the reason why I bring it up is because it shows what is it that we would need to do to get this type of treatment it's it's not easy to do but if there is a will there's a way to do it I'd like to take a quick break and acknowledge one of our sponsors function last year I became a function member after searching for the most comprehensive approach to lab testing function provides over 100 Advanced lab tests that give you a key snapshot of your entire bodily 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comprehensive blood testing is vitally important there's so many things related to your mental and physical health that can only be detected in a blood test the problem is blood testing has always been very expensive and complicated in contrast I've been super impressed by functions Simplicity and at the level of cost it is very affordable as a consequence I decided to join their scientific Advisory Board and I'm thrilled that they're sponsoring the podcast if you'd like to try function you can go to function health.com huberman function currently has a weight list of over 250,000 people but they're offering Early Access to hubman podcast listeners again that's function health.com huberman to get early access to function it's a spectacular story um it by any account um I wanted to just touch on the fact that there's no replacement for sunlight getting patients outside is hard yeah um and at the same time most people listening to this aren't fortunately are not patients of um thank goodness many people however have relatives or themselves are elderly um as people get older they tend to slow down get outside less they're any uh fortunate exceptions to this but one of the setups that I created for myself um that I think is certainly feasible for a lot of people is the following uh well first of all I always make it a point to get outside and get sunlight in my eyes yeah rain or shine right um and regardless of where I'm traveling and uh Etc I do that every single day if I miss a day it's only because of something like a like a flight where I happen to be on a plane at the time of you know sunrise or something in any but I have a setup that I um constructed for myself that is basically a 10,000 Lux light these are available I don't have any relationship to 10,000 Lux light sources um those 10,000 Lux light sources tend to be short wavelength shifted they tend to be very blue they're white light but I don't think they have power across the visible spectrum I think they're they're very a red light and infrared diminish they tend to be um very blue and green light and enriched and it shows up as very bright white light so that's what um I put in front of me when I first wake up if the sun isn't out yet but now I've started um putting a red light near infrared light next to it and I'll spend the first couple minutes of my day um usually as I journal or do something like that or sometimes just with my eyes closed just pleasantly you know uh facing in the direction of the 10,000 Lux white light and the red light near infrared light and I must say um this is anecdotal but that the combination of the two not only does it wake certainly wake you up the white light will do that alone yeah uh we know the biological basis for that but I I have noticed a a tremendous Improvement in energy mood Focus Etc that comes from the addition of this red light near infrared light this is not an advertisement for red light near infrared light I promise uh although you know I this podcast does have a relationship to a medical grade red light devices I I but I mention this because what I'm trying to simulate there is sunlight but I still get outside and get sunlight so I just mentioned this setup because it seems to me that hospitals should be able to create this setup it's for a minimum of cost certainly less cost than it takes to maintain a patient for one day exactly I mean the cost of maintaining a patient in uh for inpatient uh care is so high medical staff the the disposables the dis the the dis the um actual disposing of the disposables the janitorial to after the ca like I mean Hospital costs are outrageously high now of course people will hear this and think well that's exactly what hospitals want right like they can Char the longer you stay it's like a hotel the longer that you stay the longer they can charge you or your insurance and I'm not a conspiracy theory type yeah but it it is interesting that for many people they associate going to a hospital with staying a long time and and getting sicker sometimes they get better and go home thank goodness you're certainly a well-meaning doctor the nursing staff are well-meaning people yes put simply why don't hospitals include light therapy given the abundance of data on circadian rhythms and light therapy and I'll just attach one more thing my audience always gets upset at the duration of these these questions SL editorials but this is my wheelhouse this whole light thing so I can't help myself there's also something known as ICU psychosis absolutely which is when people who are perfectly mentally healthy go into a hospital yeah because of the relationship to light and the disruption and circadian rhythm from the overhead lights the checking of the patient in the middle of the night the disruption in sleep Etc people literally develop psychosis that resolves itself the moment they get home and get onto a normal schedule and it's well known that the patients that are in a hospital bed next to a window don't experience this to the same degree if at all so it's it's sort of like I feel like we're we're in an we're sitting under an avalanche not a waterfall but an avalanche of data telling us what we need to do and like forgive me but like what the hell is going on exactly so I I can tell you that not only do you have less likely to get uh this type of ICU psychosis but the data actually shows that people who are in a tw- bed room that are next to the window actually discharge from the hospital faster and you say ah well maybe that's the reason well it's interesting because the financial incentives with hospitals is not monolithic some hospitals uh and their relationship to the insurance companies are at a situation where when a patient comes into the hospital and the and the physician diagnoses them the insurance will pay the hospital a certain amount of money for that diagnosis and that's that and also there's something called subc capita uh Arrangements where the hospital has a contract with an insurance company to take care of 30,000 people per member per month and if that patient gets admitted to the hospital that hospital has to take care of that patient whatever the costs are so it it basically takes the risk now and puts it from the insurance company onto the healthc care provider so in those situations you'll see a hospital having a an army of case managers they come down every day what are we doing for this patient what do we need to do to get this patient out of the hospital so they're motivated to get people out and so when I say that I'm even more bewildered than when you said at the beginning well if we have good data that shows that light therapy and light getting people out into the sun actually can improve the discharge we we had that as I said that study from Brazil where there was a randomized controlled trial and they used 15 minutes of they actually made this jacket that they put on the patients and they flipped it on with some patients and they didn't flip it on with others they they the jacket was a light jacket it was an LED jacket that was giving light out at 940 nmet infrared light so you can't even tell if it's on and as I said the the the Mills per square Cen was like 2.9 so you wouldn't even feel it but yet these patients when they were done 7 Days 15 minutes a day they had better oxygen saturation they could take deeper breaths longer breaths they their heart rates their their respiratory rates improved even their lymphocytes improved the the ones that are very important for fighting off covid-19 and so at the very end of all of this the average length of stay in the control group was 12 days about 12 days in the intervention group it was 8 days how much does it cost to spend 4 days in a hospital it can be outrageous outrageous and and so all and it's potentially possible and this is why I think really people need to understand this not just not just people who are wanting for their own care but people who are in charge of hospitals people who are in charge of of of Health Care in this country is understanding that I believe why I'm happy to talk about this is I think that the lowest hanging fruit potentially after you look at that graph of deaths throughout the year is encouraging sunlight in people especially in those that are hospitalized and sick absolutely I don't know why but I think if somebody were to pick up the Baton and decide to do a very simple study where you you'd have to hire some nurses that would actually I've actually thought about doing this the study myself is having a unit outside in the sun where people go for literally 20 to 30 minutes and they come back you have a whole bunch of nurses there with monitoring so that you can make sure the patients are stable and then you send them right back up we send people down at the cat scanner all the time it takes 15 to 20 minutes this is not something that we don't do the difference is you're just sending them outside hopefully it's warm it's not too cold you know there's nothing that bad that happens and you send them right back up that would be a very easy study to do you could randomize them and then see what happens to their length of stay in my experience and it's only anecdotal I have not done the study it it it's a world of difference that's for sick people if we're thinking about health maintenance and health Improvement in healthy people who are not in the hospital which fortunately is most people it's very clear 15 minutes a day of sunlight exposure uh and if you absolutely can't get sunlight exposure think about um some artificial light Arrangement that might be beneficial I want to make sure that we talk about not just sunlight exposure and long wavelength light exposure from artificial sources but the flip side of all this which is is the importance of Darkness yeah at night um I'm aware of a study published in proing the National Academy of Sciences where they basically had kids sleep in either a completely black room or a room that had aund Lux this is very dim light folks 100 Luxe light source down in the corner kind of like a night light and then looked at morning glucose level blood glucose levels and there was a significant difference in the direction of you don't want any light in the room that you're sleeping now that's hard to do especially if you're you know if you're traveling hotels but IM masks in particular um silk or even faux faux silk eye masks which are very comfortable um Can essentially provide that it's very clear that it's the light exposure to the eyes what if anything do you recommend for people who are basically living in an environment that's too bright at night um you know do you yourself use like blackout curtains I mean what I mean how rigid I find that this is the one that's a little bit harder for people um you have kids I mean what do you how do you how should we work with these data um and what what are your thoughts about the importance of getting things really dark at night yeah that that that is the same question and the same problem that I have with people that do night shift because they go home and they're supposed to sleep and it's bright it's this daylight outside so what do you do um you know that's where you get the aluminum foil around the Windows that's where you you know you basically have to block out all of that light and then the eye patch of course is a nice thing to do as well um uh realizing though that um that even when you close your eyes if there's a light source in the room people think well I'll just close my eyes those those uh photons can go through the eyes just like we talked about with infrared light can go through the skin and and I don't know if this is true or not but I've heard even one or two photons of light hitting the back of the retina can cause enough signal to go to the supermatic nucleus that shut down melatonin production or at least impair it in some way yeah in um experimental conditions that's definitely true even um I mean the the sensitivity of the of the human visual system is extraordinary I mean your rods the more the higher sensitivity photo receptors in the back of your eye can can detect a single Photon yeah one Photon most people aren't familiar with thinking in in photon quantities so um that might not mean anything to them put differently and this is these are wild data from Chuck cers Lab at Harvard uh Medical School light suppresses melatonin the question is how much light do you need because of the increase in sensitivity of the of the eye at night this rod rod system and these specializ cells that that send signals to the circadian clock 15 seconds 15 seconds of artificial light exposure will significantly quash your melatonin that's a whiz at night 15 yeah right so if you go to the bathroom so then be say well what am I supposed to do how do I navigate at night and how do I make sure I'm peeing in the toilet especially for men right um and how do I not trip and fall this kind of and root to to the bathroom or getting a glass of water it's actually you know it's funny the answer turns out to be so logical but you almost have to hear it before it's you kind of go oh that makes sense so perfectly fine to use your phone as a flashlight and then people say well flashlights really bright but yeah but you're you're not shining the light into your eyes so looking at your screen limed way down in the middle middle of the night is going to be very detrimental to the Melatonin system right at the time where you want melatonin high and other things too yeah but looking at a flashlight shown into the you know the hallway so you can navigate right very different scenario than it shining directly into your eyes so you can um and then there are a number of different red light sources that are that are pretty good like little red light lamps that are effective and or you can just turn your phone to uh red light mode there's a there's a a way to do that well I remember a podcast that you had probably a couple of years ago where you had someone I forgot his name but he he he said his his uh house is very dark at night and people would be afraid to go over because tripping all that's my good friend Dr Samar herar now keep in mind that Samar is the head of the chronobiology unit the National Institutes of mental health so he like literally lives and breathes this stuff right the other thing about Samar which is interesting is when I first met Samar um he was very very overweight what samur may have relayed on that podcast um perhaps not is that by changing his relationship to light sunlight and in getting sunlight during the day and darkness at night and by the way he lived in Baltimore at that time so it's not trivial to do that and changing his sleep schedule to one of getting into bed around 9 or 10 p.m. and waking up earlier as opposed to staying up late and sleeping the equivalent amount into later in the morning yeah he lost over 80 pounds wow effortlessly his appetite just adjusted because he finally got in tune with his natural circadian cycles and and Glen jeffy's work has made me think in my mind because of the presence of light in that study and the fact that the glucose was less it makes me wonder whether or not we really shouldn't be eating only when the Sun is up I agree that we probably should only be eating when the Sun is up I myself I like dinner somewhere around 6 6:30 it's tough for me um but but I totally agree if people would if people were willing to meet me for dinner earlier I'm good now it is true that sleep is vast improved when you haven't eaten in the previous couple of hours it's also true that trying to fall asleep and stay asleep when you have gnawing hunger in your belly is not easy okay yeah and I I would say the other thing is too is uh making sure that these rules that we're coming up with here based on physiology aren't laws so so that we get so anxious about following them that they actually become a detriment there's there's a point where we just have to do well enough and then move on to to the you know to the next we try to do it the next day we're human yeah I want to talk about the other aspects of new start nutrition exercise um trust rest Etc but before we do that I want to touch on something that I've been curious about for a long time it's somewhat controversial I've stated my stance on this previously took some heat for it um but maybe I'll revise my stance you see a lot of patients in the ICU with flu yeah obvious VI ly the flu can be deadly in some circumstances but for most people that are healthy generally healthy first of all how concerning is flu like should I really be concerned about flu this winter season even though I feel robust and then the second question is do you personally get the quote unquote flu shot I said on a previous podcast that I don't get it um and I took a lot of heat for that I understand that the flu shot does protect against certain forms of flu not all of them uh that statement was um kind of pushed out there by folks saying that I was going against CDC guidelines I'm not going against CDC guidelines people should do as they choose they should just know what they're doing I've never gotten a flu shot I I don't know if I've ever gotten the flu um but that's my personal choice and it's not based on any specific fear of the flu shot it's because it's never been an issue for me and I'm okay with getting a cold or a flu every couple of years years feeling miserable for a week or two and bouncing back I feel like that's good to develop my own antibodies but maybe I'm thinking about this completely irrationally so do you get the flu shot do you recommend the flu shot for healthy people do you recommend the flu shot for people that are met metabolically challenged yeah it's a good question I think it's and the approach that I take is is the approach that I take with any intervention in medicine every intervention in medicine has a benefit and every intervention has a risk no matter what it is so for me because I work in an intensive care unit around sick patients all the time I'm exposed to a lot of flu I mean you literally walk in and the next day they say oh by the way that guy he had the flu so you you find out after the fact so for me I've always since I've been a physician I've always gotten the flu shot every single year do you get it multiple times per season no just once okay so at the beginning of the flu season when they say flu shot available now it's it's a mix of antibodies against known um strains of the flu yeah interesting the the way that they try to figure out or guess uh the way it is because that's what it is it's a guess is they look six months earlier to see what happened in the Southern Hemisphere and they see what was circulating there and then they believe that's what's going to be circulating uh in the Northern Hemisphere and they do the same in in the South they look and see what's circulating up here and they try to figure out what it's going to be there so there's usually about three or four different ones that they try to put in there ever since 2009 they've tried to put one in there about 2009 because that was a really bad year we we mentioned that in terms of that study on sunlight but but in terms of the uh of the the side effects as a result of that it's it's been pretty bad I mean to give you an example I had a patient really recently in the Intensive Care Unit uh this patient came in uh very poorly controlled diabetes hemoglobin A1c of like 16 17 it was very bad and she developed uh she got the flu and she her immune system was not well she actually also got uh a very bad fungal infection that was near fatal um and so that's that's the typical patient that we're going to see who's going to have that type of a bad reaction to the flu people who are imuno compromised people who are not metabolically healthy these are the ones that are wide open and so a flu virus is going to to do a lot of of damage there so what does the flu vaccine do it gives the immune system a an advanced notice of what this antigen is and that has two effects what a lot of people believe is that it's going to protect you from ever getting infected it's not the case uh you can still get infected but what happens is that the symptomatology or the the side effects of that infection will be greatly diminished so instead of you being hospitalized perhaps maybe you're only you coming down with the flu and you stay at home a lot of people would say I got the flu shot and it didn't help I got the flu anyway what we don't know is how severe that infection would have been in the first place so that's why for people who are imuno compromised I generally recommend it to get the flu shot or people that are exposed to a lot of flu because like you you work in the ICU but it and if I may like do you um do your kids get the flu shot yeah we give them the flu shot as well um it's more because they're the kids of doctors who might bring home the flu got it um and and more than anything else but uh there there was a point where we were not doing it it when they're in their teenage years that's when we start actually giving them the flu shot that was just a personal opinion even though I know it's approved up down to 6 months of age I believe so you started your kids once they were in their teen years yeah yeah um I remember one year our our uh our son Ryan he he uh he got some some virus I don't know what it was but he had very bad diarrhea and we had to take him to the uh to the to the emergency room to actually get an IV and get fluids into him he was very dehydrated um I don't know what that was I don't know if it was Rota virus but something was going around that year so and he's perfectly healthy so this is something that can happen and um you just have to look at the risks and benefits so if well I am telling you that I've never gotten a flu shot am I being irresponsible as a citizen I I don't tend I mean I go places I go to restaurants I go to the gym I I um I've remained healthy um for the most part I'm an occasional sniffle here and there every couple years I'll get it's been a long time actually now that I think about it I think irresponsible is probably too strong of a word the way I look at things is is through what I call the Swiss Cheese model I don't know if You' ever heard of the Swiss Cheese model I love swiss cheese okay so the Swiss Cheese model says this every if I cut up a bunch of pieces of Swiss cheese you'll know that every piece has a hole in it right or maybe a couple holes and if you line up those pieces of Swiss cheese those holes might be in different places so if you are let's say you're on one end of those multiple slices of Swiss cheese and little particles are coming through if you have enough pieces of those swiss cheese no no particles are going to get through and and that's really what we look at in medicine we don't just depend on one slice of Swiss cheese like in the operating room for instance we don't want to have infections so what do we do we sterilize the instruments but we don't just leave it there right we sterilize the skin that we're going to ins size we make sure that the room is the right temperature the right humidity because that has an effect we make sure it's under positive pressure the the surgeon is wearing a mask he's also wearing sterile gloves so we we we go through we try to do everything that we can possibly do so that if there is a breakdown in one place we still have a bunch of other swiss cheese slices in place it's the same thing with the flu and new start so nutrition exercise water all of those things and then at the end when you've done that for yourself if you want to have extra protection you want to add on another piece of Swiss cheese then you well you can talk to your doctor see what the risks and the benefits are and then make that decision if that's something that's right for you are there any known risks of the so-called flu shot um and if so what what's the percentage risk yeah well definitely there are risks in terms of allergies so they'll they should be asking you when you get it you know have you ever been allergic to the flu shop before I mean you can have anaphylactic shock that's one possibility um of course you can have that with anything right but specifically to the flu there was actually interestingly one year and I can't remember which year it was but there was a I think it was in Europe and we actually never got it in the United States but there was a rash of narcolepsy that was occurring so something about the the flu vaccine was causing a reaction that was causing an autoimmune response and the antibodies they believe were were acting against the um where hypocretin is made in the in the uh in the brain hypothalamus yeah and uh and so they they they noticed that there was an association I don't know if they actually determined that it was causal but they stopped that uh that brand I I would not want narcolepsy I used to work in a laboratory for a summer that wor uh studying narcolepsy it was the laboratory Emanuel minol Lab at at Stanford School of Medicine um he and his colleague s nishino identified the uh hypocretin ere yes mutation as the source of narcolepsy and people with narcolepsy people think it's just excessive daytime sleepiness but anytime they have it at the extreme in the extreme examples when people with narcolepsy have any kind of emotional activation they fall asleep and they have cataplexy too so they can't they can't drive they become essentially paralyzed like a like a sleep aonia right um pretty devastating disease so it sounds like um that particular strain of the flu shot in was neurotox in some way yeah there was one particular string we'd never seen it before um never seen it since and so yeah it's uh there are these one-offs right but you know everything has risk sure and so the example that I give is look I I'm in the ICU all day and I'm seeing people with you know occasionally with head beds right and they're on a blood thinner and but I don't I don't go back to my clinic in the pulmonary office and then take everybody off of blood thinners because we know that blood thinners epidemiologically in the long run actually save lives because they prevent Strokes heart attacks things of that nature so what we try to do is figure out what's the right individual for this medication or what's the you know what's the right medicine for this type you know type of situation and that that requires training and that requires you know sometimes you have calculators that can figure out these risks in the winter months when flu levels are high are you wearing a mask from the moment you walk into the clinic in the morning until when you leave um when you walk up to a new patient um if you know they have a flu or if you know they don't have the flu um are you masked up I mean this became a big issue around the um the covid discussion uh but to what extent is wearing a conventional um mask or even an95 actually protect you from from flu yeah so the the the regular surgical masks are very good at preventing things from coming out of your mouth and going to other people or coming onto your mouth if you happen to have one on so in our Clinic where we work we actually look at the flu incidents and then we see if it's if it's rising everybody that comes into that place Physicians patients everybody puts a mask on to to to reduce that uh n95s are a little different in that they don't prevent viruses from coming out of somebody you may notice when you put an n95 mask on they may even have a valve that pops open and and and gas can come out your respiratory air can come out or comes out the sides it's when you take a breath in and it's seals now it's filtering that air so n95s are very good for people who don't want to get infection and don't have respiratory issues because you're now having to to breathe air in through a filter that takes a little bit more work if someone has COPD or you know or which is a obstructive lung disease or or other lung diseases that might not be the best thing to have in those situations so uh yeah I do wear a mask um I was very careful I know I was coming on your show this winter time and I was like there's no way I want to get the flu miss and miss miss getting on uh to see you so yeah thank you for not for for avoiding bringing flu here it's wild because ever since I started this podcast you know we put out now two episodes a week full length episodes on Mondays and these shorter essential episodes on Thursdays so uh I can't afford to get sick yeah you know and I haven't been sick in years I I I take care uh to not get sick but I'm going to think real carefully about this flu shot thing um what about handwashing is that so A Friend let me Let me Give a Little Bit of backstory uh the guy I worked for as a postto was an mdphd and he used to joke about the fact that handwashing did nothing because he was a in his prior life he was a a surgeon he did a I think he did rotation a surgery uh rotation he eventually became a neurologist okay then then a researcher um and I used to say what do you mean the handwashing does nothing and he's like well have you ever seen what a physician does before surgery you know they wash up to their up to their basically their shoulders they um they've beta dine they glove in properly and you know that's how you prevent infection washing your hands does nothing it's a formality and I thought there's no way that could be true then I started digging around in the literature about this yeah and it's kind of mixed like so to what extent does washing our hands actually help us avoid getting infection I you know it's a good question and I I think it probably comes down to some of the studies are probably not good data or or heterogenous enough to do a metaanalysis but what's what's really interesting is how many times a day if you were to watch yourself that you touch your nose you touch your face and these are the these are the portals for viruses to come into your body yeah eyes nose mouth that's where they come and we we touch them all the time um you touch handles I mean if you think about it it's it's almost uh I don't know creepy and flu it is creepy and flu and cold can survive out on surfaces for how long I I have to look up the numbers but it's it's it's longer than you might think I know that we when we looked at Co it it it's that really we we I know we went crazy at the beginning of the co pandemic about wiping things down and really that's not the way it seems to spread uh for Co and more Airborne things but for influenza droplets um that is uh you know Rota virus CI that's a claustrum defal infection of the bowel that's that's the primary way that it actually spreads I'd like to take a quick break and acknowledge our sponsor our place our place makes my favorite pots pans and other cook wear surprisingly toxic compounds such as pases or forever chemicals are still found in 80% of non-stick pans as well as utensils appliances and countless other Kitchen products now I've talked before on this podcast about these pases or forever chemicals like Teflon which have been linked to major health issues such as hormone disruption gut microbiome disruption fertility issues and many other health problems so it's really important to avoid them this is why I'm a huge fan of ourplace ourplace products are made with the highest quality materials and are all p and toxin-free I particularly love their titanium always pan Pro it's the first non-stick pan made with zero chemicals and zero coating instead it uses pure titanium this means it has no harmful forever chemicals and it also doesn't degrade or lose its 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on the body uh water we get into this kind of thing and then air uh humidity temperature um ozone any anything interesting in those yeah um let's talk about water so the most obvious one is the internal use of water and what's interesting about that is that we actually can do a blood test on people and it's called the sodium concentration one of the first things you learn as a medical student is that the sodium concentration in somebody has very little to do with how much sodium they take into their body it has much more to do with how much water they take into their body so the more water they take in the lower the sodium concentration goes but it's very well regulated there's a study that was done a number of years ago that looked at the chances of death so mortality and sodium concentration and as sodium concentration went up so did the chances of dying so it's important to drink water how much water you know there's this old eight glasses of water uh thing it's um it's probably not that much but uh it it certainly is important so internal use of water is well known I mean it's it's a substrate that allows your kidneys to to dump toxins and you need to to flush those things out and you sweat especially if you're exercising you're going to need to take more water in because you're sweating you're breathing faster you have something called insensible losses of water but I think um the other part of water that I'd like to talk about is not the internal use of water which is pretty obvious and and the data is there but the external use of water and the reason why I bring that up is in the context of what we're talking about which is illnesses and flu and viruses one of the properties of water that is is very very important is its high enthalpy what does that mean means it takes a lot of energy to raise water the substance 1 degre Cel and the opposite is also true so if you put warm water on someone uh it can transfer a lot of energy into that person without losing temperature why is that important if you want to use if you want to increase someone's body body temperature water is a very good way of doing it if you've ever gone into a sauna and it's a dry sauna you haven't yet put the little Ladle onto the heating you can you can tolerate 170 180 degree uh sauna pretty well as soon as you put that water on the heat just starts to come down on you and that's because water is such a very good way of transmitting that heat so why is that important let's let's put that away for a little bit and I'll explain why that's important let's switch gears and talk about viruses in the immune system so your immune system is divided into two components an annate immune system and an Adaptive immune system the Adaptive immune system is what we've all learned about in terms of vaccines and antibodies and all the things the discussion that we've had the last four or five years you see something very specific your immune system does and it makes an antibody directly against that if it's slightly different the antibody response is not going to be as effective so it's very high tuned very specific that's the Adaptive immune system the innate immune system on the other hand is the one that goes out first gobbles things up and presents it to the Adaptive immune system but there's also something else in the innate immune system that's very important and that is the system that has to do with recognizing damaged molecules and recognizing pathological molecules there are certain pathological patterns PM is pathologic iCal Associated molecular patterns that the innate immune system recognizes without ever having seen it and it can take those things out and the greatest tool that the innate immune system has to take those things out is something called interferon interferon is an extremely important um molecule it has a very wide ranging ability to take out viruses something that's important to understand is that with all of the variants that we've been talking about with covid with all all of the the different strains that we have of influenza none of that matters with interferon interferon has very why and that's why it's such an important molecule it's been said that the immune system is so well-designed that there are no viruses that can infect it unless they have countermeasures and that is absolutely true this was first seen when SARS kovy 2 came out they looked at SARS kovi 1 the original one that came out in 200 too and and sure enough that virus SARS kov1 if you want to call it that or just SARS had a mechanism contained within it to neutralize and to suppress the secretion of interferon uh they did some searching and they looked at SARS kov 2 and sure enough mac 1 which is a a gene in SARS kov 2 is is a is a gene that is specifically I don't want to say designed but it's there to get around interferon that should tell you how important interferon is so with that in mind let's go back to our talk about water and temperature there was a number of studies that had been done looking at temperature interferon and what they showed this was an inv vitro study where they took lymphocytes they put it into a medium and they bathed it in uh LPS LPS is basically a a molecule that is seen in bacteria that usually sets off the immune system so you have lymphocytes you have LPS and then what they did was they slowly increased the temperature and they measured interferon once it hit 39° C there was a 10-fold increase in interferon secretion from the lymphocytes 39 degrees for those uh who are on the Fahrenheit system that's about 102.2 okay so slight fever slight fever yeah or or a good fever yeah good fever so what do this means this means that and this gets into the whole discussion philosophically about fevers in general should you block them exactly and I'll tell you in the hospital I'll I'll get so many calls hey doctor this patient has a fever and and the the idea is is that the fever is part of the problem and we need to fix the fever because it's part of the problem by the way that was the same thought process in the in the 1918 Spanish flute pandemic that we had aspirin had just been discovered bare aspirin 18 1999 and uh it was great it seemed because aspirin took away fever it took away the body aches it took away the pain and all of that was subscribed to the virus that was going on they didn't know even know it was a virus just the influenza disease and so uh it was being used almost excessively in fact in many cases probably toxically in these Army hospitals in 1918 people were coming in with the flu young people were coming in with the flu and they were getting high doses of aspiring they thought this was the way to treat it and the mortality rate the case fatality rate was like 6% it might have been even higher than that so getting back to water external use of water here is a way to deliver large amounts of energy that can be stored in water as a substance to the patient to elevate to actually help Elevate body temperature to see whether or not we can improve the innate immune system to actually help out in that type of a situation so we're talking about hot baths hot baths sauna hot shower hot showers um probably the most effective way of doing it is uh the old term and again something that was used a 100 years ago is hydrotherapy or hot fermentations is the term that you'll find if you look at the old literature this is where they would get hot towels linen towels they would uh soak it in water they would heat it up usually in a stove but you could do the same thing in a microwave the big thing is that you have to make sure you don't burn yourself or the house down exactly um and so you would put a protective layer of of batting or or cloth on the patient and this would go on top of them and you would basically cover them up until you started to see them sweat and you do that for about 20 minutes once you start to see them sweat you know that you're elevating the body temperature above the set point and what that's supposed to do is to activate the immune system to uh to secrete interferent look we we have studies there's a study that was published a couple years ago looking at covid giving exogenous interferon to people with covid-19 reduced hospitalizations by 50% so you're getting around take exogenous interferon oh yeah absolutely you take it as a pill uh it's an infusion you would digest it in the stomach so this this was an infusion that they gave to patients uh I'm surprised that I haven't heard of like peptide Clinic selling into feron um can you can you inject interfer on sub subcutaneously uh you can in this this was actually published in the New England Journal of Medicine um it was uh interfer on Lambda I believe and it was a it was a uh phase three's trial looking at getting FDA approval I think probably because of the fact that um we weren't having as many hospitalized patients that probably hasn't gone through but in that study it reduced hospitalizations by 50% wow for those that don't have access to interfere on infusions um or a sauna or even a bath it so what is it you know a 5 to 10 minute hot shower then get under the blankets this kind of thing I mean this kind of um good old uh good old mom's advice kind of stuff isn't it interesting so I'll tell you what the protocol was um there was uh and actually this is quite interesting historically there were a number of sanitariums in the northeast of the United States back at that time of the century and um they were run by the Adventist Church and their their way of dealing with the pandemic was different they were not using drug medications they were using hydrotherapy and sunlight some of the things that we've been talking about here and there was a guy by the name of Wells Rubble who was the medical director of the uh New England sanitarium and he said let's just take a look and see what's going on here let's look at let's pull the 10 sanitariums in this area see what's gone on in terms of the way we treat the patients and then look at the published data from the the Army hospitals and there was a stark difference he divided into two sections the first phase of influenza is the early phase and and the major uh end point of that early phase was did they get pneumonia okay and then from pneumonia the second end point after that was the second phase and that was the question was did they die so where the sanitarium seem to do a much better job than in the Army hospitals was in that first phase they had one sixth of the people actually go to the pneumonia phase so what were they doing immediately they were doing hydrotherapy immediately they were doing uh which was basically increasing body temperature doing fever types of treatments getting them out into the sunlight you you can remember maybe in your mind's eye these photographs of these Army hospital or these Army Camps and the tents were outside because they didn't have any place to put them in some of these cases so the sunlight was good but the thing that they weren't doing was the hydrotherapy once they got to the pneumonia stage there was no difference between what the sanitariums were doing and the Army hospitals the mortality was 50% remember this is prior to penicillin this is 1918 this is before 1928 when we discovered penicillin so once you hit pneumonia it was really difficult to treat so he he actually wrote this up and I actually found it in a uh someone directed it to me they actually showed it to me it was in a um it wasn't even in a scientific journal that he published it it was some sort of periodical called life and health May 1st 1919 still remember in my head and he says hey this is what we did this is what they did they had one sixth of the mortal it in their uh in their institution and this was repeated multiple times this is not done in isolation there let's lead you up to the to the big thing here there was a Nobel Prize that was given for this in 1927 Jules Wagner yor was a Austrian psychiatrist who noticed that in his uh patients that had neuros syphilis that when they had a fever their symptoms improved so this is again prior to penicillin he actually took patients with malaria and he took the blood from these patients and carefully infected his neurosyphilis patients with malaria and of course you know that malaria causes very very high fevers he cured neurosyphilis by causing fevers from malaria wild um and all he really had to do was heat them up um there was many ways of doing it at the time he closets sometimes they would inject foreign proteins to create a fever this was another way of doing it with malaria of course at the time they had the treatment for malaria right um quinine well and LPS will do this yes right LPS as you mentioned is lipid polysaccharide I think they get it from um yeast cell wall or something and um it's a foreign antigen yeah it's a contaminant in a lot of gray Market peptides and things that I suggest people don't take you know there are a lot of people now who are interested in peptides and they buy them on the gray market and it says not for human or uh animal use research purposes only and people often say well why not use those you know why do people have to go through a physician and a compounding pharmacy if they're going to explore that territory at all yeah and the reason is there it's very clear that most of the gry market peptides have LPS um in them so small amounts but injected repeatedly over time people start getting the systemic inflammation and fever response there you go um you that's it's a little bit of a tangent but it gets to the same mechanism yeah uh so when when you say um the use of water in this context it's really about trying to heat up the core temperature of the body exactly okay and so when we think about Russian Bas uh which I'm a huge fan of you know there's some a bunch of them in different cities um whenever I'm in New York I go to this place down on Wall Street Spa 88 um I have no relation to them and they have a medium hot sauna for Russians medium hot as very hot it's like a spice for uh in in certain restaurants you know you have to calibrate to the the the uh the local ethnicity um and then they have very hot sauna and what they do there even when they're not sick is they'll go from you know moderately hot to hot to um Steam and then back to hot hot SAA then into cold water so they're doing heat cold contrast therapy and they and you know the Eastern Europeans and Russians have been and Scandinavians have been doing this for centuries absolutely right here we think of it is like biohacking and this new new domain of Health but this has been going on for a very long time so in my mind anthropologically I'm wondering those cultures that don't have access to the sunlight that we have here maybe they use this as a way of supplementing that CU we don't see in Winter right so we don't see that we don't see a lot of sauna use near the equator in any kind of culture yeah I don't I'm sure they exist down there but I feel like um Brazil in the summertime probably feels like a sauna so you don't need a SA right right whereas Siberia in Winter feels a lot like the way I imagine Siberia in Winter if you look at probably the biggest purveyor of this type of therapy that we're talking about hydrotherapy was at the Battle Creek sanitarium in Battle Creek Michigan and they had whole protocols for this and when I looked it up the general protocol for this was 20 minutes of hot followed by a very very short probably Le a minute of cold that involves some sort of physical rubbing or or sort of um abrasion on the chest okay and and when I saw that it's like I immediately thought of what they do in Finland and where they where they hit themselves with yeah the the um the Russians use these eucalyptus branches eucalyptus and it's the um it is it's eucalyptus branches I call it I think it's called platza or something like that yeah um and uh yeah it costs a little bit more but if you go to one of these Russian Bas you could pay someone who's skilled in this they make basically make you lie down you cover your face and and groin and then they they hit you with these uh eucalyptus branches not not to smack you with them but to now the idea is that in the sauna you're going to bring some of the um uh additional Vasa dilation to the to the uh surface of the skin so you're getting more blood flow to the periphery is the idea I don't know if there's any truth to it but um my understanding from what I've heard and read is that um obviously the heat part is to heal up the core body temperature and that has a whole host of of uh of responses which I'll I'll I'll touch on after this that I I read a recent article that was just amazing but the the cold part of it is going to cause vasil constriction and we know this in medicine we're actually taught this in medical school that a cold shower Vasa constriction causes demargination of the white blood cells that are actually attached to the inside of your blood vessels and it knocks them into circulation so if you think about this what what is it that you're doing with you're doing the heat aspect and the fever goes up and the temperature is is basically a it's a non hormonal signal to the entire body to start up up uh regulation and transcription and then the very last thing is the cold now what does that do number one it knocks those cells into circulation to go wherever they need to go that's number one and number two vas of constriction peripherally which is what you will see prevents that heat that you've just built up from going out to the periphery and and being lost so it kind of locks the heat in in a sense allowing that heat to last longer amazing could you just repeat one more time even though you said it incredibly clearly yeah um this uh this phenomenon of of how the uh white blood cells are liberated by by cold and constriction yeah so when you have imagine a a tube that's lined with white blood cells they all have little poyes little things that attach and what happens when you have Vasa constriction is it causes Vasa constriction it shrinks down because of the smooth muscle muscle in the wall and you have release of these white blood cells into the circulation um and that's called demargination so after a cold shower you will actually be able to see and this is kind of a trick question does one's white blood cell count go up after a a cold shower the answer is technically you have the same number of white cells but now they're just more of them in the circulation so yes the number that you get back on the Lab Test shows that it's gone up and the white blood cells for those that aren't familiar they go out yeah these are the these are the macras the neutr these are all different branches if you will of the Arm Forces of your body that go out to try to find things and neutralize them and this is part of the innate immune response this is not so both actually white blood cells right on white blood cells are involved in the the Adaptive IM immune response as well amazing I've never heard of um deliberate cold exposure being used to liberate uh white blood cells in that way but it makes perfect sense it sounds like it's largely mechanical it it is um and it also may seem to be mechanical in terms of locking that heat in so um one of the things that I that I always was puzzled about is I've I don't know how many people are able to really get their core body temperature up to 102.2 I mean it's possible you'd have to really try to do it and then I came across a paper that was incredible and this was a paper where they actually looked at mice which by the way I looked this up they actually have the same Target temperatures that humans have and also ham ERS and again the same Target temperature and what they showed in this they looked at the inate immune system and the signaling that's required for the secretion of interferon and they looked at stat and Jack these were the two um areas or signaling and what they showed was essentially that whereas before I had told you that you had to go up to 39° Celsius to get a 10-fold increase in interferon secretion what they did was they looked at 36 37 38 and 39 and they saw a jump going from 37 to 38 so in other words at 38 degrees which is only 100.4 Fahrenheits there was a dramatic increase in in the signaling in probably six or seven different areas of the stat and the Jack system uh signaling when they did further analysis they said what what's going on here is it is it the lack of breakdown of mRNA what what's actually happening this is the clusion that they came to after they did all the molecular studies it was simply the just the increase in temperature that was causing an increase in transcription in the nucleus transcription of of of the proteins leading to more interferon correct so these we're talking about not the transcription of the protein interferon but the transcription of the factors that regulate the increase in interferon yeah so it was basically transcription in the nucleus is actually upregulated itself by nothing else other than temperature I love it uh one thing that people might want to play with a little bit although they should be careful right if you're pregnant forget the sauna for a while um you know if you're absolutely you know everyone has different thresholds for heat tolerance and cold tolerance but uh spend a little time in a Russian B and you'll soon realize that they all wear these uh like wool hats yes and you might think oh well that's just going to heat you up more no it insulates you against the Heat and so you can stay in much longer because the signal to get out like that it's too that it's quotquot tooo hot is a is a brain signal first oh wow which makes sense right your brain basically evokes something um analogous to the gasp reflex when you're not getting enough oxygen right okay so if you go in there with a with a towel on your head or or you cover your head what you find is that you can sit comfortably at much hotter temperatures than the sauna got it that could be a problem right because you don't want to burn your skin but the sauna actually provides a lot more um degrees of freedom exploration safely then does hot bath because if you get into a bath that's truly too hot you'll burn your skin correct right whereas in the sauna you know you might go into a very hot sauna I'm very heat tolerant I don't like the cold so much but I do it anyway but I'm very heat tolerant and but when I first hit a um you know a 210 degree sauna which is very very warm sauna um if you if your head isn't covered your heart starts racing you feel like you want out of there if you go in there wearing a like a wool beanie cap yeah you like you're fine yeah yeah you're fine because the the brain signal does doesn't get kicked off for a while so so that's interesting because I've seen some old photographs of when they used to do this like in mass in the big hospitals back East 100 years ago and there was these treatment rooms and each of the treatment rooms had a little hole in not a little hole but a hole enough to put your head and so it was it was kind of funny because you saw this long hallway and all of these humans heads kind of sticking out of a hole while the treatment was going on inside the room their heads were outside the room you know it's so amazing how humans um find the same Solutions through different portals I'm fascinated by this you know every once in a while I sit back from the information that we touch on in this podcast since we launched in 2021 and I think you know there are so many different tools and protocols and um and you're providing additional ones today they almost all fall into about six to 10 batches and whether one comes through the the portal of traditional Western medicine or Eastern medicine or what the you know fins or the Russians do it's so interesting that you know we're talking light yeah temperature and these things obviously relate um hydration which I'm sure we'll talk about um mitochondria cellular metabolism I mean that you know there's there isn't an infinite number of conceptual themes and they tend to sort of batch into them and I think understanding those themes helps people make decisions like if you're on the road and you're feeling run down after getting off the plane and you're thinking you might be coming down with something you get that little throat tickle mhm you know you only have access to a hot shower that that's your best bet do that like you don't need a sauna ideally you're getting sunlight you don't have sunlight you can you know take some of the other measures that we were talking about before um yeah I find it fascinating that humans eventually Converge on the same answers it just sort of varies in terms of what you call these things exactly you call it hydrotherapy I call deliberate heat exposure deliberate cold exposure if you're you know in some cases and people from all over the world in different cultures have talked to me in Asia in the Middle East and they say you know what my grandmother my mother they used to do this to us all the time they put us in the hot sand I remember someone telling me from from Iraq they said if we were hot if we were sick they would put us into the hot sand to heat us up and then you you talk to somebody you know from the 1950s uh Grandma's say oh they put us to bed and and make sure we're all warm with the covers and hot water bottle hot water bottle exactly I mean in Asia they would do something uh different i' I've heard them tell it it's interesting to me how all of these cultures that really haven't connected necessarily have come up with the same answers for for a lot of these things that said um there are things that purportedly we can take to accelerate our progression through uh an illness should we get one uh and to help avoid illness one of the things I'm most interested in is uh your thoughts on maack and acetal cysteine U my understanding is that a few years ago in this country there was an FDA ban on netal cysteine but that the people who had already been taking anical cysteine were so bullish about it that they SW back and it has remained freely available without a prescription my understanding is that netal cine requires a prescription in some countries could you tell us what the various uses of an acetylcysteine are um and what its potential role is for avoiding or even accelerating the progression uh through a viral or other type of infection yeah so the an and I I sometimes say n ayine it may be just my Canadian accent coming through I'm guessing I oh I didn't realize you're a Canadian uh I'm guessing you are correct and I'm incorrect no I think you are correct cuz people have corrected me so I think if I say it if slip up that's that's what happens so Mom Mom you know ninth grade grade nine these are all Canadian that true yeah so so the probably the most obvious one to start with is the one that's actually we use all the time in the hospital and it's for Tylenol overdose and that's because Tylenol uh the metabolism of Tylenol depletes the liver of these reducing agents glutathione things of that nature so um an acetal cysteine is going to replace that and that's one of the things that's well known we actually have dosing protocols we have nomograms to tell us when we should use it when we shouldn't use it and it's it's very well documented so it supports liver metabolism it it supports liver metabolism and prevents the liver from going into failure so people could literally die if we didn't give them this medication does it also effectively treat liver failure due to other things like alcohol that's a excellent question uh I would say if you ask asked me that question 20 to 25 years ago I would have said no there's no evidence but now if you talk to some GI Specialists they'll say yeah there's some data that it it actually may be beneficial it's certainly not going to hurt and so in patients who have liver failure uh from one thing or another they may actually recommend using that medication as well and estaline so Knack is a glutathione precursor is that right it is it is one that it's recharging so if you want to think about it in terms of redo this is a good way to think about it is think about a um a sulfur uh element with an a hydrogen attached to it that is the reduced form because it can donate that proton off and and it'll be in a reduced situation so it can reduce something that was oxidized however when it reduces something that was oxidized and it it does that in a in a good way it itself becomes oxidized and instead of having an s h it's now SS so now it's it's oxidized that's really important in a lot of places because of that SS Bond so you'll know that the SS bonds occurs in in amuno acids it's the reason why you're you can perm your hair uh you may not know that but uh the way your hair is is because of ss bonds and then what you do is you reduce all of those SS Bonds in other words you know basically disconnecting them and then you can curl it however you want and then when you take it away those SS bonds clamp down and you have a perm all right Next Episode I'll show up looking like a Chia Pet that's the reason why when you go to get a perm that stuff smells like rotten eggs is because that's the sulfur group yeah so um that's also by the way the same reason why and this gets it a little bit other discussion about why I think Knack may be I'll just call it knack uh is used in other areas is um this is also the main reason why we get thrombosis of platelets so pulmonary artery if you have the endothelial lining which makes sure that the red blood cells as they're going through the pulmonary artery are not causing clots if those if that endothelial lining would become damaged it would release underneath it and expose a huge collection of something called Von willbrand Factor Von willbrand factor is a monomer but it quickly becomes a polymer and the way it does that is in forming SS bonds so that's a a quick pull ization then of course the next step that happens is that these polymers will then trap platelets and cause them to Clump and you will get something called a white clot so for those that aren't familiar with monomers and polymers and this kind of thing basically you're taking a a bead and you're creating the polymer which is more like beads on a string exactly exactly and that can capture more things like a big clumpy Mo big clumpy sticky molecules aren't quote unquote bad or good but in this context they're definitely bad they would be yeah so imagine now if you will uh the pulmonary artery in somebody who becomes infected with either influenza or covid-19 and that causes an oxidative stress situation where you have the cell having more oxidative stress than it should causes dysfunction of the cell the cell becomes damaged peels back releases some of the Von Willer Brands factor and now you have clots in the in the pulmonary artery this is something actually that we did see with co uh when they did the autopsies found many times more of these specific white clots in these patients and so um I don't know if that's the mechanism that's occurring in influenza but there was a lot of papers that were published in Co and the interesting thing about that was is that uh do you remember when they published they they had a paper that was published looking at blood types and covid and they said you know what what we're finding is is that those with type O blood are just slightly less SU suceptible to getting Co they have a slightly less mortality yeah that was a relief to me because I'm O blood okay yeah well the interesting thing about that is well known is that people with typo blood have slightly less Von willbrand Factor so does that mean in general that that we clot less if that clotting is related to Von will Brand's Factory and platelets then yes there's other ways of causing clot gen the CL clotting Cascade but yes so I found it really interesting that was kind of two independent points that sort of connected each other the other thing that was actually really interesting about this and this will lead to the conversation about Knack and why I was using it in actually patients with co9 and influenza and we'll talk about that study too is is ace2 so ace2 is a receptor for the spike protein for SARS kov 2 true but let's take it one step further that ace2 what is it actually there for what why is it even there it's not there to be a receptor for for Spike protein the actual job that ace2 does is converts Angiotensin 2 which is a prooxidant into Angiotensin 17 which is an antioxidant so let's go back to the beginning of our discussion again here's the mitochondria here's the the mitochondria is doing what it needs to do and it's producing oxidative stress and it's got all these different enzymes that are there to lessen the heat from that engine catalase glutathion peroxidase superoxide dismutase melatonin as we discussed at the beginning and Angiotensin 17 so now what happens you've got these patients that have obesity you have these patients that have cancer um heart disease dementia these are people whose engines are running hot they're barely making it because of all of the oxidative stress damage that has occurred now what happens this virus comes in Spike protein hits the A2 receptor and now that thing that was in balance is now out of balance because you're no longer taking a pro oxy and making an antioxidant so now the the analogy is is that you're you're in a car and your car the the the Heat and the engine's barely I mean it's it's coming up right and you're barely making it and now you approach a Hill Called covid-19 and you're going up that hill you're going to burn out your engine's going to overheat and that's what was happening with these patients remember they were coming in happy hypoxics they were calling them they were there they looked they were fine but they were they were severely um uh hypoxic what I believe what was happening and some data to show this is the case is that the as the virus went into the lungs and I believe this also happens with influenza these the virus was getting into the pulmonary circulation and as it was going down it was binding to the very rich A2 receptors and all of these pulmonary endothelial cells and it was causing these enzymes to stop working and now the oxidative balance was being knocked out these cells were becoming damaged they were peeling off Von willbrand Factor was coming into circulation and this polymerization was occurring and these white clots were occurring and that was leading to hypoxemia how do we stop that from happening well certainly one way of doing it is to make sure that the redo balance in these cells are are are maintained and one way of doing that is light and melatonin and all the things that we just talked about but another way of doing it in addition would potentially be in preventing those sulfide bonds from forming and causing polymerization and that's where you have Knack which is basically it would go through to those SS bonds that are causing the polymerization and break them off I see so I started taking Knack at I think at 600 milligrams or even 900 milligrams three to four times per day which is a very high dose yeah but restricted to times when I felt like I might be coming down with an infection or I was traveling um in the winter months I still do this or if I had any kind of um low-level congestion and uh my understanding is that it's a mucolytic yes because mu mucus again the reason why mucus is so thick is because of those SS bonds so when you put Knack in there it breaks it off and now it's liquidy it's used to treat cystic fibrosis and the uh to counteract the buildup of fluid in the lungs as I understand yeah um so it will make your nose run a bit if you have a little lowle congestion but what I love about it and I don't have any Rel to be clear f I don't have any relationship to any company that sells Knack no one I'm not paid by big Knack um uh or anything similar or Big Mac no or certainly not by Big Mac but um by Big Mac either um but I don't like conventional decongestant I like steam um but but I don't like taking over the counter decongestants of the sort of uh conventional commercial type because they tend to be very drying they sometimes have a little bit of a stimulant quality to them I I just don't like them and I find that neck in addition to increasing glutathione which can only be a good thing um is a great decongestant you do have to keep blowing your nose quite a lot if you take it right before you go to sleep and you sleep on your back you can wake up like feeling more congested so you have to kind of understand what it's doing that's why we're talking about it in this way yeah but um I I find that it's helped me move through um periods of uh you know sort of exposure to uh colds maybe flu but certainly colds um much faster and actually there to support that it can prevent Contracting the flu virus well uh not necessarily Contracting it but certainly having the symptoms of it so this was a this is this is like the best study you could ever imagine right so this is a multi-centered double blinded Placebo controlled trial right so you're eliminating a lot of the confounders and what they did was in a winter season so I think it was over six three to six months people were taking 600 milligrams of knack twice a day and what they did was they looked to see how many people got infected and what they're symptoms were and it while it did not reduce the number of infections from influenza there was a significant reduction in the symptoms of influenza so infections no it doesn't reduce but symptoms dramatically and which symptoms specifically it's the most annoying symptoms so the the one that dropped the most was the runny nose and the sore throat those that was what it was best at reducing there's been some question about Knack because it's so it's so good for cells right because it it replenishes uh there are some studies in vitro in cells that are designed to be models for cancer that that can actually cause the propensity for some of these cells to uh to um grow and and and uh expand um I think that probably needs to be taken with a little bit of grain of salt because these were in models that are designed for cancer cells to grow so the same thing would happen if you were to give nutrition to cancer cells on a p Tre dish right that doesn't necessarily mean that that nutrition causes cancer right yeah you ra a really important Point around this I mean the uh the joke that was told to me years ago is you know a drug or a compound is a substance that when injected in to an animal uh creates a scientific paper meaning meaning it's very easy to see things change when you add when you do a dose response curve of just about anything right um and some people might say Well thank goodness are are any compounds doing anything that are that's real or is it all Placebo I think there are real effects of compounds uh the context is really important yeah um do you take Knack continuously given your job or do you uh do you increase your your dosage when you are you know you're coming into contact with flu patients I do uh I do exactly as this paper was doing in a winter season when I know that things are going to be elevated and high and I'm going to be seeing a lot of uh influenza patients I do take 600 milligrams twice a day U but I tried not to do it for more than 3 months I don't know the long-term effects but I think three months is probably good enough yeah I know people take it continuously I've never taken it continuously I I sort of enjoy the fact that there are certain compounds out there like Knack that um I personally can observe of a benefit from if I take it for short periods in slightly higher Doses and then I stop and I have the you know unfounded theory that it um it helps punctuate the the effectiveness because you're not you know because there is downregulation of pretty much every mechanism you could possibly imagine right I mean there's so many redundancies that are built into the system but uh in this situation I I I don't know what the mechanism is but I believe that with influenza there is a um there is a a tilting of the scale toward oxidative stress and Knack in that sense can be very helpful and as I recall in the study that you described um where people took this 600 milligrams of knack twice a day the uh reduction in um what in severe symptoms or or was it the number of people that experienced severe symptoms went from somewhere in the high 70% maybe 78% or something like that I'm not quite um uh exact on the numbers here folks to about 28% is that right yeah so that's that's uh about a 50% uh absolute risk reduction which if you do the math it's a number needed to treat of two which is extremely low and very amazing and you're getting um and a increasing glutathione to boot so yeah wonderful um other things that have been shown to improve symptomology or perhaps even immune system function um maybe we could talk about zinc yeah I take what most people would consider very high levels of zinc and I've been doing it for a long time and I'm going to continue to do it because I I do my blood work and I it works for me I think there is actually good data for zinc um some people might uh might disagree but I think the studies that I've seen seem to show that that zinc supplementation can be beneficial um the theoretical of course and I'm sure you're familiar with it is is the copper deficiency and if you're checking that then that's fine um the recommendations that I have seen um is 40 milligrams of Elemental zinc so you have to be careful when you look up zinc on your on your bottle tell you how many milligrams but it's the entire molecule that they're measuring so you've got it'll also say how many milligrams of Elemental zinc that is equivalent to and the recommendation that I've heard from people is is 40 milligrams but um I don't I if you're checking your copper levels then you should be fine yeah well it's never charted out by body weight either so I weigh you know 215 lbs so um what's the risk of copper depletion um blood um deficiencies and things of that nature yeah okay I'll get my copper levels checked I believe it's in my blood uh blood panel um it is in my blood panel and I don't have a flag there but I'll keep an eye on it yeah liver I believe also is involved with copper as well so what is zinc doing to improve immune system function there's a couple of enzymes that use zinc as a co-actor um and I believe that that's what it's related to uh I'm not I can't remember exactly which ones they are but zinc is used as a co-actor in some of the enzymatic reactions of the immune system yeah why doesn't somebody Market an interfere on inhaler or n nasal spray you know actually they they are looking at that um when I was researching this for you know the uh intravenous interferon um I was I remember seeing something about interferon in terms of a nasal spray I haven't seen that yet though someone out there who's industrious can yeah can um create one it doesn't make you feel very nice okay I mean uh when when these patients for instance uh well this might be material to understand too for many years we had hepatitis C that was incurable and um interferon actually is the is the cure there was a point where we was used to give uh infusions of interferon to cure people with hepatitis C um but when we gave them the treatment they felt horrible felt like they had the flu and it's for good reasons because when you have high levels of interferon you you do have the flu it feels like that it's worth touching on this that so much of the uh symptomology when we have a flu or a cold or what have you is the is the immune system doing its thing the fever the congestion or correct um and we think think of that as the illness but it's often the byproduct of the body trying to extrude or kill exactly nobody likes congestion um so you know I don't have I don't mind treating that but I think out of all of those symptoms that you mentioned there the one that I think is probably the most beneficial to keep is the fever what about these cocktails that I see of eucalyptus oil oregano oil all this stuff is it completely worthless no it's not completely worthless um so let's look let's talk about the science let's talk about the um the actual data we don't have I don't have a randomized control trial to give you like I did with light but there was a study that was done and they the reason why they were looking at this was a bunch of oncologists that were looking to see if there was something that could improve the immune system when people were getting chemotherapy and they did an invitro study so this is in vitro but they were able to show that just a very small amount of eucalyptus oil had a tremendous impact on phagocytosis uh on the inate immune system they actually fyos folks sorry for interrupting but is a gobbling up of of yeah of bad stuff by good cells yeah exactly so they had these beads uh and you in the paper uh showed that these beads and they were fluorescent and you could see in the cells that had not yet gotten uh the eucalyptus oil that there was a number of beads outside and these cells were just kind of mosing around and uh they had both white microscopy and electron microscopy and a few few of these beads had gotten you know eaten up inside and then they showed the next slide it was like a transformation with the eucalyptus oil so the instead of these nice rounded cells they were like all of these things just coming out like like little poyes like reaching for things and then a few hours later it showed all of all of the beads that were outside were now inside so there was something in the eucalyptus oil itself that was stimulating the annate immune system to gobble this stuff up and again we go back to the folksy type of you know old stuff the main ingredient in vix Vapor Rub is eucalyptus oil could I have a theory yeah that um it's not going to be uh very kind to eucalyptus trees or koalas or anything related to Eucalyptus which is that maybe the eucalyptus oil is a mild irritant yeah at the cellular level you inhale it you know you get this Menthol like or um uh odorant it's kind of custic yeah and the immune system reacts to it by activating fago sites to go gobble up more stuff it could very well be um in that line of of discussion it I it's very imperative to understand that eucalyptus oil is never recommended to be taken internally um there's actually been reported deaths from taking too much eucalyptus oil so I just put that out there that people think that it's going to work and more is better um usually the way it's used and the way it has been used historically is and for instance in hydrotherapy they would put um maybe a few drops of that or rub it onto the skin and allow it to to sink and it's it's extremely potent if you if you go online to buy eucalyptus essential oil uh that should not really be taken internally it's not designed for that um it's extremely potent and um you know putting it maybe on your sometimes I'll do that put it on the upper lip so I'm inhaling it um and actually can can be um actually very soothing in fact one of the things that I found very soothing and there are actually some data in the literature on this is if you get a cold and you're congested is just U heating up some hot water on the stove putting a towel over your head and just inhaling that steam it tends to open things up and uh decrease the congestion and I've been known to put a couple of drops of eucalyptus oil into that and that's actually been beneficial as well great don't ingest eucalyptus oil folks I'll uh take it as a personal insult but I'm not take a responsibility if you do it anyway yeah um that's a great segue to air yeah um I've heard conflicting things uh Visa should we sleep with an air humidifier should we sleep with a cold room under warm blankets you know uh lowering core body temperature definitely helps us fall asleep but that's under conditions where we're not combating an illness I have had the experience several times now to the extent that I really believe it's a real effect where if a room is extremely cold even if I'm under warm blankets breathing that cold air at night I'll often get some um respiratory stuff going on probably because of a drying out of the respiratory Pathways yeah that's that's very possible um so let's talk about air um 30,000 foot level first of all don't inhale anything that's not either a medicine designed for your lungs or air itself so goes without saying but smoking um cigar vaping exactly sorry folks vaping might be better for you than smoking but it's still terrible for your lungs I I'm The Vaping Community hates me because they want me to say it's not carcinogenic but the data show that it can cause popcorn lung I mean it's just not good no uh right before Co hit I can't tell you how many young kids were being admitted to my ICU on ventilators um it was a little different at that time because it was so expansive that people were making Vitamin E oil to cut the nicotine and they were making basically garage out of their garage brand Vapes and selling it and these kids were ending up in the ICU this is totally unrelated to co this is totally unrelated to co okay and to be fair totally unrelated to the brand of vaping the brand names so this is off-label stuff people making their own thing and selling it it was crazy but let's talk about you know briefly the brand so yeah we're starting to understand now that um vaping doesn't have as many toxins that smoking does but it's it's not uh it's it's not a healthy choice and contrary to to the thought process is that it really doesn't get people off of nicotine in fact there's higher concentrations of nicotine in the vape than than in regular cigarettes very high concentrations incidentally what what are your thoughts on non-smoked non Vaped non- dipped non- snuffed nicotine so nicotine gum nicotine pouches I mean it's a will raise blood pressure vas a constrictor but definitely increases alertness while causing relaxation I'll come clean I occasionally will take a milligram or two which is very little um of nicotine gum um yeah so you know but never smok or vape or Dipper snuff it I use it all the time in my patients who I'm trying to get off of smoking so um and and that's a safer alternative especially for the lungs right because this is not they're not um atins that are going into the lungs so no problem with that especially if it's used to to get them off of smoking um it's it's something that we use all the time do you use nicotine no no yeah there's a a massive expansion in the number of people taking nicotine pouches now yeah and and it's it's something that affects the brain as you know it affects the um pregnant women um affects a a number of aspects of of the nervous system we we have receptors called nicotinic receptors for a reason because that's the neurotransmitter so um yeah it has an effect it is highly habit forming SL addictive um it does seem that at least in people 60 and older there may be some mild cognitive sparing or enhancement due to nicotine use I think that's an area that needs further exploration yeah I I'm not familiar with that data but certainly something to look into yeah yeah I'm not going to try and convince you to get on nicotine I I I'll also say that it it doesn't just hit the nicotinic receptors it'll also hit the muscarinic acetylcholine receptors and that's one reason why if you do take nicotine gum or use nicotine gums or pouches what you'll notice is when you don't use it you'll feel as if your throat is a little um mildly irritated and and then you take it and it and it relaxes it interesting and this is one of the more subtle but powerful ways in which it is habit forming is that people feel like they're more verbally fluid they can breathe easier when they're taking nicotine but it's a vasal constrictor so that for those interested in performance enhancing effects um it's run pushing you in the opposite direction anyway so in terms of air we've talked about what should not be in the air but um there's actually some data that's really surprising that I was I found during the pandemic that was interesting to me that should be in there that maybe isn't in there and that's fresh air associated with going outside so what is out there in the air what should be out there obviously clean air um people who live you know next to freeways and pollution those are bad things we've talked about that but um the Japanese seem to have a corner on This research it's really interesting stuff um you've heard heard of forest bathing so there was a number of studies where they've taken uh the CEOs in Tokyo and they took them up to the Hanoi Cypress forests sounds beautiful it is and um what they found was they did actually very controlled research where they checked blood levels and they they did blood tests and they had them walk around for three days in the forest uh Forest bathing and they actually took air samples and they found that there's these substances called phon sides which are given off by the trees not just Hanoi Cyprus trees but just about any kind of trees so fur trees oak trees all sorts of uh pine trees and that these substances interact with our bodies and specifically again the innate immune system they were actually able to look at chromogranin a which is a a substance that's in some of these white blood cells that are are you know fighting white blood cells that fight infections and they were able to show that when they were in that environment there were definite changes in the immune system toward the positive and that these changes lasted for seven days so they did another aspect of the study so there was multiple Publications that this group in Japan did they took these same guys and they took them down to a hotel in Tokyo out of the honoki Cypress forests and they infused these same fight and sites from these hoki Cyprus trees they basically took the oil from these trees and Infused it in the hotel room and they found very similar results to what they were getting out there when they were walking in the forest so that would seem to indicate that there was something that this was what was being made responsible the one difference which was interesting between when they were up there walking around in the forest and when they were down in Tokyo in the hotel room with the infuser is the urinary cortisol levels were lower when they were walking in the forest than when they were in the hotel and that's as you know a symbol of basically stress so there is there is something that there is a junqua I guess the French would say there's something Galt about walking in the forest that's different than just infusing the Hanoi Cyprus but I I thought that was an interesting thing and it kind of goes along again with what we were talking about at the beginning when you're out there in nature in the in the forestry in the green walking green spaces we have this evidence these leaves reflect a lot of infrared light which we've already talked about but there's also Al something else in the equation as well and it kind of leads just a bigger picture and bigger philosophy of of life and that's the reductionism of science we always trying to reduce something to an active ingredient to try to figure out what it is but there is actually something to be said for getting these things in the environment that we would normally be getting them in I think that's interesting someone made the comment recently that so much of modern health or our attempts at um being healthier in modern times perhaps the better way to put it is about trying to bring the out ofd Dooors indoors you know we we exercise in gyms whereas we're used to you know carry buckets of fruit and soil and you know uh we are talking about some artificial light um there's no replacement but uh ways to supplement artificial light excuse me ways to supplement sunlight with artificial light you know we're just indoors a lot more and uh no one's suggesting that we all run around in loin claws outside all the time um but there really does seem to be many factors within outdoor environments so many both known and unknown seems that the reductionist approach to science while I you know I've made it my profession um for many decades is um it makes sense why no one thing seems to solve all the all the uh issues that we're we're after that we need to experience these things in combination Maybe is just the best way to do that yeah and I I I can't help but think of some studies that have been done in the past where this has really highlighted it um there was some evidence they believed that people with lung cancer would do better if they had they because they noticed that people with lung cancer did better when they had diets that were rich in vitamin E and vitamin A derivatives so they said oh reduction of science let's go ahead and get vitamin E vitamin A let's package it let's give them to them in high doses maybe this will solve lung cancer or help lung cancer they have to stop the study early because they did worse than the control subjects important important to point that out yeah that the high dose supplementation is not the same as ingesting something in the context of of a food and we didn't we didn't discuss it uh directly but we kind of alluded to it with light and indoor light and artificial light so what do we get the human body since its existence has always had blue light in the presence of red light and altogether the entire biological Spectrum and now what we've done is we've essentially created an indoor environment where we have efficient lights which are supposed to be you know more efficient would imply that it's equivalent But realize that led lights or the LED lights that are commercially available for us to buy are energy efficient because they're no they're not broadcasting if you will in the infrared or in the ultraviolet it's a very specific narrow range of visible light we we alluded to this often times there's there's no red light in there either exactly they are really blue green yellow sometimes even UV light right I mean the fluorescent lights in a in a department store for instance or in a pharmacy I haven't done the um spectral waveform analysis but you know those who have it's published it's out there there are a lot of data about environmental Occupational Health stuff um would show that it is the um the emission Spectra are severely tilted toward short wavelengths and there's hardly any red light in there whereas a candle for instance or a fire roaring fire roaring candle people ask that sorry to interrupt is almost all orange and red light right and then people say well won't that wake me up at night and a lot of people are surprised to know this I'll just ask you and it's not a it's not a a trick question but how many looks do you think come from like a um a really bright candle or a roaring fireplace or the brightest Moon moonlit night on a full moon since you asked it that way I'm going to try to guess the other direction and say like 50 so somewhere between one and and 10 would be high level and then and then I started and I was like there's no way that could be right you know how could it be it's like this roaring fireplace or the the Moon that lights up so it turns out that if you're at a at a campfire and we're facing one another around the campfire I can see your face across the campfire I can see the front of your body and so there it looks like the it's so bright must wake me up but no you have no trouble going back to your tent and falling asleep or your cabin if you turn away from that bright campfire you need a flashlight to navigate even the shortest distance which tells you that it's not very bright at all it's it's very concentrated but the falloff of that brightness is is is really what indicates just how how dim it really is but if we think about an LED coming off a wall panel to adjust temperature in a hotel room uh it has something like 100 to 400 locks and and yet we think of it as a dim NightLight and so it's it this is sneaky stuff yeah it's really diabolical because that wall night light or uh thermostat light messes up our glucose regulation as shown in really good peer- reviewed studies absolutely and then the other aspect of it and I actually I think I learned this from you is that um the photo receptors are in the lower portion of our retina right or sorry the um yeah the lower portion of our retina and so this and so your the type of light that's going to affect your circadian rhythm is going to be much more likely to do that if it's coming from up above or you know at the same level than down below that's right and the Scandinavians I have my stepmom a Scandinavian um understood this intuitively and so in the evening they don't have ceiling light they turn off the ceiling lights and then they only use desk you know sort of table level um or even floor lights yeah now candles along the floor would be the ultimate but it's super dangerous and we just had a bunch of fires here and those were outdoor Fires at first anyway but I and the reason we're kind of um uh that we're riffing in a kind of light bio uh uh you know improv here is that when you step back and you just look at it logically yeah we have dim days as you pointed out before we have bright evenings and and nights and it's all short wavelength at night it's terrible I I'm beginning to think that many many many of the problems that we have in terms of our metabolic Health sure it has to do with food certainly has to do with lack of exercise and a number of things screens Etc but I'm convinced that the light piece is at least one of the top three if not the top two major factors in determining the kind of obesity metabolic crisis I I completely agree with you the the one um thing I was going to add to that too are the windows so you you're aware of course in in California we have um we need efficiency um and we have these windows called Low e glass and they're specifically designed to filter out infrared light so the way you can tell whether or not your window is uh is filtering that out is just stand in it when the sun is on it if if there is a lot if you can feel the warmth of that sun then you know that it's one of the old windows that's allowing that to come in if you don't feel it that's a low E glass and so what we've done is we've created this environment inside there's no the we've gotten rid of the incandescent bulbs we have LED bulbs we've gotten rid of the regular window it's all for Energy Efficiency which is a a reasonable thing to do we need Energy Efficiency but but we no one's no one's asked what the human collateral damages to this type of of uh efficiency yeah and we shouldn't have to take vacations to expensive sunny places to overcome this stuff that's not the the right way to think about the way is to try and weave it into our lives low expense or no expense getting outside for instance opening Windows um in cars is the worst yeah so what's Wild is if you go to the Pacific Northwest in the fall or winter when it's really hard to get lighted you know I think Seattle's the northernmost City in the contiguous us it's so dark up there and you get into an Uber they have tinted windows it's so crazy like it's you know it's so wild especially since the research on this stuff is being pioneered largely out of the University of Washington in Seattle okay like we've got a number of things exactly backwards and and light in our relationship to light is one of the the ways in which we do the problem I think is when we start talking like this people think oh well we're all supposed to have you know atriums and skylights and be outside all day it's like yeah actually that would be great and dimmer and darker at night yes so taking small steps towards adjusting toward Bright Days yeah and very dim and Dark Nights is key we didn't talk about incandescent bulbs it used to be until about 15 years ago that the quote unquote efficiency bulbs that were present in all our homes the the bulbs that would burn out pretty often were we know that the incandescent bulbs are more full spectrum yeah they have a lot of red and orange emission you see them as white or but they look a little warmer it has that warm those are great yeah um those are great they're harder to find now actually they were illegal for a short while I don't think anyone was going to come to your house and arrest you but you couldn't get them they were banned and now they're available again is my understanding oh I I haven't seen them but um I know that in new constructions they're not even putting in sockets they're putting in receptacles that can only be replaced with other LEDs so in New in new constructions that's what's going on um you know uh we'll see what happens I I believe there is a movement right now based on the new Administration to see if we can change some of those rules and maybe uh get some rule changes I I believe it's with the Department of energy so do you know who are really the smartest about this stuff that um if you want to know where human self-directed human health is going to be in 5 years you know where uh you know where you can look tell me you talk to the people who are really good at maintaining Aquaria and reptiles ah yes because those animals literally die under conditions of pure blue light like if you've ever had fish tanks I'm a fish like you don't want to send me down this path but there's there's a very famous fish tank designer I was a huge fan of his unfortunately he died of pneumonia in uh at when he was 60 tekashi Mano um there's museums in Japan about we developed this thing called aquascaping which is about plants and lighting more than the fish although there's fish in it and everyone I've been involved in aquascaping in one level or another for a while now um super geeky I know but the whole principle is that you're trying to create full spectrum light plants air you're trying to create the right conditions for these fish and other um aquatic elements like plants to thrive and anyone that understands how to maintain reptiles or understands how which I'm not into I don't like scaly things except fish um or Aquaria they know you can't have a dir of long wavelength light or all the fish get sick the plants die they they just can't do it now there are deep sea plants where the red light long wavelength light doesn't get down to the bottom um and forgive me for for going off on this maybe I should just do a solo episode but you know what's amazing is you know the intrinsically photosensitive cells of the eye that that set our Circ rhythms and that do all this the quote unquote reason um why the peak of the um portion of the V of the visible spectrum is where it is for those cells is because it's the wavelength of light that can go deep into water if you've ever been snorkeling you only see Reds down to about 10 m or so you you swim down a little bit lower you need to bring a light with you right now of course the fish that are red are still red down there you just can't see it because the lack of reflectance of light long wavelength light so yeah so we we are walking around in the evening basically um being exposed to what our eye and brain think is daytime just as our retinal sensitivity is going up oh and then all day we're in this and it's not bright enough right so anyway I'll stop now but um it it has me activated as you can imagine because you hear about all the mental health issues the physical health issues yeah I think they're all Downstream as you pointed out of M andrial dysfunction yeah put differently mitochondrial function is Downstream of proper relationship to light absolutely which you so beautifully Illustrated and I learned a ton that I hadn't known before about that um okay if I continued on Aquaria we won't get out we'll be here this will be the longest podcast episode ever okay I'd love to talk a little bit about two more things um we will return to New Start okay um but I want to know about long covid is long covid a real thing oh yeah and it uh what is long covid what can be done about long covid um how do you know if like like most people by now have had covid at a high level or low level yeah how do you know if you have long covid long covid is defined as having symptoms of of of a number of different types of symptoms typically it's fatigue could be headaches could be all sorts of things um even loss of of uh taste and smell for more than 12 weeks after the infection so we're talking a good three months the thing about long covid in my experience and what I've seen is that it's very heterogeneous and it can be due to many different things so it's been very difficult to put together exactly what the issue is but I'll tell you one one uh as a as a physician as a pulmonologist one of the Cardinal symptoms of long covid is shortness of breath and so because because I'm a lung doctor and uh and people believe that shortness of breath always has to do with the lungs I get a lot of consults for people who have shortness of breath long covid after they were infected months ago and so a lot of these people came to me and one of the things I had to do is research this topic and um as as it turns out one of the not for everybody but for many people with long Co guess what's at the center of long covid and actually we have research to show this mitochondrial dysfunction the thing that gets them covid is the thing that keeps them actually having long so there was a study that was done looking at metabolism and they showed it was uh one of these plots where they looked at up regulation and down regulation of metabolism in the mitochondria and uh they looked at the enzymes of glycolysis if you can remember back all those enzymes and they looked at the enzymes of beta oxidation so fatty acid basically oxidation and it was pretty well shown that there was a significant downregulation in people with long covid versus people who had covid that didn't have long covid that had a downregulation in beta oxidation so they are they were not able to very well utilize and metabolize fatty acids in the mitochondria why is this the case well based on what we talked about earlier one of the certainly one of the the possibilities here is that they were infected with covid it downregulated for many of the systems in their body oxidative stress mechanisms caused damage to their mitochondria and we don't know why but perhaps the areas of the mitochondria that were damaged most had to do with beta oxidation and fatty acid so you you'll talk to people who have been infected with covid and they said we gain weight after after we infected with Co and I have all these symptoms first of all when when someone comes to you like that as a physician you have to make sure that you're ruling out all of the obvious things so I'm getting an echocardiogram to make sure they didn't have some sort of cardiac issue I'm getting pulmonary function tests to make sure they didn't get scarring in their lungs and to you know have restrictive lung disease so I'm ruling out all of these things and so about a month or two later I've got all these tests back and I'm going over it and and for the ones where everything is negative CU there were some where I actually discovered they had clots and we had to treat them for that but for people who have everything negative and they're still complain I remember one gentleman in particular he had eight out of 10 shortness of breath and uh he couldn't sleep very well and this had been going on for over a year and we ruled out pulmonary embolism we ruled out congestive heart failure we ruled out interstitial lung disease with all of the tests and it was about this time that I was coming on to this idea about light and looking at these studies about the mitochondria and I had this idea because there was nothing else left um I had this idea that if there was some way we could regenerate the mitochondria but instead of it being damaged because you know when you have damaged mitochondria that that creates just more oxidative stress and damages it even more so in other words we have to basically get his body into a situation where he was generating new mitochondria so we could get rid of these issues with metabolism so I had this idea and I don't know if it worked this way but I I actually got him to do intermittent fasting this whole idea about how intermittent fasting allows the body to generate things at night because you're now the body knows what it needs to to down regulate and break up you just have to give it the opportunity this is how I understood it the innate immune system looking at pathological molecular patterns and also damaged molecular patterns so pamps and damps DP if we were to allow the immune system to do what it needs to do it would find these areas that are not working well tear them down destroy those cells and then allow regeneration of new cells with hopefully brand new virgin mitochondria so that was the first thing I did he vowed that he would never eat after 5:30 after I explained all this to him I took a clinic visit we explained all of this the other thing I did was told him to get out in the sun now this may sound you know dismissive can you imagine you've got long Co you've been suffering and you go to a physician and they tell you well I want you to stop eating after 5:30 I want you to get outside more like is he taking me seriously does he really believe that I have a condition but I took the time to explain why I was thinking about these things and going through the studies so he did it and I saw him back a month later he was he was amazed I was amazed he said that he um his gastrosoph reflex disease completely went away after he stopped eating after 5:30 his shortness of breath went from an 8 out of 10 to a 3 out of 10 and he said it doesn't even bother him anymore this is after a year of having this type of of uh of symptoms so that really took me a pause now I'll tell you the first thing that that doesn't happen to all of my patients with long covid but it tells me that when you're dealing with long covid you're dealing with people who have had uh an infection that has caused damage to the system and some of the studies from what I reviewed sometimes people have residual virus still in the system there was a study that was done looking at to see whether vaccination of covid-19 would work after patients with with long covid there was some uh benefit it wasn't big but it was some and it may it may be that you're just stimulating the immune system again to fight off this res this this remaining virus that's still in the system um but we have data that shows that the type of inflammation that we get with Spike protein is actually a toll-like receptor 4 type of inflammation there's a study that looked at this and they were actually able to show and demonstrate that infrared light coming back to that again can actually mitigate the inflammation from tolik receptor uh mediated inflammation which is exactly the inflammation mediated in covid-19 so short answer to your question or that's a long answer but the short answer is yes I do believe that long Co is is something and I believe people are suffering with it it's a very heterogeneous um uh disease and it's hard to just pin one thing on everything and and have it work for everything that being said I don't see a lot of downside in instituting some of these things that we think may work sunlight as being one of those things uh people who are sick with uh covid and long Co tend to be sick and they stay indoors and so there may be an exacerbation of the process the last thing they want to do is to get outside um but it may actually be beneficial yeah I would imagine that pretty much everything that you shared with us today would be benefit icial my understanding is that some of the heterogeneity of even just the covid response in various people who got it in addition to the heterogenity and long covid symptoms could be due to the fact that the distribution of A2 receptors is very widespread in the body yeah um SARS K2 uh binds to the A2 receptor um it's the primary receptor site is I understand yeah um and you know I remember early in the pandemic um asking on social media are there A2 receptors in the brain and on neurons and people are like no there's no A2 receptor turns out the olfactory uh thefactory neurons are chocka block through full of uh A2 receptor and they are bonafied uh CNS neurons um their brain neurons um and so and and you lose them fortunately those can replenish over time in an activity dependent way but yeah when I hear that some people you know got covid and it was no big deal other people got covid and um they felt like they had brain fog for six months and are still coping with it probably has to do with the extent to which the virus was able to bind to A2 receptors in one person's brain versus someone else maybe their bloodb brain barrier you know it didn't get in there at all right yeah as I recall from the um from the and this is actually kind of interesting about olfactory is that the Nerf cells that are next to those neurons in the AL Factory are the ones that have a lot of A2 receptors and and that's so what happen is these Nur supporting cells that were helping with the you know whatever they do to support the neurons were dying off and that's why they were losing a sense of smell and so when the nurse cells came back and replenished people didn't smell exactly the same because it when isn't exactly in the same uh didn't come back in the same way there was uh and this has been used for years in in air nose and throat circles is uh something as as this sounds kind of silly but smelling sticks there's actually a protocol that is used that these Mar markers that are manufactured in Europe where they have a different uh different orange lemon chocolate exactly and and smelling these things uh actually over there's a randomized crossover Placebo control trial that actually showed that they were able to regain their sense of smell by training their sense of smell with these sticks it makes sense because the olfactory neurons are replenished not just regenerate but they turn over um in an activity dependent way and so it requires electrical activity and their electrical activity is dictated by smell um in it and so certain clusters of olfactory neurons and the Brain neurons that they connect to or reconnect to in this case are going to be activated by different smells and so the the smell training based protocols for bringing your sense of smell back um uh uh intentionally includes a variety of smells you don't just want to smell lemon you want to smell lemon coffee this um people always say do I need foul smells too in in kind of in and kind of unfortunate way um the neurons that detect noxious odors and bad odors um tend to not die off as readily but it makes sense because those are the the cells that actually preserve your um innate uh aversion reflex right they're the ones that can you know our ability to detect smoke in the air something very relevant to the recent history here in LA or uh ammonia you know things that are potentially hazardous for us is are the detection thresholds are incred ibly low we're just so sensitive this like the fifth cranial nerve isn't it that does that uh uh well yeah so the trigeminal um will you know it it's involved in some of the protection of the the nasal epithelium and and whatnot but these are the this is a direct line through um the olfactory Pathway to the amydala a fairly direct line that's right it bypasses the thalamus right so right all of olfaction bypasses the thalmus but the but the learning of odors is um your odor maps are going to be slight than mine based on your experience but when it comes to the representation of smoke vomit feces and and and rotting bodies all the dangerous stuff yeah um our our Pathways look pretty similar got it got it to be to be blunt um given your expertise in lungs and uh a number of people I know have mold issues they claim or they believe that um mold has infiltrated their lungs um some doctors tell them they're crazy some doctors tell them that they're not crazy uh about that idea um is mold toxicity a real thing can it be treated maybe we do an entire episode about this another time but yeah uh is it a real thing and what is the kind of primary treatment for for mold toxicity it it is a real thing and mold is a is a substance that um can have multiple different effects on on the body let me give you an example um there's a fungus called aspergillis and uh there's two ways that aspergilus can affect the human body one is if it just sets up shop in your lungs and it doesn't invade you could become allergic to it and so the symptoms are allergic actually there's a condition called allergic Bronco pulmonary aspergillosis so it's kind of like an autoimmune situation ex exactly and so you have you have symptoms of asthma you have symptoms of of of inability to breathe and the primary treatment ironic there is steroids because you need to reduce the inflammation but Al also antifungals to get rid of the thing that's inciting in the first place that's as opposed to invasive aspergillosis that's where the fungus comes in and starts to invade and create a cavitary lesion usually with a fungus ball sitting in the middle of it oh yeah it's pretty pretty bad sometimes it's so bad that you actually have to do surgery to cut out that thing because you can't cure it um the way that this often happens is mold and fungus is are in the air all the time so so here's this this understanding of there's germ Theory and there is terrain Theory and today and I I almost hate to even get into it but people think it's one or the other and I can tell you as a physician it's both there are certain diseases it doesn't matter what your terrain is it's it's going to like neria menius if you get that it's going to cause a bad menitis no matter how healthy you are okay there was just a I remember reading about a young um Japanese star I think or Taiwanese star just recently here that died of of influenza 48 years old no no medical problems so it's possible no matter how good your terrain is you could get a bad bug a bad germ and it could kill you on the other hand there are certain bugs that are just sitting out there and they will go in and your immune system will just kick it out like it's nothing why because your terrain is good because you so I can talk about like different types of infections that could do that so that's where we are with molds so typically you're breathing in all sorts of mold and fungus spores all the time but if your immune system is good it'll just kick it out and it won't have a chance to survive where you have a problem is if you have a situation where your immune system is compromised to give you an example of that practically there are some biological medications that people get when they have rheumatoid arthritis before we would if we get to that point where you have rheumatisms there's an antib body there that's suppressing the immune system so that you don't have the symptoms of rheumatoid arthritis that's actually suppressing your immune system in those patients we'll always check them for tuberculosis because certain people walking in the population will have an inactivated tuberculosis they've infected but their immune system has walled it off then we put put them on a biologic and the tuberculosis pops up so all of that to say that yes it is possible if you have mold in your house versus if you don't have mold in your house that just increases the burden of mold that you're inhaling and to the degree that it's going to match against the uh your immune system you know that could depend on whether or not it jumps in and actually causes a problem so you know we're coming up this is the time of year where we're coming up to the Super Bowl so it's the question about terrain Theory versus germ Theory and the question is is whoever wins the Super Bowl did did they win the Super bowl or did the other two lose the Super Bowl and that's who knows so this is where this thing is it's not it's not or it's and and really what determines whether or not you get infected is how good is your immune system and how varent is the burden of of pathogen that's going in the reason I asked is it a real thing is that people that I know who um believe they have a mold infection or they did do seem to have symptoms that last a long time yeah and there doesn't seem to be any general agreement about what specific treatment to use for for this unless maybe they need surgery or something so do you give people antifungals um are there is there anything over the- counter that can help will the sauna protocols and steam protocols we were talking about earlier help I would imagine a lot of warm moist air is exactly what fungus loves yes uh it it does if if if someone came to me with mold uh with a mold complaint thinking they had mold um there are a number of tests that you can do to see whether or not there's antibodies to those things and you can see whether or not that may or may not be there it's not definitive but if if somebody actually truly has mold growing in their lungs we should be able to see that on a CAT scan we should be able to identify it we should be able to go and biopsy it we should be able to go and collect it and if that's exactly what grows out on the culture after we take a biopsy or culture we can tailor antifungals for that particular thing in the sense though that someone may be having uh symptoms of some sort of infection or something and there's nothing on the CAT scan um it's harder to really isolate exactly which one it would be and what would be the right treatment although there are some syndromes um known as RADS or reactive Airways disease uh where you can have an exposure to something that's so egregious that even though you don't get exposed that thing again it can still cause persistent uh um difficulty with breathing it's very similar by the way to um to asthma so for instance somebody let's say someone's working in a vat and uh there's a chemical that's spilled and they get an incredible amount of inhalation of that chemical it's well known that these people can go on and have these types of problems even though their lungs May image uh correctly and they may never be exposed to that chemical again let's talk about the T in New Start trust yeah you talked about higher power you talked about Community you talked about connection generally and specifically um you know I've always been struck by how the belief system can impact our physical health we recently had Dr Ellen Langer on the podcast from Harvard who's done incredible studies really about how beliefs can shape our phys physical health in any number of different ways um what is your clinical observation of people who are ill severely ill mildly ill and the role that trust in you know fill in the blank um you can fill in the blank has in terms of the severity of their symptoms and the rate at which they recover and hopefully they do recover yeah they do um some of the times sometimes they don't we can't help that but um you do do the best that we can no it does help uh quite a bit so people who have a a a um a network people that have uh Faith people that have Community have that um that strength that allows them to get through uh those those very difficult times there there's been a number of studies that have have looked at this you think that this area is kind of nebulous and hard to study now there's actually some some pretty good data on this and uh I think back to a number of studies that have been done and where they looked at thankfulness and the the the Mind Body Connection people who are more thankful um have less um sematic complaints for instance than those that are not so they actually did an experiment where they had people write out letters they thought about some mentors in their past and they wrote out letters to thank them and it and it was interesting because not all of the people that wrote the letters were able to actually deliver those letters to those recipients but it didn't matter what they found in the study was just simply the thought of of writing out those letters actually had a a change in the end points in those studies there was another study that was done that that was very um telling to me it was a survey that was done of 1500 people it was published out of of Texas in this particular case they wanted to limit the population of of the uh of the recipients so these were just Christians in this case uh just because of the um the heterogenity they want to see if they can get an endpoint and what they did was they looked at they asked people in this survey um how do you forgive forgiveness has to do a little bit about faith and and Trust as well and there was basically two major types of forgiveness there was forgiveness that was conditional and there was forgiveness that was unconditional and what I mean by that is is that you know people that would forgive conditionally would be if someone did something to somebody they might forgive them if they came back and apologized or they showed some sort of remorse those are the people that forgave conditionally the other people people who forgave unconditionally were the ones that would just forgive regardless of what that other person would do they would just forgive them and it would be off their mind they would just go on their way what they found was really interesting between those two populations now this was an associative study but they found that when they looked at uh anxiety at the end of life uh in terms of anxiety in terms of dying uh well-being somato sensory complaints um all sorts of a whole list of of different things they found that people who for gave conditionally the ones that would wait for someone to come back to them had higher marks in those in those cases in other words they had more anxiety they had more somato complaints um they were less feeling of well-being and so they found that that was really interesting well they didn't stop there they wanted to figure out what was going on and they asked the question okay well what is the biggest determinate that determines whether or not somebody forgives conditionally versus uncondition Al and I think the odds ratio on this statement was like a two or three which is it's getting up there it's almost it's almost you could say that the likelihood ratios are high enough to say causation but not quite but it was high and it came down to this statement and the and the and the statement was do you feel like you have been forgiven by God if they felt like they were forgiven by God they were much more likely to forgive unconditionally if they had ever felt that they were forgiven by if they feel like they were forgiven by God yes for whatever it was that they had done so this was really interesting to me because I often times I will have patients in my Intensive Care Unit who are very anxious they know that I mean anybody who gets admitted to the hospital starts to think about the mortality just imagine if you get admitted to the Intensive Care Unit A lot of my patients are not able to communicate they're they're mentally out but there are a few that can and those you can tell become very anxious so this is an area that I have to sort of delicately ask about because you don't know people's Faith structure you don't know who they are um I'm a I'm a graduate of Lind University and and our motto um and it's it's a Christian institution is is to make man whole and part of that is not just the physical not just the mental but also the spiritual aspect of that so we make no no excuses about that but it's it's important to also understand that not everybody wants to have a spiritual component to their care so you have to approach it in a way that you're almost do give me permission to do this and you have to watch for things it's it's not an easy thing to do but you want to help if someone wants to be helped so often times I will I will talk to them about this very issue and I will say you know is there something on your mind that you need to get off your chest you would be surprised about how many times people have this issue it's because they've done something at some to somebody in their past and they don't feel like they're forgiven and if you have the opportunity to do that to actually give them that ability in their in their belief structure to tell them that they are forgiven it's there's a world of difference and it's it's quite it's quite actually it's quite amazing it's interesting to me that uh in all hospitals not just hospitals with a uh you know an affiliation to a particular branch of religion uh you have chaplain yeah uh you have different um people Associated often with different religions that people can call upon which I find amazing right in this in this quote unquote modern time I mean you know of modern medicine right as far as I know every major hospital has this doesn't matter how Cutting Edge or how small a community hospital which by the way many Community Hospitals are excellent should point that out the words Community Hospital ju opposed to you know cuttingedge research institution you know there's actually a debate as to like which one you would prefer to go to depending on on your needs but they all have um generally as far as I know have um access to uh people um with whom patients and family of patients and Friends of patients can pray and um I that's not a coincidence I think that there's a deep understanding of of the of some sort of relationship there um and certainly there's good science to support everything you just said um and your clinical experience in my mind goes um along with that you know science as you said is very reductionist right but people in two groups one prayes one doesn't you know that's sort of that's the way science is done course but ultimately um the the real world clinical implications are are what um what really resonates so thank you thank you for that I have one final question yeah and and it might get you in trouble okay but I'm gonna ask anyway um let's say I or someone that I care about is admitted to the hospital what are the things to do or ask that were not told that can facilitate better care that are within bounds now I will go on record since these days I'm in the habit of just kind of saying it all um I'm aware that families of donors to hospitals get special care this is I will just tell you there you go to a hospital there's a Code language I happen to know it for several hospitals um there's a Code language of this is a quote unquote special patient this will anger some listeners but it's true this is the way the world works not only some listeners but some Physicians some Physicians too right so that there's a there's a CO there's a Code language that differs by hospital and and I know it for several hospitals and um um I don't want to get into that it's it's uh it's one of the more complicated aspects of medicine in hospital as businesses and things like that yeah um I'm going to get some angry calls about this now the point of asking this is that most people are not donors to hospitals they're not going to um be flagged as a special patient that gets the room with the window that gets sunlight in the morning that gets the room alone without somebody next to them who's coughing all night um and on and on so Are there specific things that people should mention or ask for in order to get the best possible care when um admitted to a hospital sorry I got to put you on the spot no this is this is excellent this is an excellent question um some of the things you can control some of the things you can't control getting a bed is is just completely out of your controls if you're in the emergency room uh you can ask when you're going to go upstairs you'll get to get you're going to get a bed when there's going to be a bed and sometimes I can't even get patients upstairs so they're triaging right they're this one this person is at risk of dying yes this person is miserable right and you're less miserable you're going to wait is that how it works okay potentially I think in terms of in terms of where you are in the hospital and the Great and the care that you're going to get I believe that the number one thing that you can do to make sure that you're getting the appropriate care is to in as many ways as possible communicate to The Physician usually not directly that you are familiar with the disease that the patient is being admitted for and you're going to ask some tough questions um yelling yelling at the nurse uh is not going to help you um saying insulting things to the nurse or the doctor the staff is not going to help you it's going to make things worse I think the number one way and I can tell you that in terms of as me as a physician if I'm speaking to a patient and we have a family member that is asking me intelligent questions about something that's going to put me up on my game that's going to make sure that I know I'm going to be ready for Rounds because you're not going to be glossing over things they're going to be asking some tough questions I got to know what I'm doing and and that's kind of what um I I've been doing for the last 10 years 12 years in terms of uh of the teaching that I do we have a a website called medcram.com where we put up you know if you get a like you go to your doctor and you get a CBC back right how do you interpret that c CBC can you explain CBC to people CBC is a complete blood count and it's the blood test that you get back when you get your blood test there's a there's a metabolic panel that you get back how do you know what's going on with the things um what about a EKG you know you have these smart watches that can actually measure your your heart rate how can you interpret what's going on there we've put courses together to educate people we even have courses on diseases uh congestive heart failure what what kind of questions do you need to ask in congestive heart failure what are the things that you need to watch out for what are the medicines they're going to put you on what are the side effects of those medicines um I think if and you don't have to be that educated actually or even know that much but if you can show that you're ask asking the right questions to a physician they're going to ask you are you in the medical field you're like no I just know about this disease and I have these questions about when are you going to start to do this when is this happening and when's the ne I think that more than anything puts those people who are taking care of you on alert to know that you're intelligent you're going to be asking some questions and they're going to need to make sure that they focus on and answering those questions effectively I think that's that's the number one thing I love it and thank you for stepping right in the line of fire with that one not trying to dodge it so it speaks to uh the kind of person you are it speaks to uh the spirit behind your work which is so clearly in service to helping people you know it's such a cliche thing we hear you know helping people I want to help people but it's very clear that you want to help people you do this in your social media you do this through your um uh online teaching we'll by the way provide links to all these um sources and you're doing this in so many ways and of course in your clinical practice and you know for all those reasons and also for coming here today to take time out of your very busy professional and Family schedule and you have your own self-care right if you're not healthy you can't take care of other people's Health right um I just want to say on behalf of myself and everyone listening and watching thank you so much I learned a ton and I know everyone else listening did as well it's all actionable in service to basic health and improving health and in service to avoiding illness those are not the same thing necessarily although they go hand inand and to moving through illness should one um contract a an infection and you know just a treasure Trove of knowledge so thank you so much I'd love to have you back again I would love to come back I look forward to seeing you online but um even more so in person so uh thank you so much Dr schwell you're a real gem thank you so much thank you once again for joining me for today's discussion with Dr Roger schwell to learn more about his work and to find links to him on social media and YouTube please see the show note captions if you're learning from and or enjoying this podcast please subscribe to our YouTube channel that's a terrific zeroc cost way to support us in addition please click follow for the podcast on both Spotify and apple and on both Spotify and 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all of that is available completely zero cost you simply go to hubman lab.com go to the menu tab in the top right corner scroll down to news letter and enter your email and I should emphasize that we do not share your email with anybody thank you once again for joining me for today's discussion with Dr Roger schwell and last but certainly not least thank you for your interest in science [Music]