Huberman Lab - How to Enhance Your Immune System | Dr. Roger Seheult

Episode Date: February 24, 2025

My guest is Dr. Roger Seheult, M.D., a board-certified physician in internal medicine, pulmonary diseases, critical care, and sleep medicine at Loma Linda University. We discuss the powerful benefits of light therapy, including infrared light, red light, and sunlight, for improving mitochondrial function in all the body’s organs. We also explore ways to reduce the risk of influenza, colds, and other illnesses that affect the lungs, sinuses, and gut. Topics include the flu shot, whether handwashing truly prevents illness transmission, and treatments for long COVID and mold toxicity. We review the efficacy of N-acetylcysteine (NAC), the power of hydrotherapy for combating infections, and strategies for improving sleep and overall health. Additionally, we discuss air quality. This episode provides actionable, science-based tools for preventing and treating infectious illnesses. Read the full show notes for this episode at hubermanlab.com. Sponsors AG1: https://drinkag1.com/huberman Joovv: https://joovv.com/huberman Eight Sleep: https://eightsleep.com/huberman LMNT: https://drinklmnt.com/huberman Function: https://functionhealth.com/huberman Our Place: https://fromourplace.com/huberman Timestamps 00:00:00 Dr. Roger Seheult 00:02:16 Avoiding Sickness, Immune System, Tool: Pillars of Health, NEWSTART 00:08:03 Sponsors: Joovv & Eight Sleep 00:10:46 Sunlight, Mitochondria, Tool: Infrared Light & Melatonin 00:19:09 Melatonin Antioxidant, Reactive Oxygen Species (ROS)/Free Radicals 00:26:38 Infrared Light, Green Spaces, Health & Mortality 00:31:35 Infrared Light, Mitochondrial Dysfunction, Disease 00:38:46 Sunlight & Cancer Risk?, Tools: UV Light, Clothing & Sunlight Exposure 00:41:01 Sponsors: AG1 & LMNT 00:43:32 Sunlight, Incidence of Influenza or COVID 00:48:41 Tools: Sunlight Exposure Duration, Winter Months 00:55:18 Infrared Lamps?, Winter Sunlight Exposure; Obesity & Metabolic Dysfunction 00:59:48 Cloudy Days; Sunlight, Primitive Therapy, Hospitals 01:11:33 Sponsor: Function 01:13:21 Artificial Lights, Hospitals & Light Therapy?, ICU Psychosis 01:22:16 Sleep & Darkness, Tools: Eye Mask, Bathroom Navigation; Meals & Light 01:28:27 Influenza, Flu Shots, Swiss Cheese Model; Flu Shot Risks? 01:38:13 Masks?, Flu; Handwashing 01:42:16 Sponsor: Our Place 01:43:57 Water, Sodium; Innate Immune System, Fever & Hydrotherapy 01:53:46 Fever, Heat Hydrotherapy, Interferon & Immune System 01:58:25 Cold Hydrotherapy, Vasoconstriction & White Blood Cells 02:09:56 N-Acetyl Cysteine (NAC), Glutathione, White Clots, Flu, Covid 02:19:28 Tool: NAC Dose & Regimen; Mucous, Flu Symptoms 02:25:25 Zinc Supplementation, Copper; Exogenous Interferon 02:28:40 Eucalyptus Oil, Inhalation 02:32:22 Air, Smoking, Vaping, Nicotine Gum 02:36:49 Fresh Air, Forest Bathing, Tool: Go Outdoors 02:40:09 Nature vs Inside Environments, Dark Days/Bright Nights Problem 02:52:38 Long COVID, Mitochondrial Dysfunction, Intermittent Fasting, Sunlight 03:00:43 Covid & Varied Severity, Smell Loss Recovery 03:05:04 Mold Toxicity, Lungs, Germ vs Terrain Theory, Immunocompromised 03:11:46 Trust, Spirituality, Community, Faith; Forgiveness 03:19:46 Hospital Admission, Tool: Asking Questions 03:25:42 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures

Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Roger Schwelt. Dr. Roger Schwelt is a board-certified medical doctor

in pulmonology, which is the understanding and treatment of conditions that impact the respiratory system, such as colds, flus, and other viruses, mold infections, asthma, and more. Dr. Schwelt is also board certified in sleep medicine. He does his clinical work in the intensive care unit at Loma Linda University,

and he is actively involved in medical and public health education through his terrific online channel called MedCram. Today, we discuss how to avoid getting colds, flus, 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 therefore 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 well-established 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. Schwalz, as you'll soon hear, is world-class 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 altogether. Before we begin, I'd like to emphasize that this podcast is separate 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 Schwelt. Dr. Roger Schwelt, 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 infectious 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 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 flus, and other viruses, as it were. If you were to think about the major pillars of remaining healthy, especially when one is exposed to colds and flus from kids,

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 flus 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 infectious diseases? And as it turns out, the question is how do you avoid getting sick in terms of infectious diseases? And as it turns out, the answer to that 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 actually a physician that I know very well just outside of Stanford, actually, in a place called Weimar, Weimar University, Dr. Neil Nedley, and he's actually coined this mnemonic called New Start. And each of those letters to me in my mind is something that I go to when I want to improve health in people in general. So the N 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. Exercise is E. And 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 J-hook type 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 in 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. 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's an issue.

So I'm referring to just mild to moderate exercise is good. The next one would be W, water. So this is something that's really interesting. Obviously, it seems pretty 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 100 years on how that's been used. Start, S-T-A-R-T. 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. A lot of interesting information there. T, T stands for the old term called temperance, which you may recall is a term that we use

to prevent us from taking in toxins into our body. That's a whole nother 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, phytoncides, 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 innate immune system. Finally, R, and we'll get into R and T at the end, R is rest. Now this goes without saying, but people who have good sleep habits are going to have much better immune systems.

Whether you're talking about the antibody response after a vaccine versus just 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. It has to do with cortisol and beta receptors and all sorts of things. And the last T, which is trust. And for some, it is trust in a higher power, trust in God. These are the sorts of things that can help us relieve stress. If someone else is helping you,

if someone else is there, T would also include community, people that are around you. These are some of the less tangible ways of measuring it. But when someone asks 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, JOOVE.

JOOVE 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 JuveLights 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 Jove whole body panel

about three to four times a week. And I use the Jove handheld light both at home and when I travel. If you'd like to try Jove, you can go to Jove spelled J-O-O-V-V.com slash Huberman. Jove is offering an exclusive discount to all Huberman Lab listeners with up to $400 off Jove products.

Again, that's Jove spelled joovv.com slash Huberman to get up to $400 off. Today's episode is also brought to us by 8 Sleep. 8 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 great night's 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 one to three degrees. And in order to wake up feeling refreshed and energized, your body temperature actually has to increase

about one to three degrees. 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 four 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 airflow and stop your snoring. If you'd like to try an eight sleep mattress cover, go to eightsleep.com slash 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 eightsleep.com slash 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 a bigger proponent of getting morning sunlight in one's eyes as one could possibly be without repeating himself 10 million times per year. 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, it goes beyond just getting morning sunlight in one's eyes. 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'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, super chiasmatic nucleus, it does have an effect on mood, goes to the peri-hibbanyl or nucleus in the brain and has an effect there. Those are well known and very important. 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 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 effect of sunlight on the human body, the skin penetrating into the human body.

Now this at first sounds kind of woo-woo, I guess we could say, but 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 nother 52% of the photons coming from the sun in the infrared spectrum. 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 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 a hormone in our body. It's very, very important. On the other side of that though, on the infrared side, 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 would point to an article that really changed my thinking on this and really opened my eyes, no pun intended. There was an article that

was published in 2019 in Melatonin Research by Scott Zimmerman and Russell Ryder. And then 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, infrared light, because of its very long wavelength, it can penetrate through into the skin actually very deep. And we're not talking about how long a path length goes through.

You have to remember that this type of long wavelength can scatter. And it can scatter throughout up to, they say, up to eight centimeters, according to this data. A single photon. A single photon can bounce around. It's a very low energy photon. But low energy photons, because they're very long in wavelength, can penetrate very deeply. A good way of thinking about this is 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 are you hearing 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 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 gonna hear?

It's low rumbling. It's because that low frequency energy is able to penetrate very deeply. There's an astrophysicist in Europe, 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 the first guy who took an X-ray

of his hand, Rotogen, I guess is his name, and he said, he looked at his hand, he says, I almost like saw my own death, because 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 understanding, he put his hand in front of an infrared light sensor or infrared light source and took a infrared light photograph.

And the light comes through the hands, it illuminates the entire hand. And this is, of course, a lot more than a few millimeters. And the mind blowing 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 can actually test this out on a summer day, or even on a winter day if the sun is out. Wear a few layers of clothing, go outside, close your eyes, clothes of 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 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 the cell. And in the process of doing this, it makes oxidative stress, oxidative reactive oxygen species. If you don't deal with those reactive oxygen species, that could shut down the mitochondria. And quite truly, just about every single chronic disease that we have in this country, whether it's diabetes, hypertension, heart disease, dementia, all of those, they all have at the root of them, all of those. They all have at the root of them mitochondrial dysfunction.

And 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. 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 carbons 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 suprachiasmatic nucleus

to there's a circuitous loop to the, you know, the brainstem and then up to the pineal. 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 melatonin is a powerful antioxidant. Yes. So I'm guessing that next you're gonna tell me that it is combating the reactive oxygen species that are produced as a function of mitochondrial metabolism. Absolutely. Okay. Absolutely. So 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 up regulates the glutathione system

by regulation. So what this melatonin does is it's able to mop up these reactive oxygen species. Let's back up a little bit there. Reactive oxygen species, what are they? So 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 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. As they start to fall down and get transferred from one enzyme to another, they cause the outproduction or the out transfer of protons into the inner 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 electronegative that it would actually take these electrons and that's oxygen. And that's the reason why we breathe oxygen. 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. 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 divorces us from the, you know, the classic biochemical pathway so that more people can grasp it because it's really a beautiful mechanism. So if you have a positive charge to effectively work with the free negative charge, then the system is stabilized,

or at least isn't pushed in the direction of inflammation. Many people have heard of free radicals. Exactly. And that's what we're referring to. You want to offset the free radicals. Correct. And to the biochemists out there and the biologists, I'm using the term offset loosely. Okay, so melatonin in the context of how sunlight can activate melatonin within cells, maybe

it's 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. Pheromones act between bodies, right? In the context that you're describing, melatonin is acting within cell. Correct.

Okay. So let's think of this dichotomy. The mitochondria always needs to have antioxidants, otherwise it's going to become damaged. If these free radicals are produced, the very next molecule that they bump into, it's going to change it. If that's the mitochondria, the mitochondria is going to be damaged. 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, 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-organelle. 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. It's very unusual for melatonin levels to be high when body temperature is high.

These things normally are coordinated at night. I'm not aware that it actually drops body temperature, but it might. 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 gonna be blown by the fact that long wavelength light can actually go through clothing and skin, and so you can imagine that if you have

a minimum of clothing on, whatever's appropriate for that context, and you get some sunlight on your skin, even on a cloudy day, some of this should be coming through. We could talk about that. It's more UV light, short wavelength light that's gonna break through thick cloud cover. Correct.

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, we're getting a lot of red light, long wavelength light, and infrared and near infrared light coming through.

I think a lot of people don't realize that because in this age of red light devices and infrared light devices, of which I own one and I love and I use, but people forget that the primordial and arguably, 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 no device that can replace the sun. 100%, 100%, yeah. Okay, great, so how does this keep us safe from infection?

As long as we're here, what else is it doing to offset the 70% reduction in mitochondrial function? Because what we're talking about now is the role of melatonin within cells to lower temperature and reduce these 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 mitochondria that normally occurs? It does. The increase in melatonin from infrared 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 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 point about infrared light and its characteristic, and then number two,

let's actually get to some data, because we're saying a bunch of things, but what we really need is evidence-based stuff. 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 that not only can it penetrate through clothes, you may remember the Sony cam night vision thing 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,

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, yeah. 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 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 gonna be extremely hot. Touch a leaf. 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 infrared light is being reflected off. So, 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 trained to think scientifically and they'll know, well, it's not necessarily causal, right? People living in green spaces tend to walk more, they tend to perhaps eat more fruits and vegetables and on and on. So getting onto that,

there was a study that was just done in Louisville, Kentucky. Four square miles, they measured, Kentucky. Four square miles. They measured everybody in that four square miles, HSCRP, what's HSCRP? 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. It took them about a year. Two to three years later, they went out. The income of these people living in this four square mile area did not change. 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 dropped by 13%. And that's about on the order, almost on the order of doing exercise three times a week. I should mention that CRPC reactive protein has been associated with a number of blinding eye diseases, associated with inflammation, and basically everything bad you can imagine in every organ of the body, heart attack, ischemia, yeah, this kind of thing. Incredible. Yeah.

So, 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 turned to Glenn Jeffrey, who's in the Department of Ophthalmology. You know him well, actually, at 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, the first one he did was he took 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 17% increase in color sensitivity that lasted for days. Now, why would that be? Again, you should know that the retina is 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 diffusing, electrical conductions, and it has to happen very, very quickly. Otherwise, what you see is gonna be there as a blur. So this is constantly being updated.

So it's no surprise that mitochondria is so 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 Courdegra or the piece de la resistance was his next study, which he did, where he took 30 subjects, he gave them 75 grams of glucose, and in a blinded way, so they couldn't tell if the light was on or off, he exposed their backs to the same 670 nanometer light, and he monitored their

glucose over time, 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 guy's in England.

That's a joke for my British friends. Yeah, it tends to be very overcast there, but the sun does come out in England as well. 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 trials that show the same thing. So when I started to see this in my patients, 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 spurred me on to look at this was when I was in the middle of something called the COVID pandemic, and I was seeing patients in my ICU that were dying.

And what were they dying of? COVID, but what were they in there for? They had things like diabetes, hypertension, dementia, all of these things which have at the root of them, mitochondrial dysfunction. So what we have 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. There was a study that was done, Oxford and the University of Leiden in 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 seven-day period of time. There was another study that was done.

This was in Sweden. 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 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. 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 do to people here in this country that wanna 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 and from getting sunlight, but it is a remarkable study. I mean, this is the, certainly, smoking would be under the T for temperance. That would be where I would put a new start. We would not wanna do that.

But 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, except this time they actually measured UVA. So they used 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 the name of that article was published last year. It was titled, 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 dermatologist that I hosted on this podcast, Dr. Theo Soleimani also happens to be a derm oncologist. So his specialty is skin cancers. And I was surprised to learn, but we've talked about several times now offline as well, Theo and I, I was surprised to learn, but we've talked about several times now offline as well, Teo and I, I was surprised to learn that the sunlight-induced cancers of the skin, while they do exist, that's real, right?

You get too much UV exposure, you're going to age your skin more rapidly, you're 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.

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, a lot of zero cost apps out there, I can put links to one or two in the show note captions that I like that have no affiliation to whatsoever, by the way.

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'd even take it a step further because 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 skinned and they're concerned about getting skin damage, wear a broad-rimmed hat. Put a long-sleeved shirt on, but get outside because that's where the infrared, especially if you're around green shrubs and leaves and things,

because that's where you get a lot of infrared light. We know that green spaces are beneficial in terms of that. And we've talked about 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 align your digestive tract and impact things such as your immune system status, your metabolic health, your hormone health, and much more. So I've consistently found that when I take AG1 daily, my digestion is improved, my immune system is more robust, and my mood and mental focus

are at their best. In fact, if I could take just one supplement, that supplement would be AG1. If you'd like to try AG1, you can go to drinkag1.com slash Huberman to claim a special offer. They'll give you five free travel packs plus a year supply of vitamin D3K2 with your order of AG1. Again, go to drinkag1.com slash Huberman to claim this special offer. Today's episode is also brought to us by Element. Element is an electrolyte drink that has everything you need, but nothing you don't. That means the electrolytes, sodium, magnesium, and potassium,

all in the correct ratios, but no sugar. Proper hydration is critical for optimal brain and body function. Even a slight degree of dehydration can diminish cognitive and physical performance. It's also important that you get adequate electrolytes. The electrolytes, sodium, magnesium, and potassium, are vital for the functioning of all the cells in your body, especially your neurons or your nerve cells. Drinking element dissolved in water makes it extremely easy

to ensure that you're getting adequate hydration and adequate electrolytes. To make sure that I'm getting proper amounts of hydration and electrolytes, I dissolve one packet of element in about 16 to 32 ounces of water when I wake up in the morning, and I drink that basically first thing in the morning. I also drink element dissolved in water during any kind of physical exercise that I'm doing,

especially on hot days when I'm sweating a lot and therefore losing a lot of water and electrolytes. They have a bunch of different great tasting flavors of element. They have watermelon, citrus, et cetera. Frankly, I love them all. If you'd like to try element, you can go to drinkelement.com slash Huberman to claim a free element sample pack with the purchase of any element drink mix Again, that's drink element dot com slash Huberman to claim a free sample pack In terms of your original question, which is getting back to influenza or flus or things So there's a step

There's a great study that I always love to talk about in terms of this and it was actually done by Harvard It was a Harvard Kennedy School, which is not the medical school. This is the public policy and politics school. And what they did was they looked at this very question of influenza and why do we always get it in the wintertime and 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 Thanksgiving. There's New Year's.

It's cold. You know, does the temperature have anything to do with it? 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 because,

not because of the deaths that we had, but from a 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 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 absolutely, they said, quote, sunlight strongly protects against getting influenza. It was an amazing study. 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 wintertime 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, 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 flat line. Temperature did not predict which country, how the country got COVID-19 when the surge

started to happen. They did the same thing for humidity, flat line. 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, it 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 short the shortest day Or a short enough day and then and then Germany and then further on what it showed was Latitude 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 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, 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 December and January. Now, if you look at Australia, what do you think you'd see?

The inverse. Exactly. It's actually in Australia, the influenza season peaks late June, early July. So if you now go look at something like Singapore, Singapore is I think within a hundred 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 in hospitals and other recovery wards, as it were,

that there used to be, classically, there was 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're absolutely correct. You're absolutely correct. 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 a hundred 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 light 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 it's a beautiful thing when you start to look at this

because you start to realize that the infrared, 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 and green light in the absence of red light.

In fact, 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. And then after that, I'd like to talk to you briefly about this shift away from incandescent bulbs to indoor lighting with LEDs. But just to make sure that I don't move us along before providing some of the key takeaways, how much sunlight should we get each day in the shorter days of winter and in the fall?

And when should this be done? In the Jeffery study, it was clear 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 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 related to getting sunlight in one's eyes for circadian rhythm setting? So how much time, what time of day, and what frequency across the week? Excellent question. And you've hit on exactly the issue.

Based on Glenn Jeffries' 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 seven 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 talked to Glenn 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. Yeah, that was 940 and it was actually very low. It was about 2.9 milliwatts per square centimeter.

So low energy. Most people are not going to own a red, a far red or an infrared light. So I just wanna emphasize again for people, you can get that wavelength and all the other relevant wavelengths from the sun. Exactly. That's your red light therapy folks.

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 milliwatts. I mean, sunlight, all sunlight is about 100 milliwatts per centimeter squared. By time it reaches. Through the atmosphere.

Through the atmosphere. Yeah, so 130 when it hits the atmosphere, by the time it hits you, it's about 100. If you're looking at just infrared light, we're talking about 20 milliwatts per square centimeter. And so this was 2.9 at a very specific wavelength, so something that's completely doable. And so what they did, it was 15 minutes a day for seven days. And what Glenn Jeffrey was telling me is that Roger, he says, Roger, it doesn't matter 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 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 for three minutes was all that was necessary. So is this 15 minutes outside in the first three hours of your conventional day, as I call it, because people will say, well, the sun comes up later, this conventional day, meaning after the sun

has crossed the horizon, it has risen. I don't think it matters. I don't really think it matters. I think 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 that when you need it the most in the wintertime 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 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. 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,% to 7% inside of a vehicle.

And this is a relatively new thing. I mean, certainly when I was growing up, if I came home and had a snack after school, I was getting kicked out of the house to go outside. It was routine for parents to tell kids they had to go outside. And I think there's also, it's also the case, as you mentioned, that we're working later or at least on devices later into the evening, 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 gonna 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 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 gotta 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 biphasic response. And that's really important to understand. Don't come into this if you're gonna get a red light therapy and think that more is better because more may not be better.

You actually could do detriments 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. You 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 four hours a day for eight weeks. And they did the study and they did it in the summertime and they did it in the wintertime. 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. 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 kidney disease, Alzheimer's disease. All of those deaths go up all at the same time, and they all go up about one to three weeks after the shortest day of the year. They all come down, and they all are at the nadir about one to three weeks after the shortest day of the year. And they all come down and they all are at the nadir about one to three weeks after the longest day of the year.

When you see that and 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 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 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 wintertime. Two questions. One, it's hard to attach a single number to this, but what fraction of the obesity epidemic that we observe in the United States, do you think is caused by altered interactions with sunlight or artificial light and its consequences or put differently? Let me put it, let me phrase the question differently. 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, you know, adipose tissue, et cetera, independent of caloric intake.

I know this is kind of a heretical idea. 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 gonna wear short sleeves if they can or just a simple long sleeve clothing. They're gonna get this long wavelength light from the sun 15 minutes a day.

Based on what you told us about the light shown on the back and the lower glucose response, independent of all other variables, what percentage improvement in sort of the overall metrics of obesity and metabolic disease do you think you would predict if we were just gonna, you know, we're better sushi dinner for instance. Yeah, yeah.

You know. I guess another way of asking the question is, at what level would I be really surprised? If it was 50%, I would be surprised. 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 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 very helpful. I think a lot of people hearing about the role of sunlight and long wavelength light in particular, its potential influence on improving overall immune system function, metabolic health, et cetera, might think that this sounds a little bit kind of biohacky because the moment we get into red lights

that sort of light cold plunges, it's kind of immediately associated with kind of 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 specific wavelengths of light can be used in order to treat cellular health

or offset cellular disease is not a new idea at all. And you mentioned this earlier, but I just wanted to underscore that for people. The other way of looking at all this is that it's primitive. So some people will say, oh, this is biohacking, right? Other people will say, well, this is just primitive, like get sunlight, of course. But you made a very key point,

which is that the way we interact with light, and 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 without sunglasses on and just measure your total exposure to outdoor time, let alone sunlight? 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 looking at just this, except they actually used watches that was able to detect how much light, and it wasn't infrared light, but just total light. And the name of the study was basically, dark days and bright nights. 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 sorts of bad things. But the dark days was something that 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 daylight about midnight, but right around seven o'clock in the morning, eight o'clock in the morning, if you were out there and you're getting light now, instead of 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. Go outside, folks, and look at how bright it is at 10 a.m. or even 2 p.m. Compare that to the middle of the night. There is sunlight. Unless you live in a cave, there's sunlight all year round. It's just striking. So this morning, for Southern California,

it's pretty overcast today. It's a misty rain, a little bit more. And I didn't wanna go outside and get my sunlight this morning, but I know I was gonna be in the studio all day. And so I went downstairs and I put on a beanie cap and a hoodie and I just got outside with no sunglasses and got some sunlight in my eyes.

It's really bright outside even when it's raining. 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. And there are many gems that you're providing us today, but one key takeaway is I want people to understand there is sunlight all year round.

Yeah. I guess, 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. To your point about it being primitive, I was looking at the history of this, and it

was actually very interesting to me. We used to have tuberculosis sanitariums at very high altitude, and part of that treatment was getting out into 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 found it was very interesting what people started to say and what these people were actually saying at the time about sunlight. In terms of these people, these physicians and these healthcare 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 were able to get a stethoscope, put it on the chest, listen to the space between the second heart sound and the opening snap, and be able to say, this person's got severe mitral stenosis. This is the one you need to operate on.

And they would do that. And sure enough, when they opened it up, sure enough, this is the one that had... 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 founder of Modern Nursing. And she was there, you know,

in, there during the Crimean War, taking care of British 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 soldiers to recover is fresh air. But she said, a very close second is direct sunlight, getting them out into sunshine, getting them out into direct sunlight.

When I was looking at 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 the most translated female author 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 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 nine o'clock, it's a wretched health destroying habit. Every light should be extinguished, she said after nine o'clock. So I know about her sayings a little bit because she was the founder of Loma Linda University, which is where I went to school. So, but just, we had this knowledge,

but as you said, 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 kind of have the 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, actually try to get them out. It's difficult to do. These people are critical. The people that we admit to the hospitals today are far sicker than the people that we admitted to sanitariums and hospitals in the 1800s. You have to make sure that they don't desaturate. You gotta 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 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 some of my hospital staff to do that. and I've had a number of success stories where we've had patients that were ready to be intubated, and we got them outside in the sunlight,

and they steadily improved dramatically. After days of getting worse, and they got better, there was a lady that actually contacted me. Her name is Amy Hahnmeier, H-O-N-M-Y-H-R, if you want to look up, she's on social media. Her son, this is a really amazing story. Her son basically at the age of 15 got leukemia, got put on chemotherapy and this was in Minnesota, fortunately it was in the summertime, and he got admitted to the hospital with what they call neutropenic fever. Very high fevers, very low white counts as a result of the chemotherapy. And his immune system was completely shot

and unfortunately he developed a very severe fungal infection in his lung called mucor. Just basically eats up the lung, goes right to the blood vessels. He got so bad that 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 get worse, had higher fevers. 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 the staff came to him, and you can imagine, and I've been in this position before, where you're 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, this is his dying wish, take me outside.

I just wanna go outside. And you know that nursing staff will move heaven and earth to do something that the patient requests to do, even though it's not gonna benefit them. This is dying wish, they're gonna do it. So they hooked up oxygen tanks. They got this 15-year-old boy in a hospital bed outside on BiPAP with oxygen tanks for five hours a day.

His mom was telling me they are also using something called a firefly device where they were just basically shining lights onto him to see if it would work. You know how this 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 I'm not telling you this as a proof that this is what happens, but you have to realize

that he was in the hospital for six weeks underneath 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 little thing on our MedCram channel on it. And the disease was almost gone. There's no explanation to this day,

they don't have an explanation. He's still alive today. He's still alive. He's getting chemotherapy. He went from basically, and of course he's missing a lung, but he still has that lung. He's getting 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 present it as proof. The things that I present as proof is randomized controlled trials, epidemiological trials with dose response curves. These are things that we could 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 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 health. This snapshot offers you with insights on your heart health, hormone health, immune functioning, nutrient levels, and much more. They've also recently added tests for toxins, such as BPA exposure from harmful plastics and tests for PFASs or forever chemicals.

Function not only provides testing of over a hundred biomarkers key to your physical and mental health, but it also analyzes these results and provides insights from top doctors who are expert in the relevant areas. For example, in one of my first tests with Function, I learned that I had elevated levels of mercury in my blood.

Function not only helped me detect that, but offered insights into how best to reduce my mercury levels, which included limiting my tuna consumption. I'd been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with NAC and acetylcysteine, both of which can support glutathione production

and detoxification. And I should say by taking a second function test, that approach worked. Comprehensive blood testing is vitally important. There's so many things related to your mental and physical health that can only be detectedprehensive 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 Function 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 functionhealth.com slash Huberman. Function currently has a wait list of over 250,000 people, but they're offering early access to Huberman podcast listeners. Again, that's functionhealth.com slash Huberman to get early access to Function. So spectacular story by any account.

I wanted to just touch on the fact that there's no replacement for sunlight. Getting patients outside is hard. And at the same time, most people listening to this aren't fortunately are not patients. Thank goodness. Many people, people however have relatives or themselves are elderly. As people get older, they tend to slow down,

get outside less. There are many fortunate exceptions to this, but one of the setups that I created for myself that I think is certainly feasible for a lot of people is the following. Well, first of all, I always make it a point to get outside and get sunlight in my eyes, rain or shine. And regardless of where I'm traveling and et cetera,

I do that every single day. If I miss a day, it's only because of something like a flight where I happen to be on a plane at the time of sunrise or something like that. In any case. But I have a setup that I 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. 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 very red light and infrared diminished.

They tend to be very blue and green light enriched. And it shows up as very bright white light. So that's what I put in front of me when I first wake up if the sun isn't out yet. But now I've started putting a red light near infrared light next to it. And I'll spend the first couple minutes of my day, usually as I journal or do something like that,

or sometimes just with my eyes closed, just pleasantly, you know, facing in the direction of the 10,000 lux white light and the red light near infrared light. And I must say, again, this is anecdotal, but the combination of the two, not only does it certainly wake you up, the white light will do that alone. We know the biological basis for that. But I have noticed a tremendous improvement in energy, mood, focus, et cetera, 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, although this podcast does have a relationship to a medical grade red light devices. But I mentioned 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 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 for inpatient care is so high. Medical staff, the disposables,

the actual disposing of the disposables, the janitorial staff, the cafeteria. 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, the longer you stay, it's like a hotel, the longer you stay, the longer they can charge you or your insurance.

And I'm not a conspiracy theory type. Yeah. But it is interesting that for many people, they associate going to a hospital with staying a long time 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 questions slash 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, because of the relationship to light and the disruption in circadian rhythm from the overhead lights, the checking of the patient in the middle of the night, the disruption in circadian rhythm from the overhead lights,

the checking of the patient in the middle of the night, the disruption in sleep, et cetera, 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 sort of like, I feel like 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's going on? Exactly. So I can tell you that not only do you have less likely to get this type of isopsychosis, but the data actually shows that people who are in a two-bed room that are next to the window actually

Discharged 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 and their relationship to the insurance companies are in a situation where when a patient comes into the hospital 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

subcapitative 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 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 basically takes the risk now and puts it from the insurance company onto the healthcare provider.

So in those situations, you'll see a hospital having 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 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.

The jacket was a light jacket? It was an LED jacket that was giving light out at 940 nanometers, infrared light. So you can't even tell if it's on. And as I said, the milliwatts per square centimeter was like 2.9. So you wouldn't even feel it. But yet, these patients, when they were done, seven days, 15 minutes a day, they had better oxygen saturation. They could take deeper breaths, longer breaths.

Their heart rates, their respiratory rates improved. Even their lymphocytes improved, 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 eight days. How much does it cost to spend four days in a hospital?

Can be outrageous. It's outrageous. And it's potentially possible. And this is why I think really people need to understand this, not just people who are wanting for their own care, but people who are in charge of hospitals, people who are wanting for their own care, but people who are in charge of hospitals, people who are in charge of healthcare 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 would have to hire some nurses that would actually, I've actually thought about doing this 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, there's nothing 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'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. And if you absolutely can't get sunlight exposure, think about 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 the importance of darkness at night.

I'm aware of a study published in ProSignis and the National Academy of Sciences where they basically had kids sleep in either a completely black room or a room that had a hundred lux, this is very dim light folks, 100 lux light source down in the corner, kind of like a nightlight. 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 eye masks in particular, silk or even faux silk, eye mask, which are very comfortable 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? Do you yourself use like blackout curtains? I mean, how rigid, I find that this is the one that's a little bit harder for people. You have kids, I mean, how should we work with these data? And what are your thoughts about the importance

of getting things really dark at night? Yeah, 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? That's where you get the aluminum foil around the windows. That's where 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. Realizing though 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 photons can go through the eyes, just like we talked about with infrared light, can go through the skin. 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 super-chiasmatic nucleus that shut down melatonin production, or at least impair it in some way. Yeah, in experimental conditions, that's definitely true. Even, I mean, the sensitivity of the human visual system is extraordinary. I mean, your rods, the higher sensitivity photoreceptors

in the back of your eye can detect a single photon, one photon. Most people aren't familiar with thinking in photon quantities, so that might not mean anything to them. Put differently, and these are wild data from Chuck Zeiser's lab at Harvard Medical School. Light suppresses melatonin.

The question is, how much light do you need? Because of the increase in sensitivity of the eye at night, this rod system and these specialized cells 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 people 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? How do I not trip and fall? This kind of thing and route 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, flashlight's really bright, but you're not shining the light into your eyes. So looking at your screen dimmed way down in the middle of the night

is gonna be very detrimental to the melatonin system, right at the time where you want melatonin high and other things too. But looking at a flashlight shown into the hallway so that you can navigate very different scenario than it shining directly into your eyes. Makes sense. And then there are a number of different red light sources

that are pretty good, like little red light lamps that are effective, or you can just turn your phone to a red light mode. There's 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 said his house is very dark at night

and people would be afraid to go over because they'd be tripping all. That's my good friend, Dr. Samer Hurtar. Now keep in mind that Samer is the head of the chronobiology unit, the National Institutes of Mental Health. So he like literally lives and breathes this stuff. The other thing about Samer, which is interesting,

is when I first met Samer, he was very, very overweight. What Samer may have relayed on that podcast, perhaps not, is that by changing his relationship to light, sunlight and getting sunlight during the day and darkness at night, and by the way, he lives 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 nine or 10 PM and waking up earlier as opposed to staying up late and sleeping the equivalent into later in the morning, he lost over 80 pounds. Effortlessly, his appetite just adjusted because he finally got in tune with his natural circadian cycles. And Glenn Jeffries' 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, but I totally agree. If people were willing to meet me for dinner earlier,

I'm good. Now it is true that sleep is vastly 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. No. Okay. Yeah. And I would say the other thing is too, is making sure that these rules hunger in your belly is not easy. No. Okay. Yeah.

And I would say the other thing is too is making sure that these rules that we're coming up with here based on physiology aren't laws. So that we get so anxious about following that they actually become a detriment. There's a point where we just have to do well enough and then move on to the next day and try to do it the next day. We're human. Yeah. I wanna talk about the other aspects of New Start,

nutrition, exercise, trust, rest, et cetera. But before we do that, I wanna 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, but maybe I'll revise my stance. You see a lot of patients in the ICU with flu. Obviously 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. 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. That statement was 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 don't know if I've ever gotten the flu, 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, 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 metabolically challenged? Yeah, it's a good question. I think it's, and the approach that I take 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 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, so it's a mix of antibodies against known strains

of the flu. Yeah, interesting. The way that they try to figure out or guess 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 gonna be circulating in the Northern Hemisphere, and they do the same in the South. They look and 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 in the Northern Hemisphere.

And they do the same in the South. They look and see what's circulating up here, and they try to figure out what is 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 mentioned that in terms of that study on sunlight.

But in terms of the side effects as a result of that, it's been pretty bad. I mean, to give you an example, I had a patient recently in the intensive care unit. This patient came in, very poorly controlled diabetes, hemoglobin A1C of like 16, 17. It was very bad. And she developed, she got the flu and her immune system was not well. She actually also got a very bad fungal infection that was near fatal. And so that's the typical patient that we're gonna see who's gonna have that type of a bad reaction to the flu.

People who are immunocompromised, people who are not metabolically healthy, these are the ones that are wide open. And so a flu virus is going to do a lot of damage there. So what does the flu vaccine do? It gives the immune system an advanced notice of what this antigen is. And that has two effects.

What a lot of people believe is that it's gonna protect you from ever getting infected. That's not the case. You can still get infected, but what happens is that it's going to protect you from ever getting infected. That's not the case. You can still get infected, but what happens is that the symptomatology or the side effects of that infection will be greatly diminished. So instead of you being hospitalized, perhaps, maybe you're only 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 immunocompromised, I generally recommend it to get the flu shot. Or people that are exposed to a lot of flu. Exactly. Because like you, you work in the ICU.

Right. And if I may, do your kids get the flu shot? Yeah, we give them the flu shot as well. It's more because they're the kids of doctors who might bring home the flu and more than anything else. But there was a point where we were not doing 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 six months of age, I believe. So you started your kids once they were in their teen years. Yeah. Yeah I remember one year our son Ryan he he he got some some virus I don't know what it was But he had very bad diarrhea and that we had to take him to the to the to the emergency room to actually get an IV and get fluids into him. He was very dehydrated. I don't know what that was I don't know if it was rotavirus, but something was going around that year.

So, and he's perfectly healthy. So this is something that can happen and 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 don't tend, I mean, I go places. I go to restaurants, I go to the gym.

I've remained healthy for the most part. I'm in an occasional sniffle here and there. Every couple of years I go places, I go to restaurants, I go to the gym, I've remained healthy for the most part. I'm in an occasional sniffle here and there. Every couple of 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 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. 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 of 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 particles are gonna get through. And that's enough pieces of those Swiss cheese, no particles are going to get through. 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 incise. We make sure that the room is the right temperature, the right humidity, because that has an effect. 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 surgeon is wearing a mask. He's also wearing sterile gloves. So 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 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? And if so, what what's the percentage risk? Yeah, well, definitely there are risks in terms of allergies. So they should be asking you when you get it, have you ever been allergic to the flu shot before?

I mean, you can have anaphylactic shock. That's one possibility. 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 flu vaccine was causing a reaction that was causing an autoimmune response, and the antibodies, they believe, were acting against the, where hypocretin is made in the brain, hypothalamus. And so they noticed that there was an association. I don't know if they actually determined that it was causal, but they stopped that brain.

I would not want narcolepsy. I used to work in a laboratory for a summer that were studying narcolepsy. It was the laboratory, Emmanuel Mignons lab at Stanford School of Medicine. He and his colleagues, Seiji Nishino, identified the hypocretin orexin 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 drive. They become essentially paralyzed like a sleep atonia.

Pretty devastating disease. So it sounds like that particular strain of the flu shot in Europe was neurotoxic in some way. Yeah, there was one particular strain. We'd never seen it before, never seen it since. There are these one-offs, but everything has risks. The example that I give is, look, I'm in the ICU all day and I'm seeing people occasionally with head bleeds and they're on a blood thinner.

But 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 right medicine for this type of situation. And that requires training and that requires, 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? When you walk up to a new patient,

if you know they have a flu or if you know they don't have the flu, when you walk up to a new patient, if you know they have a flu or if you know they don't have the flu, are you masked up? I mean, this became a big issue around the COVID discussion, but to what extent does wearing a conventional mask or even an N95 actually protect you from flu? Yeah. So 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 incidence, and then we see if it's rising, everybody that comes into that place, physicians, patients, everybody puts a mask on to reduce that. N95s are a little different in that they don't prevent

viruses from coming out of somebody. You may notice when you put a N95 mask on, they may even have a valve that pops open and gas can come out, respiratory air can come out, or comes out the sides. It's when you take a breath in and it seals, now it's filtering that air. So N95s are very good for people

who don't wanna get infection and don't have respiratory issues because you're now having to breathe air in through a filter that takes a little bit more work. If someone has COPD, which is an obstructive lung disease or other lung diseases, that might not be the best thing to have in those situations. So yeah, I do wear a mask.

I was very careful. I know I was coming on your show this winter time and I was like, there's no way I wanna get the flu and miss getting on to see you. So yeah, I wore a mask. Well, thank you for not, for avoiding bringing flu here. It's wild because ever since I started this podcast, we put out now two episodes a week, the full length episodes on Mondays and the shorter essential episodes

on Thursdays. So I can't afford to get sick. Yeah. Yeah. And I haven't been sick in years. I take care to not get sick, but I'm going to think real carefully about this flu shot thing. What about hand washing? Is that so a friend, let me give a little bit of backstory. The guy I worked for as a postdoc was an MD PhD. And he used to joke about the fact that hand washing did nothing because he was in his prior life, he was a surgeon. He did a, I think he did rotation, a surgery rotation. He eventually became a neurologist, then a researcher.

And I used to say, what do you mean? The hand washing does nothing. And he's like,, what do you mean? The hand washing does nothing. And he's like, well, have you ever seen what a physician does before surgery? They wash up to their, basically their shoulders, they've got Betadine, they glove in properly, and 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, and it's kind of mixed. So to what extent does washing our hands actually help us avoid getting infection? It's a good question. And I think it probably comes down to some of the studies are probably not good data or heterogeneous enough

to do a meta-analysis. But 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 portals for viruses to come into your body. Eyes. Yeah, eyes, nose, mouth. That's where they come and we touch them all the time. You touch handles. I mean, if you think about it, it's almost, I don't know, creepy. And flu, it is creepy. And flu and cold can survive out on surfaces for how long? I have to look up the numbers, but it's longer than you might think. I know that when we looked at COVID, it's that really, I know we went crazy at the beginning

of the COVID pandemic about wiping things down. And really, that's not the way it seems to spread for COVID and more airborne things, but for influenza droplets, that is, you know, rotavirus, C. diff, that's a claustrium difficile infection of the bowel. 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 cookware.

Surprisingly, toxic compounds such as PFASs or forever chemicals are still found in 80% of non-stick pans, as well as utensils, appliances, and countless other kitchen products. I've talked before on this podcast about these PFASs 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 Our Place. Our Place products are made with the highest quality materials and are all PFAS and toxin-free. I particularly love their Titanium Always Pan Pro. It's the first nonstick 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 nonstick effect over time. It's extremely durable and it's also beautiful to look at. I cook eggs in my titanium always pan pro almost every morning. The design allows for the eggs to cook perfectly without sticking to the pan. I also cook burgers and steaks in it, and it puts a really nice sear on the meat, but again, nothing sticks to the pan. I also cook burgers and steaks in it, and it puts a really nice sear on the meat. But again, nothing sticks to the pan,

so it's really easy to clean, and it's even dishwasher safe. I love it, and I use it every day. For a limited time, Our Place is offering an exclusive 20% discount on the Titanium Always Pan Pro. If you go to the website from ourplace.com slash Huberman and use the code SAVEHUBERMAN20,

you can claim the offer. With a hundred day risk-free trial, free shipping, and free returns, and use the code savehuberman20, you can claim the offer. With a hundred day risk-free trial, free shipping and free returns, you can experience this fantastic cookware with absolutely zero risk. Again, that's from our place.com slash Huberman to get 20% off. Let's talk about water and air.

I think I, like many people are am curious as to, you know, how much water I drink. Is that influencing my susceptibility to infections, et cetera? Water on the body, water we get into, this kind of thing. And then air, humidity, temperature, ozone, anything interesting in those? Yeah.

Let's talk about water. So the most obvious one is the internal use of water. Ozone, anything interesting in those? Yeah. Yeah. 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 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 thing. It's probably not that much, but it certainly is important. So internal use of water is well known. I mean, it's a substrate that allows your kidneys to dump toxins, and you need 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 the other part of water that I'd like to talk about is not the internal use

of water, which is pretty obvious, 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 flus and viruses. One of the properties of water that is very, very important is its high enthalpy. What does that mean? It means it takes a lot of energy to raise water, the substance, one degree Celsius. And the opposite is also true. So if you put warm water on someone, 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 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 tolerate 170, 180 degree 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 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 innate 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 highly 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, PAMPs, pathological 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 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 of the different strains that we have of influenza. None of that matters with interferon.

Interferon has very wide, 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-CoV-2 came out. They looked at SARS-CoV-1, the original one that came out in 2002.

And sure enough, that virus, SARS-CoV-1, 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. They did some searching and they looked at SARS-CoV-2 and sure enough, MAC1, which is a gene in SARS-CoV-2, 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 in vitro study where they took lymphocytes, they put it into a medium, and

they bathed it in LPS. LPS is basically 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 degrees Celsius, there was a tenfold increase in interferon secretion from the lymphocytes. 39 degrees for those who are on the Fahrenheit system, that's about 102.2.

Okay, so- Slight fever. Slight fever, yeah. Or a good fever. Yeah, good fever. So what does this mean? This means that, and this gets into the whole discussion philosophically about fevers in general.

Should you block them, and should you not? Exactly. And I'll tell you in the hospital, I'll get so many calls, hey, doctor, this patient has a fever. And 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 1918 Spanish flu pandemic that we had. Aspirin had just been discovered, Bayer aspirin, 1899, and 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 even know it was a virus, just the influenza disease. And so 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 coming in with the flu, and they were getting high

doses of aspirin. They thought this was the way to treat it. And the mortality rate, the case fatality rate was like 6%. It might've 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. sauna hot shower hot showers probably the most effective way of doing it is In the old term and again something that was used a hundred years ago is Hydrotherapy or hot fomentations 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 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. And so you would put a protective layer of batting 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 secrete interferon. Look, we have studies, there was a study that was published

a couple of years ago, looking at COVID, giving exogenous interferon to people with COVID-19 reduced hospitalizations by 50%. So you're getting around- You can take exogenous interferon? people with COVID-19 reduced hospitalizations by 50%. So you're getting around- You can take exogenous interferon? Oh yeah, absolutely. You take it as a pill? It's an infusion.

You would digest it in the stomach. So this was an infusion that they gave to patients. I'm surprised that I haven't heard of like peptide clinic selling interferon. Can you inject interferon subcutaneously? You can. This was actually published in the New England Journal of Medicine. It was interferon lambda, I believe. It was a phase three trial looking at getting FDA approval, I think probably because of the fact that we weren't having as many hospitalized patients. It probably

hasn't gone through. In that study, it reduced hospitalizations by 50%. Wow. For those that don't have access to interferon infusions or a sauna or even a bath, so what is it, you know, a five to 10 minute hot shower that can get under the blankets, this kind of thing. I mean, this is kind of good old mom's advice kind of stuff. Isn't it interesting?

So I'll tell you what the protocol was. There was, 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 they were run by the Adventist Church and 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 Ruble, who was the medical director of the New England Sanitarium. And he said, let's just take a look and see what's going on here. Let's pool 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 Army hospitals. And there was a stark difference. He divided it into two sections. The first phase of influenza is the early phase.

And the major endpoint of that early phase was did they get pneumonia? And then from pneumonia, the second endpoint after that was the second phase, and the question was did they die? So where the sanitarium seemed 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, which was basically increasing body temperature, doing fever types of treatments, getting them out into the sunlight. 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 hostels. 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 actually wrote this up, and I actually found it in a, someone directed it to me. They actually showed it to me. It was in a, it wasn't even in a scientific journal that he published it in. It was some sort of periodical called Life and Health,

May 1st, 1919. I still remember it in my head, and he says, hey, this is what we did, this is what they did. They had one sixth of the mortality in their institution. And this was repeated multiple times. This is not done in isolation. Let's lead you up to the big thing here. There was a Nobel Prize that was given for this.

In 1927, Jules Wagner-Jorag was a Austrian psychiatrist who noticed that in his patients that had neurocephalus 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 neurocephalus patients with malaria. And of course, you know that malaria causes very, very high fevers. He cured neurocifilis by causing fevers from malaria.

Wild. And all he really had to do was heat them up. There was many ways of doing it at the time. Heat closets. Sometimes they would inject foreign proteins to create a fever. This was another way of doing it at the time, heat 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, quinine. Well, and LPS will do this.

LPS, as you mentioned, is lipopolysaccharide. I think they get it from yeast cell wall or something. It's a foreign antigen. 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 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 gonna explore that territory at all? And the reason is it's very clear that most of the gray market peptides have LPS in them.

Small amounts, but injected repeatedly over time, people start getting the systemic inflammation and fever response. There you go. That's a little bit of a tangent, but it gets to the same mechanism. Yeah. So when you say 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 banyas, which I'm a huge fan of, you know, there's some, a bunch of them in different cities. Whenever I'm in New York, I go to this place down on Wall Street, Spy 88. I have no relation to them. And they have a medium hot sauna for Russians. Medium hot

is very hot. It's like a spice in certain restaurants. You have to calibrate to the local ethnicity. 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 steam and then back to a hot, hot sauna, then into cold water. So they're doing heat, cold contrast therapy. And, you know, the Eastern Europeans and Russians and Scandinavians have been doing this for centuries. Absolutely.

Right, here we think of it as like biohacking and this 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. Because we don't see- In winter.

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 know. I'm sure they exist down there, but I feel like Brazil in the summertime probably feels like a sauna. So you don't need a sauna.

Right. Right. Whereas Siberia in winter probably 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 a minute of cold, that involves some sort of physical rubbing or sort of abrasion on the chest. And when I saw that, it's like, I immediately thought of what they do in Finland and where they hit themselves with. Yeah.

The Russians use these eucalyptus branches. Eucalyptus. And it's the, it is, it's eucalyptus branches. I call it, I think it's called platza or something like that. Yeah. And yeah, it costs a, it is, it's a eucalyptus branches. I call it, I think it's called plot or something like that. Yeah. And yeah, it costs a little bit more, but if you go to one of these Russian Banias, you can pay someone who's skilled in this.

They may busy make you lie down, you cover your face and groin, and then they hit you with these eucalyptus branches. Not to smack you with them, but now the idea is that in the sauna, you're gonna bring some of the additional vasodilation to the 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- My understanding from what I've heard and read is that obviously the heat part is to heat up the core body temperature, and that has a whole host of responses, which I touch on after this that I read a recent article that was just amazing. But the cold part of it is going to cause vasoconstriction and we know this in medicine.

We're actually taught this in medical school that a cold shower vasoconstriction 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 is it that you're doing? When you're doing the heat aspect and the fever goes up and the temperature is basically a, it's a non-hormonal signal to the entire body to start up 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, vasoconstriction peripherally, which is what you will see, prevents that heat that you've just built up from going out to the periphery and being lost. So it kind of locks the heat in, in a sense, allowing that heat to last longer. Amazing. Can you just repeat one more time, even though you said it incredibly clearly, this phenomenon of how the white blood cells are liberated by cold and constriction?

Yeah. So when you have, imagine a tube that's lined with white blood cells. They all have little podocytes, little things that attach. And what happens when you have vasoconstriction is it causes vasoconstriction, it shrinks down because of the smooth muscle in the wall. And you have release of these white blood cells into the circulation. 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 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 cold shower? The answer is, technically you have the same number of white cells, but now there are 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 essentially go out and- Yeah, these are the macrophages, the neutrophils. These are all different branches, if you will, of the armed 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- Yes, both actually. White blood cells, right. Once white blood cells are involved in the adaptive immune response as well. Amazing, I've never heard of deliberate cold exposure being used to liberate white blood cells in that way,

but it makes perfect sense. It sounds like it's largely mechanical. It is, and it also may seem to be mechanical in terms of locking that heat in. So one of the things that I always was puzzled about is 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 hamsters. And again the same target temperature. And what they showed in this, they looked at the innate immune system and the signaling that's required for the secretion of interferon. And they looked at stat and Jack. These were the two areas or signaling.

And what they showed was essentially that, whereas before I had told you that, you had to go up to 39 degrees Celsius to get a tenfold 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 Fahrenheit, there was a dramatic increase in the signaling in probably six or seven different areas of the STAT and the JAKS system signaling.

When they did further analysis, they said, what's going on here? Is it the lack of breakdown of mRNA? What's actually happening? This is the conclusion that they came to after they did all the molecular studies. It was simply just the increase in temperature that was causing an increase in transcription in the nucleus. Transcription 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 regulates 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. One thing that people might wanna play with a little bit,

although they should be careful, right? If you're pregnant, forget the sauna for a while. Yeah. You know, if you're- Absolutely forget the sauna for a while. Yeah, I- You know, if you're- Absolutely. You know, everyone has different thresholds for heat tolerance and cold tolerance, but spend a little time in a Russian banya

and you'll soon realize that they all wear these wool hats. Yes. And you might think, oh, well, that's just gonna heat you up more. No, it insulates you against the heat. Oh. And so you can stay in much longer

because the signal to get out, like that it's too hot is a brain signal first. Oh, wow. Which makes sense, right? Or your brain basically evokes something analogous to the gas reflex when you're not getting enough oxygen. Right? Okay.

So if you go in there with a towel on your head or you cover your head, what you find is that you can sit comfortably at much hotter temperatures in the sauna. Got it. That could be a problem, right? Cause you don't want to burn your skin, but the sauna actually provides a lot more degrees

of freedom and exploration safely than 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. But when I first hit a, you know, a 210 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. But when I first hit a 210 degree sauna, which is very, very warm sauna, if your head isn't covered, your heart starts racing. You feel like you want out of there. If you go in there wearing like a wool beanie cap, you're like, you're fine. You're fine because the brain signal

doesn't get kicked off for a while. 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 a hundred years ago. And there was these treatment rooms and each of the treatment rooms had a little hole, not a little hole, but a hole enough to put your head. And so 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. It's so amazing how humans find the same solutions through different portals. It is true. I'm fascinated by this. Every once in a while, I sit back from the information that we touched on in this podcast

since we launched in 2021. And I think there are so many different tools and protocols and you're providing additional ones today, they almost all fall into about six to 10 batches. And whether one comes through the portal of traditional Western medicine or Eastern medicine or what the, you know, Finns or the Russians do or what they, it's so interesting that, you know, we're talking light,

temperature, and these things obviously relate, hydration, which I'm sure we'll talk about, mitochondria, cellular metabolism. I mean, you know, 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 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. You only have access to a hot shower. 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 take some of the other measures that we were talking about before. 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. Yeah. I call it 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 Iraq, they said if we were sick, they used to do this to us all the time. They put us in the hot sand. I remember someone telling me from Iraq, they said if we were sick, they would put us into the hot sand to heat us up. And then you talk to somebody from the 1950s, grandma would say, oh, they put us to bed 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 different. 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 a lot of these things. That said, there are things that purportedly we can take to accelerate our progression through an illness should we get one and to help avoid illness. One of the things I'm most interested in is your thoughts on NAC, N-Acetylcysteine.

My understanding is that a few years ago in this country, there was an FDA ban on N-Acetylcysteine, but that the people who had already been taking N-Acetylcysteine were so bullish about it that they fought back and it has remained freely available without a prescription. My understanding is that N-acetylcysteine requires a prescription in some countries.

Could you tell us what the various uses of N-acetylcysteine are, and what its potential role is for avoiding or even accelerating the progression through a viral or other type of infection? Yeah, so the anesthetics, and I sometimes say anacetylcysteine, it may be just my Canadian accent coming through.

I'm guessing, I didn't realize you were Canadian. I'm guessing you are correct and I'm incorrect. No, I think you are correct, because people have corrected me. So I think if I say it, it'll slip up, that's what happens, so. Mom, mom, you know, ninth grade, grade nine, these are all Canadian.

That is 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, the metabolism of Tylenol depletes the liver of these reducing agents, glutathione, things of that nature.

So, N-acetylcysteine 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 very well documented. So it supports liver metabolism. 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 an excellent question. I would say if you 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 actually may be beneficial. It's certainly not going to hurt. And so, in patients who have liver failure from one thing or another, they may actually

recommend using that medication as well, N-S-Steel Cysteine. So NAC 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 redox, this is a good way to think about it, is think about a sulfur element with a hydrogen attached to it. That is the reduced form because it can donate that proton off and it will be in a reduced

situation so it can reduce something that was oxidized. However, when it reduces something that was oxidized and it does that in a good way, it itself becomes oxidized and instead of having having an S-H, it's now S-S. So now it's oxidized. That's really important in a lot of places because of that S-S bond. So you'll know that the S-S bonds occurs in amino acids. It's the reason why you can perm your hair.

You may not know that, but 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, 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. It's because that's the sulfur group, yeah. So that's also, by the way, the same reason why, and this gets into a little bit other discussion about why I think NAC maybe, I'll just call it NAC, is used in other areas is 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 that endothelial lining would become damaged, it would release underneath it and expose a huge collection of something called von Willebrand's factor. Von Willebrand's 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 quick polymerization. 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 clots. So for those that aren't familiar with monomers and polymers and this kind of thing, basically you're taking 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 molly, 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, 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 Willebrand factor, and now you have clots in the pulmonary artery. This is something actually that we did see with COVID when they did the autopsies. They found many times more of these specific white clots in these patients. And so 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 COVID. And the interesting thing about that was, is that, do you remember when they published, 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 susceptible to getting COVID. 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 as well now is that people with type O blood have slightly less von Willebrand's factor. So does that mean in general that we clot less? If that clotting is related to von Willebrand's factor in platelets, then yes. There's other ways of causing clotting cascade, but yes. So I found it really interesting. There 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 NAC and why I was using it in actually patients with COVID-19 and influenza, and we'll talk about that in the study too, is ACE2. So ACE2 is the receptor for the spike protein for SARS-CoV-2, true. But let's take it one step further. That ACE2, what is it actually there for? Why is it actually there for?

Why is it even there? It's not there to be a receptor for spike protein. The actual job that ACE2 does is it converts angiotensin 2, which is a pro-oxidant, into angiotensin 1,7, which is an antioxidant. So let's go back to the beginning of our discussion again. Here's the mitochondria. Here's the mitochondria is doing what it needs to do and it's producing oxidative stress. It's got all these different enzymes that are there to lessen the heat from that engine,

catalase, glutathione peroxidase, superoxide dismutase, melatonin, as we discussed at the beginning, and angiotensin 1,7. So now what happens? You've got these patients that have obesity. You have these patients that have cancer, 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 ACE2 receptor,

and now that thing that was in balance is now out of balance because you're no longer taking a pro-oxidant and making an antioxidant. So now the analogy is that you're in a car and the heat in the engine is barely, I mean, it's coming up, right? You're barely making it and now you approach a hill called COVID-19, and you're going up that hill. You're gonna burn out. Your engine's gonna 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 severely hypoxic. What I believe what was happening, and there's some data to show this is the case, is that as the virus went into the lungs, and I believe this also happens with influenza, the virus was getting into the pulmonary circulation, and as it was going down, it was binding to the very rich ACE-2 receptors in 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 Willebrand's 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 redox balance in these cells are maintained. One way of doing that is light and melatonin and all the things that we just talked about. Another way of doing it, in addition, would potentially be in preventing those sulfide bonds from forming and causing polymerization. That's where you have NAC, 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 NAC at, I think it's 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 in the winter months, I still do this, or if I had any kind of low level congestion. And my understanding is that it's a mucolytic. Yes, because mucus, again, the reason why mucus is so thick is because of those SS bonds. So when you put NAC in there, it breaks it off and now it's liquidy. It's used to treat cystic fibrosis and to counteract the buildup of fluid in the lungs

as I understand. So it will make your nose run a bit if you have a little low level congestion, but what I love about it, and I don't have any relate to be clear folks, I don't have any relationship to any company that sells NAC, I'm not paid by the Big NAC or anything similar. Or Big Mac.

No, or Big Mac. Certainly not by Big Mac, but by Big Mac either. But I don't like conventional decongestants. I like steam, but I don't like taking over the counter decongestants of the sort of conventional commercial type because they tend to be very drying. They sometimes have a little bit

of a stimulant quality to them. I just don't like them. And I find that NAC, in addition to increasing glutathione, which can only be a good thing, 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. But I find that it's helped me move through periods of sort of exposure to colds, maybe flus, but certainly colds much faster. And actually there are data to support

that it can prevent contracting the flu virus. Well, not necessarily contracting it, but certainly having the symptoms of it. So this was a, 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 three to six months, people were taking 600 milligrams of NAC twice a day. And what they did was they looked to see how many people got infected and what their symptoms were. And 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 one that dropped the most was the runny nose and the sore throat. That was what it was best at reducing. There's been some question about NAC because it's so good for cells, right?

Because it replenishes. There are some studies in vitro in cells that are designed to be models for cancer that NAT can actually cause the propensity for some of these cells to grow and expand. 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 Petri dish, right?

That doesn't necessarily mean that nutrition causes cancer. Yeah, you raise a really important point around this. I mean, the joke that was told to me years ago is, you know, a drug or a compound is a substance that when injected into an animal creates a scientific paper. Meaning it's very easy to see things change when you add, when you do a dose response curve of just about anything. And some people might say,

well, thank goodness, are any compounds doing anything that's real or is it all placebo? I think there are real effects of compounds. The context is really important. Do you take NAC continuously given your job or do you increase your dosage when you know you're coming into contact with flu patients?

I do exactly as this paper was doing. In a winter season when I know that things are gonna be elevated and high and I'm gonna be seeing a lot of influenza patients, I do take 600 milligrams twice a day. But I try not to do it for more than three 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 sort of enjoy the fact that there are certain compounds out there like NAC that I personally can observe a benefit from if I take it for short periods and slightly higher doses, and then I stop. And I have the, you know, unfounded theory that it helps punctuate the effectiveness

because you're not, you know, because there is down regulation of pretty much every mechanism that you could possibly imagine. Yeah, I mean, there's so many redundancies that are built into the system, but in this situation, I don't know what the mechanism is, but I believe that with influenza, there is a tilting of the scale toward oxidative stress,

and NAC, in that sense, can be very helpful. And as I recall in the study that you described, where people took this 600 milligrams of NAC twice a day, the reduction in severe symptoms, 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 exact on the numbers here, folks, to about 28%, is that right? Yeah, so that's about a 50% 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 an increase in glutathione to boot. Yeah, yeah.

So, yeah, wonderful. Other things that have been shown to improve symptomology or perhaps even immune system function, maybe we could talk about zinc. 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 gonna continue to do it.

Because I do my blood work and it works for me. I think there is actually good data for zinc. Some people might disagree, but I think the studies that I've seen seem to show that zinc supplementation can be beneficial. The theoretical, of course, and I'm sure you're familiar with it, is the copper deficiency, and if you're checking that, then that's fine.

The recommendations that I have seen is 40 milligrams of elemental zinc. So you have to be careful when you look up the zinc on your bottles to tell you how many milligrams, but it's the entire molecule that they're measuring. So it'll also say how many milligrams of elemental zinc that is equivalent to. And the recommendation that I've heard from people

is 40 milligrams, but 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 215 pounds. So what's the risk of copper depletion? Blood deficiencies and things of that nature, yeah. Okay, I'll get my copper levels checked. I believe it's in my blood panel.

It is in my blood panel and I don't have a flag there, but I'll keep an copper levels checked. I believe it's in my blood panel. It is in my blood panel and I don't have a flag there, but I'll keep an eye on it. 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 cofactor and I believe that that's what it's related to. I can't remember exactly which ones they are, but zinc is used as a cofactor

in some of the enzymatic reactions of the immune system. Why doesn't somebody market an interferon inhaler or nasal spray? Actually, they are looking at that. When I was researching this for the intravenous interferon, 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 create one.

It doesn't make you feel very nice. When these patients, for instance, well, this might be material to understand too. For many years, we had hepatitis C that was incurable. And interferon actually is the cure. There was a point where we used to give infusions of interferon to cure people with hepatitis C. 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 do have the flu. It feels like that.

It's worth touching on this, that so much of the symptomology when we have a flu or a cold or what have you, is the immune system doing its thing. The fever, the congestion or- Correct. And we think of that as the illness, but it's often the byproduct of the body

trying to extrude or kill. Exactly, nobody likes congestion. 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. So let's talk about the science. Let's talk about the actual data. 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 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 in vitro 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 on the innate immune system. They actually- Phagocytosis folks, sorry for interrupting, but is it a gobbling up of bad stuff by good cells? Yeah, exactly. So they had these beads and in the paper showed that these beads and they were fluorescent. And you could see in the cells

that had not yet gotten the eucalyptus oil that there was a number of beads outside and these cells were just kind of moseying around and they had both white microscopy and electron microscopy and a 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 instead of these nice rounded cells, they were like all of these things just coming out like little podocytes like reaching for things.

And then a few hours later, it showed all of the beads that were outside were now inside. So there was something in the eucalyptus oil itself that was stimulating the innate immune system to gobble this stuff up. And again, we go back to the folksy type of old stuff. The main ingredient in Vicks VapoRub is eucalyptus oil. I have a theory that it's not going to be very kind to eucalyptus trees or koalas or anything related to eucalyptus, which is that maybe the eucalyptus oil is a mild irritant at the cellular level.

You inhale it, you get this menthol-like or the odorant. It's kind of caustic, and the immune system reacts to it by activating phagocytes to go gobble up more stuff. It could very well be. In that line of discussion, it's very imperative to understand that eucalyptus oil is never recommended

to be taken internally. There's actually been reported deaths from taking too much eucalyptus oil. So I've just put that out there, that people think that it's gonna work and more is better. Usually the way it's used, and the way it has been used, historically, is, and for instance in hydrotherapy, they would put maybe a few drops of that

or rub it onto the skin and allow it to sink in. It's extremely potent. If you go online to buy eucalyptus essential oil, that should not really be taken internally. It's not designed for that. It's extremely potent and putting it maybe on your, sometimes I'll do that, put it on the upper lip, so I'm inhaling it.

It actually can be 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, it's just 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 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 take it as a personal insult, but I'm not gonna take responsibility if you do it anyway. That's a great segue to air. responsibility if you do it anyway. Yeah.

That's a great segue to air. Yeah. I've heard conflicting things vis-a-vis, should we sleep with an air humidifier? Should we sleep with a cold room under warm blankets? 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 respiratory stuff going on probably because of a drying out of the respiratory pathways.

Yeah, that's very possible. So let's talk about air, 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 it goes without saying, but smoking, cigar smoke, vaping, exactly. Sorry, folks. Vaping might be better for you than smoking,

but it's still terrible for your lungs. 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. Right before COVID hit, I can't tell you how many young kids

were being admitted to my ICU on ventilators. It was a little different at that time because it was so expansive that people were making vitamin E oil to cut the nicotine in, 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 COVID.

This is totally unrelated to COVID. 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 briefly the brand. So yeah, we're starting to understand now

that vaping doesn't have as many toxins that smoking does, but it's not a healthy choice. And contrary 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 in regular cigarettes, very high concentrations. Incidentally, what are your thoughts on non-smoked,

non-vaped, non-dipped, non-snuffed nicotine? So nicotine gum, nicotine pouches, I mean, it will raise blood pressure, raise a constrictor, but definitely increases alertness while causing relaxation. I'll come clean. I occasionally will take a milligram or two,

which is very low of nicotine gum. Yeah, so- But never smoke or vape or dip or snuff it. I use it all the time in my patients who I'm trying to get off of smoking. So, and that's a safer alternative, especially for the lungs, right? Cause this is not, they're not irritants

that are going into the lungs. So no problem with that, especially if it's used to get them off of smoking. It's something that we use all the time. Do you use nicotine? No. No. There's a massive expansion, the number. Do you use nicotine? No. No. There's a massive expansion,

the number of people taking nicotine pouches now. Yeah, and it's something that affects the brain, as you know, it affects the pregnant women, affects a number of aspects of the nervous system. We have receptors called nicotinic receptors for a reason, because that's the neurotransmitter. So yeah, it has an effect. It is highly habit-forming slash addictive.

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'm not familiar with that data, but certainly something to look into. Yeah, I'm not familiar with that data, but certainly something to look into. Yeah, I'm not gonna try and convince you to get on nicotine.

I'll also say that 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 mild little mildly irritated and then you take 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 vasoconstrictor. So that for those interested in performance enhancing effects, it's pushing you in the opposite direction.

Anyway. So in terms of air, we've talked about what should not be in the air, but there's actually some data that's really surprising that I found during the pandemic that was interesting to me that should be in there that maybe isn't in there. And that's the fresh air associated with going outside. So what is out there in the air? What should be out there? Obviously clean air. People who

live next to freeways and pollution, those are bad things. We've talked about that. But the Japanese seem to have a corner on this research. It's really interesting stuff. You've heard of forest bathing. So there was a number of studies where they've taken these CEOs in Tokyo and they took them up to the Hinoki Cypress forests. Sounds beautiful. It is. And what they found was they did actually very controlled research where they checked blood levels and they did blood tests and they had them walk around for three days in

the forest, forest bathing. And they actually took air samples and they found that there's these substances called phytosides, which are given off by the trees, not just Hanokycypress trees, but just about any kind of trees. So, fir trees, oak trees, all sorts of pine trees. And that these substances interact with our bodies and specifically again again the innate immune

system. They were actually able to look at chromogranin A, which is a substance that's in some of these white blood cells that are 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 a 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 phytoncides from these Hanoi cypress 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're 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 something that, there was a je ne sais quoi, I guess the French would say, there's something gestalt about walking in the forest that's different than just infusing the Honoki Cypress.

But 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 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 something else in the equation as well.

And it kind of leads just to bigger picture and a bigger philosophy of life. And that's the reductionism of science. We always try 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 being healthier in modern times, perhaps the better way to put it, is about trying to bring the outdoors indoors. That's great. We exercise in gyms, is about trying to bring the outdoors indoors. That's great.

We exercise in gyms, whereas we used to carry buckets of fruit and soil. And we are talking about some artificial light. There's no replacement, but ways to supplement artificial light, excuse me, ways to supplement sunlight with artificial light. We're just indoors a lot more.

And no one's suggesting that we all run around in loincloths outside all the time. 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've made it my profession for many decades, it makes sense why no one thing seems to solve

all the issues that we're after, that we need to experience these things in combination. Maybe nature is just the best way to do that. Yeah, and I can't help but think of some studies that have been done in the past where this has really highlighted it. There was some evidence they believed that people with lung cancer would do better if they had, 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 some high doses. Maybe this will solve lung cancer or help lung cancer. They had to stop the study early because they did worse than the control subjects. And important to point that out

that the high dose supplementation is not the same as ingesting something in the context of a food. And we didn't discuss it 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 lights in the presence of red lights 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 not broadcasting, if you will, in the infrared or in the ultraviolet. It's a very specific, narrow range of visible light. We alluded to this. Oftentimes 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 department store, for instance, or in a pharmacy, I haven't done the spectral waveform analysis, but those who have, it's published, it's out there.

There are a lot of data about environmental occupational health stuff, would show that it is 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 were surprised to know this, I'll just ask you, and it's not a trick question, but how many lux do you think come from like a really bright candle or a roaring fireplace? Or the brightest 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 10 would be high level.

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 moon that lights up. So it turns out that if you're 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 it looks like it's so bright, it 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 very concentrated,

but the fall off of that brightness is really what indicates just how dim it really is. But if we think about an LED coming off a wall panel to adjust temperature in a hotel room, it has something like a hundred to 400 lux. And yet we think of it as a dim nightlight. And so this is sneaky stuff. It's really diabolical because that wall nightlight

or 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 the photoreceptors are in the lower portion of our retina. Sorry, the lower portion of our retina. And so the type of light that's going to your circadian rhythm is gonna be much more likely to do that if it's coming from up above

or at the same level than down below. That's right. And the Scandinavians, I have my stepmama Scandinavian, understood this intuitively. And so in the evening, they don't have a ceiling light. They turn off the ceiling lights and then they only use desk, sort of table level 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, we're riffing in a kind of a light bio, you know, improv here is that when you step back

and you just look at it logically, we have dim days, as you pointed out before, we have bright evenings and nights, and it's all short wavelength at night. It's terrible. I'm beginning to think that many, many, many of the problems that we have in terms of our metabolic health,

sure that has to do with food, certainly. Has to do with lack of exercise and a number of things, screens, et cetera. 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 completely agree with you.

The one thing I was gonna add to that too, are the windows. So you're aware of course in California, we have, we need efficiency 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 filtering that out is just stand in it when the sun is on it. If there is a lot, if you can feel whether or not your window is filtering that out is just stand in it when the sun is on it. 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. We've gotten rid of the incandescent bulbs. We have LED bulbs. We've gotten rid of the regular window. It's, we have LED bulbs, we've gotten rid of the regular window.

It's all for energy efficiency, which is a reasonable thing to do. We need energy efficiency. But no one's asked what the human collateral damage is to this type of efficiency. Yeah, and we shouldn't have to take vacations to expensive, sunny places to overcome this stuff. That's not the right way to think about it. The way is to try and weave it into our lives at low expense or no expense, getting outside, for instance, opening windows.

In cars is the worst. So what's wild is if you go to the Pacific Northwest in the fall or winter when it's really hard to get light, 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 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 light in our relationship to light is one of 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 atriums and skylights and be outside all day.

It's like, yeah, actually, that would be great and dimmer and darker at night. So taking small steps towards adjusting toward bright days 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 low efficiency bulbs that were present in all our homes, the bulbs that would burn out pretty often, were, we know that the incandescent bulbs

are more full spectrum. They have a lot of red and orange emission. You see them as white, but they look a little warmer. It has that warm, those are great. Those are great, they're harder to find now. Actually, they were illegal for a short while. I don't think anyone was gonna 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 haven't seen them, but 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 constructions, that's what's going on. You know, we'll see what happens. 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 get some rule changes. I believe it's with the Department of Energy. So do you know who are really the smartest about this stuff that if you want to know where human, self-directed human health is going to be in five years, 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. at maintaining aquaria and reptiles. Because those animals literally die under conditions of pure blue light. Like if you've ever had fish tanks, I'm officially like, you don't want to send me down this path. But there's a very famous fish tank designer. I was a huge fan of his.

Unfortunately, he died of pneumonia when he was 60, Takashi Amano. There's museums in Japan about, developed this thing called aquascaping, which is about plants and lighting more than the fish, although there's fish 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, 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 aquatic elements like plants to thrive. And anyone that understands how to maintain reptiles or understands how to, which I'm not into, I don't like scaly things except fish or aquaria,

they know you can't have a dearth of long wavelength light or all the fish get sick. The plants die. 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. And forgive me 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 set our circadian rhythms and that do all this, the quote unquote reason why the peak of the portion 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 meters or so. You swim down a little bit lower and you need to bring a light with you. Now, of course, the fish that are red are still red down there. You just can't see it because of the lack of reflectance of long wavelength light. So we are walking around in the evening,

basically being exposed to what our eye and brain think is daytime, just as our retinal sensitivity is going up. And then all day we're in this and it's not bright enough. So anyway, I'll stop now, but it has me activated as you can imagine, because you hear about all the mental health issues, the physical health issues. I think they're all downstream, as you pointed out,

of mitochondrial dysfunction. Put differently, mitochondrial function is downstream of proper relationship to light, which you so beautifully illustrated. And I learned a ton that I hadn't known before about that. 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. Okay. If I continued on Aquaria, we won't forget.

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. We will return to new start. Okay. But I wanna know about long COVID. Is long COVID a real thing?

Oh yeah. And what is long COVID? What can be done about long COVID? How do you know if, like most people by now have had COVID at a high level or low level. Yeah. How do you know if 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 a number of different types of symptoms. Typically it's fatigue, could be headaches, could be all sorts of things, even loss of 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 as a physician, as a pulmonologist, one of the cardinal symptoms of long COVID is shortness of breath. And so, because I'm a lung doctor 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 as it turns out, one of the, not for everybody, but for many people with long COVID, 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 COVID. So there was a study that was done looking at metabolism and they showed it was one of these plots where they looked at up regulation and down regulation of metabolism in the mitochondria. And 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 down regulation in people with long COVID versus people who had COVID that didn't have long COVID that had a down regulation in beta oxidation.

So 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, certainly one of the possibilities here is that they were infected with COVID. It down-regulated 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 acids. So you'll talk to people who have been infected with COVID

and they said, we gain weight after we're infected with COVID and I have all these symptoms. First of all, 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 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 for the ones where everything is negative, because there were some where I actually discovered they had blood clots and we had to treat them for that.

But for people who have everything negative and they're still complaining, I remember one gentleman in particular, he had eight out of ten shortness of breath and 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 onto this idea about light and looking at these studies about the mitochondria. And I had this idea, because there was nothing else left, 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 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 actually got him to do intermittent fasting. And 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 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, D-A-M-P. 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 and 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 COVID,

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 amazed. I was amazed. He said that his gastroesophageal reflex disease completely went away after he stopped eating after 5.30. His shortness of breath went from an eight out of 10 to a three out of 10.

And he said, it doesn't even bother him anymore. This is after a year of having this type of symptoms. So that really took me a pause. Now I'll tell you the first thing, 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 an infection that has caused damage to the system.

And some of the studies from what I've 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 long COVID. There was a study that was done looking at to see whether vaccination of COVID-19 would work after patients with long COVID. There was some benefit. It wasn't big, but it was some. And it may be that you're just stimulating the immune system again to fight off this

remaining virus that's still in the system. But we have data that shows that the type of inflammation that we get with spike protein, it's actually a toll-like receptor four 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 toll-like receptor 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 COVID is something and I believe people are suffering with it. It's a very heterogeneous disease and it's hard to just pin one thing on everything 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 is being one of those things. People who are sick with COVID and long COVID tend to be sick and they stay indoors. And so there may be an exacerbation of the process. The last thing they wanna do is to get outside. But it may actually be beneficial. Yeah, I would imagine that pretty much everything that you've shared with us today actually be beneficial. Yeah, I would imagine that pretty much everything

that you've shared with us today would be beneficial. My understanding is that some of the heterogeneity of even just the COVID response in various people who got it in addition to the heterogeneity and long COVID symptoms could be due to the fact that the distribution of ACE2 receptors is very widespread in the body. SARS-CoV-2 binds to the ACE2 receptor.

It's a primary receptor site, as I understand. And I remember early in the pandemic, asking on social media, are there ACE2 receptors in the brain and on neurons? And people were like, no, there's no ACE2 receptor. It turns out the olfactory neurons are chock-a-block full of ACE2 receptor and they are bona fide CNS neurons, their brain neurons.

And so, and you lose them. Fortunately, those can replenish over time in an activity dependent way. But yeah, when I hear that some people got COVID know, got COVID and it was no big deal, other people got COVID and 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 ACE-2 receptors in one person's brain versus someone else, maybe their blood brain barrier, you know, it didn't get in there at all.

Right. Yeah. As I recall from the... This is actually kind of interesting about olfactory, is that the nerve cells that are next to those neurons in the olfactory are the ones that have a lot of ACE2 receptors. What happened is these nerve supporting cells that were helping with 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 wasn't exactly in the same, didn't come back in the same way. There was, and this has been used for years in, in air, nose and throat circles is something as interesting. This sounds kind of silly, but smelling sticks. There's actually a protocol that is used that these markers that are manufactured in Europe where they have a different- Orange, lemon, chocolate.

Exactly. And smelling these things actually over, there was a randomized crossover placebo controlled 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 in an activity dependent way. And so it requires electrical activity and their electrical activity is dictated by smell. Smell, got 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 smell training based protocols for bringing your sense of smell back intentionally includes a variety of smells. You don't just want to smell lemon. You want to smell lemon, coffee, this. People always say, do I need foul smells too? In kind of unfortunate way, the neurons that detect noxious odors and bad odors

tend to not die off as readily. But it makes sense because those are the cells that actually preserve your innate aversion reflex. 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 ammonia, you know, things that are potentially hazardous for us is

the detection thresholds are incredibly low. We're just so sensitive. It's like the fifth cranial nerve, isn't it, that does that? Well, yeah, so the trigeminal will, you know, it's involved in some of the protection of the nasal epithelium and what not. But these are the, this is a direct line

through the olfactory pathway to the amygdala, a fairly direct line. That's right, it bypasses the thalamus. Right, so, right, all of olfaction bypasses the thalamus, but the learning of odors is, your odor maps are gonna be slightly different than mine based on your experience. But when it comes to the representation of smoke,

vomit, feces, and rotting bodies, all the dangerous stuff, our pathways look pretty similar. Got it. Got it, to be blunt. Given your expertise in lungs, and a number of people I know have mold issues. They claim or they believe that mold has infiltrated their lungs.

Some doctors tell them they're crazy. Some doctors tell them that they're not crazy about that idea. Is mold toxicity a real thing? Can it be treated? Maybe we do an entire episode about this another time, but is it a real thing? And what is the kind of primary treatment for mold toxicity?

It is a real thing. And mold is a substance that can have multiple different effects on the body. Let me give you an example. There's a fungus called Aspergillus, and there's two ways that Aspergillus 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 bronchopulmonary aspergillosis. So it's kind of like an autoimmune situation. Exactly. Exactly. And so you have symptoms of asthma.

You have symptoms of inability to breathe. And the primary treatment, ironically, there is steroids because you need to reduce the inflammation, but 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 bad.

Sometimes it's so bad that you actually have to do surgery to cut out that thing because you can't cure it. The way that this often happens is mold and fungus are in the air all the time. So here's this understanding of there's germ theory and there is terrain theory. And today, and I almost hate to even get into it, but people think it's one 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 gonna like Neisseria meningitis. If you get that it's gonna cause a bad meningitis No matter how healthy you are. Okay, there was just I remember reading about a young Japanese star I think think, or Taiwanese

star just recently here that died of influenza. 48 years old, 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, so I can talk about like different types of infections that could do that. So that's where we are with mold. So typically you're breathing in all sorts of molds and fungus spores all the time. But if your immune system is good, it'll just kick it out and 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 rheumatoid is so bad that we have to put you on a biologic, that means there's an antibody 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're infected, but their immune system has walled it off. Then we 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 gonna match against the 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, whoever wins the Super Bowl, did they win the Super Bowl or did the other two lose the Super Bowl? And that's... Who knows? So this is where the thing is, 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 virulent is the burden of a pathogen that's going in. The reason I asked, is it a real thing, is that people that I know who believe they have a mold infection or they did,

do seem to have symptoms that last a long time. And there doesn't seem to be any general agreement about what specific treatment to use for this, unless maybe they need surgery or something. So do you give people antifungals? 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, it does. If someone came to me with mold, with a mold complaint, thinking they had mold, 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 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 a culture, then we can tailor antifungals for that particular thing.

In the sense though, that someone may be having symptoms of some sort of infection or something, and there's nothing on the CAT scan, it's harder to really isolate exactly which one it would be and what would be the right treatment. Although there are some syndromes known as RADs or reactive airways disease where you can have an exposure to something that's so egregious that even though you don't get exposed to that thing again it can still cause persistent difficulty with breathing. It's very similar by by the way, to asthma. So, for instance, somebody,

let's say someone's working in a vat and 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 correctly and they may never be exposed to that chemical again. Let's talk about the T in New Start, trust. You talked about higher power, you talked about community, you talked about connection generally and specifically. 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 physical health in any number of different ways. 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, 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. Some of the times, sometimes they don't, and we can't help that, but we do the best that we can. No, it does help quite a bit.

So people who have a network, people that have faith, people that have community have that strength that allows them to get through those very difficult times. There's been a number of studies that have looked at this. You think that this area is kind of nebulous and hard to study. Now there's actually some pretty good data on this. And I think back to a number of studies that have been done

and where they looked at thankfulness and the mind-body connection. People who are more thankful have less somatic 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 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 writing out those letters actually had a change in the endpoints in those studies. There was another study that was done that was very telling to me. It was a survey that was done of 1,500 people. It was published out of Texas.

In this particular case, they wanted to limit the population of the recipients. So, these were just Christians in this case, just because of the heterogeneity. They wanted to see if they can get an endpoint. And what they did was they asked people in this survey, how do you forgive? Forgive this has to do a little bit about faith 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 that 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 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 anxiety at the end of life, in terms of study, but they found that when they looked at anxiety at the end of life in terms of anxiety and in terms of dying, well-being, somatosensory complaints, all sorts of, a whole list of different things, they found that people who forgave conditionally the ones that would wait for someone to come back to them had higher marks in those cases. In other words, they had more anxiety.

They had more somato complaints. 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 determinant that determines whether or not somebody forgives conditionally versus unconditionally?

And I think the odds ratio on this statement was like a two or three, which is getting up there. 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 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 God. 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 oftentimes 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 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. I'm a graduate of Loma Linda University and our motto, and it's a Christian institution, 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 excuses about that. But 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 you give me permission to do this?

And you have to watch for things. It's not an easy thing to do, but you want to help if someone wants to be helped. So oftentimes 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 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 belief structure to tell them that they are forgiven, there's a world of difference.

And it's quite, actually it's quite amazing. It's interesting to me that in all hospitals, not just hospitals with a, you know, an affiliation to a particular branch of religion, you have chaplains. Yeah. You have different people associated often with different religions that people can call upon,

which I find amazing, right, in this, in this quote unquote modern time, you know, of modern medicine. Right. As far as I know, every major hospital has this. It doesn't matter how cutting edge or how small a community hospital, which by the way, many community hospitals are excellent.

I should point that out. The words community hospital juxtaposed to, cutting edge research institution. There's actually a debate as to like, which one you would prefer to go to, depending on your needs. But they all have, generally as far as I know, have access to people

with whom patients and family of patients and friends of patients can pray. And that's not a coincidence. I think that there's a deep understanding of some sort of relationship there. And certainly there's good science to support everything you just said. And your clinical experience in my mind goes along with that.

Science, as you said, is very reductionist, right? But people in two groups, one praise, one doesn't, that's the way science is done. But ultimately the real world clinical implications are what really resonates. So thank you. Thank you for that. I have one final question and it might get you in trouble, but I'm gonna ask anyway.

Let's say I or someone that I care about is admitted to the hospital. What are the things to do or ask that we're 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. I'm aware that families of donors to hospitals get special care.

This is, I will just tell you, you go to a hospital, there's a code language. I happen to know it for several hospitals. There's a code language of, this is a it for several hospitals. 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 as well.

Some physicians too, right? So there's a code language that differs by hospital and I know it for several hospitals. And I don't want to get into that. It's one of the more complicated aspects of medicine and hospitals as businesses and things like that. Yeah. 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 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 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 admitted to a hospital? Sorry, I gotta put you on the spot. No, this is excellent. This is an excellent question. Some of the things you can control, some of the things you can't control. Getting a bed is just completely out of your control.

So if you're in the emergency room, you can ask when you're gonna go upstairs, you're gonna get a bed when there's gonna be a bed. And sometimes I can't even get patients upstairs. And they're triaging, right? They're triaging. This person's at risk of dying. Yes.

This person is miserable. Right. And you're less miserable, right? They're saying this person's at risk of dying. This person is miserable. And you're less miserable, you're gonna wait. Is that how it works? Potentially. I think in terms of where you are in the hospital 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. Yelling at the nurse is not going to help you. Saying insulting things to the nurse or the doctor or the staff is not going to help. It's going to make things worse. I think the number one way, I can tell you that in terms

of 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've got 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've got 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've got to know what I'm doing. And that's kind of what I've been doing for the last 10 years, 12 years in terms of the teaching that I do. We have a website called MedCram.com where we put up, you know, if you go to your doctor and you get a CBC back, right? How do you interpret that 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 metabolic panel that you get back. How do you know what's going on with those things? What about an EKG? You know, you have these smartwatches that can actually measure 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, congestive heart failure.

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 that they're gonna put you on? What are the side effects of those medicines? 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 asking the right questions to a physician, they're gonna 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 gonna start to do this? When are you gonna start to do this? When is this happening? And once the next, 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 answering those questions effectively. I think that's the number one thing. I love it. And thank you for stepping right in the line of fire with that one and not trying to dodge it. So it speaks to the kind of person you are, it speaks to 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 wanna help people, but it's very clear that you wanna help people. You do this in your social media, you do this through your online teaching. We'll, by the way, provide links to all these sources. And you're doing this in so many ways.

And of course in your clinical practice. And 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. 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 in hand and to moving through illness should one contract 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. Thanks. I look forward to seeing you online, but even more so in person. So thank you so much, Dr. Schwelt. You're a real gem.

Thank you so much. Thank you once again for joining me for today's discussion with Dr. Roger Schwelt. To learn more about his work and to find the 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 zero cost way to support us. In addition, please click follow for the podcast on both Spotify and Apple. And on both Spotify and Apple, you can leave us up to a five-star review.

If you have questions for me or comments about the podcast or guests or topics you'd like me to consider for the Huberman Lab podcast, please put those in the comment section on YouTube. I do read all the comments. Please also check out the sponsors mentioned at the beginning and throughout today's episode. That's the best way to support this podcast.

For those of you that haven't heard, I have a new book coming out. It's my very first book. It's entitled, Protocols, an Operating Manual for the Human Body. This is a book that I've been working on for more than five years, and that's based on more than 30 years

of research and experience. And it covers protocols for everything from sleep, to exercise, to stress control, protocols related to focus and motivation. And of course, I provide the scientific substantiation for the protocols that are included. The book is now available by presale at protocolsbook.com. There you can find links to various vendors.

You can pick the one that you like best. Again, the book is called, Protocols, an operating manual for the human body. If you're not already following me on social media, I am Huberman Lab on all social media platforms. So that's Instagram X, formerly known as Twitter, Facebook, LinkedIn, and threads. And on all those platforms,

I discuss science and science related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the content on the Huberman Lab podcast. Again, that's Huberman Lab on all social media platforms. And if you haven't already subscribed to our neural network newsletter,

the neural network newsletter is a zero cost monthly newsletter that includes podcast summaries, as well as what we call protocols in the form of one to three page PDFs that cover everything from how to optimize your sleep, how to optimize dopamine, deliberate cold exposure. We have a foundational fitness protocol that covers cardiovascular training and resistance training.

All of that is available completely zero cost. You simply go to hubermanlab.com, go to the menu tab in the top right corner, scroll down to newsletter 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 Schwelt.

And last, but certainly not least, thank you for your interest in science.