back to indexUsing Your Nervous System to Enhance Your Immune System | Huberman Lab Podcast #44

            
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                 Welcome to the Huberman Lab Podcast,
             
            
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                 where we discuss science and science-based tools
             
            
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                 for everyday life.
             
            
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                 I'm Andrew Huberman,
             
            
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                 and I'm a professor of neurobiology and ophthalmology
             
            
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                 at Stanford School of Medicine.
             
            
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                 Today, we are discussing the immune system,
             
            
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                 and we are also discussing the nervous system,
             
            
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                 which is the brain, spinal cord,
             
            
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                 and the connections of the brain and spinal cord
             
            
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                 with all the organs of the body.
             
            
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                 We are also going to discuss how the nervous system
             
            
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                 can be used to activate and control the immune system.
             
            
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                 Now, about 10, 20 years ago,
             
            
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                 if somebody said that the mind
             
            
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                 could control the immune system,
             
            
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                 it'd probably get laughed out of most academic conferences,
             
            
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                 and certainly the work wouldn't be published
             
            
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                 in quality journals.
             
            
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                 But nowadays, there are dozens, if not hundreds,
             
            
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                 of quality peer-reviewed studies
             
            
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                 on how the mind and how the nervous system
             
            
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                 can control activation of the immune system.
             
            
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                 This is a wonderful growing body of research.
             
            
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                 And just to give you a hint
             
            
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                 of where we are headed with this,
             
            
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                 just this last week,
             
            
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                 there was a paper published in Nature,
             
            
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                 which is the apex journal for scientific publishing,
             
            
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                 premier journal, extremely stringent.
             
            
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                 A paper published in Nature from Chufu Ma's lab
             
            
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                 at Harvard Medical School
             
            
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                 explored how acupuncture can reduce inflammation in the body
             
            
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                 and I will describe this study in a bit more detail later,
             
            
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                 but what they discovered was that by stimulating the body
             
            
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                 in particular ways at particular sites on the body,
             
            
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                 they were able to liberate certain cells and molecules
             
            
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                 that enhance the function of the immune system
             
            
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                 and potentially can be used
             
            
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                 to combat different types of infection.
             
            
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                 And just to give you another little hint,
             
            
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                 they found that a particular type of organ tissue
             
            
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                 called fascia, some of you may have heard of fascia,
             
            
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                 fascia surrounds our muscles,
             
            
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                 just to look at it,
             
            
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                 you might think it's a kind of useless tissue,
             
            
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                 it's sort of like a dense bag
             
            
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                 in which the muscles are contained.
             
            
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                 Well, it turns out that those dense bags
             
            
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                 are much smarter than we thought,
             
            
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                 they don't have a mind of their own,
             
            
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                 but by stimulating the fascia
             
            
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                 in a particular location on the body,
             
            
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                 there's a pathway leading out of that fascia
             
            
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                 directly to an organ called the adrenal medulla,
             
            
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                 I'll explain what all this means,
             
            
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                 that could liberate particular chemicals
             
            
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                 that had a potent anti-inflammatory effect.
             
            
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                 So what we're basically saying
             
            
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                 is that the nervous system acts as a set of highways
             
            
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                 between the different tissues of your body,
             
            
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                 calling into action the immune system,
             
            
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                 liberating particular molecules
             
            
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                 that can reduce inflammation and lead to faster healing.
             
            
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                 And I will explain how all of that works
             
            
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                 as well as some other non-acupuncture methods
             
            
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                 for activating and enhancing
             
            
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                 the function of the immune system.
             
            
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                 So today we're going to be talking
             
            
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                 all about healing with the mind
             
            
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                 in a completely non-mystical, non-abstract sense.
             
            
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                 Before we begin, I'd like to emphasize
             
            
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                 that this podcast is separate
             
            
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                 from my teaching and research roles at Stanford.
             
            
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                 It is however, part of my desire and effort
             
            
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                 to bring zero cost to consumer information
             
            
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                 about science and science-related tools
             
            
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                 to the general public.
             
            
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                 In keeping with that theme,
             
            
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                 I'd like to thank the sponsors of today's podcast.
             
            
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                 Our first sponsor is Roca.
             
            
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                 Roca makes eyeglasses and sunglasses
             
            
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                 that are absolute superb quality.
             
            
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                 I've spent a lifetime working on the visual system.
             
            
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                 And I can tell you that one of the major issues
             
            
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                 our visual system has to contend with
             
            
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                 is how to see things clearly in bright environments
             
            
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                 or dimmer environments, et cetera.
             
            
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                 Roca clearly understands the science of the visual system
             
            
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                 because one thing that's wonderful about their sunglasses
             
            
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                 is that you can be in a very bright environment
             
            
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                 and then walk into a shadowed environment
             
            
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                 and you don't even notice the transition.
             
            
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                 Everything is still seen with crystal clarity.
             
            
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                 Their eyeglasses as well allow you to see things
             
            
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                 regardless of how bright or dim internal lighting is.
             
            
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                 I wear readers at night.
             
            
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                 I wear sunglasses during the day.
             
            
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                 And Roca eyeglasses and sunglasses are particularly nice
             
            
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                 because they're very lightweight.
             
            
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                 I often forget that they're even on my face.
             
            
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                 They also don't slip off if you get sweaty.
             
            
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                 They were actually designed to be used
             
            
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                 while running or cycling.
             
            
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                 And so I can use them while exercising.
             
            
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                 They also have a great aesthetic.
             
            
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                 So you can go from exercising to dinner or to work
             
            
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                 without having to change from one set of glasses
             
            
            
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                 If you'd like to try Roca glasses,
             
            
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                 you can go to roca.com.
             
            
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                 That's R-O-K-A.com and enter the code Huberman
             
            
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                 to save 20% off your first order.
             
            
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                 Today's episode is also brought to us by Athletic Greens.
             
            
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                 Athletic Greens is an all-in-one
             
            
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                 vitamin mineral probiotic drink.
             
            
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                 I've been taking Athletic Greens since 2012.
             
            
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                 And so I'm delighted that they're sponsoring the podcast.
             
            
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                 The reason I started taking Athletic Greens
             
            
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                 and the reason I still take Athletic Greens
             
            
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                 once or twice per day is because it allows me
             
            
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                 to cover all of my basic nutritional bases.
             
            
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                 It's got the vitamins and minerals
             
            
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                 that make sure that no matter what I'm eating,
             
            
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                 I'm covering all of my micronutrient bases.
             
            
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                 And it has the probiotics.
             
            
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                 And probiotics, we now know,
             
            
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                 are essential for a healthy gut microbiome.
             
            
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                 And a healthy gut microbiome, we know,
             
            
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                 is essential for many important biological functions
             
            
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                 related to human health, like metabolic needs,
             
            
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                 endocrine function, immune function, and so on.
             
            
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                 With Athletic Greens, I can mix that up with water.
             
            
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                 and I'll drink it once early in the day,
             
            
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                 and once again later in the afternoon.
             
            
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                 If you'd like to try Athletic Greens,
             
            
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                 you can go to athleticgreens.com slash Huberman.
             
            
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                 And if you do that, you can claim a special offer.
             
            
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                 There is now a lot of data showing that vitamin D3
             
            
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                 is important for many biological functions
             
            
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                 that impact our immediate and long-term health,
             
            
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                 and most people do not get enough vitamin D3,
             
            
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                 even if they're getting a lot of sunshine.
             
            
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                 And K2 is also important,
             
            
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                 or has been shown to be important for heart health
             
            
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                 and for blood lipid function, et cetera.
             
            
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                 So again, if you'd like to try Athletic Greens,
             
            
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                 you can go to athleticgreens.com slash Huberman
             
            
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                 to get the Athletic Greens, the five free travel packs,
             
            
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                 and the year supply of vitamin D3K2.
             
            
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                 Today's episode is also brought to us by Inside Tracker.
             
            
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                 Inside Tracker is a personalized nutrition platform
             
            
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                 that analyzes data from your blood and DNA
             
            
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                 to help you better meet your immediate
             
            
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                 and long-term health goals.
             
            
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                 I've long been a fan of getting regular blood work done
             
            
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                 for the simple reason that many of the things
             
            
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                 that impact your immediate and long-term health
             
            
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                 can only be analyzed from a quality blood test.
             
            
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                 There's just simply no other body surface marker
             
            
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                 that you can look at somebody or yourself and say,
             
            
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                 ah, I know that my blood lipids or my cholesterol are good,
             
            
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                 or that my hormone levels are X, Y, or Z.
             
            
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                 We really need numbers on those things
             
            
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                 to know where they sit.
             
            
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                 The problem with a lot of blood tests, however,
             
            
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                 is you get all those numbers back.
             
            
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                 You don't know what to do with that information.
             
            
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                 Inside Tracker has solved that problem.
             
            
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                 They have a very easy to use dashboard
             
            
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                 where when you get your numbers back,
             
            
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                 it can tell you, for instance,
             
            
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                 where your numbers are high or low or on target,
             
            
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                 and they can suggest very specific dietary interventions,
             
            
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                 supplemental interventions, and behavioral interventions
             
            
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                 that can allow you to bring those numbers
             
            
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                 to where you would like them to be.
             
            
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                 So they've simplified the whole process.
             
            
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                 And in terms of getting the blood tests,
             
            
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                 you can go to a local center to get the blood drawn,
             
            
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                 or they can even send somebody to your house.
             
            
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                 They've made the whole thing very, very easy
             
            
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                 from start to finish.
             
            
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                 If you'd like to try Inside Tracker,
             
            
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                 you can visit insidetracker.com slash Huberman
             
            
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                 to get 25% off any of Inside Tracker's plans.
             
            
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                 You just use the code Huberman at checkout.
             
            
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                 Okay, let's talk about the immune system
             
            
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                 and the nervous system and how the two interact
             
            
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                 and how you can control your immune system
             
            
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                 to serve you better.
             
            
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                 We are going to talk a lot of mechanistic science,
             
            
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                 a little bit of detail.
             
            
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                 You learned some new language around the immune system,
             
            
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                 names of the different cell types and so forth,
             
            
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                 but I promise to make it all very clear
             
            
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                 regardless of your background.
             
            
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                 We are also going to discuss a lot of tools.
             
            
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                 And I think many of you are probably here
             
            
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                 because you want to know what you can do
             
            
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                 in order to boost or enhance the function
             
            
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                 of your immune system.
             
            
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                 That's a very reasonable question to ask.
             
            
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                 I want to begin by just acknowledging that
             
            
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                 if one were to put that question into the internet,
             
            
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                 you would get back a lot of answers.
             
            
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                 And there is now a sort of generic form of that answer
             
            
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                 that deserves our respect,
             
            
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                 but is not going to be the topic of conversation today.
             
            
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                 I just want to tip my hat to it, however,
             
            
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                 and list off a few of the things that we know
             
            
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                 set us up to be healthier than we would be
             
            
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                 if we didn't do these things.
             
            
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                 So the first of course,
             
            
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                 is the foundation of all mental and physical health,
             
            
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                 which is to get adequate sleep, meaning enough sleep,
             
            
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                 whatever it is for you that you require to get deep sleep.
             
            
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                 So it's got to be of high quality
             
            
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                 and to time that sleep correctly,
             
            
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                 meaning you can't sleep during the day one day
             
            
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                 and at night the next day
             
            
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                 and expect your system to function well.
             
            
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                 Talked a lot about that before on this podcast,
             
            
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                 you need a relatively consistent sleep schedule
             
            
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                 most of the time, about 80% of the time,
             
            
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                 or even better would be 90% of the time.
             
            
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                 But the realities of life make it that
             
            
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                 we can't always go to bed at the same time
             
            
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                 and wake up at the exact same time, okay?
             
            
            
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                 We do need sunshine.
             
            
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                 Why do we need sunshine?
             
            
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                 Because it sets our rhythm into a regular state
             
            
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                 where the genes in all of our cells
             
            
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                 can be expressed at the correct times.
             
            
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                 We're sort of a factory of cells, if you will,
             
            
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                 and that factory can only run properly
             
            
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                 if it knows when certain things should be active
             
            
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                 and when certain cells should not be active.
             
            
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                 And the best way to coordinate all of those activities
             
            
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                 of all the cells is to get sunshine in your eyes
             
            
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                 in the morning and again in the evening
             
            
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                 and not to get too much bright light in your eyes
             
            
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                 in the middle of the night.
             
            
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                 That's just foundational.
             
            
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                 And then any lists that you'll find
             
            
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                 on any number of websites on the internet would say,
             
            
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                 okay, get good sleep, get sun, get exercise,
             
            
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                 how much exercise?
             
            
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                 We should all be getting 150 to 180 minutes
             
            
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                 of zone two cardio.
             
            
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                 That's cardiovascular exercise
             
            
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                 where we can just barely hold a conversation
             
            
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                 or maybe not per week.
             
            
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                 We should be eating well.
             
            
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                 We're always told we have to get good nutrition.
             
            
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                 What good nutrition means to you is going to be different
             
            
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                 than what it means to somebody else.
             
            
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                 But we acknowledge that food intake
             
            
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                 and quality of food in particular,
             
            
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                 avoiding processed foods, that's going to be important.
             
            
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                 Social connection is important.
             
            
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                 Hydration is important.
             
            
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                 You're starting to get the picture.
             
            
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                 We can take all that, acknowledge it as useful
             
            
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                 and foundational for mental and physical health.
             
            
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                 But of course, there are many people who still struggle
             
            
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                 with getting ill too often or with not being able to heal
             
            
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                 from physical injuries and wounds
             
            
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                 or from various bacterial and viral infections
             
            
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                 quickly enough or deal with chronic disease.
             
            
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                 And so today is really about how you can take all
             
            
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                 of that information, acknowledge it and follow it.
             
            
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                 But in addition to that, there are things that you can do
             
            
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                 to leverage your nervous system in order
             
            
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                 to enhance the function of your immune system
             
            
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                 in very robust ways.
             
            
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                 So that's where I'd like to shift the conversation to.
             
            
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                 The first topic we have to attack is the question
             
            
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                 of what is the immune system and how does it work?
             
            
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                 I think many of you have heard of antibodies
             
            
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                 or killer cells or the various organs of the body
             
            
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                 that are involved in the immune system like the bone marrow,
             
            
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                 the spleen, the thymus and the lymph nodes.
             
            
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                 I'd like to just take a moment
             
            
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                 and do a sort of brief immune system 101.
             
            
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                 Really simple, cover the basic elements of the immune system
             
            
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                 so that everyone listening or watching this
             
            
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                 can get a clear sense of how the immune system functions
             
            
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                 and what its basic parts are.
             
            
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                 For some of you, this might be too basic.
             
            
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                 It might be a little bit of background
             
            
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                 that you already know.
             
            
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                 I think for most of you, this information will be new.
             
            
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                 And I promise you, you don't need a biology
             
            
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                 or medicine background in order to understand this.
             
            
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                 It's actually really simple
             
            
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                 because it is truly elegant in design.
             
            
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                 You have three main layers of defense for your health.
             
            
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                 These are the three things that are constantly at work
             
            
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                 to protect you from invasion and illness,
             
            
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                 from bacteria, from viruses and from parasites.
             
            
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                 And the first of those three is a physical barrier
             
            
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                 that we call your skin.
             
            
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                 And that might seem kind of obvious,
             
            
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                 but everything about you is contained in this compartment
             
            
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                 that is boundaried by your skin.
             
            
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                 And your skin is a very important aspect
             
            
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                 of your immune system.
             
            
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                 If you've ever had a cut,
             
            
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                 you essentially have a breach of the boundary
             
            
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                 that is your immune system.
             
            
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                 And you would notice a number of things would happen.
             
            
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                 You might get some swelling around that cut.
             
            
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                 You might get a scab.
             
            
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                 Likely you would get a scab over time.
             
            
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                 If it got dirty, there were some bacteria that got in there.
             
            
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                 You might see some accumulation of white blood cells,
             
            
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                 what's called pus.
             
            
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                 I know it's kind of gross, but that's what that is.
             
            
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                 It might take on a yellow tint
             
            
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                 because of the accumulation of some dead cells there.
             
            
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                 But basically your skin is the primary barrier
             
            
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                 through which you keep things from the outside
             
            
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                 that could harm you from getting to the inside.
             
            
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                 Now, still in category one,
             
            
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                 your body and your external surface,
             
            
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                 you have openings to that surface, right?
             
            
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                 You're not just a round or a body shaped,
             
            
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                 completely covered up with skin, you have openings.
             
            
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                 What are those openings?
             
            
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                 Well, let's start at the top and work our way down.
             
            
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                 A primary site of potential infection are your eyes.
             
            
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                 You have your ears, you have your nostrils,
             
            
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                 you have your mouth, okay?
             
            
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                 Those are going to be the primary sites
             
            
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                 by which things can get into your system.
             
            
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                 And you need to put things into your system.
             
            
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                 You need to drink and eat
             
            
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                 and you need to get light into your system.
             
            
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                 That's why you have those openings.
             
            
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                 But bad things, meaning things that can harm you,
             
            
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                 can get into those systems.
             
            
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                 And then of course, along the back of your throat,
             
            
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                 all the way down to your stomach and your digestive system
             
            
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                 and through your intestines and out your rectum,
             
            
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                 you have a tube that you are basically a series of tubes.
             
            
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                 I've said that before in this podcast,
             
            
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                 and this is one such tube by which you extract nutrients
             
            
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                 from the outside environment.
             
            
                link |
                
                 But all along that tube,
             
            
                link |
                
                 including your nose and your mouth, it's lined with mucus.
             
            
                link |
                
                 And while mucus might seem kind of gross to some of you,
             
            
                link |
                
                 the more you learn about mucus,
             
            
                link |
                
                 the more you realize that mucus is really, really cool
             
            
                link |
                
                 because mucus essentially acts as a filter,
             
            
                link |
                
                 as a trap for bacteria and viruses.
             
            
                link |
                
                 And it has certain ways of scrubbing or killing
             
            
                link |
                
                 those bacteria and viruses.
             
            
                link |
                
                 Now, the mucus is constantly being turned over.
             
            
                link |
                
                 As we'll talk about later,
             
            
                link |
                
                 the chemistry of that mucus is really important
             
            
                link |
                
                 in order to make sure that certain things
             
            
                link |
                
                 don't make it into your system
             
            
                link |
                
                 and other things are allowed to move through your system
             
            
                link |
                
                 and you can extract nutrients from them.
             
            
                link |
                
                 So the reason I'm talking about this first category
             
            
                link |
                
                 of a barrier for immune system in such detail
             
            
                link |
                
                 is I'd like you to envision yourself as a human, of course,
             
            
                link |
                
                 but as a human that is a clear entity from everything else,
             
            
                link |
                
                 and you have to bring in the right things
             
            
                link |
                
                 and you have to keep out the wrong things or kill them.
             
            
                link |
                
                 Now, inevitably, bacteria, viruses,
             
            
                link |
                
                 and parasitic infections are going to make their way
             
            
            
                link |
                
                 But whether or not they are killed off
             
            
                link |
                
                 or whether or not they take over and cause us harm
             
            
                link |
                
                 is going to be determined by layers two and three.
             
            
                link |
                
                 So layers two and three are the so-called
             
            
                link |
                
                 innate immune system and the adaptive immune system.
             
            
                link |
                
                 So the innate immune system
             
            
                link |
                
                 is what I would call the second layer of defense.
             
            
            
                link |
                
                 So whether or not it's bacteria, virus, or parasite,
             
            
                link |
                
                 what happens when you have something enter your body,
             
            
                link |
                
                 maybe you swallowed it, maybe it got in through your eyes,
             
            
                link |
                
                 maybe you shook somebody's hand
             
            
                link |
                
                 who is carrying a particular kind of illness,
             
            
                link |
                
                 and then you wiped your eyes.
             
            
                link |
                
                 And I've talked about on this podcast before,
             
            
                link |
                
                 very soon after we meet another person,
             
            
                link |
                
                 usually within 30 seconds, believe it or not,
             
            
                link |
                
                 most people wipe that person's chemicals
             
            
                link |
                
                 somewhere on their face or on their body surface.
             
            
                link |
                
                 This has been demonstrated over and over again.
             
            
                link |
                
                 If you want to learn more about that,
             
            
                link |
                
                 we did an episode all about chemical signaling
             
            
                link |
                
                 where you can learn about it.
             
            
                link |
                
                 I know it sounds weird and you might say,
             
            
                link |
                
                 I don't do that, but indeed you do most of the time.
             
            
                link |
                
                 Most everybody does.
             
            
                link |
                
                 Okay, so this innate immune system is this rapid response.
             
            
                link |
                
                 When something enters our system
             
            
                link |
                
                 and our body doesn't recognize it,
             
            
                link |
                
                 it's not food, it's not clean air,
             
            
                link |
                
                 it's something that's either a bacteria, virus, or parasite.
             
            
                link |
                
                 And the innate immune system involves the release
             
            
                link |
                
                 of particular cells that are waiting dormant,
             
            
                link |
                
                 ready to attack whatever this invader is.
             
            
                link |
                
                 And some of these cell types you've heard of before,
             
            
                link |
                
                 the most typical one are the so-called white blood cells.
             
            
                link |
                
                 So the white blood cells will actively go to the site
             
            
                link |
                
                 of invasion and will start to encapsulate
             
            
                link |
                
                 or try and surround that given invader.
             
            
                link |
                
                 The other names of these different cell types
             
            
                link |
                
                 are things like neutrophils, macrophages,
             
            
                link |
                
                 natural killer cells,
             
            
                link |
                
                 just a few of the many types of immune cells.
             
            
                link |
                
                 So there's kind of like an ambulance system,
             
            
                link |
                
                 but rather than go and try and heal something
             
            
                link |
                
                 like a paramedic would,
             
            
                link |
                
                 they go there and they try and surround and kill
             
            
                link |
                
                 whatever this invader is.
             
            
                link |
                
                 They work in concert with two other assistants.
             
            
                link |
                
                 And those assistants are called the complement proteins.
             
            
                link |
                
                 Complement proteins exist in the blood.
             
            
                link |
                
                 And what they do is they travel to sites
             
            
                link |
                
                 where there's an invasion and they mark certain things
             
            
                link |
                
                 for being engulfed and eaten.
             
            
                link |
                
                 So they sort of put an eat me tag on it.
             
            
                link |
                
                 They basically put a chemical tag onto invaders
             
            
                link |
                
                 that then allows those white blood cells,
             
            
                link |
                
                 neutrophils, macrophages, and natural killer cells
             
            
                link |
                
                 to say, ah, I need to basically wrap,
             
            
                link |
                
                 you'll kill this thing and then wrap it in a body bag
             
            
                link |
                
                 and send it off, kill that thing,
             
            
                link |
                
                 wrap it in a body bag and send it off.
             
            
                link |
                
                 And I'm using the analogy of the body bag,
             
            
                link |
                
                 but in a sense it is one, it's the right one rather,
             
            
                link |
                
                 because the cells that come in and kill things,
             
            
                link |
                
                 the way they do that is actually to engulf
             
            
                link |
                
                 the invading bacteria virus or parasite.
             
            
                link |
                
                 So they actually surround it.
             
            
                link |
                
                 And when you see pus or you see infection
             
            
                link |
                
                 in maybe a cut on the skin or something like that,
             
            
                link |
                
                 or even in an ingrown hair that gets some bacteria in it,
             
            
                link |
                
                 that pus and that the white part,
             
            
                link |
                
                 I know it's kind of gross to talk about,
             
            
                link |
                
                 but those are the white blood cells.
             
            
                link |
                
                 And those are the dead, oftentimes it's dead cells,
             
            
                link |
                
                 and that's the dead invader sitting there.
             
            
                link |
                
                 So it's trying to create an isolated compartment
             
            
                link |
                
                 because it wants to keep it in that part of the body.
             
            
                link |
                
                 So you've got the innate immune system.
             
            
                link |
                
                 The compliment comes through blood
             
            
                link |
                
                 and helps it by tagging certain things
             
            
                link |
                
                 with an eat me signal.
             
            
                link |
                
                 And then there are the cells that are either damaged
             
            
                link |
                
                 from the injury or from the parasite
             
            
                link |
                
                 or are suffering because of the bacteria
             
            
                link |
                
                 or the virus itself.
             
            
                link |
                
                 And the cells of your body will also release
             
            
                link |
                
                 an alarm signal, which is not an eat me signal,
             
            
                link |
                
                 but a help me signal.
             
            
                link |
                
                 And those help me signals come in the form
             
            
                link |
                
                 what we call cytokines.
             
            
                link |
                
                 And the cytokines are things like interleukin-1,
             
            
                link |
                
                 interleukin-6, tumor necrosis factor alpha.
             
            
                link |
                
                 You may have heard of these things
             
            
                link |
                
                 if you are at all curious about
             
            
                link |
                
                 or been learning about the health space,
             
            
                link |
                
                 online health space, especially in the last few years,
             
            
                link |
                
                 inflammation is all the buzzword now.
             
            
                link |
                
                 Everyone's talking about inflammation,
             
            
                link |
                
                 inflammation, inflammation.
             
            
                link |
                
                 What do we mean when we say inflammation?
             
            
                link |
                
                 Well, inflammation is a physical response,
             
            
                link |
                
                 but it's also a chemical response.
             
            
                link |
                
                 And many times the markers of inflammation
             
            
                link |
                
                 that are measured in people or an animal model,
             
            
                link |
                
                 excuse me, where this research is done
             
            
                link |
                
                 are things like interleukin-1, interleukin-6,
             
            
                link |
                
                 tumor necrosis factor alpha.
             
            
                link |
                
                 So when those go up in the blood,
             
            
                link |
                
                 it's a sign that somewhere there's a cell
             
            
                link |
                
                 that's saying, help me, help me,
             
            
                link |
                
                 and it's secreting these things,
             
            
                link |
                
                 which calls in those neutrophils, macrophages,
             
            
                link |
                
                 natural killer cells, and white blood cells, okay?
             
            
                link |
                
                 And it might help to remember all this
             
            
                link |
                
                 but by just telling people that what interleukin means
             
            
                link |
                
                 is to communicate, right?
             
            
                link |
                
                 So the interleukin is shouting out, help me,
             
            
                link |
                
                 the complement proteins are coming in and saying, eat this,
             
            
                link |
                
                 and tagging the invader with an eat me signal,
             
            
                link |
                
                 and then the killer cells and the white blood cells
             
            
                link |
                
                 are doing the job of trying to kill off that thing.
             
            
                link |
                
                 That's the innate immune system.
             
            
                link |
                
                 So your skin and your mucus lining,
             
            
                link |
                
                 plus your innate immune system
             
            
                link |
                
                 are a beautiful two-layered set of defenses
             
            
                link |
                
                 against various kinds of invaders and infections.
             
            
                link |
                
                 And then there's the third type,
             
            
                link |
                
                 which is the adaptive immune system.
             
            
                link |
                
                 And you'll notice that leading up until now,
             
            
                link |
                
                 I haven't said the word antibody at all,
             
            
                link |
                
                 and that's because it is the job,
             
            
                link |
                
                 not of the skin or the mucus or the microbiome
             
            
                link |
                
                 or the innate immune system to produce antibodies
             
            
                link |
                
                 that can recognize specific invaders,
             
            
                link |
                
                 but rather it is the job of the adaptive immune system
             
            
                link |
                
                 to create antibodies against bacteria, viruses,
             
            
                link |
                
                 and even parasites and even physical intruders
             
            
            
                link |
                
                 So the adaptive immune system has this incredible ability
             
            
                link |
                
                 to show up at the site of invasion
             
            
                link |
                
                 or infection or inflammation.
             
            
                link |
                
                 It's called there by various cues,
             
            
                link |
                
                 including the cytokines that we talked about earlier.
             
            
                link |
                
                 And what it does is it actually attaches to
             
            
                link |
                
                 and creates a sort of an imprint of the shape
             
            
                link |
                
                 of whatever invader happens to be there.
             
            
                link |
                
                 So if that particular invading bacteria or virus
             
            
                link |
                
                 has a contour that's kind of rippled or kind of spiky
             
            
                link |
                
                 or whatever shape it happens to have,
             
            
                link |
                
                 it creates an imprint of that.
             
            
                link |
                
                 And then using that imprint in concert with some other cells
             
            
                link |
                
                 creates antibodies that are specific
             
            
                link |
                
                 to recognize that invader
             
            
                link |
                
                 should the body ever have that invader inside of it again.
             
            
                link |
                
                 Now that's why it's called the adaptive immune system.
             
            
                link |
                
                 And in many ways, it creates a memory of a prior infection
             
            
                link |
                
                 so that these antibodies can be made anytime
             
            
                link |
                
                 that same invader comes back again, all right?
             
            
                link |
                
                 And so this is the basis of what we call immunity.
             
            
                link |
                
                 This is the basis of what we call an enhanced ability
             
            
                link |
                
                 to combat certain types of infections.
             
            
                link |
                
                 And it's really a wonderful,
             
            
                link |
                
                 and I mean, just, I can't even state
             
            
                link |
                
                 how incredible this really is
             
            
                link |
                
                 that all of our bodies have this capacity, right?
             
            
                link |
                
                 We have something called leukocytes.
             
            
                link |
                
                 These are essentially white blood cells.
             
            
                link |
                
                 We have red blood cells and white blood cells,
             
            
                link |
                
                 and they both are derived from the same type of origin cell.
             
            
            
                link |
                
                 When you hear stem cell, a stem cell just means
             
            
                link |
                
                 a cell that can become many different types of other cells.
             
            
                link |
                
                 We sometimes hear about stem cells
             
            
                link |
                
                 in terms of people that are getting injections of stem cells
             
            
                link |
                
                 or the potential therapeutic effects of,
             
            
                link |
                
                 or potential of stem cells,
             
            
                link |
                
                 but we all harbor certain stem cells within us as well
             
            
                link |
                
                 that can become lots of different cell types.
             
            
                link |
                
                 And there's one particular type of stem cell,
             
            
                link |
                
                 which is the hemopoietic stem cell,
             
            
                link |
                
                 which can give rise to red blood cells and white blood cells.
             
            
                link |
                
                 And in general, these reside in the marrow,
             
            
                link |
                
                 at least in adults.
             
            
                link |
                
                 So in our bone marrow,
             
            
                link |
                
                 we have this ability to make certain cells
             
            
                link |
                
                 that can go out when they are called out chemically,
             
            
                link |
                
                 they're called out to sites of infection
             
            
                link |
                
                 and create antibodies,
             
            
                link |
                
                 and then maintain those antibodies in our system
             
            
                link |
                
                 or have a memory of that particular infection
             
            
                link |
                
                 so that if the infection comes back again,
             
            
                link |
                
                 we can kill it off immediately.
             
            
                link |
                
                 And it doesn't have to pass through these multiple stages
             
            
                link |
                
                 of first the innate response, then the adaptive response,
             
            
            
                link |
                
                 Now, there are a lot more details
             
            
                link |
                
                 to the adaptive immune system,
             
            
                link |
                
                 but I just want to emphasize a few points
             
            
                link |
                
                 that might be relevant.
             
            
                link |
                
                 First of all, the name of the antibodies that are created
             
            
                link |
                
                 sometimes come in the form of IgM and IgG,
             
            
                link |
                
                 things of that sort.
             
            
                link |
                
                 This isn't a full deep dive immunology class,
             
            
                link |
                
                 but Ig stands for immunoglobulin, okay?
             
            
                link |
                
                 So the immunoglobulins are part
             
            
                link |
                
                 of the adaptive immune response in creating antibodies.
             
            
                link |
                
                 If you hear IgM, the IgM is the first
             
            
                link |
                
                 of the adaptive immune responses,
             
            
                link |
                
                 and it tends to come on earlier.
             
            
                link |
                
                 So if somebody is immunopositive for IgM
             
            
                link |
                
                 for a particular type of viral or bacterial invader,
             
            
                link |
                
                 that means that it was a fairly recent infection.
             
            
                link |
                
                 Later, one creates the adaptive immune system,
             
            
                link |
                
                 I should say, creates an IgG,
             
            
                link |
                
                 which is the more stable form of the specific antibody
             
            
                link |
                
                 that's going to recognize a given invader.
             
            
                link |
                
                 So IgG tends to come up a little bit later.
             
            
                link |
                
                 So just to recap, something gets into your system
             
            
                link |
                
                 through your eyes, through some hole in your skin,
             
            
                link |
                
                 a cut through your mouth.
             
            
                link |
                
                 Sexually transmitted diseases come in
             
            
                link |
                
                 through the mucous membranes that are on the genitalia
             
            
                link |
                
                 or in the genitalia.
             
            
                link |
                
                 Sexually transmitted disease, airborne disease,
             
            
                link |
                
                 gets into the mucus, somehow gets into the bloodstream.
             
            
                link |
                
                 Then there's the innate response,
             
            
                link |
                
                 which is a more general response of trying to contain
             
            
                link |
                
                 and combat the infection or invader.
             
            
                link |
                
                 And then the adaptive response is the one
             
            
                link |
                
                 that generates the antibodies.
             
            
                link |
                
                 First, the IgM response, the immunoglobulin M response,
             
            
                link |
                
                 and then the immunoglobulin G response, IgG response.
             
            
                link |
                
                 So how do we keep these three barriers
             
            
                link |
                
                 or these three defense systems to infection tuned up?
             
            
                link |
                
                 Well, leaving aside the list of things
             
            
                link |
                
                 that I mentioned before
             
            
                link |
                
                 that generally enhances their function,
             
            
                link |
                
                 things like sleep and sunlight and good nutrition, et cetera,
             
            
                link |
                
                 the sort of generic things for good health,
             
            
                link |
                
                 one of the key ways we can do that
             
            
                link |
                
                 is to keep that mucus lining in really good shape.
             
            
                link |
                
                 And what does that mean?
             
            
                link |
                
                 Well, the mucus lining needs to turn over quite often,
             
            
                link |
                
                 and it needs to be the correct chemistry
             
            
                link |
                
                 to be a trap for the bad stuff
             
            
                link |
                
                 and for it to be permeable to the good stuff,
             
            
                link |
                
                 to the nutrients that we need.
             
            
                link |
                
                 And it is now very clear from hundreds,
             
            
                link |
                
                 if not thousands of studies,
             
            
                link |
                
                 that the best way to do that is to maintain
             
            
                link |
                
                 a healthy so-called microbiome.
             
            
                link |
                
                 The microbiome being these little bacterial organisms
             
            
                link |
                
                 that are good for us that live all along our mucus pathways
             
            
                link |
                
                 and even in our eyes.
             
            
                link |
                
                 Now, just to be really clear,
             
            
                link |
                
                 it's not just about the gut microbiome.
             
            
                link |
                
                 We actually have a microbiome in our eyes.
             
            
                link |
                
                 We have one that's specific to our mouth.
             
            
                link |
                
                 We have a nasal-specific microbiome.
             
            
                link |
                
                 There's one all along the gut,
             
            
                link |
                
                 and the species of microbiota
             
            
                link |
                
                 that live all along the digestive tract
             
            
                link |
                
                 differ from the mouth to the throat
             
            
                link |
                
                 to the stomach, intestines, and to the rectum.
             
            
                link |
                
                 It's well-established that there are healthy microbiota
             
            
                link |
                
                 that live all along that length
             
            
                link |
                
                 and they differ along that length.
             
            
                link |
                
                 There's also a urethral microbiota,
             
            
                link |
                
                 and there's a vaginal microbiota
             
            
                link |
                
                 that promotes health of that environment as well.
             
            
                link |
                
                 So how is it that one can maintain the healthy microbiota
             
            
                link |
                
                 and not favor growth of harmful bacteria
             
            
                link |
                
                 or allow that mucus lining to become too permeable
             
            
                link |
                
                 to the bad stuff that can come in from the environment?
             
            
                link |
                
                 Well, as far as we know,
             
            
                link |
                
                 there are three main ways to do that.
             
            
                link |
                
                 The first two are purely structural and mechanical.
             
            
                link |
                
                 It's very clear now from work,
             
            
                link |
                
                 some of which was done at Stanford, but elsewhere as well,
             
            
                link |
                
                 that the nasal microbiome is particularly good
             
            
                link |
                
                 at scrubbing bacteria,
             
            
                link |
                
                 at preventing certain types of infections.
             
            
                link |
                
                 So this is a reminder that whenever possible,
             
            
                link |
                
                 unless eating or speaking,
             
            
                link |
                
                 you want to be nasal breathing,
             
            
                link |
                
                 not breathing through your mouth.
             
            
                link |
                
                 Your nose is a much better filter for viruses and bacteria
             
            
                link |
                
                 than is your mouth.
             
            
                link |
                
                 The mouth contains certain structural features,
             
            
                link |
                
                 even organs and cell types
             
            
                link |
                
                 that can protect against incoming infection,
             
            
                link |
                
                 but you don't want to be a mouth breather
             
            
                link |
                
                 for a variety of reasons.
             
            
                link |
                
                 And there's a terrific book called Jaws, A Hidden Epidemic,
             
            
                link |
                
                 which was written by my colleagues,
             
            
                link |
                
                 Sandra Kahn and Paul Ehrlich at Stanford
             
            
                link |
                
                 and Stanford Medicine
             
            
                link |
                
                 with a forward by Jared Diamond and Robert Sapolsky.
             
            
                link |
                
                 So it's really a lot of heavy hitters on that book
             
            
                link |
                
                 that talks about the increase in infection
             
            
                link |
                
                 that one gets when breathing through the mouth,
             
            
                link |
                
                 as opposed to the nose.
             
            
                link |
                
                 Now, of course, during hard exercise,
             
            
                link |
                
                 one breathes through the mouth.
             
            
                link |
                
                 That's not necessarily bad when one is eating or speaking.
             
            
                link |
                
                 That's not necessarily bad at all.
             
            
                link |
                
                 I guess it depends on what you're saying.
             
            
            
                link |
                
                 But in general, when possible,
             
            
                link |
                
                 you want to be breathing through your nose.
             
            
                link |
                
                 Many people have trouble breathing through their nose
             
            
                link |
                
                 because of so-called deviated septums
             
            
                link |
                
                 or chronically collapsed sinuses.
             
            
                link |
                
                 The best way to dilate those sinuses
             
            
                link |
                
                 is actually to breathe through your nose.
             
            
                link |
                
                 So it can take a little bit of time,
             
            
                link |
                
                 but there is some plasticity to the sinuses.
             
            
                link |
                
                 And so be a nose breather, not a mouth breather.
             
            
                link |
                
                 You will combat more of the infections
             
            
                link |
                
                 that you are constantly confronted with.
             
            
                link |
                
                 I should mention that we are always bombarded
             
            
                link |
                
                 with different types of bacteria, viruses,
             
            
                link |
                
                 and parasites in our environment.
             
            
                link |
                
                 And the goal, of course, is to reinforce your immune system
             
            
                link |
                
                 so you can keep these things at bay and not get sick.
             
            
                link |
                
                 There's actually a paper that was published in Cell Report,
             
            
                link |
                
                 Cell Press Journal, excellent journal,
             
            
                link |
                
                 that showed that the nasal microbiome,
             
            
                link |
                
                 it has particular species of microbiota
             
            
                link |
                
                 that are good at fighting off infection.
             
            
                link |
                
                 There has not been a direct link
             
            
                link |
                
                 between particular patterns of nasal breathing
             
            
                link |
                
                 and the nasal microbiome yet,
             
            
                link |
                
                 but oxygenation of that environment
             
            
                link |
                
                 by breathing through your nose
             
            
                link |
                
                 turns out to be quite important overall
             
            
                link |
                
                 for enhancing it as a filter.
             
            
                link |
                
                 So don't just think of your nose
             
            
                link |
                
                 as something to smell foods and to bring in air.
             
            
                link |
                
                 It's also an active filter for things that could invade you.
             
            
                link |
                
                 The other way to try and keep out bad things
             
            
                link |
                
                 and to avoid getting sick is the advice
             
            
                link |
                
                 that your mother and certainly my mother gave me,
             
            
                link |
                
                 which is to not touch your eyes
             
            
                link |
                
                 after touching other people or touching other surfaces.
             
            
                link |
                
                 And as I mentioned earlier,
             
            
                link |
                
                 we tend to do this subconsciously.
             
            
                link |
                
                 But the reason to avoid doing that
             
            
                link |
                
                 is the eyes are a primary entry point
             
            
                link |
                
                 for a lot of bacteria and viruses.
             
            
                link |
                
                 You're constantly lubricating the surface of your eyes
             
            
                link |
                
                 with the so-called lacrimal glands and tears
             
            
                link |
                
                 and things of that sort.
             
            
                link |
                
                 If you've ever noticed when you wake up in the morning,
             
            
                link |
                
                 you have some sleep in your eyes,
             
            
                link |
                
                 either the kind of crusty stuff
             
            
                link |
                
                 in the corners of your eyes or on your eyelashes,
             
            
                link |
                
                 that sleep, that crust are actually dead bacteria
             
            
                link |
                
                 that you've successfully battled during the night.
             
            
                link |
                
                 That's what that is.
             
            
                link |
                
                 It's not the accumulation of some healthy tissue.
             
            
                link |
                
                 It's the accumulation of your healthy mucous membranes
             
            
                link |
                
                 and tears and other things
             
            
                link |
                
                 that are specifically combating those bacteria.
             
            
                link |
                
                 So I know that sounds a little bit gross,
             
            
                link |
                
                 but that's what that is.
             
            
                link |
                
                 So you're wiping away the casualties of a battle
             
            
                link |
                
                 that you fought at night.
             
            
                link |
                
                 So during the daytime, you don't want to introduce viruses
             
            
                link |
                
                 and things to your eyes as much as possible.
             
            
                link |
                
                 It is a primary site of entry.
             
            
                link |
                
                 This is why people wear goggles in surgical units
             
            
                link |
                
                 and things of that sort
             
            
                link |
                
                 to try and avoid getting things into their eyes.
             
            
                link |
                
                 Very, very important.
             
            
                link |
                
                 And then the third way to keep a healthy line of defense
             
            
                link |
                
                 for your entire mucus tract
             
            
                link |
                
                 is to enhance the proliferation of good gut microbiota.
             
            
                link |
                
                 The best way to enhance the quality of your gut microbiome
             
            
                link |
                
                 and the mucus lining that serves as this protective layer
             
            
                link |
                
                 all along your body is to ingest two to four servings a day
             
            
                link |
                
                 of fermented foods, low sugar fermented foods.
             
            
                link |
                
                 I've talked about this before a bunch of times
             
            
                link |
                
                 on the podcast, but these are data
             
            
                link |
                
                 from my colleague Justin Sonnenberg's lab at Stanford Med,
             
            
                link |
                
                 and there I just wiped my eyes.
             
            
            
                link |
                
                 But a paper published in the journal Cell,
             
            
                link |
                
                 which is a absolutely spectacular journal,
             
            
                link |
                
                 really points to the fact that when people eat
             
            
                link |
                
                 fermented foods, two to four servings per day,
             
            
                link |
                
                 it helps reduce the activity of certain cytokines.
             
            
                link |
                
                 Now you know what those are, right?
             
            
                link |
                
                 Cells make cytokines to call out, help me, help me,
             
            
                link |
                
                 to reduce the amount of cytokines,
             
            
                link |
                
                 the so-called inflammatome.
             
            
                link |
                
                 Now that doesn't render those cells more vulnerable.
             
            
                link |
                
                 The reason they saw a reduction in IL-6 and IL-1
             
            
                link |
                
                 and some of these other cytokines
             
            
                link |
                
                 is because when people have a healthy gut microbiome,
             
            
                link |
                
                 there are fewer cells in the body being infected
             
            
                link |
                
                 from outside infections and therefore less of a reason
             
            
                link |
                
                 for cells to be crying out help
             
            
                link |
                
                 because they are thriving, not suffering.
             
            
                link |
                
                 So don't wipe your eyes, keep your hands clean.
             
            
                link |
                
                 Everyone tells you that, right?
             
            
                link |
                
                 But keep your hands clean, don't wipe your eyes.
             
            
                link |
                
                 Be a nasal breather, not a mouth breather,
             
            
                link |
                
                 unless you're speaking, exercising, or eating,
             
            
                link |
                
                 and keep a healthy gut microbiome
             
            
                link |
                
                 by eating two to four servings a day
             
            
                link |
                
                 of quality low sugar fermented foods,
             
            
                link |
                
                 things like sauerkraut, things like natto,
             
            
                link |
                
                 if you can access that.
             
            
                link |
                
                 I've tried it before, it's interesting.
             
            
                link |
                
                 It's sort of an acquired taste.
             
            
                link |
                
                 Kimchi, pickles, again, low sugar sources
             
            
                link |
                
                 are going to be the sources
             
            
                link |
                
                 that are going to be most effective for this.
             
            
                link |
                
                 So now you're armed with three ways
             
            
                link |
                
                 to enhance the function of your immune system
             
            
                link |
                
                 and combat infection that is, I like to think,
             
            
                link |
                
                 separate from the typical type of information that you get,
             
            
                link |
                
                 such as get good sleep, good nutrition,
             
            
                link |
                
                 good social connection, et cetera.
             
            
                link |
                
                 All that stuff still holds true,
             
            
                link |
                
                 but these three other points,
             
            
                link |
                
                 I think can really make a substantial difference
             
            
                link |
                
                 in terms of bolstering the immune system,
             
            
                link |
                
                 your immune system.
             
            
                link |
                
                 I do want to mention,
             
            
                link |
                
                 because these names are going to come up several times
             
            
                link |
                
                 during this episode,
             
            
                link |
                
                 that while interleukins like IL-6 and IL-1
             
            
                link |
                
                 encourage inflammation,
             
            
                link |
                
                 they are these help me signals
             
            
                link |
                
                 that call in cells to gobble up invaders.
             
            
                link |
                
                 There are some interleukins that are anti-inflammatory,
             
            
                link |
                
                 and the one that I'd like to highlight in particular,
             
            
                link |
                
                 because it will come up again in a little bit,
             
            
                link |
                
                 is interleukin-10.
             
            
                link |
                
                 So not all of the IL, insert number,
             
            
                link |
                
                 not all of the interleukins are inflammatory,
             
            
                link |
                
                 some are anti-inflammatory.
             
            
                link |
                
                 So that's an important point to keep in mind
             
            
            
                link |
                
                 Next, I'd like to talk about
             
            
                link |
                
                 what's called sickness behavior.
             
            
                link |
                
                 And indeed, there is a category of behavior
             
            
                link |
                
                 that we call sickness behavior
             
            
                link |
                
                 that is very informative
             
            
                link |
                
                 as to the things that we can do
             
            
                link |
                
                 to avoid getting sick.
             
            
                link |
                
                 Now, this notion of sickness behavior
             
            
                link |
                
                 goes back several decades or more,
             
            
                link |
                
                 and it's a very interesting way of looking
             
            
                link |
                
                 at the function of the immune system,
             
            
                link |
                
                 because what it does is it bridges us from this thing
             
            
                link |
                
                 that we're calling the immune system,
             
            
                link |
                
                 where it's T cells and B cells and cytokines and leukocytes,
             
            
                link |
                
                 and it starts taking us into the realm of the nervous system
             
            
                link |
                
                 because, of course, the nervous system controls behavior.
             
            
                link |
                
                 So sickness behavior is a suite of responses
             
            
                link |
                
                 that we tend to all undergo when we are feeling sick.
             
            
                link |
                
                 So this is going to vary from person to person,
             
            
                link |
                
                 but there's some general categories of things
             
            
                link |
                
                 that we all do and that happen to all of us
             
            
                link |
                
                 after we are wounded or sick
             
            
                link |
                
                 or dealing with an infection of any kind.
             
            
                link |
                
                 And by examining sickness behavior in some detail,
             
            
                link |
                
                 it can be really informative
             
            
                link |
                
                 as to routes that we can take to health.
             
            
                link |
                
                 So the main thing about sickness behavior
             
            
                link |
                
                 is that it tends to involve a slowing
             
            
                link |
                
                 of our usual levels of activity.
             
            
                link |
                
                 People start to feel lethargic
             
            
                link |
                
                 or they feel like the activities
             
            
                link |
                
                 that previously they could do with relative ease
             
            
                link |
                
                 are very difficult for them or somewhat overwhelming.
             
            
                link |
                
                 The other thing you start to see
             
            
                link |
                
                 is that people and animals, by the way, stop grooming.
             
            
                link |
                
                 They stop taking care of themselves,
             
            
                link |
                
                 not necessarily stop showering,
             
            
                link |
                
                 although oftentimes that's the case,
             
            
                link |
                
                 but they will stop doing their hair.
             
            
                link |
                
                 They'll stop putting on makeup.
             
            
                link |
                
                 You know, depending on whether or not they did that before,
             
            
            
                link |
                
                 Animals will stop licking and grooming themselves.
             
            
                link |
                
                 People will stop taking care of their cosmetic appearance.
             
            
                link |
                
                 Now, it's not just because they don't care
             
            
                link |
                
                 how they look when they're sick.
             
            
                link |
                
                 It's because there's this overall suppression
             
            
                link |
                
                 of certain kinds of activities
             
            
                link |
                
                 and an enhancement of other kinds of activities.
             
            
                link |
                
                 And this is really important.
             
            
                link |
                
                 Sickness behavior is actually a motivated state.
             
            
                link |
                
                 It's a state that's designed to accomplish certain things.
             
            
                link |
                
                 One of the other features of sickness behavior,
             
            
                link |
                
                 in addition to being lethargic, loss of grooming,
             
            
                link |
                
                 will be a loss of appetite, right?
             
            
                link |
                
                 Oftentimes people who have a great appetite
             
            
                link |
                
                 normally just won't feel hungry at all.
             
            
                link |
                
                 And there are several theories as to why this would be.
             
            
                link |
                
                 One prominent idea in the literature
             
            
                link |
                
                 is that it's to discourage vomiting and diarrhea,
             
            
                link |
                
                 which of course can be infectious to other people.
             
            
                link |
                
                 So that's a theory.
             
            
                link |
                
                 I don't know that that's ever been tested directly,
             
            
                link |
                
                 but that's one idea.
             
            
                link |
                
                 The other idea is that it's simply
             
            
                link |
                
                 to harbor more resources for sake of repair.
             
            
                link |
                
                 And I want to talk about that
             
            
                link |
                
                 because we are all told to get extra sleep
             
            
                link |
                
                 when we aren't feeling well or to rest.
             
            
                link |
                
                 But just like any good two or three-year-old
             
            
                link |
                
                 constantly asks, why, why?
             
            
                link |
                
                 Good scientists, good people who are interested
             
            
                link |
                
                 in health information should always be asking,
             
            
                link |
                
                 why, why should I get more sleep?
             
            
                link |
                
                 What happens in sleep
             
            
                link |
                
                 that I should get more sleep when I'm sick?
             
            
                link |
                
                 Why shouldn't I just push through this?
             
            
                link |
                
                 And there are a couple reasons for this
             
            
                link |
                
                 that have been established in the literature.
             
            
                link |
                
                 The first is that there does seem to be something useful
             
            
                link |
                
                 about slowing circulation when we are ill.
             
            
                link |
                
                 One idea that has some data to support it
             
            
                link |
                
                 is that when we slow our circulation,
             
            
                link |
                
                 our blood circulation,
             
            
                link |
                
                 so not running around so much or running at all,
             
            
                link |
                
                 but rather lying down, getting extra rest,
             
            
                link |
                
                 maybe sleeping, maybe even just remaining still
             
            
                link |
                
                 is that the lymphatic system,
             
            
                link |
                
                 which carries a lot of the immune-related cells and fluids
             
            
                link |
                
                 is able to ramp up its levels of activity.
             
            
                link |
                
                 So this is interesting, right?
             
            
                link |
                
                 So reducing circulation of the blood,
             
            
                link |
                
                 but increasing circulation of the lymphatic system.
             
            
                link |
                
                 You've all probably been familiar with the lymphatic system.
             
            
                link |
                
                 When you're combating an infection,
             
            
                link |
                
                 your lymph nodes can get sore.
             
            
                link |
                
                 You've got lymph nodes behind your ears
             
            
                link |
                
                 and your groin, your armpits, around your throat,
             
            
                link |
                
                 around near your thyroid, in your throat, et cetera.
             
            
                link |
                
                 So that's the other reason.
             
            
                link |
                
                 Now, some people, when they get sick,
             
            
                link |
                
                 psychologically go into a very vulnerable state
             
            
                link |
                
                 where they really, really want people,
             
            
                link |
                
                 other people to take care of them.
             
            
                link |
                
                 You've probably witnessed this
             
            
                link |
                
                 or you feel this way yourself.
             
            
                link |
                
                 About 50% of people have that response.
             
            
                link |
                
                 They really want to be taken care of.
             
            
                link |
                
                 Now, when you think about it from an adaptive perspective,
             
            
                link |
                
                 this makes sense, right?
             
            
                link |
                
                 A member of our species is ill
             
            
                link |
                
                 and they more or less will cry out for help
             
            
                link |
                
                 in one form or another to the other members of their species
             
            
                link |
                
                 to take care of them.
             
            
                link |
                
                 And of course, this will be especially apparent
             
            
                link |
                
                 in cases where people are young enough
             
            
                link |
                
                 or incapacitated enough
             
            
                link |
                
                 that they can't actually get resources on their own.
             
            
                link |
                
                 If you've ever been really sick,
             
            
                link |
                
                 just getting up and going to the fridge
             
            
                link |
                
                 or to the restroom can feel like a monumental task.
             
            
                link |
                
                 So about 50% of people report or describe
             
            
                link |
                
                 seeking of help and support when they are sick.
             
            
                link |
                
                 But you could also imagine
             
            
                link |
                
                 how this would be a very non-adaptive response
             
            
                link |
                
                 because it increases the opportunity
             
            
                link |
                
                 to spread infection to the caretaker.
             
            
                link |
                
                 So that's an interesting consideration.
             
            
                link |
                
                 Another 50% of people seem to have the opposite response
             
            
                link |
                
                 when they're sick.
             
            
                link |
                
                 So somehow, regardless of how they were
             
            
                link |
                
                 prior to getting ill,
             
            
                link |
                
                 the sickness behavior that's engaged
             
            
                link |
                
                 by these neural circuits in the brain,
             
            
                link |
                
                 they are indeed neural circuits in the brain,
             
            
                link |
                
                 create a stay away from me.
             
            
                link |
                
                 I don't want to be bothered.
             
            
                link |
                
                 I want to be left alone.
             
            
                link |
                
                 I don't want to be taken care of, right?
             
            
                link |
                
                 It's not stubbornness.
             
            
                link |
                
                 It's literally a lack of interest or a disinterest
             
            
                link |
                
                 in social connection when one is sick.
             
            
                link |
                
                 And you see this in animals too.
             
            
                link |
                
                 Some animals will seek out other members of their species.
             
            
                link |
                
                 Others, like my unfortunately now passed away,
             
            
                link |
                
                 Bulldog Costello, when he was sick,
             
            
                link |
                
                 I always knew because he would go around
             
            
                link |
                
                 the back of the house and he would just hide there.
             
            
                link |
                
                 He would just take himself away from everybody else.
             
            
                link |
                
                 He did not want to be taken care of.
             
            
                link |
                
                 And it was just a natural response to him.
             
            
                link |
                
                 I don't think he was trying to prevent me
             
            
                link |
                
                 from getting whatever it was that he had.
             
            
                link |
                
                 So if ever somebody doesn't want to be taken care of,
             
            
                link |
                
                 or if they do want to be taken care of,
             
            
                link |
                
                 realize that people tend to fall into these two bins naturally
             
            
                link |
                
                 and animals tend to fall into these bins,
             
            
                link |
                
                 regardless of what species they are, it's about 50-50.
             
            
                link |
                
                 And again, this sickness behavior is a motivated state.
             
            
                link |
                
                 It's designed to slow circulation of the blood,
             
            
                link |
                
                 increase circulation of the lymph
             
            
                link |
                
                 and the other killer cells in the body,
             
            
                link |
                
                 reduce the probability of infecting others
             
            
                link |
                
                 by reducing its thought, diarrhea and vomit,
             
            
                link |
                
                 but also breathing on others, interacting with others.
             
            
                link |
                
                 And in some cases it will activate this,
             
            
                link |
                
                 I don't want to call it a regressed state,
             
            
                link |
                
                 but many people feel somewhat more if they are adults,
             
            
                link |
                
                 they feel more childlike when they are ill
             
            
                link |
                
                 and they want to be taken care of very badly.
             
            
                link |
                
                 Some of it might be learned,
             
            
                link |
                
                 some of it might be innate, we don't know,
             
            
                link |
                
                 but the sickness behavior is very interesting
             
            
                link |
                
                 for a couple of reasons.
             
            
                link |
                
                 First of all, it mimics another state
             
            
                link |
                
                 that has been described in the neuroscience literature,
             
            
                link |
                
                 which is major depression.
             
            
                link |
                
                 And in both sick individuals,
             
            
                link |
                
                 sick from bacterial viral infection,
             
            
                link |
                
                 and in people with major depression,
             
            
                link |
                
                 it's been shown that there are robust increases
             
            
                link |
                
                 in the levels of interleukin-6
             
            
                link |
                
                 and tumor necrosis factor alpha.
             
            
                link |
                
                 So there is an idea now circulating that depression
             
            
                link |
                
                 involves these inflammatory cytokines being very active.
             
            
                link |
                
                 And we know that illness involves inflammatory cytokines
             
            
                link |
                
                 being very active.
             
            
                link |
                
                 So if you think about it,
             
            
                link |
                
                 the similarity between major depression and being sick
             
            
                link |
                
                 ought to be able to point us in a direction of interventions
             
            
                link |
                
                 that could help us either prevent illness
             
            
                link |
                
                 or move through illness more quickly.
             
            
                link |
                
                 But as we head in that direction,
             
            
                link |
                
                 because indeed that's the case,
             
            
                link |
                
                 I just want to emphasize that sickness behavior
             
            
                link |
                
                 is what provides this bridge
             
            
                link |
                
                 between the immune system and the nervous system.
             
            
                link |
                
                 And what we'll soon see also is that healthy behavior,
             
            
                link |
                
                 behavior that allows us to avoid infection
             
            
                link |
                
                 also points to a clear bridge
             
            
                link |
                
                 between the nervous system and the immune system.
             
            
                link |
                
                 That it isn't just that we have a brain
             
            
                link |
                
                 and body and our organs,
             
            
                link |
                
                 and then we have an immune system.
             
            
                link |
                
                 That's true, but they're interacting all the time.
             
            
                link |
                
                 And this is going to lead us to a place
             
            
                link |
                
                 where it's going to be very clear
             
            
                link |
                
                 and not at all surprising how certain patterns of thinking
             
            
                link |
                
                 and certain behaviors that we can elect to take
             
            
                link |
                
                 can help enhance our immune system function and vice versa.
             
            
                link |
                
                 There are two other features of sickness behavior
             
            
                link |
                
                 definitely worth pointing out.
             
            
                link |
                
                 One is a theory, which is that the reduced appetite,
             
            
                link |
                
                 in particular appetite for protein-rich foods when sick
             
            
                link |
                
                 is thought to be an attempt,
             
            
                link |
                
                 a subconscious attempt of the organism
             
            
                link |
                
                 to reduce the amount of iron that it's taking in.
             
            
                link |
                
                 Now, typically the amount of iron intake
             
            
                link |
                
                 that's recommended or more or less is for men,
             
            
                link |
                
                 it's about eight milligrams per day.
             
            
                link |
                
                 For women, it's anywhere from 18 to 27 milligrams per day,
             
            
                link |
                
                 depending on whether or not they're pregnant,
             
            
                link |
                
                 lactating or menstruating, et cetera.
             
            
                link |
                
                 The ranges can vary.
             
            
                link |
                
                 But, and indeed it's true that if iron levels in the blood
             
            
                link |
                
                 go too high, like over 45 milligrams per day,
             
            
                link |
                
                 it can be very toxic to the system.
             
            
                link |
                
                 But the theory that's prominent in the biology literature
             
            
                link |
                
                 and in the health literature is that the reduction
             
            
                link |
                
                 in appetite is actually an attempt to reduce iron intake
             
            
                link |
                
                 specifically because many bacteria
             
            
                link |
                
                 and other forms of infection seem to thrive
             
            
                link |
                
                 when levels of iron in the blood are high.
             
            
                link |
                
                 Now, I don't want to see anyone take this to extreme
             
            
                link |
                
                 and suddenly do an iron deprivation diet
             
            
                link |
                
                 in order to get well.
             
            
                link |
                
                 But it's an interesting theory that I'd be remiss
             
            
                link |
                
                 if I didn't mention, because it makes good sense.
             
            
                link |
                
                 Iron is actually attached to hemoglobin
             
            
                link |
                
                 and red blood cells in the bloodstream.
             
            
                link |
                
                 Normally that can help us quite a lot.
             
            
                link |
                
                 It's also in muscle.
             
            
                link |
                
                 I should mention that iron can be sequestered into muscle
             
            
                link |
                
                 and iron serves a lot of important health promoting roles,
             
            
                link |
                
                 but by reducing appetite and thereby reducing iron intake,
             
            
                link |
                
                 it does reduce the capacity of certain things,
             
            
                link |
                
                 including infections to travel
             
            
                link |
                
                 in certain compartments within the body.
             
            
                link |
                
                 So again, that's just theory,
             
            
                link |
                
                 but I think many of you are probably familiar
             
            
                link |
                
                 with not having an appetite when you're sick.
             
            
                link |
                
                 The other thing that's very typical
             
            
                link |
                
                 of people with major depression is loss of appetite.
             
            
                link |
                
                 Not always, but often loss of appetite.
             
            
                link |
                
                 So here again, we have loss of appetite
             
            
                link |
                
                 in sickness behavior, loss of appetite in major depression.
             
            
                link |
                
                 And perhaps not surprisingly,
             
            
                link |
                
                 one of the major symptoms of sickness behavior
             
            
                link |
                
                 and major depression that map more or less onto one another
             
            
                link |
                
                 is loss of libido or interest,
             
            
                link |
                
                 not just in social interactions,
             
            
                link |
                
                 but in sex and reproduction.
             
            
            
                link |
                
                 if you think about sickness behavior and depression,
             
            
                link |
                
                 they are very, very similar.
             
            
                link |
                
                 Okay, so sickness behavior and major depression
             
            
                link |
                
                 have certain core features in common.
             
            
                link |
                
                 We need to therefore ask ourselves why and how
             
            
                link |
                
                 does being sick influence the way that we think
             
            
                link |
                
                 and perceive our environment and impact our appetite,
             
            
                link |
                
                 whether or not we want to be cared for more
             
            
                link |
                
                 or cared for less.
             
            
                link |
                
                 Again, people tend to diverge
             
            
                link |
                
                 into two different bins there.
             
            
                link |
                
                 And believe it or not,
             
            
                link |
                
                 the pathway for this has been identified.
             
            
                link |
                
                 When we have an infection someplace in our body,
             
            
                link |
                
                 and it could be up in our head,
             
            
                link |
                
                 it could be a sinus infection,
             
            
                link |
                
                 it could be an ear infection,
             
            
                link |
                
                 or I should also mention many of these same mechanisms
             
            
                link |
                
                 can also be the consequence of a wound
             
            
                link |
                
                 or an injury to the body,
             
            
                link |
                
                 you know, a back injury or a slipped disc,
             
            
                link |
                
                 or I guess it's called a herniated disc
             
            
                link |
                
                 is the way that you hear it described.
             
            
                link |
                
                 When we have that, we can be kind of irritable.
             
            
                link |
                
                 We don't want to do certain things
             
            
                link |
                
                 and we just want to be left alone.
             
            
                link |
                
                 Things are harder.
             
            
            
                link |
                
                 Well, there's a known pathway,
             
            
                link |
                
                 which is the so-called vagus nerve
             
            
                link |
                
                 that connects the body and the brain,
             
            
                link |
                
                 signals to particular brain sites
             
            
                link |
                
                 to engage this category of motivational state
             
            
                link |
                
                 that we call sickness behavior.
             
            
                link |
                
                 Many of you have probably heard of the vagus,
             
            
            
                link |
                
                 The vagus nerve is a very extensive nerve pathway.
             
            
                link |
                
                 It's the 10th cranial nerve
             
            
                link |
                
                 comes out of the back of the brainstem,
             
            
                link |
                
                 heads into the body and branches out extensively
             
            
                link |
                
                 to innervate or connect to many of our organs,
             
            
                link |
                
                 including our lungs, our heart, our gut, et cetera.
             
            
                link |
                
                 And all of those organs are able also
             
            
                link |
                
                 to send neural signals back up to the brain.
             
            
                link |
                
                 We sometimes hear the vagus
             
            
                link |
                
                 as the route to calming ourselves down.
             
            
                link |
                
                 Unfortunately, that's more or less a myth
             
            
                link |
                
                 that I don't know how it got propagated.
             
            
                link |
                
                 You have lots of different pathways in the vagus.
             
            
                link |
                
                 Usually vagal stimulation
             
            
                link |
                
                 actually creates more arousal and alertness,
             
            
                link |
                
                 although it does have multiple pathways.
             
            
                link |
                
                 But there have now been many studies of the vagus
             
            
                link |
                
                 in various contexts, including in sickness behavior.
             
            
                link |
                
                 And it's very clear that the vagus nerve
             
            
                link |
                
                 is the fast pathway by which an infection in the body
             
            
                link |
                
                 is signaled to the brain
             
            
                link |
                
                 to a particular location in the brain
             
            
                link |
                
                 called the hypothalamus,
             
            
                link |
                
                 which harbors a lot of different types of neurons.
             
            
                link |
                
                 Neurons, for instance, in the preoptic area
             
            
                link |
                
                 that increase body temperature and fever, right?
             
            
                link |
                
                 That's one of the most important things
             
            
                link |
                
                 is to increase body temperature
             
            
                link |
                
                 in order to, it's the body's attempt
             
            
                link |
                
                 to kill off this invader
             
            
                link |
                
                 because many viruses and many bacteria
             
            
                link |
                
                 don't survive well at elevated heat.
             
            
                link |
                
                 That's the function of a fever.
             
            
                link |
                
                 A fever actually has a functional role.
             
            
                link |
                
                 So in biology, we like complicated words.
             
            
                link |
                
                 So we call anything that increases body temperature
             
            
                link |
                
                 or creates a fever a pyrogen.
             
            
                link |
                
                 Many years ago in my undergraduate years,
             
            
                link |
                
                 I was working on pyrogens,
             
            
                link |
                
                 injecting something called lippy polysaccharide
             
            
                link |
                
                 into the belly, which then gives you a fever.
             
            
                link |
                
                 The way it does that is LPS causes
             
            
                link |
                
                 an inflammation response in the gut.
             
            
                link |
                
                 The gut doesn't know what is happening.
             
            
                link |
                
                 The stomach cells don't know what's happening.
             
            
                link |
                
                 So they just start secreting the IL-6, the IL-1,
             
            
                link |
                
                 all those cytokines, the killer cells migrate into the gut.
             
            
                link |
                
                 That's why you sometimes get a stomach ache
             
            
                link |
                
                 when you don't feel well,
             
            
                link |
                
                 you have a flu or something like it.
             
            
                link |
                
                 So a neural signal, electrical signals get sent up
             
            
                link |
                
                 to the hypothalamus.
             
            
                link |
                
                 The hypothalamus says,
             
            
                link |
                
                 oh, I don't know what's going on out there,
             
            
                link |
                
                 but there's a signal something's going on.
             
            
                link |
                
                 Let's just heat up the body.
             
            
                link |
                
                 Let's just start cooking whatever it is out there.
             
            
                link |
                
                 And of course, you don't want fever to go too high
             
            
                link |
                
                 because you can kill brain cells,
             
            
                link |
                
                 but within a particular range,
             
            
                link |
                
                 the fever is a functional and adaptive response, okay?
             
            
                link |
                
                 So if you're taking drugs to try and lower the fever,
             
            
                link |
                
                 that might make you feel more comfortable,
             
            
                link |
                
                 but actually that's limiting the response
             
            
                link |
                
                 that your body is creating
             
            
                link |
                
                 in order to try and kill off that invader.
             
            
                link |
                
                 And again, you don't want fever to go too high.
             
            
                link |
                
                 This is going to vary depending on age.
             
            
                link |
                
                 You can look up online
             
            
                link |
                
                 what the tolerable ranges are for fever,
             
            
                link |
                
                 but when you're trying to lower body temperature,
             
            
                link |
                
                 when you have a fever,
             
            
                link |
                
                 unless you're heading into dangerous levels of heating up,
             
            
                link |
                
                 that's actually the wrong way to take your system
             
            
                link |
                
                 if you do indeed want to kill off that invader.
             
            
                link |
                
                 Okay, so the vagus nerve is the quick response.
             
            
                link |
                
                 It also sends input to areas of the brain
             
            
                link |
                
                 that change your perception of the outside world.
             
            
                link |
                
                 One of the most obvious of these,
             
            
                link |
                
                 obvious once I tell it to you, is photophobia, right?
             
            
                link |
                
                 I love bright sunshine.
             
            
                link |
                
                 I love bright lights when I want to be alert.
             
            
                link |
                
                 We all have different levels of light sensitivity,
             
            
                link |
                
                 but most people, when they are sick,
             
            
                link |
                
                 when there's an inflammation response in the body,
             
            
                link |
                
                 they feel like bright lights are kind of aversive.
             
            
                link |
                
                 They get a well-described kind of classical photophobia.
             
            
                link |
                
                 And that's mediated by a pathway that goes from your eye
             
            
                link |
                
                 to an area of your thalamus
             
            
                link |
                
                 called the anterior nucleus of the thalamus.
             
            
                link |
                
                 This is work that was done by Clifford Saper
             
            
                link |
                
                 at Harvard Medical School.
             
            
                link |
                
                 It's really beautiful work.
             
            
                link |
                
                 And then from there up to the outer lining of the brain,
             
            
                link |
                
                 which is the meninges,
             
            
                link |
                
                 just sort of on the outside of the brain
             
            
                link |
                
                 where the brain starts to interface
             
            
                link |
                
                 with some of the other connective tissues.
             
            
                link |
                
                 We'll talk more about these later.
             
            
                link |
                
                 It can actually create a photophobia and a headache
             
            
            
                link |
                
                 So here's the pathway.
             
            
                link |
                
                 Some invader gets into your system
             
            
                link |
                
                 because you wiped your eyes or it got in through your mouth.
             
            
                link |
                
                 You didn't listen to your mother
             
            
                link |
                
                 and got in through your eyes.
             
            
                link |
                
                 You're feeling sick.
             
            
                link |
                
                 Something's going on there.
             
            
                link |
                
                 You have a stomach ache
             
            
                link |
                
                 because of all the inflammation there.
             
            
                link |
                
                 The signal goes up from your vagus nerve.
             
            
                link |
                
                 You're heating up with a fever.
             
            
                link |
                
                 You've got photophobia
             
            
                link |
                
                 because you've activated this pathway
             
            
                link |
                
                 by which what would normally be tolerable light
             
            
                link |
                
                 is triggering this thalamic nucleus, the anterior thalamus.
             
            
                link |
                
                 That's projecting up to the meninges.
             
            
                link |
                
                 You've got a headache in response to looking at light.
             
            
                link |
                
                 It's basically triggering an overall pathway
             
            
                link |
                
                 to get you to go into a quiet, dark place and rest.
             
            
                link |
                
                 And the last element I'd like to talk about is the rest.
             
            
                link |
                
                 There's something that gets triggered
             
            
                link |
                
                 from the body to the brain to the hypothalamus.
             
            
                link |
                
                 And we think we know which hypothalamic area it is.
             
            
                link |
                
                 It's the supraoptic nucleus, we think.
             
            
                link |
                
                 Supraoptic because it's right above
             
            
                link |
                
                 your so-called optic chiasm.
             
            
                link |
                
                 If you want to look up where that is,
             
            
                link |
                
                 it's right above the roof of your mouth.
             
            
                link |
                
                 And there are nuclei there that promote the desire to sleep
             
            
                link |
                
                 even during the daytime,
             
            
                link |
                
                 what would normally be the active phase
             
            
                link |
                
                 of your circadian cycle.
             
            
                link |
                
                 Now, that is really interesting
             
            
                link |
                
                 because what's happening here
             
            
                link |
                
                 is you've got multiple pathways that are saying,
             
            
                link |
                
                 avoid light, reduce your amount of behavior,
             
            
                link |
                
                 heat up all the things that are making you sick.
             
            
                link |
                
                 This is sickness behavior,
             
            
                link |
                
                 and it's going from your body to your mind
             
            
                link |
                
                 to make you do the right thing.
             
            
                link |
                
                 Now, there's also a slow pathway
             
            
                link |
                
                 that's purely mediated by the blood,
             
            
                link |
                
                 so-called humoral factors, not because they're funny,
             
            
                link |
                
                 but humoral factors are factors of the blood.
             
            
                link |
                
                 As you have an infection for many hours or days,
             
            
                link |
                
                 the amount of IL-6 and IL-1 and tumor necrosis factor
             
            
                link |
                
                 and other inflammatory cytokines
             
            
                link |
                
                 is starting to increase such that the total amount
             
            
                link |
                
                 in your circulation gets high enough
             
            
                link |
                
                 and is communicated to the brain.
             
            
                link |
                
                 And it tends to enter the brain
             
            
                link |
                
                 through a particular type of tissue
             
            
                link |
                
                 that's really interesting called choroid,
             
            
            
                link |
                
                 Choroid is really interesting.
             
            
                link |
                
                 It's kind of this fluffy tissue
             
            
                link |
                
                 that sits in your ventricles.
             
            
                link |
                
                 The ventricles are the spaces in your brain,
             
            
                link |
                
                 and the spaces in your brain
             
            
                link |
                
                 have what's called cerebral spinal fluid in them.
             
            
                link |
                
                 The cerebral spinal fluid contains
             
            
                link |
                
                 a number of important things,
             
            
                link |
                
                 but the choroid starts releasing and responding
             
            
                link |
                
                 to these cytokines, the inflammatory cytokines,
             
            
                link |
                
                 and then the brain actually starts to experience
             
            
                link |
                
                 all sorts of changes in terms of inflammation to neurons.
             
            
                link |
                
                 Your memory tends to get poor.
             
            
                link |
                
                 Your cognition tends to get poor.
             
            
                link |
                
                 These are transient things most often.
             
            
                link |
                
                 Eventually these things will pass,
             
            
                link |
                
                 but this is deep into sickness
             
            
                link |
                
                 when you're really feeling lousy.
             
            
                link |
                
                 You can't read, you can't watch a movie,
             
            
                link |
                
                 you can't do anything.
             
            
                link |
                
                 So if you ever get sick
             
            
                link |
                
                 and you just can't be bothered by anything,
             
            
                link |
                
                 it's probably because you've had that fast response
             
            
                link |
                
                 from the body, and you've also had this slower response
             
            
                link |
                
                 where you literally have a set of tissues in your brain
             
            
                link |
                
                 that are sending out these inflammatory signals,
             
            
                link |
                
                 and now your whole brain is starting to cope
             
            
                link |
                
                 or is trying to cope with this infection.
             
            
                link |
                
                 So you've got a slow pathway and a fast pathway.
             
            
                link |
                
                 That all sounds really terrible.
             
            
                link |
                
                 So now I'd like to talk about what you can do
             
            
                link |
                
                 to reduce the probability of getting sick,
             
            
                link |
                
                 and there are actually things that one can do
             
            
                link |
                
                 as you start to get sick and once you're sick
             
            
                link |
                
                 to accelerate the healing process by flipping the equation.
             
            
                link |
                
                 Up until now, we've been talking about
             
            
                link |
                
                 how the body activates certain areas in the brain
             
            
                link |
                
                 to create sickness behavior
             
            
                link |
                
                 that's very much like depression.
             
            
                link |
                
                 You're probably all familiar with this
             
            
                link |
                
                 from any time you've had a cold or a flu
             
            
                link |
                
                 or something really lousy or an injury.
             
            
                link |
                
                 Now let's flip the equation and ask,
             
            
                link |
                
                 what can we do with our nervous system
             
            
                link |
                
                 in order to enhance the function of our immune system
             
            
                link |
                
                 in order to be able to heal and recover
             
            
                link |
                
                 from illness and injury more quickly?
             
            
                link |
                
                 So let's say you are in that unfortunate circumstance
             
            
                link |
                
                 of waking up one day or coming home,
             
            
                link |
                
                 and you've got that tickle in your throat,
             
            
                link |
                
                 or when you breathe, your nasal passages
             
            
                link |
                
                 don't feel the same way,
             
            
                link |
                
                 you've got a little bit of a headache,
             
            
                link |
                
                 you're feeling kind of off.
             
            
                link |
                
                 We all know what we should do.
             
            
                link |
                
                 We should all hydrate, drink some water, and go to sleep.
             
            
                link |
                
                 Right, that's what we are all told.
             
            
                link |
                
                 But there are actually things that you can actively do
             
            
                link |
                
                 in order to get your immune system
             
            
                link |
                
                 to deploy a more robust response
             
            
                link |
                
                 at that early phase of potential infection.
             
            
                link |
                
                 Let's focus first on the rest component.
             
            
                link |
                
                 Yes, of course, we are all told
             
            
                link |
                
                 that we should take a hot shower and go to sleep,
             
            
                link |
                
                 and get nine or 10 hours of sleep.
             
            
                link |
                
                 But there's an interesting way of looking at sleep
             
            
                link |
                
                 specifically for its role in enhancing the immune system.
             
            
                link |
                
                 And there's a wonderful review.
             
            
                link |
                
                 I'll put the review in the captions
             
            
                link |
                
                 that looked specifically at the literature
             
            
                link |
                
                 surrounding sleep that is different
             
            
                link |
                
                 because it occurs in support of the immune system.
             
            
                link |
                
                 So normally when we go to sleep,
             
            
                link |
                
                 we have slow wave sleep predominantly
             
            
                link |
                
                 in the early phase of the night.
             
            
                link |
                
                 And then over time, as we sleep longer and longer,
             
            
                link |
                
                 we get more so-called REM, rapid eye movement sleep.
             
            
                link |
                
                 Talked all about this on the episodes on sleep.
             
            
                link |
                
                 Of course, you have slow wave sleep and REM sleep
             
            
                link |
                
                 throughout the night always,
             
            
                link |
                
                 but it's the fraction of slow wave sleep
             
            
                link |
                
                 to REM sleep that shifts.
             
            
                link |
                
                 And they have different functions, et cetera.
             
            
                link |
                
                 There is some evidence that the sleep
             
            
                link |
                
                 associated with an infection,
             
            
                link |
                
                 in particular early stage of infection,
             
            
                link |
                
                 is associated with elevated levels of serotonin in the brain
             
            
                link |
                
                 that either through an adaptive mechanism
             
            
                link |
                
                 or for whatever reason,
             
            
                link |
                
                 the brain, the neurons in the brain
             
            
                link |
                
                 of the so-called raffae nucleus
             
            
                link |
                
                 start releasing more serotonin.
             
            
                link |
                
                 And that that serotonin and its related pathways
             
            
                link |
                
                 can help enhance some of the immune system function
             
            
                link |
                
                 that could combat the infection.
             
            
                link |
                
                 There is starting to be some data,
             
            
                link |
                
                 and I emphasize starting
             
            
                link |
                
                 because it's not a very robust literature yet,
             
            
                link |
                
                 looking at whether or not supplementing precursors
             
            
                link |
                
                 to serotonin like 5-HTP,
             
            
                link |
                
                 which can be taken in a supplement form,
             
            
                link |
                
                 or consuming foods that increase serotonin naturally.
             
            
                link |
                
                 So these would be any foods
             
            
                link |
                
                 that contain high levels of tryptophan.
             
            
                link |
                
                 You can look up what those are.
             
            
                link |
                
                 So white meat turkey, for instance,
             
            
                link |
                
                 certain complex carbohydrates
             
            
                link |
                
                 can often be rich with tryptophan.
             
            
                link |
                
                 That consuming those foods
             
            
                link |
                
                 can enhance the amount of serotonin
             
            
                link |
                
                 that's available in the brain and blood,
             
            
                link |
                
                 and thereby lead to the particular quality of sleep
             
            
                link |
                
                 that allows for more deep healing,
             
            
                link |
                
                 or for, when I say deep healing,
             
            
                link |
                
                 I mean for a more robust immune response.
             
            
                link |
                
                 Now, again, those are still emerging data.
             
            
                link |
                
                 What is very clear, however,
             
            
                link |
                
                 is that during sleep,
             
            
                link |
                
                 and in particular during sleep
             
            
                link |
                
                 that's associated with the early stage
             
            
                link |
                
                 of any kind of viral or bacterial infection,
             
            
                link |
                
                 the so-called glymphatic system
             
            
                link |
                
                 is much more active than it would be normally.
             
            
                link |
                
                 What's the glymphatic system?
             
            
                link |
                
                 The glymphatic system
             
            
                link |
                
                 is actually a relatively recent discovery.
             
            
                link |
                
                 I mentioned lymph and the lymphatic system earlier.
             
            
                link |
                
                 The glymphatic system with a G
             
            
                link |
                
                 is a system in the brain
             
            
                link |
                
                 by which debris that accumulates throughout the day,
             
            
                link |
                
                 but in particular,
             
            
                link |
                
                 debris that accumulates under conditions of neuroinflammation
             
            
                link |
                
                 and inflammation of the body
             
            
                link |
                
                 is cleared out or is washed out of the brain.
             
            
                link |
                
                 And the activity of this glymphatic system
             
            
                link |
                
                 is extremely important
             
            
                link |
                
                 for the recovery from infection of any kind.
             
            
                link |
                
                 And it's now becoming clear
             
            
                link |
                
                 is important for recovery from traumatic head injury
             
            
                link |
                
                 and maybe even from psychological trauma.
             
            
                link |
                
                 So the glymphatic system
             
            
                link |
                
                 can be thought of more or less as a plumbing system
             
            
                link |
                
                 that runs through the ventricles,
             
            
                link |
                
                 but also mainly through the lining
             
            
                link |
                
                 that sits between the brain and the skull
             
            
                link |
                
                 and some of the other tissues and things of that sort.
             
            
                link |
                
                 The choroid is involved as well.
             
            
                link |
                
                 Brain imaging reveals the glymphatic system
             
            
                link |
                
                 is very active during deep sleep,
             
            
                link |
                
                 and there's this kind of washout of the glymphatic system.
             
            
                link |
                
                 And I'm aware of some studies that are ongoing now
             
            
                link |
                
                 where augmenting the serotonin system
             
            
                link |
                
                 through either supplementation of tryptophan or 5-HTP
             
            
                link |
                
                 or even serotonin itself, these are laboratory studies,
             
            
                link |
                
                 is being looked at for its capacity
             
            
                link |
                
                 to increase the amount of circulation
             
            
                link |
                
                 in the glymphatic system.
             
            
                link |
                
                 And the idea is that it might, and I want to underscore,
             
            
                link |
                
                 might potentially lead to more rapid recovery
             
            
                link |
                
                 from injury and illness and potentially ramp up,
             
            
                link |
                
                 if you will, the activity of the immune system.
             
            
                link |
                
                 So it essentially is a ramping up
             
            
                link |
                
                 of the activity of the immune system.
             
            
                link |
                
                 Now, regardless of whether or not you decide to,
             
            
                link |
                
                 for instance, supplement with 5-HTP before sleep or not,
             
            
                link |
                
                 I'll talk about what that might look like in a moment,
             
            
                link |
                
                 there is a way that you can increase the activity
             
            
                link |
                
                 of your glymphatic system under normal circumstances.
             
            
                link |
                
                 Because of the mechanics of the glymphatic system,
             
            
                link |
                
                 it turns out that if you elevate your heels
             
            
                link |
                
                 by about 12 degrees,
             
            
                link |
                
                 it doesn't have to be exactly 12,
             
            
                link |
                
                 as you sleep by putting maybe a rolled pillow
             
            
                link |
                
                 or two pillows underneath your feet,
             
            
                link |
                
                 by having the head below your legs,
             
            
                link |
                
                 it seems that there's more glymphatic washout
             
            
                link |
                
                 or clearance during sleep.
             
            
                link |
                
                 And this is without taking any compound
             
            
                link |
                
                 to adjust the serotonin system.
             
            
                link |
                
                 So I would say, if you're not feeling well,
             
            
                link |
                
                 yes, take the hot shower.
             
            
                link |
                
                 Yes, get into bed and go to sleep,
             
            
                link |
                
                 but elevate your feet to try and increase the activity
             
            
                link |
                
                 of the glymphatic system.
             
            
                link |
                
                 Some might even consider that if you have to be awake,
             
            
                link |
                
                 that you might want to be awake with your feet
             
            
                link |
                
                 elevated above your head.
             
            
                link |
                
                 Now that might not be practical for the workplace,
             
            
                link |
                
                 but it might be practical for a short nap during the day
             
            
                link |
                
                 or something of that sort.
             
            
                link |
                
                 The glymphatic system is not just active during sleep,
             
            
                link |
                
                 it's also active during certain phases of waking,
             
            
                link |
                
                 in particular, when we are in a deep state of relaxation.
             
            
                link |
                
                 So as many of you probably know,
             
            
                link |
                
                 I'm a big proponent of self-hypnosis
             
            
                link |
                
                 because of the quality scientific literature on this.
             
            
                link |
                
                 If you're interested in self-hypnosis,
             
            
                link |
                
                 you can go to Reveri, R-E-V-E-R-I.com.
             
            
                link |
                
                 Reveri is a cost-free app for Apple and Android
             
            
                link |
                
                 that was developed by my colleague, David Spiegel,
             
            
                link |
                
                 and others at the Stanford University School of Medicine
             
            
                link |
                
                 based on quality studies and peer-reviewed data
             
            
                link |
                
                 showing that deep states of relaxation can be used
             
            
                link |
                
                 to improve pain management,
             
            
                link |
                
                 improve transition time to sleep,
             
            
                link |
                
                 and a number of other things.
             
            
                link |
                
                 You can select the various sort of outcomes
             
            
                link |
                
                 that you're seeking using Reveri.
             
            
                link |
                
                 It's a great thing that,
             
            
                link |
                
                 especially for people that are challenged
             
            
                link |
                
                 with meditation could use
             
            
                link |
                
                 because you just listen to the script,
             
            
                link |
                
                 involves deep relaxation.
             
            
                link |
                
                 I would suggest using that script,
             
            
                link |
                
                 or the script for sleep,
             
            
                link |
                
                 but with feet elevated to increase activity
             
            
                link |
                
                 of the glymphatic system.
             
            
                link |
                
                 Now, if you do decide that you want to test out
             
            
                link |
                
                 this serotonin hypothesis on your own,
             
            
                link |
                
                 obviously check with a doctor.
             
            
                link |
                
                 I'm not a doctor, I'm a professor,
             
            
                link |
                
                 so I'm professing things, not suggesting things.
             
            
                link |
                
                 But 5-HTP is a supplement that I've talked about before
             
            
                link |
                
                 on this podcast that I actually do not recommend
             
            
                link |
                
                 for most people for sake of sleep
             
            
                link |
                
                 because it can disrupt the normal architecture of sleep
             
            
                link |
                
                 and create a deep sleep early in the night
             
            
                link |
                
                 and then a spontaneous waking
             
            
                link |
                
                 with some trouble to get back to sleep.
             
            
                link |
                
                 And that's because of the way that the serotonin system
             
            
                link |
                
                 and the melatonin system interact.
             
            
                link |
                
                 However, under conditions where one is feeling
             
            
                link |
                
                 like they might have an infection
             
            
                link |
                
                 or an early stage of illness,
             
            
                link |
                
                 in that case, 5-HTP might be a useful supplement
             
            
                link |
                
                 in order to access these states of sleep
             
            
                link |
                
                 that are not typical.
             
            
                link |
                
                 They're not the typical deep sleep that you would achieve
             
            
                link |
                
                 when you're feeling healthy.
             
            
                link |
                
                 These are states of sleep that are specifically there
             
            
                link |
                
                 in order to try and repair some of the immune system
             
            
                link |
                
                 related inflammation that's occurring.
             
            
                link |
                
                 If you'd like to explore the 5-HTP approach
             
            
                link |
                
                 and you feel it's right and safe for you
             
            
                link |
                
                 and you've talked to your doctor,
             
            
                link |
                
                 it's 300 to 500 milligrams taken about 30 to 60 minutes
             
            
                link |
                
                 before going to sleep for the night.
             
            
                link |
                
                 That's the typical protocol.
             
            
            
                link |
                
                 increasing serotonin is also one typical approach
             
            
                link |
                
                 for the treatment of major depression.
             
            
                link |
                
                 This is the basis for things like SSRI,
             
            
                link |
                
                 selective serotonin reuptake inhibitors
             
            
                link |
                
                 like Prozac and Zoloft and so forth.
             
            
                link |
                
                 The 5-HT approach is a much milder approach
             
            
                link |
                
                 than prescription drug, of course,
             
            
                link |
                
                 but will allow more serotonin to be synthesized
             
            
            
                link |
                
                 Now, for those of you that are interested
             
            
                link |
                
                 in learning more about the glymphatic system,
             
            
                link |
                
                 it's a fascinating system,
             
            
                link |
                
                 and you might want to do a deep dive there
             
            
                link |
                
                 in terms of the behavioral protocols
             
            
                link |
                
                 and what's known about it.
             
            
                link |
                
                 There's a wonderful article called
             
            
                link |
                
                 The Glymphatic System, A Beginner's Guide.
             
            
                link |
                
                 This is a scientific article.
             
            
                link |
                
                 The first author is Jessen is the last name, J-E-S-S-E-N.
             
            
                link |
                
                 If you put in Jessen, the glymphatic system,
             
            
                link |
                
                 A Beginner's Guide,
             
            
                link |
                
                 you can access the full length manuscript easily online.
             
            
                link |
                
                 It'll show up immediately in your search.
             
            
                link |
                
                 And in a really interesting way,
             
            
                link |
                
                 the glymphatic system has now also been tied
             
            
                link |
                
                 to the iron deposition system.
             
            
                link |
                
                 Earlier, we were talking about iron
             
            
                link |
                
                 and how, of course, getting enough dietary iron
             
            
                link |
                
                 is important, but if levels of iron are too high,
             
            
                link |
                
                 it isn't good for a number of reasons.
             
            
                link |
                
                 There's a very interesting article
             
            
                link |
                
                 that just came out last year called
             
            
                link |
                
                 Dysfunction of the Glymphatic System Might Be
             
            
                link |
                
                 Related to Iron Deposition in the Normal Aging Brain.
             
            
                link |
                
                 So we're starting to see these links
             
            
                link |
                
                 between iron levels being too high,
             
            
                link |
                
                 the glymphatic system not being active enough,
             
            
                link |
                
                 and so forth, leading to sickness behavior,
             
            
                link |
                
                 inflammation, and maybe even damage to neurons
             
            
                link |
                
                 associated with aging.
             
            
                link |
                
                 We can flip that on its head and say that
             
            
                link |
                
                 increasing the activity of the glymphatic system,
             
            
                link |
                
                 feet elevated during deep sleep,
             
            
                link |
                
                 maybe even feet elevated above the head,
             
            
                link |
                
                 while awake during a nap or doing a reverie script
             
            
                link |
                
                 once a day or something of that sort,
             
            
                link |
                
                 could increase the activity of the glymphatic system,
             
            
                link |
                
                 lowering iron to a point that's probably below
             
            
                link |
                
                 the typical intake during periods of infection,
             
            
                link |
                
                 perhaps, perhaps I should say,
             
            
                link |
                
                 can enhance the glymphatic system and vice versa.
             
            
                link |
                
                 And then you've got this specialized sleep
             
            
                link |
                
                 that's related to sickness behavior
             
            
                link |
                
                 that seems to have heightened levels of serotonin
             
            
                link |
                
                 that might be augmented by increasing, excuse me,
             
            
                link |
                
                 that might be augmented by ingesting 5-HTP.
             
            
                link |
                
                 Again, not on a regular basis.
             
            
                link |
                
                 I don't suggest that people take compounds
             
            
                link |
                
                 that increase serotonin unless it's prescribed to you
             
            
                link |
                
                 for depression or something,
             
            
                link |
                
                 but not doing it by supplement with tryptophan or 5-HTP
             
            
                link |
                
                 on a regular basis, but only under conditions where,
             
            
                link |
                
                 as I mentioned, you might be starting to feel sick
             
            
                link |
                
                 or you're coming down with something
             
            
                link |
                
                 or you're combating some sort of infection.
             
            
                link |
                
                 So if we consider the advice that we typically get
             
            
                link |
                
                 when we're not feeling well of take a hot shower,
             
            
                link |
                
                 get into bed and go to sleep,
             
            
                link |
                
                 and we've now touched on ways to potentially increase
             
            
                link |
                
                 the efficacy of the sleep part through the glymphatic
             
            
                link |
                
                 and the serotonin system.
             
            
                link |
                
                 What about the take a hot shower part?
             
            
                link |
                
                 Is that good advice?
             
            
                link |
                
                 Well, it turns out it is,
             
            
                link |
                
                 and there's actually a way to do even better.
             
            
                link |
                
                 There's a study, very interesting study.
             
            
                link |
                
                 The title reveals where I'm going with this.
             
            
                link |
                
                 It's effect of a single finish sauna session
             
            
                link |
                
                 on white blood cell profile and cortisol levels.
             
            
                link |
                
                 In this case, it was done in athletes and non-athletes,
             
            
                link |
                
                 which is kind of nice.
             
            
                link |
                
                 This involves taking athletes and non-athletes
             
            
                link |
                
                 and exposing them to sauna.
             
            
                link |
                
                 It wasn't particularly hot.
             
            
                link |
                
                 It was 96 degrees, which isn't cool,
             
            
                link |
                
                 but it's not really hot.
             
            
                link |
                
                 Nowadays, you hear about people doing very, very hot sauna.
             
            
                link |
                
                 The humidity of the sauna, if you want to know,
             
            
                link |
                
                 is 15 plus or minus 3%.
             
            
                link |
                
                 But basically what they found
             
            
                link |
                
                 was that just one 15-minute sauna session
             
            
                link |
                
                 could really increase white blood cell profiles
             
            
                link |
                
                 and could adjust cortisol levels in ways
             
            
                link |
                
                 that were beneficial for combating infection.
             
            
                link |
                
                 And now there are many other studies like this.
             
            
                link |
                
                 Now, this should immediately make sense
             
            
                link |
                
                 based on what we said before about fever.
             
            
                link |
                
                 Heating up can actually help combat infection.
             
            
                link |
                
                 But for those of you that have listened
             
            
                link |
                
                 to the episodes on temperature,
             
            
                link |
                
                 what you probably know is that when you get into a sauna
             
            
                link |
                
                 or any kind of hot environment,
             
            
                link |
                
                 your body is also going to be actively pushing
             
            
                link |
                
                 to cool itself off.
             
            
                link |
                
                 So there's probably an increase in heat.
             
            
                link |
                
                 There is an increase in heating,
             
            
                link |
                
                 that then afterwards your body will cool off,
             
            
                link |
                
                 maybe even with a dip below baseline.
             
            
                link |
                
                 I do want to provide a cautionary note
             
            
                link |
                
                 that if you are already running a fever,
             
            
                link |
                
                 getting into a sauna could take your body temperature
             
            
                link |
                
                 into dangerously high levels,
             
            
                link |
                
                 dangerously meaning you can kill neurons.
             
            
                link |
                
                 And once you kill neurons, they do not come back.
             
            
                link |
                
                 So please don't kill your neurons.
             
            
                link |
                
                 I don't recommend getting into a sauna
             
            
                link |
                
                 if you're already running a fever.
             
            
                link |
                
                 So this would be something to do
             
            
                link |
                
                 at the initial stage of an infection
             
            
                link |
                
                 or if you're feeling a little bit off.
             
            
                link |
                
                 So this is kind of a ramping up or a super protocol
             
            
                link |
                
                 of the typical advice of take a hot shower
             
            
            
                link |
                
                 That is good advice.
             
            
                link |
                
                 Now we're talking about a hot sauna,
             
            
                link |
                
                 probably showering off and then getting into bed,
             
            
                link |
                
                 maybe augmenting serotonin.
             
            
                link |
                
                 I know many people don't have access to sauna.
             
            
                link |
                
                 So in that case, a very hot bath or shower,
             
            
                link |
                
                 don't scald yourself of course,
             
            
                link |
                
                 but as hot as you can comfortably tolerate
             
            
                link |
                
                 or right at that edge of what you can tolerate
             
            
                link |
                
                 would be a good idea.
             
            
                link |
                
                 Some people I've heard are creating saunas in their bathrooms
             
            
                link |
                
                 by running hot water and creating a ton of steam.
             
            
                link |
                
                 Anything that really heats you up,
             
            
                link |
                
                 but not to dangerously high levels
             
            
                link |
                
                 is going to be beneficial.
             
            
                link |
                
                 If you have access to a sauna, terrific.
             
            
                link |
                
                 This again was only 15 minutes.
             
            
                link |
                
                 They'd had a cool off session.
             
            
                link |
                
                 Would you get more of an increase?
             
            
                link |
                
                 People always want to know if you did it twice as much,
             
            
                link |
                
                 would you get twice increase?
             
            
                link |
                
                 Those data don't really exist yet.
             
            
                link |
                
                 However, if you are interested
             
            
                link |
                
                 in maximizing the effects of sauna,
             
            
                link |
                
                 it is clear that a cool off period is important.
             
            
                link |
                
                 So it's not that a 15 minute sauna is good
             
            
                link |
                
                 and a 30 minute sauna is better.
             
            
                link |
                
                 If you are going to take that route of exploring more,
             
            
                link |
                
                 it does seem that doing a 15 minute heating period
             
            
                link |
                
                 followed by a five to 10 minute cooling period
             
            
                link |
                
                 and then getting back into the heat can be beneficial.
             
            
                link |
                
                 And this is interesting.
             
            
                link |
                
                 It gets to the mechanisms by which the hypothalamus
             
            
                link |
                
                 that areas, the areas of the hypothalamus that is,
             
            
                link |
                
                 that generate increases in body heat.
             
            
                link |
                
                 The activation of those neurons occurs as you heat up.
             
            
                link |
                
                 And then were you to just stay in that heated environment,
             
            
                link |
                
                 they would actually shut off
             
            
                link |
                
                 and some other neurons would be handling the job,
             
            
            
                link |
                
                 But by getting in and out of the heated environment,
             
            
                link |
                
                 you actually force that system to send repeated pulses
             
            
                link |
                
                 of these cortisol lowering
             
            
                link |
                
                 and white cell stimulating signals to the body.
             
            
                link |
                
                 Some of you have probably heard the phrase,
             
            
                link |
                
                 feed a fever, starve a cold.
             
            
                link |
                
                 I don't know who first said that.
             
            
                link |
                
                 I couldn't find the citation, but we hear this
             
            
                link |
                
                 and we can speculate that the reason that phrase,
             
            
                link |
                
                 feed a fever, starve a cold came to be
             
            
                link |
                
                 is because of the adaptive function of fever
             
            
                link |
                
                 that increases in body temperature,
             
            
                link |
                
                 make it challenging for intruding viruses
             
            
                link |
                
                 and bacteria to survive.
             
            
                link |
                
                 Even though of course,
             
            
                link |
                
                 highly elevated body temperatures pose a danger
             
            
                link |
                
                 to the host organism, to you.
             
            
                link |
                
                 Feeding, eating does cause an increase in body temperature
             
            
                link |
                
                 through the so-called thermogenic effect of food.
             
            
                link |
                
                 So I can understand the logic of feed a fever.
             
            
                link |
                
                 It would mean that when you have a fever,
             
            
                link |
                
                 it's your body's natural attempt
             
            
                link |
                
                 to heat up and kill some invading thing.
             
            
            
                link |
                
                 you would further increase your body temperature.
             
            
                link |
                
                 Why you would want to starve a cold, I don't know, however.
             
            
                link |
                
                 Maybe it's because when your nasal passages are congested,
             
            
                link |
                
                 it's uncomfortable to eat or something of that sort.
             
            
                link |
                
                 So the feed a fever part makes sense to me
             
            
                link |
                
                 that the starve a cold part is still mysterious to me.
             
            
                link |
                
                 I couldn't find any logical reason why that would be good.
             
            
                link |
                
                 There are communities out there
             
            
                link |
                
                 that believe that fasting is a viable way
             
            
                link |
                
                 to combat certain types of infection.
             
            
                link |
                
                 Fasting in particular prolonged fast
             
            
                link |
                
                 do increase the amount of adrenaline,
             
            
                link |
                
                 also called epinephrine in the brain and body.
             
            
                link |
                
                 And as we will next explain epinephrine,
             
            
                link |
                
                 adrenaline does have a powerful effect
             
            
                link |
                
                 on the various inflammatory cytokines
             
            
                link |
                
                 and on the immune system in general.
             
            
                link |
                
                 So let's talk about a behavioral protocol
             
            
                link |
                
                 that anyone can use.
             
            
                link |
                
                 It doesn't involve any equipment.
             
            
                link |
                
                 You don't need a sauna.
             
            
                link |
                
                 You don't need anything at all
             
            
                link |
                
                 that has been demonstrated
             
            
                link |
                
                 in excellent peer reviewed research
             
            
                link |
                
                 to enhance the function of the immune system
             
            
                link |
                
                 and actually allow people to combat infection
             
            
                link |
                
                 in very dramatic ways.
             
            
                link |
                
                 Next, I'd like to do an in-depth analysis of a study
             
            
                link |
                
                 that has achieved some prominence out there,
             
            
                link |
                
                 not just in the scientific literature, but on the internet,
             
            
                link |
                
                 because it relates to how particular types of breathing
             
            
                link |
                
                 can impact the immune system
             
            
                link |
                
                 and the ability to combat infection.
             
            
                link |
                
                 The title of this paper is voluntary activation
             
            
                link |
                
                 of the sympathetic nervous system
             
            
                link |
                
                 and attenuation of the innate immune response in humans.
             
            
                link |
                
                 This is a paper that was published in PNAS,
             
            
                link |
                
                 which is the Proceedings of the National Academy
             
            
            
                link |
                
                 It's a very prestigious journal.
             
            
                link |
                
                 For those of you that know PNAS,
             
            
                link |
                
                 you know that there are certain papers published in PNAS
             
            
                link |
                
                 or there used to be that were not peer reviewed.
             
            
            
                link |
                
                 I think all of them have moved to peer reviewed papers.
             
            
                link |
                
                 So this is a peer reviewed, very high quality study.
             
            
                link |
                
                 And I just want to describe the basic contour of the study.
             
            
                link |
                
                 I'll explain the findings,
             
            
                link |
                
                 and then I want to go in depth
             
            
                link |
                
                 and explain the mechanistic basis for these findings
             
            
                link |
                
                 and the protocol that we can all export from these findings.
             
            
            
                link |
                
                 First of all, a couple of terms
             
            
                link |
                
                 so that everybody is on the same page.
             
            
                link |
                
                 The sympathetic nervous system
             
            
                link |
                
                 is one division of our nervous system.
             
            
                link |
                
                 It's a set of neurons down the middle of our spinal cord
             
            
                link |
                
                 and in our brain that generally lead to a heightened state
             
            
                link |
                
                 of arousal and alertness.
             
            
                link |
                
                 It's associated with epinephrine release in the brain
             
            
                link |
                
                 and adrenaline release in the body.
             
            
                link |
                
                 It's the so-called fight or flight system
             
            
                link |
                
                 when it's really active,
             
            
                link |
                
                 but it's the system that's active when we are wide awake.
             
            
                link |
                
                 And we already talked about the innate immune system.
             
            
                link |
                
                 That's that first line of defense
             
            
                link |
                
                 after the skin barrier, of course,
             
            
                link |
                
                 whereby some infection comes into the body
             
            
                link |
                
                 and there's this rapid response of increasing inflammation.
             
            
                link |
                
                 And that's also about the time that you first feel lousy.
             
            
                link |
                
                 So when you start to feel like,
             
            
                link |
                
                 oh, I think I've got something.
             
            
                link |
                
                 I don't feel right.
             
            
                link |
                
                 I have a headache.
             
            
            
            
                link |
                
                 I don't feel good.
             
            
                link |
                
                 That's the innate immune system kicking in.
             
            
                link |
                
                 That's what they did in this study.
             
            
                link |
                
                 And by the way, I should say they,
             
            
                link |
                
                 this is the first author is Cox, K-O-X,
             
            
                link |
                
                 last author, last name Pickers, P-I-C-K-K-E-R-S.
             
            
                link |
                
                 What they did was they exposed human subjects
             
            
            
                link |
                
                 In other words, they injected people with E. coli,
             
            
                link |
                
                 there's a bacteria,
             
            
                link |
                
                 which makes people, all people feel terrible.
             
            
                link |
                
                 See nauseous, fever, vomiting, diarrhea, very unpleasant.
             
            
                link |
                
                 These people voluntarily signed up for this study.
             
            
                link |
                
                 However, some of the subjects in this study
             
            
                link |
                
                 performed a behavioral protocol
             
            
                link |
                
                 that can best be described as cyclic hyperventilation.
             
            
                link |
                
                 My lab works on these types of breathing protocols.
             
            
                link |
                
                 This is not work that my lab did,
             
            
                link |
                
                 but basically subjects hyperventilate,
             
            
                link |
                
                 followed by breath retention, by breath holds.
             
            
                link |
                
                 And I'll explain exactly what they did.
             
            
                link |
                
                 They also looked at other forms of behavioral protocols,
             
            
                link |
                
                 but let's focus on that one.
             
            
                link |
                
                 So they're comparing controls
             
            
                link |
                
                 that do just sort of a basic meditation
             
            
                link |
                
                 versus people that do this intense breathing
             
            
                link |
                
                 followed by some breath holds.
             
            
                link |
                
                 I'm just paraphrasing here.
             
            
                link |
                
                 In the intervention group, the breathing group,
             
            
                link |
                
                 plasma levels of anti-inflammatory cytokine IL-10,
             
            
                link |
                
                 so this is a cytokine that lowers inflammation,
             
            
                link |
                
                 increased after endotoxin administration,
             
            
                link |
                
                 and that was triggered by an increase
             
            
                link |
                
                 in epinephrine and adrenaline.
             
            
                link |
                
                 So in other words, doing a particular pattern of breathing
             
            
                link |
                
                 allowed an anti-inflammatory cytokine to be turned on,
             
            
                link |
                
                 whereas that was not the case in the subjects
             
            
                link |
                
                 that did not do this particular breathing protocol.
             
            
                link |
                
                 And they discovered that levels of pro-inflammatory
             
            
                link |
                
                 TNF alpha, tumor necrosis factor alpha,
             
            
                link |
                
                 IL-6, interleukin-6, and interleukin-8,
             
            
                link |
                
                 which you should all be familiar with now,
             
            
                link |
                
                 as pro-inflammatory cytokines
             
            
                link |
                
                 were lower in the intervention group,
             
            
                link |
                
                 whereas these IL-10 levels
             
            
                link |
                
                 that are anti-inflammatory went up.
             
            
                link |
                
                 Finally, flu-like symptoms were lower
             
            
                link |
                
                 in the intervention group.
             
            
                link |
                
                 So this is an amazing finding, right?
             
            
                link |
                
                 These are human subjects.
             
            
                link |
                
                 One group of subjects is doing this breathing protocol.
             
            
                link |
                
                 The other group of subjects is just meditating.
             
            
                link |
                
                 They both, both sets of subjects
             
            
                link |
                
                 have been injected with E. coli,
             
            
                link |
                
                 so you know everyone's getting the same amount
             
            
                link |
                
                 placed into their system.
             
            
                link |
                
                 This is very, very interesting,
             
            
                link |
                
                 and it leads to the question that every good scientist,
             
            
                link |
                
                 two-year-old, or health information seeker asks,
             
            
            
            
                link |
                
                 How in the world does this work?
             
            
                link |
                
                 Why does this work?
             
            
                link |
                
                 Well, to make a long story short-ish,
             
            
                link |
                
                 because I am going to go into depth here,
             
            
                link |
                
                 the reason it works is because
             
            
                link |
                
                 the sympathetic nervous system,
             
            
                link |
                
                 the so-called stress part of our nervous system,
             
            
                link |
                
                 it's not really called that,
             
            
                link |
                
                 but the part of our nervous system that triggers stress
             
            
                link |
                
                 from mild stress to severe stress, even to panic,
             
            
                link |
                
                 causes the release of adrenaline and epinephrine
             
            
                link |
                
                 in the brain and body.
             
            
                link |
                
                 And under normal circumstances,
             
            
                link |
                
                 when we have some sort of invading infection,
             
            
                link |
                
                 our body is able to push back on that to resist it
             
            
                link |
                
                 by engaging the stress response.
             
            
                link |
                
                 So what's happening here is there's a behavioral protocol
             
            
                link |
                
                 involving the nervous system,
             
            
                link |
                
                 because all behaviors are generated
             
            
                link |
                
                 from the nervous system, of course,
             
            
                link |
                
                 a behavioral protocol that people are deliberately employing
             
            
                link |
                
                 that allows them to activate the sympathetic nervous system,
             
            
                link |
                
                 which in turn allows them to activate the normal pathways
             
            
                link |
                
                 by which immune system function is enhanced, okay?
             
            
                link |
                
                 Now, the reason I'm underscoring this is that
             
            
                link |
                
                 the common interpretation of this study is that
             
            
                link |
                
                 somehow it blocks the normal immune response,
             
            
                link |
                
                 but that's not really what's happening here.
             
            
                link |
                
                 Yes, there's a reduction in inflammatory cytokines
             
            
                link |
                
                 and there's an increase in anti-inflammatory cytokines,
             
            
                link |
                
                 but that's not really the same thing
             
            
                link |
                
                 as blocking the immune response.
             
            
                link |
                
                 This could just as easily be viewed
             
            
                link |
                
                 as enhancing the immune response
             
            
                link |
                
                 and combating the intruder, in this case, E. coli.
             
            
                link |
                
                 So let's parse this study a little bit more closely.
             
            
                link |
                
                 First of all, what is this magical pattern of breathing?
             
            
                link |
                
                 Some of you may recognize this
             
            
                link |
                
                 as so-called Wim Hof breathing.
             
            
                link |
                
                 Wim, of course, the Dutchman.
             
            
                link |
                
                 I think his occupation online
             
            
                link |
                
                 used to be listed as Daredevil, believe it or not.
             
            
                link |
                
                 On Wikipedia, that's a pretty cool occupation.
             
            
                link |
                
                 Wim is best known for his activities with cold exposure.
             
            
                link |
                
                 He holds multiple world records for that,
             
            
                link |
                
                 swimming under icebergs and other incredible feats
             
            
                link |
                
                 that you definitely don't want to try
             
            
                link |
                
                 unless you're extremely skilled
             
            
                link |
                
                 and really know what you're doing as he does,
             
            
                link |
                
                 but also for the use of breath work.
             
            
                link |
                
                 The breathing that is so-called Wim Hof breathing
             
            
                link |
                
                 is very similar, not exactly the same,
             
            
                link |
                
                 but very similar to Tummo breathing
             
            
                link |
                
                 as it's been described historically.
             
            
                link |
                
                 In the science and physiology community
             
            
                link |
                
                 and in my laboratory, because I run a university laboratory,
             
            
                link |
                
                 we refer to it as cyclic hyperventilation,
             
            
                link |
                
                 which just means repeated deep breaths in and out,
             
            
                link |
                
                 and then there are these retention.
             
            
                link |
                
                 So because I'm here in the hot seat anyway,
             
            
                link |
                
                 I might as well demonstrate it for you
             
            
                link |
                
                 so you know what this looks like.
             
            
                link |
                
                 There are variations on this.
             
            
                link |
                
                 So with respect to Wim, with respect to Tummo practitioners,
             
            
                link |
                
                 with respect to the cyclic hyperventilators everywhere,
             
            
                link |
                
                 this is one general theme of it.
             
            
                link |
                
                 It involves 20 to 30 deep inhales
             
            
                link |
                
                 and then exhales through the mouth,
             
            
                link |
                
                 followed by a exhale of all one's air and a breath hold.
             
            
                link |
                
                 That's the retention.
             
            
                link |
                
                 And then at some point, 15 to 60 seconds later,
             
            
                link |
                
                 repeating the 25 or 30 breaths,
             
            
                link |
                
                 and then again, a breath hold with lungs empty.
             
            
                link |
                
                 There are variations on this, but in our laboratory
             
            
                link |
                
                 and in this particular study,
             
            
                link |
                
                 it looks something like this, okay?
             
            
                link |
                
                 I'm not going to do the whole thing right now,
             
            
                link |
                
                 but it goes something like this.
             
            
                link |
                
                 Ah, ah, ah, ah, ah, ah, ah, ah, ah.
             
            
                link |
                
                 Okay, so let's assume I did that for 30 breaths.
             
            
                link |
                
                 I can already feel myself perspiring a little bit.
             
            
                link |
                
                 You're heating up, that's the release of adrenaline.
             
            
                link |
                
                 It's caused by that breathing pattern
             
            
                link |
                
                 and then exhaling all of one's air,
             
            
                link |
                
                 no speaking in between like I'm doing.
             
            
            
                link |
                
                 And then sitting, lungs empty
             
            
                link |
                
                 until one feels the impulse to breathe
             
            
                link |
                
                 and then repeating for several rounds,
             
            
                link |
                
                 two or three or even four rounds.
             
            
                link |
                
                 Now, some people will also introduce
             
            
                link |
                
                 a big inhale and breath hold at the end
             
            
                link |
                
                 and find that indeed they can hold their breath
             
            
                link |
                
                 much longer than they normally would be able to
             
            
                link |
                
                 because the trigger to breathe is normally activated
             
            
                link |
                
                 by increases in carbon dioxide in our blood.
             
            
                link |
                
                 We have neurons in our brainstem
             
            
                link |
                
                 and in our various regions of our brain actually
             
            
                link |
                
                 that respond to when carbon dioxide is too high
             
            
                link |
                
                 and trigger the reflex to breathe.
             
            
                link |
                
                 But when we exhale deeply,
             
            
                link |
                
                 we blow off a lot of carbon dioxide
             
            
                link |
                
                 so we don't feel that impulse to breathe come quite as soon.
             
            
                link |
                
                 Basically, this study looked at people doing
             
            
                link |
                
                 these cyclic hyperventilation with retention,
             
            
                link |
                
                 25 or 30 breaths, then the retention,
             
            
                link |
                
                 25 or 30 breaths, then retention, 25 or 30 breaths,
             
            
                link |
                
                 then the retention.
             
            
                link |
                
                 So three rounds of 25 to 30 breaths followed by exhale,
             
            
                link |
                
                 hold in between of various duration,
             
            
                link |
                
                 but in general, 15 to 60 seconds is typical.
             
            
                link |
                
                 What happened physiologically?
             
            
                link |
                
                 This is one of the reasons I like this study.
             
            
                link |
                
                 What happened physiologically?
             
            
                link |
                
                 Well, a couple of things.
             
            
                link |
                
                 Of course, blood oxygenation drops.
             
            
                link |
                
                 You would expect that based on hyperventilation
             
            
                link |
                
                 and especially based on the exhale
             
            
                link |
                
                 of so much carbon dioxide.
             
            
                link |
                
                 We could explain why that is,
             
            
                link |
                
                 but blood levels of oxygen drop.
             
            
                link |
                
                 The pH, the alkalinity of the body goes way up.
             
            
                link |
                
                 This is very interesting.
             
            
                link |
                
                 If you look up this paper,
             
            
                link |
                
                 you can look at figure one, panel C.
             
            
                link |
                
                 The pH goes way up.
             
            
                link |
                
                 People become alkaline.
             
            
                link |
                
                 You've heard before of alkaline water.
             
            
                link |
                
                 I hate to say this.
             
            
                link |
                
                 I probably lose some friends for this,
             
            
                link |
                
                 but yeah, don't waste your money
             
            
                link |
                
                 on drinking alkaline water.
             
            
                link |
                
                 You can't really shift the alkalinity of your body.
             
            
                link |
                
                 There are cases where some compartment in your body
             
            
                link |
                
                 needs to be more alkaline than the rest.
             
            
                link |
                
                 Your gut is a different alkalinity
             
            
                link |
                
                 than other areas of your body, et cetera,
             
            
                link |
                
                 but ingesting high alkaline water
             
            
                link |
                
                 isn't going to shift your overall alkalinity.
             
            
                link |
                
                 If someone can send me a quality reference
             
            
                link |
                
                 that shows different,
             
            
                link |
                
                 then I'm happy to revise that statement,
             
            
            
                link |
                
                 doing that pattern of breathing that I just described
             
            
                link |
                
                 greatly increases the pH.
             
            
                link |
                
                 Greatly, I should say,
             
            
                link |
                
                 it doesn't send it off into dangerous levels.
             
            
                link |
                
                 It takes it from 7.4 to 7.6,
             
            
                link |
                
                 which is a significant increase in alkalinity.
             
            
            
                link |
                
                 for those of you who remember high school
             
            
                link |
                
                 or college chemistry,
             
            
                link |
                
                 as the numbers on the pH go down,
             
            
                link |
                
                 you're becoming more acidic.
             
            
                link |
                
                 As they go up, you're becoming more alkaline, okay?
             
            
            
                link |
                
                 So the subjects went from 7.4 to 7.6 during the breathing,
             
            
                link |
                
                 and then afterwards it returned to normal.
             
            
                link |
                
                 But that shift in alkalinity
             
            
                link |
                
                 is thought to be important here.
             
            
                link |
                
                 So what's going on here?
             
            
                link |
                
                 How is the breathing leading to these shifts in,
             
            
                link |
                
                 or I should say reduction in inflammatory cytokines
             
            
                link |
                
                 and an increase in the liberation
             
            
                link |
                
                 of these anti-inflammatory cytokines?
             
            
                link |
                
                 Well, the authors make some good arguments
             
            
                link |
                
                 as to why it's not the shift in pH per se,
             
            
                link |
                
                 or the shift in carbon dioxide levels in the blood,
             
            
                link |
                
                 but rather it's the release of epinephrine.
             
            
                link |
                
                 And there's some good reason to believe why that's the case.
             
            
                link |
                
                 It's beyond the scope of this discussion,
             
            
                link |
                
                 but that it's actually the release of epinephrine,
             
            
            
                link |
                
                 that's causing this reduction in inflammation.
             
            
                link |
                
                 And that's actually supported
             
            
                link |
                
                 by something that you've probably experienced before,
             
            
                link |
                
                 which is if you've ever worked, worked, worked,
             
            
                link |
                
                 worked really hard,
             
            
                link |
                
                 or you've been a caretaker for somebody else
             
            
                link |
                
                 or studying for exams,
             
            
                link |
                
                 and people around you are getting sick
             
            
                link |
                
                 and you're just powering through it
             
            
                link |
                
                 and you're not getting sick,
             
            
                link |
                
                 but then you stop, you turn in your final exam,
             
            
                link |
                
                 you stop taking care of somebody else,
             
            
                link |
                
                 or you finally stop and rest,
             
            
                link |
                
                 or you go on vacation and then you get sick.
             
            
                link |
                
                 Well, you've just experienced the effect
             
            
                link |
                
                 that adrenaline, epinephrine can have
             
            
                link |
                
                 in activating your immune system
             
            
                link |
                
                 by way of the nervous system
             
            
                link |
                
                 in order to keep fighting and combating infection.
             
            
                link |
                
                 And that brings us to a larger theme,
             
            
                link |
                
                 which is that stress and combating infection or a wound
             
            
                link |
                
                 is not one unique system.
             
            
                link |
                
                 It's the same stress system
             
            
                link |
                
                 that you use to combat psychological stress.
             
            
                link |
                
                 So when you're very, very stressed,
             
            
                link |
                
                 at least in the short term,
             
            
                link |
                
                 because you release so much adrenaline and epinephrine,
             
            
                link |
                
                 you're actually better able to combat infections
             
            
                link |
                
                 and you reduce inflammation
             
            
                link |
                
                 and the whole feeling lousy response, right?
             
            
                link |
                
                 Remember, reduced flu-like symptoms here.
             
            
                link |
                
                 So this pattern of breathing is actually a very useful tool.
             
            
                link |
                
                 And I confess, I use this pattern of breathing
             
            
                link |
                
                 anytime I am at the initial stages
             
            
                link |
                
                 of getting some sort of bug.
             
            
                link |
                
                 If I feel like I've been running myself ragged,
             
            
                link |
                
                 or if I somehow, for whatever reason,
             
            
                link |
                
                 have a tickle in my throat,
             
            
                link |
                
                 or I have that kind of sensation in my nose,
             
            
                link |
                
                 like I might've caught a bug of some sort,
             
            
                link |
                
                 I will do this pattern of breathing.
             
            
                link |
                
                 I've been doing it consistently, gosh,
             
            
                link |
                
                 for the last four years or more.
             
            
                link |
                
                 You know, now this is just anecdotal reports,
             
            
                link |
                
                 but I find that it allows me indeed
             
            
                link |
                
                 to either have those early symptoms disappear,
             
            
                link |
                
                 or it allows me to just kind of push through
             
            
                link |
                
                 and harder longer.
             
            
                link |
                
                 I don't suggest people continue to push through
             
            
                link |
                
                 exposure to infections.
             
            
                link |
                
                 Obviously you don't want to infect other people,
             
            
                link |
                
                 nor do you want to crash
             
            
                link |
                
                 and suddenly get a massive illness of some sort
             
            
                link |
                
                 because you stopped doing this breathing.
             
            
                link |
                
                 But I do think it's a useful tool.
             
            
                link |
                
                 It's a purely behavioral intervention
             
            
                link |
                
                 that has been shown here,
             
            
                link |
                
                 and now there are additional studies on the way
             
            
                link |
                
                 to enhance the function of your immune system
             
            
                link |
                
                 and to reduce inflammation.
             
            
                link |
                
                 And this is to me,
             
            
                link |
                
                 one of the most concrete examples of a zero cost tool
             
            
                link |
                
                 that bridges the activation of the nervous system
             
            
                link |
                
                 through breathing with the immune system
             
            
                link |
                
                 by way of releasing adrenaline
             
            
                link |
                
                 and thereby reducing the terrible effects
             
            
                link |
                
                 or feelings of lousiness from a,
             
            
                link |
                
                 in this case, an E. coli infection.
             
            
                link |
                
                 Now I'd like to focus on a couple of important points
             
            
                link |
                
                 that I haven't heard discussed broadly elsewhere,
             
            
                link |
                
                 which is that the hyperventilation
             
            
                link |
                
                 and the breath retention are both important.
             
            
                link |
                
                 So you can't simply hyperventilate
             
            
                link |
                
                 to get this effect at the level of epinephrine release
             
            
                link |
                
                 and reduction in inflammatory cytokines.
             
            
                link |
                
                 It's been shown before that the hyperventilation phase
             
            
            
                link |
                
                 which is a kind of low oxygen saturation
             
            
                link |
                
                 due to the breath retention,
             
            
                link |
                
                 they both combine to increase epinephrine adrenaline levels.
             
            
                link |
                
                 So you have to do the 25 or 30 breaths
             
            
                link |
                
                 and then the retention, 25 or 30 breaths,
             
            
                link |
                
                 then the retention,
             
            
                link |
                
                 meaning that the exhale with the breath hold
             
            
                link |
                
                 in order to get the full effect.
             
            
                link |
                
                 I also want to provide a critical cautionary note.
             
            
                link |
                
                 Don't do this anywhere near water or while driving a car.
             
            
                link |
                
                 These things might seem kind of obvious,
             
            
                link |
                
                 but obviously in the off chance that you black out
             
            
                link |
                
                 or something like that, it could be disastrous.
             
            
                link |
                
                 So please be careful.
             
            
                link |
                
                 And again, don't try and push the breath hold.
             
            
                link |
                
                 The moment you feel the impulse to breathe, just breathe.
             
            
                link |
                
                 And it did seem that the three rounds
             
            
                link |
                
                 of 25 to 30 breaths with interventions,
             
            
                link |
                
                 excuse me, with breath hold retentions in between
             
            
                link |
                
                 was the ideal protocol.
             
            
                link |
                
                 There's one last very interesting feature of this study
             
            
                link |
                
                 that I want to emphasize.
             
            
                link |
                
                 And that was that they actually measured
             
            
                link |
                
                 the so-called catecholamine concentrations.
             
            
                link |
                
                 Catecholamines are things like dopamine,
             
            
                link |
                
                 epinephrine, norepinephrine.
             
            
                link |
                
                 These are chemicals in your nervous system
             
            
                link |
                
                 and body that promotes states of alertness.
             
            
                link |
                
                 Dopamine, of course,
             
            
                link |
                
                 part of the reward and motivation pathways.
             
            
                link |
                
                 They explored the levels of these molecules in blood,
             
            
                link |
                
                 in plasma, during and after this breathing protocol.
             
            
                link |
                
                 And as interesting, as I mentioned,
             
            
                link |
                
                 before epinephrine showed robust increases
             
            
                link |
                
                 compared to the control group,
             
            
                link |
                
                 norepinephrine, significant increases occurred
             
            
                link |
                
                 in the breathing group,
             
            
                link |
                
                 but in the cyclic hyperventilation,
             
            
                link |
                
                 retention breathing group, of course, but less so.
             
            
                link |
                
                 And dopamine levels actually dropped somewhat.
             
            
                link |
                
                 But this is very interesting
             
            
                link |
                
                 because there's a new and emerging literature
             
            
                link |
                
                 largely from ISA, A-Y-S-A, Rolz Lab in Israel.
             
            
                link |
                
                 What her laboratory has shown is that
             
            
                link |
                
                 motivational state and mindset has a powerful impact
             
            
                link |
                
                 on various aspects of the immune system
             
            
                link |
                
                 that were thought to be independent
             
            
                link |
                
                 of the brain and mind and thinking.
             
            
                link |
                
                 So this brings us back to something that we discussed
             
            
                link |
                
                 at the very beginning of this episode,
             
            
                link |
                
                 which is that 20, 30 years ago,
             
            
                link |
                
                 the idea that you could heal the body with the mind
             
            
                link |
                
                 was considered kind of quackery.
             
            
                link |
                
                 I think that there was an intervening period up until now
             
            
                link |
                
                 where people might've said,
             
            
                link |
                
                 sure, if you're stressed out, it's going to make things worse
             
            
                link |
                
                 I mean, I think everyone agrees
             
            
                link |
                
                 that stress makes everything worse at some level,
             
            
                link |
                
                 outcomes to neurodegeneration,
             
            
                link |
                
                 performance in physical endeavors and mental endeavors.
             
            
                link |
                
                 If stress is too high for too long,
             
            
                link |
                
                 people experience different challenges
             
            
                link |
                
                 and essentially every major psychiatric disorder,
             
            
                link |
                
                 everything suffers.
             
            
                link |
                
                 But in the short term, stress can actually be beneficial
             
            
                link |
                
                 in the ways that we just described.
             
            
                link |
                
                 And stress, if we break it down
             
            
                link |
                
                 is really a neurochemical state, right?
             
            
                link |
                
                 It's the release of these catecholamines.
             
            
                link |
                
                 And what ISA, Rolz's laboratory has shown
             
            
                link |
                
                 is that when the so-called dopamine system,
             
            
                link |
                
                 and at several episodes I described
             
            
                link |
                
                 there are multiple dopamine systems,
             
            
                link |
                
                 but the so-called mesolimbic reward pathway
             
            
                link |
                
                 involving areas like the nucleus accumbens, et cetera.
             
            
                link |
                
                 When the reward system that's associated with dopamine
             
            
                link |
                
                 and norepinephrine is activated,
             
            
                link |
                
                 you see incredible effects, including for instance,
             
            
                link |
                
                 highly significant reduction in tumor size in cancers.
             
            
                link |
                
                 Now, why would that be?
             
            
                link |
                
                 How is it that mindset dopamine and tumors growth
             
            
                link |
                
                 are somehow linked?
             
            
                link |
                
                 We now know how this occurs,
             
            
                link |
                
                 largely through the incredible work of ISA, Rolz and others.
             
            
                link |
                
                 So now I'd like to turn our focus to how it is specifically
             
            
                link |
                
                 that certain mindsets impact the immune system
             
            
                link |
                
                 in ways that we can actually point
             
            
                link |
                
                 to specific biological pathways
             
            
                link |
                
                 and also specific protocols related to mindset.
             
            
                link |
                
                 I guess a simple way to frame all this would be to say
             
            
                link |
                
                 that most of us are aware that yes, indeed,
             
            
                link |
                
                 you can worry yourself sick.
             
            
                link |
                
                 We've been told that.
             
            
                link |
                
                 You're going to worry yourself sick.
             
            
                link |
                
                 And actually there was a paper published in Science,
             
            
                link |
                
                 again, one of the top three journals out there,
             
            
                link |
                
                 the top three really being Nature, Science and Cell.
             
            
                link |
                
                 And then other, of course, excellent journals exist,
             
            
                link |
                
                 but this was a paper that came out in Science last year.
             
            
                link |
                
                 First author is Kataoka, K-A-T-A-O-K-A,
             
            
                link |
                
                 describing psychogenic stress and fever.
             
            
                link |
                
                 So this was looking or asking the question,
             
            
                link |
                
                 are there areas of the brain that actually underlie
             
            
                link |
                
                 this notion that we can worry ourselves sick?
             
            
                link |
                
                 And they discovered a new pathway
             
            
                link |
                
                 and they were able to both activate this pathway
             
            
                link |
                
                 independent of worry and stress and see illness occur.
             
            
                link |
                
                 And they were able to inhibit this pathway,
             
            
                link |
                
                 block activity in this neural pathway
             
            
                link |
                
                 and prevent psychogenic fever
             
            
                link |
                
                 and the worrying of oneself sick.
             
            
                link |
                
                 So they were able to do this in a very controlled way.
             
            
                link |
                
                 I'll just mention the pathway in case
             
            
                link |
                
                 you want to look it up in more detail.
             
            
                link |
                
                 This is a corticolimbic pathway.
             
            
                link |
                
                 So for just to orient us,
             
            
                link |
                
                 the cortex is more or less the outer shell of the brain.
             
            
                link |
                
                 It's involved in thinking and sensation
             
            
                link |
                
                 and perceptions and learning
             
            
                link |
                
                 and maintenance of a lot of memories are stored there.
             
            
                link |
                
                 We all hear that you learn and remember in the hippocampus,
             
            
                link |
                
                 that's the initial side of learning and memory.
             
            
                link |
                
                 But then that information, believe it or not,
             
            
                link |
                
                 is passed off to the cortex
             
            
                link |
                
                 where it's stored in kind of a long, long-term
             
            
                link |
                
                 hard drive type storage.
             
            
                link |
                
                 So the corticolimbic pathway is one in which your thoughts,
             
            
                link |
                
                 your prior experiences can literally in a structural way,
             
            
                link |
                
                 feed down onto the areas of the brain
             
            
                link |
                
                 that control very basal processes,
             
            
                link |
                
                 including temperature regulation.
             
            
                link |
                
                 So this is a corticolimbic hypothalamic pathway.
             
            
                link |
                
                 We talked earlier about the hypothalamus
             
            
                link |
                
                 is controlling temperature
             
            
                link |
                
                 and a lot of sickness-related behavior, right?
             
            
                link |
                
                 Remember vagus up to the hypothalamus
             
            
                link |
                
                 and all the sleep more, less appetite, fever, okay?
             
            
                link |
                
                 That's all in the hypothalamus.
             
            
                link |
                
                 This is a top-down corticolimbic hypothalamic pathway,
             
            
                link |
                
                 and it has a fancy name.
             
            
                link |
                
                 It's the dorsopeduncular cortex, dorsotonia tecta.
             
            
                link |
                
                 The short of that is the DPDTT.
             
            
                link |
                
                 So let's just call it the DPDTT
             
            
                link |
                
                 to the dorsomedial hypothalamus.
             
            
            
                link |
                
                 It shouldn't mean anything.
             
            
                link |
                
                 Doesn't really matter what we call it,
             
            
                link |
                
                 but what's important is conceptually,
             
            
                link |
                
                 it's a pathway that originates in sites of the brain
             
            
                link |
                
                 that are associated with thinking,
             
            
                link |
                
                 with emotion and with prior history,
             
            
                link |
                
                 and feeds directly into an area of the brain
             
            
                link |
                
                 that's involved in basic physiological,
             
            
                link |
                
                 subconsciously controlled processes.
             
            
                link |
                
                 So that's incredible, right?
             
            
                link |
                
                 And it points to a physical pathway
             
            
                link |
                
                 by which the way we think about something
             
            
                link |
                
                 changes something core about our physiology.
             
            
                link |
                
                 Now, in some ways that shouldn't be surprising, right?
             
            
                link |
                
                 If you think about something that excites you,
             
            
                link |
                
                 your heart rate can increase.
             
            
                link |
                
                 You think about something that terrifies you,
             
            
                link |
                
                 your heart rate can increase.
             
            
                link |
                
                 So the idea that thinking controls our physiology
             
            
                link |
                
                 is not a new concept at all,
             
            
                link |
                
                 but somehow human beings,
             
            
                link |
                
                 we have been challenged with the idea
             
            
                link |
                
                 that we could actually think ourselves into being sick.
             
            
                link |
                
                 But this paper from Kataoka shows that
             
            
                link |
                
                 if you expose somebody to a psychological stress,
             
            
                link |
                
                 you can actually activate this pathway and create a fever.
             
            
                link |
                
                 And how did they do that?
             
            
                link |
                
                 Well, you can do this by exposing subjects
             
            
                link |
                
                 to a very stressful real event,
             
            
                link |
                
                 and you cue it through associative learning.
             
            
                link |
                
                 So maybe like my pilot V5s, which I love so much,
             
            
                link |
                
                 we could traumatize me to the pilot V5.
             
            
                link |
                
                 If I had some horrible experience happen to me
             
            
                link |
                
                 while I'm looking at and concentrating on the pilot V5,
             
            
                link |
                
                 then you take away the horrible experience,
             
            
                link |
                
                 you give me the pilot V5,
             
            
                link |
                
                 and I start to experience a lot of the symptoms
             
            
                link |
                
                 associated with that terrible event.
             
            
                link |
                
                 They were able to do this
             
            
                link |
                
                 using sickness-inducing stimuli and so forth.
             
            
                link |
                
                 They did all the various derivations
             
            
                link |
                
                 and identified this pathway that when activated,
             
            
                link |
                
                 even in the absence of some horrible event,
             
            
                link |
                
                 could create fever and illness-like behavior and so forth.
             
            
                link |
                
                 And if they blocked certain stations
             
            
                link |
                
                 along this neural pathway, they could block that effect.
             
            
                link |
                
                 So this is really concrete evidence, proof, if you will,
             
            
                link |
                
                 that there are dedicated pathways in the mammalian brain,
             
            
                link |
                
                 your brain and mine,
             
            
                link |
                
                 that allow us to turn thoughts into illness.
             
            
                link |
                
                 That's kind of a depressing idea.
             
            
                link |
                
                 What about the inverse?
             
            
                link |
                
                 What about turning thoughts into health?
             
            
                link |
                
                 Well, that's the work of ISA roles.
             
            
                link |
                
                 They explored the well-established psychological phenomenon
             
            
                link |
                
                 that when cancer patients or very ill people
             
            
                link |
                
                 or people who are suffering from very debilitating injuries,
             
            
                link |
                
                 when they had or when people had or reported a sense of hope,
             
            
                link |
                
                 their rates of recovery were much higher, right?
             
            
                link |
                
                 Sounds very subjective.
             
            
                link |
                
                 But what is a sense of hope?
             
            
                link |
                
                 A sense of hope is a sense of the future.
             
            
                link |
                
                 A sense of the future is tightly associated
             
            
                link |
                
                 with the dopamine system.
             
            
                link |
                
                 Dopamine, again, being this molecule of reward
             
            
                link |
                
                 and motivation and movement,
             
            
                link |
                
                 but movement and motivation are about things
             
            
                link |
                
                 that are beyond the confines of our skin
             
            
                link |
                
                 and are about the future.
             
            
                link |
                
                 And so what they've discovered and through other studies
             
            
                link |
                
                 from other groups have discovered is that stimulation
             
            
                link |
                
                 of the dopamine pathway,
             
            
                link |
                
                 either simply by thinking about a future,
             
            
                link |
                
                 ideally a positive future,
             
            
                link |
                
                 but thinking about a positive future leads to activation
             
            
                link |
                
                 of this so-called mesolimbic reward pathway
             
            
                link |
                
                 and could reduce the size of tumors,
             
            
                link |
                
                 could accelerate wound healing,
             
            
                link |
                
                 could greatly accelerate the passage from a state of illness
             
            
                link |
                
                 to a state of health and wellbeing.
             
            
                link |
                
                 So there are many, many studies now starting to wick out
             
            
            
                link |
                
                 There's also the idea that augmenting the dopamine system
             
            
                link |
                
                 can increase the rate of healing.
             
            
                link |
                
                 And so there are individuals out there who opt,
             
            
                link |
                
                 for instance, to take things that increase dopamine.
             
            
                link |
                
                 Now, obviously drugs of abuse would not be a good idea
             
            
                link |
                
                 in this context, even though they increase dopamine,
             
            
                link |
                
                 they lead to big crashes,
             
            
                link |
                
                 they have addictive properties, et cetera.
             
            
                link |
                
                 I've talked before on this podcast about things
             
            
                link |
                
                 like L-tyrosine, take it anywhere from 500
             
            
                link |
                
                 to 750 milligrams can increase dopamine
             
            
                link |
                
                 because tyrosine is a dopamine precursor, of course,
             
            
                link |
                
                 things like micuna purines, which are L-DOPA,
             
            
                link |
                
                 the immediate precursor to dopamine.
             
            
                link |
                
                 Some of these will lead to somewhat of a crash
             
            
                link |
                
                 in certain individuals,
             
            
                link |
                
                 other people tolerate them a little bit better.
             
            
                link |
                
                 Again, you have to talk to your doctor,
             
            
                link |
                
                 you have to figure out what's right for you.
             
            
                link |
                
                 If you have bipolar or mania or schizophrenia,
             
            
                link |
                
                 these things are, I would not recommend them at all.
             
            
                link |
                
                 I'm not recommending them all,
             
            
                link |
                
                 I'm just mentioning them for potential exploration
             
            
                link |
                
                 if it's safe and right for you.
             
            
                link |
                
                 But the point is this, the dopamine system when activated
             
            
                link |
                
                 can accelerate healing.
             
            
                link |
                
                 It can accelerate the recovery from injury of all kinds.
             
            
                link |
                
                 And that shouldn't come as a mystery or surprise result
             
            
                link |
                
                 to us, it's because this reward pathway
             
            
                link |
                
                 and the fact that it's related to a sense of the future
             
            
                link |
                
                 seems to liberate entire systems within the body
             
            
                link |
                
                 that make inflammatory cytokines go down
             
            
                link |
                
                 and anti-inflammatory cytokines go up
             
            
                link |
                
                 exactly as was demonstrated in the beautiful PNAS study
             
            
                link |
                
                 where breathing, cyclic hyperventilation
             
            
                link |
                
                 was used to increase epinephrine, increase norepinephrine,
             
            
                link |
                
                 and to augment the catecholamine system.
             
            
                link |
                
                 So I think that the bridges between these studies
             
            
                link |
                
                 are really relevant.
             
            
                link |
                
                 In one case, I'm talking about
             
            
                link |
                
                 potentially taking an over-the-counter compound
             
            
                link |
                
                 to increase dopamine to accelerate healing.
             
            
                link |
                
                 In another case, we're talking about using breathing.
             
            
                link |
                
                 There's also the use of cold water exposure
             
            
                link |
                
                 to increase dopamine.
             
            
                link |
                
                 I talked about this several episodes ago,
             
            
                link |
                
                 but it's been shown that cold water,
             
            
                link |
                
                 immersing oneself in cold water up to the neck or so,
             
            
                link |
                
                 how cold, well, it depends on what you can tolerate,
             
            
                link |
                
                 but uncomfortably cold,
             
            
                link |
                
                 but not so cold that you become hypothermic,
             
            
                link |
                
                 but where it's challenging to get in,
             
            
                link |
                
                 but you can stay there for three to 10 minutes or so
             
            
                link |
                
                 has been shown to lead to very significant
             
            
                link |
                
                 doubling or more of baseline dopamine levels
             
            
                link |
                
                 and epinephrine levels that go on for several hours.
             
            
                link |
                
                 This may be the basis for why people will do cold showers
             
            
                link |
                
                 or ice baths and then get into a sauna.
             
            
                link |
                
                 So what's called contrast, cold heat contrast therapy
             
            
                link |
                
                 as a way to augment these neurotransmitters.
             
            
                link |
                
                 Today, we've been talking about how these neurotransmitters
             
            
                link |
                
                 can be used to enhance the function of the immune system.
             
            
                link |
                
                 And so just keep in mind that anytime you're talking about
             
            
                link |
                
                 increasing neurotransmitter levels,
             
            
                link |
                
                 that can be done pharmacologically through supplementation,
             
            
                link |
                
                 or it can be done behaviorally through exposure
             
            
                link |
                
                 to cold water, for instance,
             
            
                link |
                
                 or it can be done even just simply by breathing
             
            
                link |
                
                 in a particular way, cyclic hyperventilation
             
            
                link |
                
                 followed by retention.
             
            
                link |
                
                 The catecholamines, noradrenaline, dopamine,
             
            
                link |
                
                 and norepinephrine are the bridge of activation
             
            
                link |
                
                 for the immune system and the nervous system.
             
            
                link |
                
                 They are the way that the nervous system calls out
             
            
                link |
                
                 to the immune system, aha, we have a problem,
             
            
                link |
                
                 we need to counter this.
             
            
                link |
                
                 So you can think of them,
             
            
                link |
                
                 them meaning dopamine, epinephrine, and norepinephrine
             
            
                link |
                
                 as being able to deploy larger amounts of immune cells,
             
            
                link |
                
                 all the types of immune cells that we talked about
             
            
                link |
                
                 at the beginning of the episode.
             
            
                link |
                
                 Okay, so thus far, we've been discussing
             
            
                link |
                
                 how one can prevent getting sick
             
            
                link |
                
                 or when one starts to feel ill,
             
            
                link |
                
                 how one might be able to shorten the course
             
            
                link |
                
                 of that infection by ramping up the activity
             
            
                link |
                
                 of the immune system.
             
            
                link |
                
                 But what about when you're already experiencing symptoms,
             
            
                link |
                
                 the runny nose, stuffed up nose, congestion,
             
            
                link |
                
                 headache, et cetera?
             
            
                link |
                
                 Well, there are many ways to address that
             
            
                link |
                
                 at the symptom level.
             
            
                link |
                
                 You're probably aware of all the over-the-counter
             
            
                link |
                
                 medications, many of which focus on the epinephrine system.
             
            
                link |
                
                 Things that are of the Sudafed variety prevent
             
            
                link |
                
                 or reduce congestion because of the way
             
            
                link |
                
                 that they cause release of epinephrine
             
            
                link |
                
                 and some of the effects on dilating the bronchioles
             
            
                link |
                
                 and dilating the nasal passages and so forth.
             
            
                link |
                
                 I'm not going to speak to whether or not
             
            
                link |
                
                 those are good or bad choices.
             
            
                link |
                
                 They do have a couple of effects that are not so great
             
            
                link |
                
                 for the course of treating the underlying cause,
             
            
                link |
                
                 which are, first of all, they can cause dehydration.
             
            
                link |
                
                 So you have to make sure that you're hydrating well,
             
            
                link |
                
                 both fluids and electrolytes.
             
            
                link |
                
                 And they also can interfere with sleep
             
            
                link |
                
                 because as I've talked about in the episodes on sleep,
             
            
                link |
                
                 one of the hallmarks of deep sleep and in particular,
             
            
                link |
                
                 REM sleep is that epinephrine adrenaline levels are low.
             
            
                link |
                
                 This is what allows you to have intense,
             
            
                link |
                
                 often very emotionally laden dreams during REM sleep
             
            
                link |
                
                 and not act those out.
             
            
                link |
                
                 And low adrenaline epinephrine during REM sleep
             
            
                link |
                
                 is basically a signature, a neurochemical signature
             
            
                link |
                
                 of the REM sleep state, which is so vital
             
            
                link |
                
                 for emotional and physical repair and so forth.
             
            
                link |
                
                 So the fact that they can inhibit sleep,
             
            
                link |
                
                 the fact that they can cause dehydration,
             
            
                link |
                
                 the fact that they can make people
             
            
                link |
                
                 feel kind of lightheaded and jittery
             
            
                link |
                
                 makes them not terrific choices for a number of people.
             
            
                link |
                
                 There is an interesting alternative choice.
             
            
                link |
                
                 And when I say alternative, I do mean alternative.
             
            
                link |
                
                 The choice I'm referring to is spirulina,
             
            
                link |
                
                 which is actually a form of algae.
             
            
                link |
                
                 Years ago, I think when I first heard about spirulina,
             
            
                link |
                
                 it sounded very much of the kind of 1970s, 80s,
             
            
                link |
                
                 health food store variety.
             
            
                link |
                
                 It seemed really kind of mystical and wacky,
             
            
                link |
                
                 but actually now there are some really nice studies
             
            
                link |
                
                 and some data and also an understanding of the mechanism
             
            
                link |
                
                 by which spirulina can have potent effects
             
            
                link |
                
                 in reducing what's called rhinitis,
             
            
                link |
                
                 which is a fancy word for congestion of the nose
             
            
                link |
                
                 and inflammation of the nose.
             
            
                link |
                
                 Basically, anytime you hear a word that includes itis,
             
            
                link |
                
                 at least if it's in the medical or health context,
             
            
                link |
                
                 it generally means inflammation of some tissue.
             
            
                link |
                
                 So rhinitis just being inflammation of the nasal passages,
             
            
                link |
                
                 but that's one of the most uncomfortable symptoms
             
            
                link |
                
                 of any kind of infection.
             
            
                link |
                
                 So there are two studies I'd like to highlight
             
            
                link |
                
                 just very quickly.
             
            
                link |
                
                 One is the effects of spirulina on allergic rhinitis,
             
            
                link |
                
                 and the other is a clinical comparison
             
            
                link |
                
                 to the efficacy of spirulina platensis,
             
            
                link |
                
                 that's a technical name,
             
            
                link |
                
                 and cetirizine for the treatment of allergic rhinitis.
             
            
                link |
                
                 These looked at humans, so this is not a mouse study,
             
            
                link |
                
                 this is a study on humans.
             
            
                link |
                
                 Both sexes, so males and females,
             
            
                link |
                
                 in one case looking at 100 plus subjects, 129 subjects,
             
            
                link |
                
                 the other 65 subjects, so a decent number of subjects,
             
            
                link |
                
                 randomized trial, double-blind,
             
            
                link |
                
                 both cases saw significant decreases in nasal obstruction,
             
            
                link |
                
                 improved ability to smell, improved sleep,
             
            
                link |
                
                 daily working, cytokine,
             
            
                link |
                
                 inflammatory cytokines were reduced as well,
             
            
                link |
                
                 reduction in nasal itching,
             
            
                link |
                
                 all the stuff that you'd like to experience, I can imagine,
             
            
                link |
                
                 after taking two grams, two grams, not milligrams,
             
            
                link |
                
                 but two grams of spirulina,
             
            
                link |
                
                 sometimes had to be taken for a short while
             
            
                link |
                
                 before the effect kicked in.
             
            
                link |
                
                 So that's pretty impressive, I would say,
             
            
                link |
                
                 but it doesn't really speak to mechanism,
             
            
                link |
                
                 but in exploring the underlying mechanisms
             
            
                link |
                
                 for spirulina's effects on reducing rhinitis,
             
            
                link |
                
                 it's interesting to find that spirulina
             
            
                link |
                
                 actually can inhibit the formation and or activity
             
            
                link |
                
                 of so-called histaminergic mast cells, M-A-S-T, mast cells.
             
            
                link |
                
                 We haven't talked a lot about mast cells,
             
            
                link |
                
                 but they are a very interesting cell type
             
            
                link |
                
                 in the immune response,
             
            
                link |
                
                 essentially what they are, little packets of histamine,
             
            
                link |
                
                 and when we have some sort of injury
             
            
                link |
                
                 or irritant, rather, to the skin,
             
            
                link |
                
                 so a mosquito bite, for instance, or poison oak
             
            
                link |
                
                 or poison ivy, something that causes an itch
             
            
                link |
                
                 or something that causes inflammation internally,
             
            
                link |
                
                 doesn't just have to be on the skin,
             
            
                link |
                
                 these mast cells are these little bubbles
             
            
                link |
                
                 that contain histamine that go to that site
             
            
                link |
                
                 and release their histaminergic contents
             
            
                link |
                
                 and cause swelling and inflammation
             
            
                link |
                
                 of whatever cells are affected locally.
             
            
                link |
                
                 That's caused, you might think,
             
            
                link |
                
                 well, why would I want to have a mechanism in my body
             
            
                link |
                
                 that would cause swelling and inflammation?
             
            
                link |
                
                 Ah, well, then those cells in turn send out cytokine signals
             
            
                link |
                
                 that recruit the very cell types that we were talking about
             
            
                link |
                
                 way back at the beginning of the episode,
             
            
                link |
                
                 the cells that are characteristic
             
            
                link |
                
                 of the innate immune system that come in,
             
            
                link |
                
                 the macrophages and the other types of cells
             
            
                link |
                
                 that will come in and gobble up the foreign invaders
             
            
                link |
                
                 or will help sequester and move away,
             
            
                link |
                
                 say, the poison from a bite or from whatever irritant.
             
            
                link |
                
                 Again, it doesn't just have to be at the skin surface.
             
            
                link |
                
                 I'm describing an example at the skin.
             
            
                link |
                
                 For instance, if you've ever had hives of any kind,
             
            
                link |
                
                 that almost certainly involved mast cells.
             
            
                link |
                
                 So when you take an antihistamine, antihistamine,
             
            
                link |
                
                 in order to deal with seasonal allergies, for instance,
             
            
                link |
                
                 you're dealing, you're, excuse me,
             
            
                link |
                
                 you're taking a compound that's reducing histamines
             
            
                link |
                
                 in mast cells, and spirulina has also been used
             
            
                link |
                
                 quite effectively as a way to treat seasonal allergies
             
            
                link |
                
                 and some of the symptomology,
             
            
                link |
                
                 equally on par with some of the major prescription
             
            
                link |
                
                 and over-the-counter drugs for that.
             
            
                link |
                
                 One cautionary note, spirulina does,
             
            
                link |
                
                 can carry some side effects for people
             
            
                link |
                
                 that are, have a genetic mutation
             
            
                link |
                
                 leading to something called PKU.
             
            
                link |
                
                 These people know who they are.
             
            
                link |
                
                 They're very sensitive to phenylalanine.
             
            
                link |
                
                 These same people cannot drink any sort of
             
            
                link |
                
                 nutrients to eat or diet soda for reasons
             
            
                link |
                
                 that they understand it could be quite dangerous.
             
            
                link |
                
                 It's a rare genetic disorder, but nonetheless,
             
            
                link |
                
                 spirulina can be an issue for those people.
             
            
                link |
                
                 For most people, the side effect profile is pretty minimal.
             
            
                link |
                
                 And just to be clear, I don't have any relationship
             
            
                link |
                
                 to a spirulina company or anything.
             
            
                link |
                
                 I just find it interesting that there are these compounds
             
            
                link |
                
                 that sound rather, forgive the phrase,
             
            
                link |
                
                 but rather new agey because they come from a algae,
             
            
                link |
                
                 from a plant, but when you look at the underlying mechanism,
             
            
                link |
                
                 it makes perfect sense.
             
            
                link |
                
                 So that's often what we like to point out here
             
            
                link |
                
                 is that if there are these so-called alternative therapies,
             
            
                link |
                
                 alternative because most people haven't heard of them,
             
            
                link |
                
                 it's always nice if they map to a specific logical mechanism
             
            
                link |
                
                 and framework by which that compound would work
             
            
                link |
                
                 as opposed to just some anecdote of,
             
            
                link |
                
                 oh, I hear spirulina is great for allergies.
             
            
                link |
                
                 Well, now we know why.
             
            
                link |
                
                 It inhibits mast cells and histaminergic mast cells
             
            
            
                link |
                
                 Earlier, I mentioned a new and very exciting study
             
            
                link |
                
                 published as a full article in Nature.
             
            
                link |
                
                 Full article means that it is a major finding.
             
            
                link |
                
                 It, at the journal Nature, they have letters,
             
            
                link |
                
                 which are important findings.
             
            
                link |
                
                 They're still very high stringency
             
            
                link |
                
                 for getting a letter in Nature published,
             
            
                link |
                
                 but the full articles,
             
            
                link |
                
                 generally there's only one or two per issue
             
            
                link |
                
                 in the weekly edition of Nature.
             
            
                link |
                
                 And just last week, there was a very exciting article
             
            
                link |
                
                 published from Chufu Ma's lab at Harvard Medical School.
             
            
                link |
                
                 Chufu, I've known for a number of years.
             
            
                link |
                
                 His group has done phenomenal work
             
            
                link |
                
                 on the mechanisms of itch and pain
             
            
                link |
                
                 and discovering some of the receptors and pathways
             
            
                link |
                
                 for itch and pain.
             
            
                link |
                
                 And more recently, they've been exploring
             
            
                link |
                
                 the mechanistic basis of acupuncture.
             
            
                link |
                
                 And the title of the article
             
            
                link |
                
                 is a neuroanatomical basis for electroacupuncture
             
            
                link |
                
                 to drive the vagal adrenal axis.
             
            
                link |
                
                 And while that's a mouthful,
             
            
                link |
                
                 now most all of you are probably familiar
             
            
                link |
                
                 with what I mean when I say vagal adrenal axis.
             
            
                link |
                
                 Vagal, meaning of the vagus,
             
            
                link |
                
                 and adrenal of the adrenal glands.
             
            
                link |
                
                 And so perhaps we should not be surprised,
             
            
                link |
                
                 although excited nonetheless,
             
            
                link |
                
                 that Wen-Chufu's lab looked at stimulation
             
            
                link |
                
                 of the body with so-called electroacupuncture.
             
            
                link |
                
                 So these are needles
             
            
                link |
                
                 where a small bit of electrical current,
             
            
                link |
                
                 low level of electrical current is passed into the needle
             
            
                link |
                
                 and therefore into the body.
             
            
                link |
                
                 They located sites on the body
             
            
                link |
                
                 that can increase inflammation
             
            
                link |
                
                 by way of releasing inflammatory cytokines.
             
            
                link |
                
                 These areas included the abdomen.
             
            
                link |
                
                 And they found areas on the body,
             
            
                link |
                
                 such as the lower limbs,
             
            
                link |
                
                 the hind limbs in this case,
             
            
                link |
                
                 that can stimulate the vagal adrenal reflex
             
            
                link |
                
                 and can lead to reduced inflammation.
             
            
                link |
                
                 And what was really interesting
             
            
                link |
                
                 is that they figured out
             
            
                link |
                
                 that it was activation of nerve endings
             
            
                link |
                
                 that resided in the fascia.
             
            
                link |
                
                 I mentioned earlier what fascia is,
             
            
                link |
                
                 but just to remind you,
             
            
                link |
                
                 the fascia is a really thick sheath of tissue
             
            
                link |
                
                 that surrounds muscle.
             
            
                link |
                
                 If ever you've heard of rolfing,
             
            
                link |
                
                 rolfing is a form of very intense massage.
             
            
                link |
                
                 I've never had this done,
             
            
                link |
                
                 but I've heard about this.
             
            
                link |
                
                 It involves, among other things,
             
            
                link |
                
                 actually separating the muscle away from the fascia somewhat.
             
            
                link |
                
                 So it's a very, very deep tissue massage.
             
            
                link |
                
                 Actually, a good friend of mine
             
            
                link |
                
                 who had this done told me
             
            
                link |
                
                 that it was probably the most challenging experience
             
            
                link |
                
                 at physical experience that he'd ever been through
             
            
                link |
                
                 going through this rolfing procedure.
             
            
                link |
                
                 Maybe some of you have been rolfed, as they say,
             
            
                link |
                
                 and can report to the experience
             
            
                link |
                
                 whether or not it was pleasant or unpleasant
             
            
                link |
                
                 or you felt benefits or not.
             
            
                link |
                
                 In any case, this study isn't about rolfing per se,
             
            
                link |
                
                 but it is about the fascia.
             
            
                link |
                
                 And so what they discovered is
             
            
                link |
                
                 there's a specific population of neurons.
             
            
                link |
                
                 Those neurons have a name, as they often do in science.
             
            
                link |
                
                 Name isn't important, but if you want to look it up,
             
            
                link |
                
                 it's the Prok R2 neurons, P-R-O-K R2 neurons.
             
            
                link |
                
                 And they send a connection
             
            
                link |
                
                 deep into the limb fascial tissue, okay?
             
            
                link |
                
                 And then they send another connection.
             
            
                link |
                
                 The connections we're referring to are axons.
             
            
                link |
                
                 Neurons have axons, so a wire in one direction
             
            
                link |
                
                 that goes into the deep fascial tissue
             
            
                link |
                
                 of the lower limb and near the calf and thigh.
             
            
                link |
                
                 And then they send another wire up into the spinal cord
             
            
                link |
                
                 and to a region of the hindbrain
             
            
                link |
                
                 in the back of your brain, kind of near your neck,
             
            
                link |
                
                 called the medulla, in the medulla oblongata.
             
            
                link |
                
                 That neuron also has a name called the DMZ, doesn't matter.
             
            
                link |
                
                 And that neuron connects to the adrenal gland
             
            
                link |
                
                 to release our good old friends,
             
            
                link |
                
                 the catecholamines, noradrenaline, adrenaline, and dopamine,
             
            
                link |
                
                 or norepinephrine, epinephrine, and dopamine.
             
            
                link |
                
                 And their release causes a reduction in inflammation,
             
            
                link |
                
                 even in response to an injection
             
            
                link |
                
                 of something called lipopolysaccharide,
             
            
                link |
                
                 which can actually induce fever.
             
            
                link |
                
                 So what is all this saying?
             
            
                link |
                
                 This is saying that activation of the deep fascial tissue
             
            
                link |
                
                 causes a chain of neural reactions
             
            
                link |
                
                 that leads eventually to the release
             
            
                link |
                
                 of norepinephrine, noradrenaline, adrenaline, and dopamine,
             
            
                link |
                
                 and once again, lowers inflammation,
             
            
                link |
                
                 very much like the breathing study
             
            
                link |
                
                 that we talked about earlier
             
            
                link |
                
                 in the pattern of cyclic hyperventilation with retention,
             
            
                link |
                
                 leading to reductions in inflammation.
             
            
                link |
                
                 I can't tell you how happy this makes me.
             
            
                link |
                
                 I had nothing to do with this work,
             
            
                link |
                
                 but the reason it makes me happy
             
            
                link |
                
                 is because I have a particular fondness
             
            
                link |
                
                 for when practices that have existed for many centuries
             
            
                link |
                
                 or even thousands of years, such as acupuncture,
             
            
                link |
                
                 such as respiration work,
             
            
                link |
                
                 start to converge with some of the
             
            
                link |
                
                 hardcore mechanistic science.
             
            
                link |
                
                 And the reason this excites me
             
            
                link |
                
                 is not because we want to take science
             
            
                link |
                
                 and erase the previous tools and methods
             
            
                link |
                
                 of these ancient practices, not at all.
             
            
                link |
                
                 And it certainly isn't the case
             
            
                link |
                
                 that we just want to name things or rename things
             
            
                link |
                
                 with modern science.
             
            
                link |
                
                 What's very exciting is when we can discover mechanism
             
            
                link |
                
                 that explains why certain practices work.
             
            
                link |
                
                 First of all, that validates those as legitimate practices,
             
            
                link |
                
                 maybe even insurance will start to cover them,
             
            
                link |
                
                 whereas maybe they previously had not.
             
            
                link |
                
                 I don't know what the current status is
             
            
                link |
                
                 for insurance coverage of acupuncture.
             
            
                link |
                
                 I'm guessing there are places that do it,
             
            
                link |
                
                 maybe others that don't.
             
            
                link |
                
                 I personally am not somebody who receives acupuncture.
             
            
                link |
                
                 I have in the past, but I'm,
             
            
                link |
                
                 it's not that I'm a particular fan of it,
             
            
                link |
                
                 but I think that there are a number of people
             
            
                link |
                
                 that have benefited from it.
             
            
                link |
                
                 So I think that's wonderful.
             
            
                link |
                
                 Breath work and respiration work
             
            
                link |
                
                 is something that I've cultivated as a practice
             
            
            
                link |
                
                 I mentioned earlier how I use it to push back
             
            
                link |
                
                 on incoming infections and so forth.
             
            
                link |
                
                 And now that doesn't sound like total,
             
            
                link |
                
                 like just a figment of my imagination.
             
            
                link |
                
                 There's actually a mechanism,
             
            
                link |
                
                 published mechanism to explain it.
             
            
                link |
                
                 But the most exciting thing to me about all this
             
            
                link |
                
                 is that practices that traditionally have been shrouded
             
            
                link |
                
                 in complicated language or were the unique domain
             
            
                link |
                
                 of the practitioners and relied on phrases
             
            
                link |
                
                 like the meridians or the chakras,
             
            
                link |
                
                 of which I think is perfectly valid language,
             
            
                link |
                
                 but doesn't inform mechanism.
             
            
                link |
                
                 And then in a separate community,
             
            
                link |
                
                 the community I come from, the community of scientists,
             
            
                link |
                
                 have used language like our two neurons,
             
            
                link |
                
                 medulla oblongata, vagal adrenal axis,
             
            
                link |
                
                 and basically no one can communicate with one another
             
            
                link |
                
                 because the language is shrouding.
             
            
                link |
                
                 What we're now starting to see is that
             
            
                link |
                
                 at their convergence is a common mechanism.
             
            
                link |
                
                 And with that understanding,
             
            
                link |
                
                 what's going to be really terrific
             
            
                link |
                
                 is as new protocols start to emerge.
             
            
                link |
                
                 So in understanding mechanisms and pathways
             
            
                link |
                
                 and in being able to understand the base set of practices,
             
            
                link |
                
                 like breathing, like electroacupuncture and so forth,
             
            
                link |
                
                 we can now start to daydream in a very realistic way
             
            
                link |
                
                 about the development of new protocols,
             
            
                link |
                
                 more effective protocols,
             
            
                link |
                
                 protocols that perhaps one can do at home without needles,
             
            
                link |
                
                 perhaps protocols such as the breathing
             
            
                link |
                
                 that you can do anywhere, anytime,
             
            
                link |
                
                 and be confident that you're actually impacting
             
            
                link |
                
                 the IL-6 and the IL-8 pathways,
             
            
                link |
                
                 reducing those and increasing IL-10.
             
            
                link |
                
                 So we are no longer wandering around in the fog,
             
            
                link |
                
                 hearing about these magical techniques
             
            
                link |
                
                 without understanding why they work,
             
            
                link |
                
                 nor are we just seeing a bunch of science
             
            
                link |
                
                 that is descriptive but not mechanistic
             
            
                link |
                
                 or pointing to specific protocols.
             
            
                link |
                
                 So I'm just delighted.
             
            
                link |
                
                 Again, I had nothing to do with this work,
             
            
                link |
                
                 but really terrific work, Chufu and colleagues.
             
            
                link |
                
                 And I also want to acknowledge a journal
             
            
                link |
                
                 as prominent as nature for featuring this upfront
             
            
                link |
                
                 because I think it really does mark the beginning
             
            
                link |
                
                 of a new path in medicine.
             
            
                link |
                
                 And just to underscore that point a little bit further,
             
            
                link |
                
                 the National Institutes of Health, of course,
             
            
                link |
                
                 has a cancer institute, an eye institute
             
            
                link |
                
                 that deal with trying to combat cancer
             
            
                link |
                
                 and to cure blindness and so forth.
             
            
                link |
                
                 And now they have what's called NCCIH,
             
            
                link |
                
                 which is complementary health.
             
            
                link |
                
                 And so there are good tax dollars being put
             
            
                link |
                
                 to the kinds of explorations that we're talking about
             
            
                link |
                
                 that undoubtedly are going to lead to better treatments
             
            
                link |
                
                 for immunological diseases, neurological diseases,
             
            
                link |
                
                 the convergence of the immune system and the nervous system,
             
            
                link |
                
                 very exciting times.
             
            
                link |
                
                 And I hope that by learning about some of this new
             
            
                link |
                
                 and emerging science and hearing about some of the protocols
             
            
                link |
                
                 that are either zero cost or low cost,
             
            
                link |
                
                 certainly for respiration, that's the case,
             
            
                link |
                
                 or for the use of heat or cold
             
            
                link |
                
                 or maybe even electroacupuncture,
             
            
                link |
                
                 if you have access to that,
             
            
                link |
                
                 that we can really see that we're starting to evolve
             
            
                link |
                
                 as a field of health and medicine and science
             
            
                link |
                
                 and ancient practices,
             
            
                link |
                
                 and that they're really starting to converge
             
            
                link |
                
                 and have a vector, as we say,
             
            
                link |
                
                 in a new and more exciting direction.
             
            
                link |
                
                 Once again, we've covered a lot of information.
             
            
                link |
                
                 Today, we learned about the immune system,
             
            
                link |
                
                 the adaptive immune system, the innate immune system,
             
            
                link |
                
                 and the nervous system and how those interact.
             
            
                link |
                
                 And throughout, we discuss protocols that can allow you
             
            
                link |
                
                 to tap into this relationship
             
            
                link |
                
                 between the nervous system and immune system
             
            
                link |
                
                 and hopefully avoid and or shorten the course
             
            
                link |
                
                 of any illnesses, injuries, or inflammation
             
            
                link |
                
                 that you might encounter.
             
            
                link |
                
                 If you're enjoying and or learning from this podcast,
             
            
                link |
                
                 please subscribe to our YouTube channel.
             
            
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                 And also on YouTube, please leave us a comment.
             
            
                link |
                
                 One of the best forms of comments you can give us
             
            
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                 are suggestions for future topics and future guests to have
             
            
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                 Please also subscribe to our podcast on Apple and Spotify.
             
            
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                 And on Apple, you can also leave us up to a five-star review
             
            
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                 In addition, please check out our sponsors
             
            
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                 That's the best way to support this podcast.
             
            
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                 It's patreon.com slash Andrew Huberman.
             
            
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                 And there you can support the podcast
             
            
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                 at any level that you like.
             
            
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                 A few times during this episode
             
            
                link |
                
                 and in many previous episodes, I mentioned supplements.
             
            
                link |
                
                 Not everybody needs to take supplements,
             
            
                link |
                
                 but many people find benefit from them.
             
            
                link |
                
                 A key thing if you're going to take supplements
             
            
                link |
                
                 is to know that the quality of the supplements
             
            
                link |
                
                 that you're taking is very high.
             
            
                link |
                
                 And that's not always the case with many supplement brands.
             
            
                link |
                
                 That's why we partnered with Thorne.
             
            
                link |
                
                 That's T-H-O-R-N-E.
             
            
                link |
                
                 Thorne supplements are known to be
             
            
                link |
                
                 of the very highest quality
             
            
                link |
                
                 and the specificity of the ingredients is very high as well,
             
            
                link |
                
                 meaning what they list on the bottle
             
            
                link |
                
                 is actually what's contained in that bottle.
             
            
                link |
                
                 They've worked with the Mayo Clinic,
             
            
                link |
                
                 all the major sports teams.
             
            
                link |
                
                 So trust is very, very high with Thorne products.
             
            
                link |
                
                 If you'd like to see the supplements that I take,
             
            
                link |
                
                 you can go to thorne.com slash the letter U slash Huberman.
             
            
                link |
                
                 And there you can see all the supplements that I take.
             
            
                link |
                
                 You can get 20% off any of those supplements.
             
            
                link |
                
                 And if you enter the Thorne site through that portal,
             
            
                link |
                
                 you can get 20% off any of the supplements that Thorne makes.
             
            
                link |
                
                 That's T-H-O-R-N-E.com slash the letter U slash Huberman
             
            
                link |
                
                 to see the supplements that I take
             
            
                link |
                
                 or get 20% off any of the supplements that Thorne makes.
             
            
                link |
                
                 If you're not already following Huberman Lab on Instagram,
             
            
            
                link |
                
                 There I teach neuroscience and health-related topics
             
            
                link |
                
                 sometimes, but not always overlapping
             
            
                link |
                
                 with the content of the podcast.
             
            
                link |
                
                 We are also Huberman Lab on Twitter.
             
            
                link |
                
                 And last but not least,
             
            
                link |
                
                 thank you for your interest in science.
             
            
                link |
                
                 I'll see you next time.
             
            
                link |
                
                 I'll see you next time.