Q&A 444: The Latest Tricks For Cognitive Performance, Ketosis Confusion, Muscle Cramping Fixes, Peeing At Night, Microdosing & More!

My name is Ben Greenfield, and on this episode of the Ben Greenfield Life Podcast, if you kind of like starve yourself of carbohydrates post workout, your body gets really, really good at using carbohydrates, at insulin sensitivity, at upregulation of glucose transporters, and at all the functions that would increase metabolic health. The reason this is important is I think a lot of people are still working out based on that old school idea that as soon as you finish working out, you're supposed to drop everything and go find your shake or your Jamba Juice or your, your energy bar so that you don't miss your anabolic recovery window, bro.

Faith, family, fitness, health, performance, nutrition, longevity, ancestral living, biohacking, and a whole lot more. Welcome to the show.

In this episode of the Ben Greenfield Life Podcast, the latest tricks for cognitive performance, ketosis, confusion, muscle cramping fixes, research frauds, microdosing, and much, much more. First of all, I welcome all of those of you who have joined us live on Twitter spaces. For those of you who are on live right now, congratulations. You made it. You're in the inner circle of Twitter spaces. For the rest of you listening in, this is the. I don't even know how often we do this, Jay. Weekly, Monthly, bi month, biweekly, biannually.

Well, I mean, since the last one, it has been a short period of time. Before that it was like, geez, it was like four or five months. So let's get the cadence of maybe monthly. That sounds pretty good.

Look at us. There we go. Let's do it. So anyways, this is the Q and A where we go over news flashes and then. And here's why it actually is cool to join us on Twitter when we do these. And I always. I typically tweet it out if you follow me on twitter@twitter.com is it twitter.com BenGreenfield Is that my Twitter? I forget. Anyways, you can find out there. And that being said, we should jump in pretty soon. But I got to say, Jay, I have had an amazing, amazing week. I changed up my diet this week. I know a lot of people are into fitness and nutrition and health optimization, so I'll tell you why I did this. My wife left town for the week and as I recently posted to Instagram, we're turning into the Greenfield Boy man camp while my wife is gone. Yeah, we're doing kettlebell workouts and ice B breath work in the sauna and shooting our bow and going on bike rides. We went down to the river and swam around in the river last night and played some tennis. And we're doing these deep meditation sessions in the morning and in the evening. Just having a great father son bonding time. I'm still working, but since I work from home, I'm just popping up and doing stuff with them throughout the day. I thought, well, gosh, what better to fuel a man camp father son week than steak and Liverpool. Have you ever seen an actual bone in ribeye? Like the full cut? It's the size of a human torso. Think about a rack of lamb or a rack of rabbit or something like that. And then extend that and think rack of cow. That's what an actual full rack before it's been pieced into individual steaks. Looks like I had one of those. It's been burning a hole in my meat freezer for the past few months and I finally decided to cook it. So Sunday I smoked it for about six hours and just drenched it in apple cider vinegar and barbecue sauce, did my little signature kion coffee ra rub on there with cacao and cayenne and salt and got it all prepped. Then I told my wife, look, the whole time you're gone, all your precious sons and I are going to eat is steak and liver. And so breakfast, lunch and dinner, since Sunday we've been doing steak and liver. And I just feel absolutely fantastic.

Obviously, long term, I have some reservations about the long term health of just eating steak and liver. Potentially missing out on some polyphenols and flavanols and yeah, I know that the colon cancer thing with red meat, it's more the processed, unhealthy forms of red meat and some of the things that go along with it, like the bun and the giant Dr. Pepper. But for the most part, I am feeling really, really, really good, as though I've been just injected with testosterone and creatine and fatty acids all day, which I kind of have. I guess.

I guess that's it. I mean, it's like an elimination diet, right? Man, you just gotta take out everything and go to meat and liver and. Yeah, I mean, that's awesome. I thought you were gonna tell me that since you were at a bachelor pad right now that you and your sons were just like eating pizza and donuts and gummy bears. But no, I think this is probably the better route.

Well, in my son's defense, and I told them they could do this if they wanted to last night because they're cooks, little bakers, they have their own food podcast. They wanted to make steak pizza last night and So I stuck with steak, but they actually made themselves. They roll out the dough and they bake it. So they made themselves steak pizza. I stuck with steak. But they did kind of veer into the pizza zone last night. You're right. Gotch.

I thought, okay, so steak pizza is a pizza with steak as, like, the topping, right? Because in my mind, when you said a steak pizza, I thought it was like this big slab of meat where they put, like, liver on top as the topping, and they just pretended it was.

That would be amazing. Just like a giant piece of like. Like a. Like a big old, you know, top sirloin layered with pepperoni and maybe a little bit of tomato sauce. Yeah, someone should try that.

That's it, man.

An actual steak pizza.

Get the boys on that. Yeah, get the boys to make one of those.

All right, well, shall we jump into our news flashes?

Yeah, let's go, man.

All right, all right, all right. This is the time on the show when we share with you all sorts of cool things that can optimize your life, at least hopefully, or cause you to pass out in the gym, because this first one is pretty interesting. I'd seen this concept bandied about before in literature, but this recent study in the Journal of Strength Conditioning Research was super duper interesting. And what it looked into was hyperventilation. Okay, so when you do like a WIM hof, like fully in letting go, fully in letting go, fully in letting go. And you keep doing that for two or three minutes, I mean, everybody knows you kind of get the tingle in your hands. You can hold your breath for a long time. What you're inducing is a state of metabolic alkalosis. You're breathing out a lot of CO2, and you're kind of saturating the muscles with oxygen, theoretically. And if you do this, the idea is you should be able to exercise kind of more hard after without as great of a burn due to the alkalosis. And indeed, many people who do like the WIM HOF protocol, when you're on that final breath hold out, they'll drop and do push ups or burpees or do something while you're in that metabolically demanding state. Anyways, what this study looked at was, what if you just do this as you're recovering in between your sets at the gym, right? It's like, do a bench press, then do minute WIM hof. Then bench press minute of WIM hof. They don't call it WIM hof. They just call it hyperventilation, which is basically what it is. And so what they investigated then was a hyperventilation aided recovery. And they tested this on the bench press and the leg press, and they did 30 seconds before each set. And then they, of course, had a control group that did regular breathing. Now, by doing 30 seconds of hyperventilation prior to the exercise sets, they actually found that the total repetitions performed across all the sets were greater after hyperventilation in both the bench press and leg press, and they were actually significantly greater, like 25 to 30%. And so it turns out that this may actually be the impetus for people all around the world, fitness enthusiasts all around the world, to be walking around the gym, hyperventilating, breathing into paper bags, passing out, and blaming it on this podcast episode. But ultimately, it is kind of interesting. We all know that breath can drive physiology, but it is kind of cool if you want a little step up. Maybe you're in a competition, whatever the case may be, you just kind of want to amp up your energy. Hyperventilation seems to do the trick. It, to me, kind of falls into the same category, and I don't know if you've ever done this, Jay, of getting in a super duper duper cold body of water prior to working out like a. You know, like, I'll jump in the Morozco Forge, which is at like 33 degrees, and I'll get in there for two or three minutes before I go work out. The endorphins, the adrenaline rush, the increased time to exhaustion, the decreased rating of perceived exertion, it all noticeably shifts if you get cold before the workout. A lot of people think the cold's for recovery, but if you do it before the workout, it's like a shot in the arm. And the hyperventilation might also help out a little bit. No reason you couldn't do both and just pass out in the ice tub before you go do your bench pressing.

Yeah, well, we want to enhance overall sympathetic output prior to a working set. Um, so it's really interesting because I've tried this on multiple occasions and I've tracked my data. So not to just throw in the shameless plug for Hanu, but, Ben, next time, put on your Hanu watch After you do this, your heart rate variability will drop like a rock. Your heart rate will shoot up, but you'll perform better during the next set because you're utilizing all of that mobilization of energy. Then when you're done with the set down, regulate your nervous system prior to doing another bout of cyclical hyperventilation. And I think that's where you're going to see the largest scale benefits from this type of practice. So it's like cyclical hyperventilation. For 30 seconds, do the working set, downregulate with slow paced breathing, like resonance breathing. Then when you have 30 seconds prior to your next set, do it again. And it's an amazing cycle.

Yeah, I totally agree that that's actually what Paul Check calls working in versus working out, where you'll do a set and then kind of do like 10 air squats, waving your hands down below your body and up above your body. And almost a Tibetan rite where they call it gathering up the earth's energy and bringing it up above the head and doing deep, slow, controlled breathing rather than just say sitting on the bench thumbing through Women's Health magazine or something like that. So yeah, I totally think it's a cool strategy. So that was interesting. And then the next thing that I want to get into is cognition. A few different things that have come up lately related to cognitive decline or cognitive performance and I thought some of them definitely have some cool takeaways. So the first is more like a biohack, more like a gadgety thing. And for many years I've talked about this concept of photobiomodulation on the show, meaning the use of light in a targeted manner, usually infrared light, like red light, near infrared, far infrared, to do things like help out with skin health, with the collagen and the elastin, or shining on the testes to increase the activity of Leydig cells, to potentially boost testosterone or blood flow to the genitalia, or using it to simulate sunrise or sunset when you can't actually get out to do that from a circadian rhythmicity standpoint. And also I've talked about it in the past for dementia and for Alzheimer's. And there are certain devices as well as desktop type of lights like head worn devices and desktop type of lights that will shine at specific frequencies to shift you into like an alpha 10Hz brainwave zone or like a gamma 40Hz brainwave zone. In addition to doing this, the red light devices that you put in your head actually target the cytochrome P450 enzyme in the mitochondria in neural tissue and help you to produce more ATP. Almost. I've described in the past as a cup of coffee for your head. One device that I think is probably the most popular out there is called the Vielight V I E Light. I interviewed them years ago. I still use that device every other day for 25 minutes. That's kind of like the sweet spot. Too much red light therapy can produce excess free radicals and potentially ramp up reactive oxygen species. But that sweet spot, especially for the head of three times a week for around 25 minutes seems to work really well. And I'm doing it not because I notice a huge, huge increase in my limitless function of word recall or cognitive output or executive function or anything like that. I'm doing it because I've seen so much data for that on staving off Alzheimer's and dementia and improving mitochondrial function for the head, specifically for the brain, that to me, it's a no brainer. Jay. It's a no brainer, pun intended.

I see what you did there.

Yeah, yeah. Glad you're paying attention. So anyways, the thing is, this recent study, subjective cognitive decline is what they looked at. Subjective cognitive decline, scd. So what happens is as you age, you can get what's called prefrontal cortex atrophy, which is associated with sleep disruption and cognitive decline. And the theory is that that atrophy of neural tissue can be staved off via what's called transcranial brain photobiomodulation, which not only could keep atrophy from occurring, but increase blood flow to the frontal cortex and mediate memory function. So what they did was they looked at this photobiomodulation therapy targeting the prefrontal cortex, which is actually the V light that you are does the prefrontal cortex and then also the occipital zone and a few other areas of the head. And they found that both sleep efficiency as well as what's called N back cognitive performance, which is a test of working memory, were both improved within five days of doing this type of therapy. And N back training, by the way, for those of you who want to, like when you're sitting on an airplane or waiting in line at the doctor's office or whatever, and you want to increase your memory really, really efficiently, there's a ton of free N back training apps in the app store for Android and for Apple and you can download these and train your working memory. And it's just basically it's word recall, shape recall, number recall, sound recall, and you're training your brain how to recall n number of episodes ago, like what pattern flashed across the screen, three patterns ago. And when that pattern flashes again, you're supposed to press a button, that type of thing. And it's almost addictive as far as a memory training device. And it actually works. They've done studies on it and it actually works to improve memory. That's what they use as a test for this particular study. But it turns out, long story short, that if you're not yet using some form of photobiomodulation, particularly for your head, then you're probably missing out on some of the benefits of what occurs when the head gets exposed to red light, near infrared light, far infrared light, and some of these like hertz frequencies from 10 up to about 40 hertz.

Yeah. Did they talk about in this study how long they were exposed to the brain? Photomyel modulation? I just didn't know if they talked about timing.

I can tell you that based on the studies that Vielight has done and their recommendation, it is going to be around 20, 25 minutes. So.

Yeah. Now, now, Ben, I'm curious as what Vielight would think about this and then what you think about it too. So I have a Vielight system. Used it plenty of times. Find benefit from it. I was just curious if somebody's like, I want to kill two birds with one stone. So Vielight does do the intranasal light, which I know is a part of their system. I don't know. I mean, it sounds like they were using Vielight in the study, so they were probably using that. But let's say someone just has like a JOOVV panel and they don't want to invest money into a V light system. Can you get the same benefits? Like if you basically get your entire head with like in the light of.

That panel, if you don't have the nasal probe, you're still going to have a really difficult time because the Vielight actually is up against the skin, targeting these specific areas, which is why it comes with instructions for the specificity of how to wear it. It's kind of like an ECG head map. If you were to go in and do neurofeedback and they're mapping specific parts of the brain and you have to have the electrodes very close to the actual location, which is like C3, C5, they have different points around the head. This is like that. So precision does matter. The shotgun effect is probably going to give you some benefits. Just like taking off your hat when you go outside and letting the sunl hit your skin on the top of your head could have some benefits. But as far as targeted specificity, I'd go with the Vielight. And just so you know, the one that I use is the Duo, because what the Duo does, the Vielight Duo, and they aren't a sponsor of this podcast or Anything, it's just what I use. They have the option for a 10Hz or a 40Hz frequency with 10Hz kind of being like in the zone alpha waves. And then the 40 Hz is gamma, which can kind of like wake up your brain a little bit, like make you more awake and alert that that faster frequency. But then the duo, it also has one that targets the vagus nerve via the occipital bone on the back of the head. And then that also has a nasal probe that goes into your other nostril. So you technically have double nasal probes and double lights on the head. And then the interesting thing is the duo also comes with an extra one that can wrap around the waist that does infrared light to your gut at the same time that you do it to your brain. So it's pretty cool. I mean it's not an inexpensive device. I think for the whole neuroduro setup it's like 2,400 bucks, something like that. But it's a real game changer when it comes to targeted photobiomodulation. And that's the one that I use.

That's cool. The next model that they put out is going to have a light in every orifice of the body. Pretty close. But not yet.

Exactly. But let's switch to something free. Something free for making you smarter. So we're going to shift to the free and easy stuff that actually takes blood, sweat and tears. So it's technically not free. But this was interesting. They looked at the immediate effect of high intensity exercise on brain derived neurotrophen factor bdnf, which is that stuff that we all hear bandied about as like miracle grow for the brain. And this was pretty straightforward in comparison to aerobic light intensity exercise or non exercise. There was a significant and immediate increase in BDNF when folks were doing this high intensity exercise protocol. Now here's why I think this is interesting. If you were to read a book like John Ratey has a book called Spark, great book that kind of highlights all the good things for your brain that exercise does. And it turns out that when you look at chronic repetitive motion aerobic sports, particularly those that require left and right brain hemispheric coordination, like say swimming would be a perfect example. And actually running, because it is left foot, right foot, right arm, left arm, right leg, left leg, there's a little bit of that. But then swimming, there's even more of that. They've also noted this in tennis, you actually see a pretty significant correlation between Participation in those sports and cognitive performance. And in addition to that with weightlifting, because the blood stays more localized to the joints. The theory is that the brain derived neurotrophic factor stays more local to the muscle when you're weight training, but winds up because of blood flow to the brain more in the brain after aerobic training. So if what I'm saying makes sense, basically it means that technically in the past I've said that if you have a caudally demanding day, it would be more beneficial to go for a swim or go for a walk in the sunshine, or a run, or some type of aerobic modality versus strength training. But the interesting thing is that if you think about high intensity interval training, you're still doing even for a one minute bicycle, all out high intensity interval rep, thousands and thousands of reps sometimes. So compared to weightlifting, which is a high rep range would be like 20, so 5, 8, 10, 12, 20 reps, et cetera. So even though high intensity exercise may not seem like it's aerobic compared to strength training, you're getting a lot more blood flow to the brain from high intensity interval training on a cardio modality versus strength training. So it's looking like based on this study that for getting smart, for using exercise to get smart, the best is high intensity interval training, the next best is aerobic training, and the least effective would be strength training, even though all three increase bdnf. And if you really want the high intensity interval training to be the best for cognitive performance, you would choose something that's using both the arms and the legs and involves some type of coordination. Which is again I think one of the reasons that other previous studies have found that swimming and tennis are two of the best sports for increasing your cognitive performance. From a lifetime athlete type of standpoint.

It all makes sense, man. I don't know if you feel the same way, but if I do any type of HIIT training or hurt training, it sucks while you're doing it most of the time. And it's kind of intended to suck. It's really intense. But then afterwards like as opposed to doing any type of, let's say like zone two cardio or resistance training or weight training, like I just feel this sense of like level headedness. I'm clear in thought, I just feel good, like my body's drained and I can feel like that I just got done, you know, whipping my butt. But I mean I just, there's something about the subjective level headedness afterwards and clarity of thought that I always tend to experience, experience after hit, as opposed to some of the other types of modalities.

Yeah, and now we know why. And because I know you like to dig into the nitty gritty of the studies, Jay, I should mention that I can't give an exact time for the actual intervals used because this was a meta analysis that looked at a variety of studies and the workouts ranged anywhere from 7 to 60 minutes in length. But in terms of the nature of high intensity interval training and how to choose, how long, how hard, et cetera, this actually is a perfect segue into another thing that I wanted to bring up regarding high intensity interval training. And that was a great article by our friends at Levels Health which defined why HIIT is so good, why this idea of going hard and short versus going long and slow seems to give you so much more metabolic health benefit now with this article, and I'll link to it if you go to BenGreenfieldLife.com444 that's the number for today's podcast, BenGreenfieldLife.com444 or a link to this article and the other ones that we talked about. But there's a few reasons that high intensity exercise is so good. First, it activates something called adenosine monophosphate activated protein kinase. It's called AMP K. Stay with me here if you're listening in and that sounded like gobbledygook. Basically, AMP K is the thing that causes the glucose transporters. These are called GLUT4 glucose transporters. It helps to mobilize those and allows your muscle to extract glucose from the body for energy, or from the blood more specifically for energy. So you essentially train your body how to get rid of glucose very, very quickly in the bloodstream and how to pack it into muscle much more quickly. So that's the first thing that happens in response to HIIT exercise. Which is also why if you're having carbs on any specific day like HIIT exercise or strength training, in addition to a cold bath, or three of the best things to increase the activity of those glucose transporters. But then the HIIT also does a lot of other stuff. This article talks about how it increases the production of catecholamines much, much higher than what you would get from aerobic exercise, and that causes a seven to eight times increase in glucose production. Now here's what's interesting. Because of the upregulation of the glucose transporters, when you do high intensity interval training, glucose use increases, but it only increases about three to four Times, okay, so you're looking at seven to eight times increase in glucose production, meaning like your liver breaking down carbs, shoving them out into the bloodstream to be used as glucose. But the use only increases three to four times. And this is why a lot of people who will wear like a continuous blood glucose monitor will look at their blood sugar after the workout and be like, holy cow, I'm never going to do that again. My blood sugar spiked so high. This is horrible for me. I'm supposed to keep my blood sugar low. But the fact is that the downstream effects after you finish the session in terms of the upregulation of these glucose transporters dictates that that short term rise in blood sugar results in long term metabolic health benefits. And so the other kind of cool thing is that Amp K allows for improved endothelial function too, which kind of widens blood vessels and reduces blood pressure. So, so there's a couple of other cool things that happen as well. So don't worry if you're testing your blood sugar and it's high after a HIIT session, that's actually what it's supposed to be doing. And the other cool thing is of course with that upregulation of the glucose transporters, that particular GLUT4 transporter is the one that's activated by insulin, so you don't need as much insulin, so your pancreas doesn't have to churn out as much insulin, so you increase your pancreatic health and your insulin sensitivity as well. And then the last thing that this article gets into that I should note is kind of the variance of high intensity interval training and which ones are kind of like the classic ones. And they list what I would consider to be two of the best ways to get started. And they don't list one. And I'll tell you what all three are. They list the Tabata set eight rounds of 20 seconds as hard as you can go, followed by 10 seconds of rest, also known as the suck fest, if you actually do it right and you go as hard as you're supposed to go for those 20 seconds. Yeah. And then another one is the, the 4x4 method, which is four 4 minute intervals each followed by a 3 to 4 minute recovery period. And that's actually the gold standard, really, really good for increasing your VO2 max. And then the last one is, it's called a 10 by 1 method. And that's where you do 10 one minute bursts of activity, each one followed by one minute of recovery, like getting on the bike, one minute hard, one minute easy, one minute hard, one minute Easy, et cetera. So for those of you who don't really understand what I'm talking about when I say hiit, those are perfect examples. Now, HIIT is not going out for a 30 minute run as hard as you can, right? But it could be going up for a 30 minute run, running for 1 minute, walking for 1 minute, sprinting for 1 minute, walking for 1 minutes, that type of thing. So anyways, it was a great article and it goes into more in terms of metabolic insights into high intensity interval training, but I thought it was a, it was a really good one.

So, yeah, it's good points that you made about. A lot of people will put on a CGM for the first time, go do an exercise or HIIT training, since that's what we're talking about, and they'll see blood glucose significantly elevate and then that becomes like this notion of this is a bad thing for me. And for me, the first time I ever wore a cgm, I knew what to expect, but I saw that happen. And then I almost always follow my exercise routine by a 20 minute sauna, which causes blood glucose to continue to stay up, if not rise even more. And it looks like I'm taking this huge metabolic hit. But to your point, while it may look like that, on the surface, the underpinning kind of recovery from a metabolic health standard standpoint is much greater than the detriment, or what we thought was the detriment of blood glucose rising transiently.

Yeah, exactly. And you're right, it does also tend to happen quite a bit in heat, not in cold. Interestingly, cold seems to just plummet blood glucose, but heat for sure. And that actually leads me to the last thing that I wanted to mention when it comes to cognitive performance. So thank you for teeing up that segue for me so nicely, Jay. That's the idea of how the mechanism of action via which things like this Finnish longevity study would be based upon where they look at a significant, what was it, 40% or something like decreased risk of Alzheimer's and dementia and a lot of other chronic diseases, their risk factors plummeting in response to regular sauna exposure. So there was a study that was published in Nature Communications Journal where they looked at a newly found mechanism that appears to reverse the buildup of what are called aggregates and aggregates. All aggregates are. Those are the proteins you hear about, like amyloid protein and tau protein and misfolded proteins and plaque, like plaque buildup in the brain and people have Alzheimer's and also Parkinson's. Well, that's what these aggregates are. So they looked into a mechanism that appears to reverse the buildup of aggregates. And it turns out that that mechanism is based on stressing the cells in what's called the endoplasmic reticulum. That's a membrane structure found in most mammalian cells. And it carries out a ton of functions, including the folding and the modification and transport of proteins. And the degradation of the folding and the modification and transport of proteins is notoriously correlated to increased risk of dementia and Alzheimer's and Parkinson's and other neurodegenerative diseases or central nervous system type of disorders. So stressing the endoplasmic in particular eliminated these aggregates. It literally just unraveled them, potentially allowing them to refold correctly. And it turns out that kind of like this concept of hormesis, what doesn't kill you stronger that this stress seems to be protective. And the main component that they looked at was a class of proteins known as heat shock proteins, which are made when your cells get exposed to temperatures that are above their normal growth temperature. And also this is kind of like a myth that gets bandied about. You only make heat shock proteins in the heat, you actually make them in the cold. You make them if you're, you're stressed out emotionally, you make them if you're at the gym. Heat is probably the best way to do it. But heat shock proteins are going to be available whether or not you're using a sauna to get them. It's just that a sauna really, really amps up these heat shock proteins, these HSPs. And so the mild stress triggers the higher activity of hsps. That corrects the tangled proteins. And so it turns out that the reason that sauna seems to decrease the risk of Alzheimer's and dementia is it's literally causing the proteins to unfold and then refold into correct pattern. And it's all based off of stress induced protein disaggregation in the endoplasmic reticulum. So it's kind of cool to actually know why this stuff works and what's happening in terms of retraining our bodies, how to actually fold proteins correctly.

Yeah, I know. It allows for me to provide a little bit more explanation to people when I'm in the sauna because a lot of it is talking about the effects of heat shot proteins and SIRTU and activation. And now I get to talk about this, which is phenomenal.

Yeah, well, it Depends on your sauna experience. Yeah, when I sauna in Finland, it's very almost sacred. There's the spirit of the sauna and you quietly enter and usually you're disrobed and you're sitting at a meditative state or sometimes talking very quietly. And then you go to a sauna in whatever, an American ymca and it's a bunch of dudes in basketball shorts dinking around on Candy Crush on their phones and totally different atmosphere. Yeah, yeah. So I think it depends on the sauna. But yes, I'm glad you have more sauna fodder for your intellectually driven discussions and the saunas over there in the deep south. Jay. So back to glucose control, because we kind of got on this real briefly and obviously it's relevant to overall metabolic health and longevity. A lot of people are trying to figure out, using continuous blood glucose monitors and the like, how to actually keep their blood glucose controlled or how to lower what's called glycemic variability, the extent to which your blood glucose fluctuates during the day. This study, interestingly, they used that exact ten by one high intensity interval training set that I mentioned earlier. Ten rounds of one minute of cycling hard, followed by one minute of recovery. And then what they did was they either gave people a high carbohydrate energy replacement drink drink or a placebo drink that didn't have calories in it. And then what they looked at was the glycemic control the next day. And it turns out, and this is really interesting, if you don't eat a bunch of carbs after you've done high intensity interval training, then you actually have better blood glucose control the next day. And if you consume carbohydrates after you've done high intensity interval training, and I highly suspect that this could also be applicable to weightlifting, then that attenuates glycemic control and you have poor blood glucose control the next day. So it's almost as though if you.

I'm a little bit hesitant to use this word because I don't want to cause eating disorders, but if you kind of like starve yourself of carbohydrates post workout, your body gets really, really good at using carbohydrates, at insulin sensitivity, at upregulation of glucose transporters, and at all the functions that would increase metabolic health. The reason this is important is I think a lot of people are still working out based on that old school idea that as soon as you finish working out, you're supposed to drop everything and Go find your shake or your Jamba Juice or your energy bar so that you don't miss your anabolic recovery window, bro. And that actually is true if you're a bodybuilder or a football player trying to pack on 20 pounds of muscle. You're just basically eating all day and lifting weights or training. But if you're in this for the metabolic health and the longevity game, it turns out that there's actually multiple benefits. I've talked about some of the others in the past, like an increase in testosterone and growth hormone. Here we see the increase in insulin sensitivity. There was one a couple of years back. I don't know if you saw this, Jay, but it was better heart rate variability, better recovery from a nervous system standpoint when you're not face stuffing post workout and you're actually kind of causing your body to mount a little bit of a stress based response that you're not getting food right after the workout. So very similar to the idea that you shouldn't do a long cold soak after workout or, or take a bunch of selective antioxidants, it turns out that eating immediately post workout, particularly in this case eating carbs immediately post workouts, doesn't necessarily do you any favors from a metabolic health standpoint. There's all sorts of exceptions. If you're an athlete doing a two a day. Yeah. If you're working out and then working out again with eight hours, you have to have carbohydrates after that first workout if you're serious about being able to achieve the performance that you want in the second workout of the day. Day. Another example would be again, people who are trying to put on muscle. People who perhaps are in a state of thyroid downregulation because they've been starving themselves a whole bunch. They're trying to get fit now again after making a bunch of dietary mistakes. Well, take care of your body, have carbs post workout. But for the most part, painting with a broad brush from a metabolic health standpoint is better to not have carbs post workout than to have carbs post workout. Again, throwing athleticism and muscle gain and things like that out the window and just looking at metabolic health and lifespan span.

Well, watch out folks, because Gatorade is about to sue Ben Greenfield for telling people not to drink their Gatorade after that workout.

Gatorade has probably hated this show ever since I interviewed Tim Noakes back in the day about the whole expose of sports drinks and yeah, story for another day. And also since I've been advocating a low carbohydrate approach. That is until. Until Gatorade comes out with ketone ester, at which point I suspect they will revisit their stance on carbohydrate consumption necessity during exercise. But we'll have to wait for the commercial figures.

Cross. Well, if they can make one that is effective and not full of just complete bullshit, then that would be great because they can make it probably a lot cheaper than some of these other brands that I use, which I love.

And I'm sure it'll be like purple and blue and red and they'll make it great colors as well, which we all know is super important from a marketing standpoint point. This is also related to another study that I wanted to bring up, though this one was kind of cool because what I just mentioned, these ketone supplements like ketone esters or ketone salts or ketone powders that are designed to shift the body into a state of ketosis that you have a lot of ketone bodies, which are great for cognitive performance, for endurance performance. They're a preferred fuel for the heart, the liver, the diaphragm, the brain. I mean, ketones are pretty cool, especially when it comes to going for long periods of time without much fuel on board. And so a lot of companies now are making ketone based drinks. But the question is, can you improve performance by using fake ketosis like drinking ketone esters instead of cutting carbohydrates or cutting calories or fasting, which would be a more ancestral way of getting into ketosis. And furthermore, what's better for exercise capacity and adaptation to exercise training, Eating carbohydrates, eating food, not fasting, et cetera, and then supplementing with ketone esters or just achieving ketosis naturally by fasting and carbohydrate restriction, et cetera. So what this study did was they took one group and they put them on a ketogenic diet, right? Strict, basic, natural way to achieve ketosis. Just don't eat carbs and eat a pretty high throughput of fats. They took another group and they put them on a carbohydrate rich diet. But then they gave them a ketone ester drink four times a day, day. And then they put a final group on the carbohydrate rich diet. So we got high carb diet, high carb diet plus ketones, and then just a ketogenic diet. And this didn't really surprise me because back in the day I would, prior to some of my really hard endurance races, eat a whole bunch of carbohydrate and then have a whole bunch of ketones so that I could have my cake and eat it too and have high blood glucose and high ketones during exercise. And it turns out that, that lo and behold, you actually see a really significant increase in performance when you combine carbs and ketone esters. The interesting thing also is that when you don't do that, you get an increase in fat oxidation. So what I'm getting at here is that if you really want to perform well, follow all the rules about having carbohydrates and pre and post workout nutrition, but throw ketone esters into the mix and it's almost like a cheat code code. You get all the benefits of fasting and having elevated blood ketones, but then all the performance enhancement of the carbs and the standard non ketogenic diet. But if you're looking at this more for again, metabolic health, back to the other thing we were talking about and longevity and things like your ability to burn fatty acids efficiently, turns out that it's better to try to achieve ketosis naturally and restrict carbohydrates, restrict calories fast and not necessarily use exogenous ketones to shift yourself into ketosis. The only thing that I wish that they had done in this study would have been to have a fourth group, a group that was following a ketogenic diet and consuming ketone esters just to.

See exactly what was I going to say?

Yeah, just to see if you could get pretty close via that approach to what you'd get. And I doubt this would be the case, but it would have been interesting to include if folks who are following ketogenic diet and doing ketone esters could perform as well as those eating a carbohydrate rich diet and doing ketone ester esters and also what the metabolic effects of that would be. Because here's what I personally do. I eat a low carb, relatively ketogenic diet. I'm not strict, but I'll have 150, 200 grams of carbs a day, unless it's steak and liver week, obviously. And then I will also use ketone esters because those bump up my ketones even more and have a lot of other downstream side effects like reducing inflammation. They can cause some increases in some longevity associated proteins. And so I think that because they also provide me with extra fuel for exercise, I'm getting a little bit of the best of both worlds just doing that. Ketosis plus ketone esters. So I still think if you were to put Me head to head running a 5k against somebody who had carbs and ketone esters versus me, no carbs but ketone esters. That the person who had carbs is still going to kick my butt and wax the 5K course with me. But it is interesting just to see what happens when you combine carbs with ketones and see it happen not just in anecdotal environment but in a research study.

Yeah, no, I'm totally there with you. I was kind of curious as to why they didn't run that fourth group that was keto or fat adapted plus exogenous ketones. They might have had a reason for it, but they didn't explain it in the study that I'm looking at and reading right now. But I totally agree with you on all your comments there. For me, as someone who tends to be lower carbohydrate, definitely not ketogenic, but lower carbohydrate. For me, the exogenous ketones ketones, I've used it for sports performance, but I don't use it nearly as much as I do for cognitive performance. And I found that when my carbohydrate load is a little bit higher, but my overall, let's say, exercise output is either the same or lower than when I add exogenous ketones, I don't necessarily feel more cognitively sharp. For me, it's that combo of like being on a low carbohydrate diet, maybe even having some natural ketones being produced because of the low carbohydrate nature of the diet and and then adding on the exogenous ketones. That's kind of like my good one, two punch that I've found is the most effective.

Yeah, cool. Cool. I agree. Well, good insight. Okay, let's keep going with a few before we take some questions. And I know we're starting to get long in the tooth for our news flashes, so I won't spend quite so much time on these next anecdotes, but they're pretty cool. So this next one was also from the Journal of Strength Conditioning Research and it looked at muscle cramps cramping. Many of us who are still kind of like operating in an old school exercise physiology mindset associate muscle cramping with dehydration and electrolyte depletion. And that can actually be the case. That can be the case, yeah. If you're dehydrated severely and you haven't enough salts on board, then it is likely that your muscles may cramp. And it is interesting that people will sell.

The pickle juice shots, where you pay four bucks for a dime worth of pickle juice, and you drink that when you start to cramp, and it reverses the cramp. An old school tactic I used to use when I was racing Ironman was I would take those electrolyte capsules, which are incredibly salty, and I just chew them instead of swallowing them. And it's interesting because they've shown that those strategies will reverse a cramp and stop a cramp in its tracks. But the interesting thing is the time that it takes to stop the cramp is not long enough for those salts to have been able to make it into the bloodstream and rehydrate the muscle. So actually, they're operating on a neuron reflex that when you taste something super salty or super bitter, it inhibits what's called the alpha motor neuron reflex that causes the muscle to go into a cramp. So your body releases the cramp. But it's not because necessarily because you were dehydrated or electrolyte depleted. It's just because of that neuron reflex, which means even if you're not dehydrated and you're not electrolyte depleted, just tasting something super salty or something very pickle juicy can reverse a cramp. Which is kind of a cool thing to know if you struggle with cramps. Now, the thing is, though, so the real reason that most cramps occur, and I wrote about this back in the book Beyond Training, is you're asking your body or your muscles to exceed the load that they've grown accustomed to in training. And there is a protective mechanism via what's called the Golgi tendon organ in the muscle belly that occurs, that causes the muscle to go into a protected, cramped state so that you can't damage it anymore by asking it to do something that it's not physically prepared to do something do. And so it's a protective mechanism. A cramp is much more often a protective mechanism because you haven't trained properly or you're going faster or harder or lifting more weight than your body's used to. And that's what causes the cramp. That's why if you're fully hydrated and you have all your electrolytes, you can still cramp. Sometimes it can be you have some of your electrolytes, but not all of them. Like a lot of people who are deficient in magnesium or in potassium, but they've been salting their food or whatever with just normal iodized table salt. They'll cramp. And that's because they're not getting a full spectrum of minerals sometimes anyways, though. So this study looked at dehydration and electrolyte depletion versus muscle damage. Muscle damage. And so what they did was they took a whole bunch of marathoners and they put them through an exercise test and they did blood and urine samples and then they did a road marathon. And after the race they looked at exercise associated muscle cramps, who cramped, who didn't, et cetera, et cetera, et cetera. And then what they looked at was markers of muscle damage, particularly creatine kinase and lactate dehydrogenase. And they found that those markers of muscle damage were significantly higher in the cramping group, whereas they didn't necessarily show a deficit in their electrolytes or their hydration status. And so what this means is that if you have muscle cramps in this study, I mean, the final sentence basically says that runners who suffer exercise associated muscle cramp in cramping didn't exhibit a greater degree of dehydration, electrolyte depletion, but did display significantly higher concentrations of muscle damage biomarkers. If you think about what you do based on this, it would mean, oh, well, marathoners who cramp a lot, they should be strength training or they should be training in such a manner that especially towards the last half of the race, they've asked their muscles to do in training what they're asking their muscles to do in that last half of the race. And they should basically come at the cramping problem from the standpoint of making the muscle stronger and more resilient to fatigue and stress versus just buying 6 packs of Gatorade and headed off to the race. So I just think it's interesting that it seems like sometimes we're still in the dark ages when it comes to cramping and we just think sports drinks. Sports drinks, electrolyte water. Water. But it's in fact training and muscle damage that's the bigger variable here.

Yeah, no, makes a lot of sense. Well, it's not as sexy. Right. It's not as lucrative for companies that, that cell electrolytes and other things.

Right. It's back to the high intensity interval training. Right. You could take berberine and blood glucose disposal agents and bitter melon and spend money on that. Or you could do high intensity interval training, do the work and get just as good results. I mean, I'm again back to the ketone esters. I'm a best of both worlds type of Guy where I'm like, yeah, stay hydrated, use a wide spectrum of minerals and weight train and you're going to have a lower risk of cramping or do high intensity interval training, cold thermogenesis and supplements to control blood glucose. And you'll probably have better blood glucose had you not done any of those or just one of them. So I think this isn't an all or nothing black or white thing, but it just shows the importance of stacking some of these things.

Yeah, exactly.

The next one. And I actually started with some of my clients, I have begun weaving some of these into their workouts more because this article on Stronger by Science just kind of was a great reminder of weak links. And the title of the article is the most commonly neglected movements and muscles and exercises to address weak links. So what it goes into is how in the average weight training session or in the average exercise program, there are certain muscle groups that are notoriously neglected, that when neglected leads to poor stabilization, weak links and increased risk for injury. And then it goes into what those three movements are and how you would actually train for them with really helpful pictures and video. But the three exercises, I think this is going to be common knowledge for personal trainers or physical therapists, but maybe not for a lot of other people. The three areas that tend to be the weakest links when it comes to muscle detraining or poor balance in the muscles, number one is scapular protraction, forward movement of the shoulder blades. Scapular protraction. The reason for that is a lot of times we're kind of hunched over at a computer forward head posture. And a lot of times we think about pull ups and rows and things like that to kind of fix that scapular protraction. But that's actually just training the scapular retraction. You actually have to train the scapular protraction which involves targeting muscles like the serratus anterior and the pectoralis minor. And so perfect example is that would be like you get into a pushup position and you do a pushup, but then at the top of the pushup you do a scapular protection where you're kind of trying to pull your shoulder blades up and apart and then you go back down and you do another push up and again, going to look at the videos and the photos in this article will be useful for you. So I'm going to do, I'm going to spend less time explaining the exercises and more time explaining which of the three areas that you want to target Scapular protraction is one. The next one is your hip flexion. Your hip flexion, the movement of the. Just think of this as the movement of the knee up towards the chest. That's an example of hip flexion. Ben Patrick, the knees over toes guy who does a great job at rehabbing people for not just knees, but general movement patterns. He's huge into hip flexion exercises like the sled pull or the sled drag, a lying hip flexor, reverse squat type of exercise. Knee to chest. Another perfect example, hanging leg raises or reverse crunches. Anything that's really getting the hip flexors to fire is important. And again, I think a lot of people kind of similar to the scapular piece might be. Wait, my hip flexors are all tight during the day. I'm sitting down. Why would I train my hip flexors if they're already in a tightened position? Wouldn't I want to train my hip extensors, my glutes? But that's not actually the case because when you're in a seated position, the hip flexor is actually getting weaker, not stronger. And what you can do is increase tonicity and strength in the hip flexor by doing a lot of these hip flexor exercises, again, like the hanging leg raise and the like. And what that can do, especially if you combine it with training the glutes, is help out a ton with things like back pain, running speed, overall athleticism. So hip flexion would be another one, and then the last one is hip abduction. Abduction, the movement of the thigh out and away from the midline of the body. A ton of people are just, they're poor at lateral movement patterns. Even like super fit people like Crossfitters, they have a ton of front to back motion, but very, very little of that sagittal plane motion in which you're moving side to side like lateral lunges or clam shells in a crawled position, or having an elastic band around the legs and doing side to side monster walks or squat walkouts. They're such a crucial, crucial part of movement and such a weak part in a lot of people that I would fully agree that that's a solid third for the three most neglected muscle groups. So. So if you're into exercise, if you are struggling with injury, if you feel like your body needs to be more put together, then have one workout during the week, for example, where you're just doing hip flexion, scapular protraction and hip abduction, or have a mini workout that you do at the end of each workout that's targeting those three areas. Or if you go and grab that guy Ben Patrick I mentioned he has a book called ATG for Life, and there's two workouts in there. They take 20 minutes, but they kind of hit a lot of these notorious weak variables. And that's another example of something you could just weave into your program a couple times a week. Whether you do it before or after your main workout, or you do it as a supplementary workout or a morning routine, I would highly recommend that you review the article because it's just got some solid exercises in there that will really keep you in the game from a lifespan standpoint.

I've always heard that Cat cow poses were really good for scapular protraction, which makes sense.

Yeah, they are. Especially if you have really good yoga pants. Everybody knows Cat cow requires a solid set of yoga pants.

Inevitably.

Yep, Lululemon, here we come. Let's do one more, and then I think we should move on to just a few questions so that we don't get too long in the tooth here before we're able to take on some questions from the audience. I suppose that I want to bring this up just because anybody who's a regular podcast listener knows that I recently came out pretty strong against plant medicine. At least the recreational modern use of plant medicine, specifically when it comes to things like divination, seeking God's wisdom, spiritual enlightenment, finding yourself, bro, or finding yourself CIS all the shamanism and the turning to drugs and plant medicines as a form of spirituality or a way to God. I think that folks are playing with fire, as I got into in the article, which you can read@BenGreenfieldLife.com PlantMed Part 1 because you really actually are, whether you believe it or not, opening yourself up to a spiritual universe. This is why there aren't a lot of atheists who have done plant medicine. Most atheists who do plant medicine come out the other side believing in God or some higher power or some collective consciousness or some spiritual world that's outside of us. It's not all just just boiled down to materialism and logical rational science. There are these unexplained phenomenons out there that are directly linked to some kind of a spiritual world. And I am concerned about people who are dabbling without any knowledge, often in the wrong set and setting with these types of medicines, and setting themselves up for some pretty deep and dark spiritual experiences, including, and I realize a lot of people chuckle when I say this, but we don't live in a total materialistic world world so I'll say it, including communing with demons or setting yourself up for some type of dark possession, or even being possessed by a shaman in the Amazon or someone else who wants to use you and abuse you. There's a lot of issues and of course I'm not going to get into them all on this podcast because I covered them pretty extensively in the two part podcast series and the two part article series that I did on plant medicines. I still think there's a few use cases potentially for palliative hospice care, end of life therapy, therapy with something like psilocybin, addiction treatment, such as Johns Hopkins is doing again with psilocybin, possibly couples therapy with say MDMA couples therapy, where you're wide awake, you're not journeying with a mask and music, but you're just with your couple producing a lot more oxytocin in a very heart open state. And then also I think there are a few use cases for things like microdosing, for increased sensory perception or for better sex or productivity or focus or creativity, like small and appropriately dosed amounts of these types of things, these so called entheogens or plant medicines. I think that's another acceptable use case for them. So based on all that, and so that I don't shove the entire industry under the bus, because I do see some benefit of some use cases of these, I should note a recent study that looked at the so called Stamets stack, which was made popular by a fellow Pacific Northwestern, Paul Stamets, who's a mushroom forager and I believe he's the host of that documentary Fantastic Fungi. And his stack is Lion's mane mushroom, which is not entheogen or psychedelic, and niacin which is more like a blood flow precursor combined with very small amounts of psilocybin. And there's been a lot of people for a long time saying that this is like a game changer stack. I've done it and I've noticed a significant increase in sensory perception and creativity and just overall mood and mental health health when using a stack like that. So this study actually looked at the combination of psilocybin and lion's mane and niacin and basically found that there actually is a significantly greater observed improvement in mood and mental health after just 30 days of a protocol like that compared to people who are not dosing with that. And I think the only, the only fallback of this study is very difficult to give someone like placebo magic mushroom versus regular magic mushroom. So it's possible that the people who got the microdose knew what they were getting, especially if it was anything above a slightly perceptible dose. But anyways, it is interesting that the stack actually does work. And I also bring it up because it would be an example, I think, of an appropriate use of something like psilocybin. I'm going to go do some creative writing. I'm going to take a little bit of psilocybin, like whatever, a quarter of a gram. I'm going to do a little bit of lion's mane, a little bit of niacin to open up the blood, and it actually works pretty well. I just think we have to approach these things with a great deal of caution and respect. Even after I wrote that article. Yeah, I've got a pantry full of LSD and psilocybin and Wachuma and all these plant medicines that I have used in the past for microdosing. And I actually put them all in my gun safe because I'm like, wait, if it actually is true that if someone were to grab a handful of these and not know what they were doing, that they could open themselves helps up to potential for demonic influence and entering into a spiritual portal, into a spiritual realm that they have no business being in. I probably shouldn't have these things next to the ketchup. So I've kind of changed my approach to the respect that I give to microdoses and entheogens. But I haven't sworn off microdosing. And this particular article just shows that, yeah, stuff like this can have some benefit without the risks of things like psychosis, schizophrenia, dark spiritual experiences, et cetera.

Yeah, I mean, I really appreciate you throwing out all of your well thought out thoughts. It's obvious that when you wrote this and you did the podcast, you put a lot of time, a lot of thought, a lot of prayer, a lot of discernment into it. And so it's really appreciative regardless of anybody's religious beliefs, a belief in any other type of dimensions, or demons or demonic possession. I think the one thing that people should come to an at least a unified agreeance on on is that because plant medicines and ceremonial doses or trip doses have become so common and modernized, like people are absolutely just using this very flippantly and so flippantly that like, I have seen from a mental health standpoint a lot of long term residual effects from people just jumping in and said, oh yeah, you know, I've got this dude who's doing an ayahuasca, you know, ceremony this weekend. And I'm going to. It's his first time ever doing it, but I'm gonna go do it. And the next thing they know, like, they have very long standing problems with what they experienced and what they continue to experience afterwards. So I think a lot of it comes down to just pure flippant use, disrespect almost for what, what the plant medicine does and can do. And I think that at least at a minimum, we have to come to that unified decision that that is not a good thing. But I, I think you made a lot of great points in your article. And then when it comes to microdosing, I think that's going to be an individual's decision. And if they feel like it's making them stumble or it's causing them problems with their own religious journey, spiritual journey, personal journey, whatever it may be, then they have to come to that decision.

Yeah. Yeah, agreed. Oh, and then the last thing I should mention, because this is, interestingly, I don't know why this is one of the top questions that I've gotten after publishing the article is, hey, Ben, are you still using that Feel Free stuff? Because it has Kratom in it and yes, I still use Feel Free. The whole gist of that entire article series, you guys, if I could boil it down to the simplest message ever is altering your state of consciousness with psychedelic drugs and entheogens, traditionally used for divining with the gods, for witchcraft, for sorcery and for occult magic is playing with fire. So be careful. Having a shot of Kratom before you go work out is not what I'm talking about. About. So just to clear the air there. So anyways, let's go ahead and open things up to some questions from Twitter. So if you're on Twitter Spaces, what we'll do is we'll bring you up on stage. You have a question. We'll take a few questions here. All right, who we got? Jake. We got Jake on stage. Okay, let's go with Jake. Jake, what's your question, man?

Hey, Ben, it's surreal to be speaking with you right now. Thanks for picking me first. A few years ago, I had a orthopedic injury, herniated discs. Recently I've had a shoulder injury, torn tendons. And I've done a lot of my own rehabilitation and doctors, you know, going through those hurdles and the holistic stuff has all worked out way better than anything that I've been instructed through physical therapy or I never took any medicine that was prescribed for me either. But specifically, things like Rolfing and muscle activation technique have been game changers for me. And then they've gotten me to the point where I've been able to run and I've been able to exercise and get real big again and do the things that I love. But I want to sort of fix it once and for all. And one of the things I was thinking of doing is going down south and doing some of the stem cell procedures. And I know that you've had experience with that before. I was curious if you can speak on it a little bit, especially the ones down there, because there's a lot less insight into what they're actually doing since it's not so transparent like they.

Are here with research.

Okay, cool. Yeah, great question. So the reason that you'd go international to do stem cells is because it is legal to expand stem cells internationally, even your own stem cells. And that would cause an increase in the available MSCs, the mesenchymal stem cells, and result in much, much better results than getting a count of stem cells. That's billions and billions lower in the US because you can't expand it in the US it used to be the wild, wild west. I remember I went down to Florida and had the US stem cell clinic take out my fat cells. I was 30, so 10 years ago. And they expanded them there and I think their facility got raided by the FDA a couple days after I was there. But now it's pretty much much goes without saying that unless it's a nudge, nudge, wink, wink from your doctor, which actually does occur still you're not supposed to get stem cells that have been expanded. You're supposed to only go do those in an international clinic. So the thing is though, that there's this phenomenon called paracrine signaling, which is essentially like cell to cell communication. And you can increase the effectiveness of the paracrine signaling that stem cells engage in when you co administer them them with little signaling molecules called exosomes. And there are many regenerative medicine docs in the US who are taking non expanded stem cells and combining them with exosomes and sometimes also platelet rich plasma, sometimes depending on the injury, occasionally ozone, although that can cause a hyperinflammatory response if you're not careful with that. Sometimes just basic prolotherapy, like sugar solutions and things like that, and then injecting them, preferably using ultrasound guided imaging. You really want your doctor to know where the needle is going. If they don't, they probably don't know what they're doing. And that can be very efficacious and get you very close to what you'd be getting from an expanded stem cell treatment internationally. You're still not going to get as many stem cells. But what I'm getting at here is stem cells plus exosomes, plus possibly some other forms of prolotherapy local in the US could actually get you a lot of what you're looking for overseas with less expense and time and travel and hassle. There's a few docs who are good at this type of stuff. Two of my friends who I think do a good job with stem cells would be actually three of them do a good job. Dr. Craig Conover at Conover Wellness in Charleston, South Carolina. Dr. Matt Cook in San Jose, and then Dr. Holland Chen, C H E N. He's doing some pretty cool things. What they're called V cells. Also very small embryonic like cells which are also legal in the US Those three guys do pretty good job with spot treatments. And then like the bee's knees. The best of the best gold standard treatment that's like exosomes, stem cells, bone marrow Soup, everything is Dr. Harry Adelson at Dossieri Clinics in Park City, Utah. And he'll just do like head to toe inject every single joint, your whole body. I've done that twice and that's just, that's a total game changer. So hopefully that fills you in a little bit in terms of options, Jake. But yeah, I'd look into like stem cells plus exosomes nationally and you'll probably get a lot out of that versus traveling international, so. So great question and. All right, looks like we're gonna bring Sterling up.

Yeah.

Hey.

Hey, Ben. How's it going?

It's going good, Good, good.

Awesome. Great to interact with you too as well about the psychedelic stuff here on Twitter. It's a great conversation to have. Very interesting. But yeah. So my question for you is, have you come across in your work yet around targeted low intensity pulsed ultrasound for like neuromodulation? That's an area that I work in a lot ever since like back in 2013 I started. That is pretty much my career. There's a clinic down in Tucson, Arizona with a guy named Jay Sanguinetti and Shinsen Young doing like mindfulness research. They're basically taking big focused ultrasound transducer that's like about the size of the palm of your hand and they focus sound waves deep into the, the, like the anti anterior cingulate gyrus they can essentially like, like buzz with, with pulsed ultrasound, like a thousand hertz and they, they turn that thing off and it's like the ego center apparently, you know, according to a lot of, you know, FMRI research where that's the seat of the default mode network and they can just zap it off in just a few, few minutes of stimulation. And I find that work to be really interesting. I kind of feel like it's a good alternative as well to this conversation around like psychedelia because people do want to have a shift in their state. They want something different than the, the day to day reality. But you know, I found as far as that, ultrasound is pretty safe. It's pretty controllable. As soon as you're gone, it's not flowing through your bloodstream, it's just a sound wave. It's there and it's gone. Play music. Stop the music. So yeah, what are your thoughts on that?

Yeah, I love this. This will be really cool for you to hear. Sterling is. I have a deep dive podcast coming out on this use of so called Spirit Tech. Spirit Technology. I interviewed Kate Stockley, what's her name? She wrote the book Spirit Tech. We actually talk about TFAs which is a special ultrasound based headset for meditation that they use at the SEMA lab, which I believe Shenzhen Young, who you mentioned works at. And yeah, it does require like an MRI typically beforehand to make sure that you're targeting that low intensity ultrasound to the right area of the brain. But it goes deep and the effects on people in terms of like a shift in brainwave states and a post treatment effect similar to what one might get from say like psilocybin therapy is super interesting. The whole book is really interesting called Spirit Tech and I do like, I think my podcast on it is coming out in the next week or so. We get into that and also some other forms of energy, electromagnetic et cetera and ultrasound based that as you alluded to, are ways that one can safely and arguably even more effectively than plant medicine, shift one's state of consciousness into a state of left and right brain hemispheric activity or increased oxytocin production or a drop in irritability or anger or impatience or increased resilience to stress or even relief of trauma from technology. And so you're right, you don't have a bunch of stuff, a bunch of chemicals floating in your bloodstream that you got to recover from for a week after. I've never in my life heard of anyone having a dark spiritual experience when using a brain tap or an ultrasound machine or a TDCS headset or anything like that. And yet it seems to do a really, really good job based on electrical medicine and of getting the desired effects without a lot of the downsides or the disadvantages. So I'm grateful to you for drawing that corollary, Sterling, between this technology and the altered states of consciousness. Because, yeah, this technology is kind of being developed for things like better meditation, cognitive performance, possibly trauma relief, blood flow to the brain, et cetera. But I like to see stuff like this becoming popular because I think it offers an alternative to, a safe alternative to journeying with plant medicines or going to Peru to do ayahuasca. What if you could just basically grab a little tech device off of your counter if you're dealing with deep stress and trauma and just zap yourself for 20 minutes? And again, I think we do have to step back and still say, well, I don't think anything is going to replace, especially for me as a Christian, like trusting God and faith in the healing power of the Holy Spirit and salvation through Jesus Christ and all those things that I found a deep amount of peace and joy and hope and love in. But I think that God also gave us certain tools that can be effectively used to assist with that process. And the only tool I can think of that he said not to use was pharmakia or drugs. So based on that, I think that you could make a pretty good case for, for the effectiveness of this stuff and the ethical status of it being thumbs up. And also.

I'm just excited about the emergence of it, so I'll shut up now. But yeah, thanks for bringing it to our attention. And yeah, Spirit Tech is going to be a really great book and my interview with her is going to be really cool too. And for those of you who want to see what Sterling is doing, he's erlingcooley on Twitter if you want to go check out some of the stuff he's doing with ultrasound neuromodulation and vagus nerve stimulation simulation technology. So, great question, Sterling. And you know what? We'll do one more. We're going to make a rapid fire. So my response might not be too long in the tooth, but let's do one more.

Hey, Ben, how's it going, man?

Yo, yo. It's going good.

I know you got. You don't have much time. Just quickly really wanted to say thank you so much for honestly changing my life and making me feel just so much more, so much better, healthier, have more energy, really Quick, my question is, a few years ago, I had an infection. The doctor prescribed me azithromycin and one other antibiotic doesn't come come to mind. But ever since then, I've been waking up in the middle of the night to urinate like, once or twice, and my stools have been, like, pebbly. But my blood work has all come back good. And. And I mean, I've tried, like, everything for this. I've taken probiotics, seen different types of doctors, all sorts of different tests, and just nothing's working.

Curious.

Yeah. You mean specifically for getting up at night to pee? Yeah. Yeah. Okay. Well, again, like, might not be able to give the longest, most super thorough answer on this condition, which is called nocturia, by the way. Needing to wake up at night, night to urinate. But I can just speak to a couple of things that you may want to bear in mind. You listed a bunch of stuff that could cause the issue, like poor gastrointestinal function or gastric inflammation, enlarged prostate, which can be a huge issue. A lot of times it can be just dumb stuff like drinking too much water or any other fluid after dinner. Or it could also be, for example, if you have had sexual intercourse before, you go to sleep, sleep, and then not peed after that. That can also result in you waking up at night and needing to pee. And then there are some medications. Ketamine is one that comes to mind that I know can cause this. Certain diuretics, some antibiotics, too much vitamin D. A lot of people don't know that that can actually cause it. Or a diet that's just way, way too high in sodium. Nicotine can also be a problem, like nicotine gum, nicotine lozenges, things like that. Not that they're bad, it's just for nighttime. Peace being not the greatest idea. There's a few different things that you could try. I think that the paradoxical issue here is that if you're sleeping in a cool room with a chili pad or keeping the room cool, that can also increase the need to urinate as well, which anybody who's been outside in the cold knows you sometimes have to pee more when you do that. As far as fixes, because I've had this issue in the past myself, and my PSA is just fine. The only thing that I've found to be super effective is to literally right before dinner, just start to taper off almost all fluids. I might have a small glass of wine with dinner, but I drink probably less than I should in the evening because I just don't like to have to get up tonight to pee and then try to get back to sleep. There's also one thing that some people have tried, which is compression socks. Theoretically it could prevent fluid accumulation and may help out a little bit. And then there are also anticholinergic medications and those may reduce the need to get up and pee as well. It's just like I'm kind of on the fence about recommending an anticholinergic pharmaceutical. There are certain anticholinergic agents that are out there that are natural plant based anticholinergics. Unfortunately a lot of them are poisonous and I'm not sure, I think some of them in the alkaloid family, but I don't remember off the top of my head what some of the natural plant based anticholinergics are. Anyways though, that's another thing you could look into. I can't say I have a solid answer for you. All I can tell you is a lot of people deal with this issue and sometimes it is as simple as just not drinking too much in the evening. I don't know. Jay, you want to add any color to this?

Yeah, I don't know if I have anything more intelligent than what you just said, but my mind just keeps going back to elimination intake of water. And for me, like I've actually tried to do it. I'm a, I'm a pretty young guy, but I hate waking up in the middle of the night to have to urinate. It's not a problem, but I just don't want to do it anyway because I find that when I wake up for any reason my mind just starts to go and that's never a fun thing. So for me I'll start limiting intake of water around like 6pm sometimes maybe even a little bit earlier. I know Tom Bilyeu does this and has found this to be extremely effective. So yeah, that's all. The only thing, anything, I guess semi intelligent I have to say about it.

Yeah. By the way, the anticholinergic one is, it's jimson weed. Jimson weed. You might be able to find it on Amazon. I've never actually used it, but that's one that would not be poisonous and that could work. J I M S O N weed. So I don't feel like we gave you all the answers there Alex, but hopefully at least pointed you in the right direction a little bit. So I think, gosh, I think we are just about out of time. So Jay, should we give away some swag here before we Wrap things up and tell people if they want more. Go to BenGreenfieldLife.com 444 what do you think? Should we do a giveaway?

Yeah, it's always my favorite part. Of course we should.

Well, this is the part where Jay's going to leave a review. If you leave a review and you hear us read it on the show, all you got to do is email gearngreenfieldlife.com with your t shirt size and we will send off a handy dandy Ben Greenfield life gear pack, shirt, water bottle, two beanie, all sorts of stuff your way. And so all you got to do is give us love wherever you attend to listen to your fine, fine podcast, wherever fine find podcasts are found. So, Jay, you want to take this one away?

Yeah, let's do it. So this one comes from ColorsOfDay, and they titled their review fabulous show on biohacking. I love learning from Ben and the way he and his wife do life together with their twin sons. It's so much more than just biohackers hacking. It's all about spirituality, evolving into the best human possible and being an excellent steward of the world we live in. He interviews some fascinating folks and shares from his own life experiences and research. Definitely worth your time to listen to Praying Hands Emoji.

Praying Hands Emoji. That's right. That's their title is Praying Hands emoji now.

Actually, you know, I misspoke. That's the actual emoji, but it's the praise hands emojis, like the two where the thumbs are together, not the praise.

So confused. I didn't even know what the. I didn't even know what the eggplant meant until, like a year ago. So I'm still working my way through emoji. You'll get there. Yeah. Emoji vernaculars. All right, well, that's a great review, so go ahead. And if you left that review, email gearngreenfieldfitness.com we'll get a handy dandy gear pack out to you. For everybody else, go to BenGreenfieldLife.com 444 for the show notes, all the articles, all the podcasts, all the resources, everything. Everything that we talked about. Even if I can find jimson weed for nighttime peeing, I'll put it in there. Until next time, Jay. I'm gonna go have some steak and liver.

Do it, man. Steak and liver cake. No, no, no, not cake. Pizza. Steak and liver Pizza or cake.

All right, guys, talk to you later.

More than ever these days, people like you and me need a fresh, entertaining, well informed and often outside the box approach to discovering the health and happiness and hope that we all crave. So I hope I've been able to do that for you on this episode today. And if you liked it, or if you love what I'm up to, then please leave me a review on your preferred podcast listening channel, wherever that might be, and just find the Ben Greenfield Life episode. Say something nice. Thanks so much. Means a lot.