EP 180 WTH?!?: Master HRV for Health with Dr. Torkil Færø

Hey, welcome back everybody. I'm Dr. Greg Eckel. This is what the health. Our topic today is the Pulse Cure, examining the significance of heart rate variability with Dr. Torkel Farrow. He's a general practitioner and emergency physician, a documentary filmmaker, an author and photographer. He's coming to us from Oslo, Norway with his wife and two children. In 96 he was one of the first Norwegian medics to work for Doctors Without Borders when he worked in war torn angola. Over a 25 year career as a freelance doc, he's worked all over Norway, had tens of thousands of consultations and gained a unique picture of the diseases that plague us. He has learned that the cause is most often found in the stressors of our lifestyles place on our bodies. Pharaoh is also an award winning photographer, author of the Camera Cure and has made documentaries about his pilgrimages to Nidaro and Santiago de Compostela. And inter veterate traveler, he has made his way by bicycle, motorbike, kayak, boat and car through over 80 countries. He speaks eight languages. Welcome aboard, Doc.

Thank you. Thank you. Dr. Greg, great to be on your podcast.

Oh, we're. I'm really excited to have you on. I really, I love this topic and I love that your book has been the Norwegian bestseller list for 65 weeks and counting. The Pulse Cure.

69 now. Yeah.

Oh, 69 weeks. I love it. It keeps going and it's translated into five languages.

Six. Six.

It will be six now. Okay. Holy cow. Just, you're rapidly on it today.

Added today was Italy. So that's very recent. So.

Excellent, excellent. So this component, I guess a lot of folks may not be tuned into heart rate variability and what it means, and what does it mean to our health. So maybe we can just start broadly in that meta level for folks and then we're going to kind of get into it.

Yeah. So the heart rate variability is the variation between heartbeats. So it's not the pulse rate in itself, you know, which could be 60 or 70 or 150 if you exercised hard, but it's a variation between heartbeats which is a measure of the autonomic nervous system. Whether you're in the parasympathetic restful state, the recovery state, or if you're in the stressed sympathetic state. So if you're in the parasympathetic state, when you breathe in, your heart rate goes up a little bit. There's more oxygen in the lungs, and when you breathe out and less oxygen in the lungs, the heart rate will slow down just a little bit. Measured in Milliseconds, but detectable by the smartwatches and smart rings and all the devices that we see. Now, if you're in the stressful state, the sympathetic state, then the heart rate will beat at a very steady pace. This is the way that these wearables can detect whether you're in a parasympathetic state or a sympathetic state and record it, of course, throughout the day and night. And the heart really picks up all this. It's kind of the center of command. So it's picks up all the signals from the body, from your organs, from your brain, from your feelings, from your exertion after training and, and like everything. So, so it's such a good measure of the state of our physiology and it's kind of a window into our autonomic nervous system that we doctors have no other ways of finding out. So it's really like a, like a miracle metric by biomarker. So, and so it's so easy to find, you know, it's so easy to show with the apps, you know, from the watches. So it makes the people, being the CEOs, of their own health. They can take charge of their own health. So, so it's just, so a couple.

Components on that because, you know, I was going to do research on blood pressure about over a decade ago, and you get in on the research and you realize actually it's, it's super variable blood pressure up and down, and that's not what we're talking about here. But I think it may be surprising for our listeners and viewers to hear that you actually want a variable heart rate.

Right.

You're saying you're measuring the heart rate variability? Is the variability. The more variable your heart rate is, the healthier you are, the more relaxed you are. How would you say that?

Yes, the healthier you are and the more connection you have with your vagus nerve that we understand more and more is so important. So you, your body is able to recover better, your immune system works better, your mitochondria work better. When you have a good heart rate. Variability in this distress state is a sign that your body is under pressure and is, you know, is has less energy for the recovery processes in your body, for digestion and for, for, for overall cell function. Really?

And what do you see? Do we have good research correlating heart rate variability to health?

Absolutely. So there's so much research because probably because this is such an easy metric to get. So once you're researching something, you might as well get this easy metric into your to into your data. So I often, I'm often asked a lot of questions about heart rate variability and usually I can, I can Google anything like cancer or heart disease or heart, heart attack or stroke or whatever and add heart rate variability. And there will pop up so much research on this. So, so, and that is so interesting. Like for example, cancer, the risk of getting cancer is correlated to heart rate variability. And if you get cancer, it will say something about the prognosis and if you get rid of the cancer, it will say something about the, the risk of getting it. Once again know.

Oh, interesting. How accurate are the wearable devices?

I have used wearable like ECG devices and at the same time that I've used these on, that you have on your wrist or on your finger and they seem, seem accurate enough. You know, you're, anyway, you're, there's a bit of whether your stress level is 70 or 80, it's not so important. The big difference if, is if it's 60 or 90, you know, so, so, but I find them very, very accurate really. And the, the best one so far that I found is the Garmin watches, but you also have the OURA rings and the whoop band. And I use them all at the same time. So, and, and they, they will vary. They will give me somewhat different numbers, but over the course of the day and week they will, they will vary at the same level, so to speak. So, so and giving more or less the same answer. Right.

And what, you know, I said before we got on the air, I kind of was like secretly hoping that you're going to give me some tips on how to raise my heart rate variability. I just noticed the difference between, let's say the aura and the whoop watch. I like my score on the whoop. I, I know I can't compare my heart rate variability to yours. Is that correct? This is not an absolute number.

Yeah. So it seems that the, the genetics of heart rate variability is around 50% so that you should not compare your, your number to other people's. So like if you had 30 or another person has 60 in heart rate variability in milliseconds, you could have exactly the same level of health. So you should only compare against yourself really, over time. So. And you would probably get a little bit of difference from your whoop and aura. How is your numbers.

They're about 50 points apart, actually, you know, on the baseline. Yeah.

All right. But they would vary, you know, from day to the next day with the same.

So they, they vary consistently. It's just It's a higher number, you know.

That's right, Exactly.

Call me competitive. You know, doc, I know I shouldn't be, but I am.

Yeah, yeah. And, and this is a way of gamification of your health, you know, so you get the score and you get the good night's sleep, you know, then you get a good score and you feel good. And instead of earlier, you know, all the business people and people used to brag about how little sleep they got and now it's how, how good sleep you get. So when you get to work at the lunch table, you know, I got like 90, you got 70 and. Oh, you know, so it's a gamification of your health where your life and health is at stake, you know, not some, some avatar or. Yeah.

How can we use this number? So the Apple watch has an hrv, the Oura ring, there's the ultra human, there's the Whoop watch, the Garmins like all of these wearable, you know, it is a pretty easy and as you're saying, accurate number to follow. How do we utilize this in our day to day?

Then we can see what will affect the heart rate variability and that is what the Pulse Cure is all about. It's different strategies when it comes to sleep, exercise, food, rest, alcohol, all these different things that will affect your heart rate variability. So of them, of course, alcohol is the biggest stress factor. And I talk to people all the time and I haven't met one person starting to record their HRV that is not cut down on alcohol because they see such a huge impact on their stress. Much bigger than you would think, unfortunately, because I used to like having a couple of glasses of wine every day for, for, you know, many, many years. So. And then you have food. So if you eat food late at night and maybe particularly if it's like junk food or pizza or, or crisps or, or sweets or, or things like that, it can affect your stress levels way into the night. And you will see that on your device. And then particularly, I must say, Garmin is the watch that you could see by the hour how much stress you have. So it's so much easier than to see where and when was the stress during the day. So and then you would see that these stress factors. And then of course you are more careful about eating late at night, you're more careful about exercising late at night and so on.

Interesting. So how do you utilize it? If somebody's new getting into this, clearly getting a device to track it, do you have favorites that you recommend in the book.

Yeah, Garmin at this point, Garmin is by far the best. But now of course Samsung is coming with their Galaxy Ring. You know, that must change the table. And then aura ring is very good for sleep, the sleep phases. If you have an Apple watch, you can use an app called Athletic. That's quite good. It's quite similar to Garmin. Yeah. So there's so many choices and I also very much like the whoop band also that you can, you can put into the app the different things that you do in the course of the day. So you get a weekly and monthly report with whoop and that is, I think that is very interesting. Yeah. So, so, but what I would recommend if you start, I would not change anything for a month or, or, or more to get the baseline of how you are living right now and then to start changing one thing at a time to identify what will affect it. Because if you change like two or three things, you don't know what affected the heart rate variability.

So for sure. And how do you utilize this as preventative and personal medicine in the future? I mean the future is now. How, how could, I mean we're going to recommend getting the book, I'm going to have the, the link in the show notes for sure. And but how do you utilize this for better sleep or exercise etc?

Yeah, so you can see like for example last night it was quite hot here in the, in the bedroom. And the difference between it must have been maybe 70, maybe 72 degrees Fahrenheit as opposed to 65, which is the optimal temperature at night. And then my recovery during the night will be worse because of the temperature difference. So these things you can, you can see and adjust to, the optimal temperature at night would be from 60 to 65 degrees Fahrenheit. Uh, it should be really dark. And you will also find out that you should wind down the last hour or two before you go to bed, dim down the lights, read a book, do something that actually, actually relaxes you, that you can see on your monitor. And then you would sleep better with a higher recovery rate because you may sleep for the same amount of hours, you know, like preferably more than seven hours. But there could be a big difference in, in this, in your recovery, in your, in your restitution during the night. So if you have been having a couple of glasses of wine, a late night meal and so on, you will see it that it may be the same amount of hours, but it would, it would not be as restorative.

And when you say Recovery and restorative. What is that? How is that measured?

Okay, if that, that is by the heart rate variability. So you would have a lower heart rate variability after a meal or alcohol and with an optimal sleep you would have a higher HRV and you would feel it in the, in, in the morning. This difference I'm sure you, you feel, you know, if, if the OURA ring gives you more than 80 points you would feel it as opposed to, you know like less than 60 or so.

For sure. You know, looking at that, how does the heart rate affect there? Because I've been tracking mine on, you know, when, if my heart rate decreases within the first four hours of sleep. I think that plays in on the aura on a readiness score. I'm going to get a little geeky with you a little bit I think on. Do you, are you incorporating that into your readings or in the, in the book discussion?

I don't pay so much attention to it. Maybe I should but I'm not that geeky about this. Maybe.

Yeah, no.

So no, I don't really look into the, into that variation. So but, but in general your heart rate may vary a little bit. You know, I can see that on people who exercise a lot, you know, top athletes that their heart rate could differ like from 40 beats a minute to 42. But their heart rate variability can, can vary a lot more. You can almost double, you know, so, so if you're over trained you may not see it in your heart rate, but you can see it in your heart rate variability. It becomes obvious.

Got it, Got it. Well, that is awesome. And how do you. Why does alcohol affect us so much?

That is because the alcohol in itself, the molecule that is very relaxing, you know, we feel mellow, we feel calm and that is why a lot of people use it as self medication. But the problem comes after alcohol will be converted into acetaldehyde which is a very toxic molecule and the body has to work really hard to get rid of it. And I can often see in my, in my curves during the night that I my pulse and heart rate variability as is as bad as if I'm having a lecture. It's the same amount of stress as having a lecture for like 200 people that I'm just going through at night after three or four glasses of wine. And this is also an individual variation. So some people may not affect them as much. You know, there will be big individual differences. So this is so important that this is a device that will tell you how you react to things and not how an Average of people will react to the same things, you know, because that could be very, very different. But that is what we are reading, you know, out of the research. We are, we are looking at the averages, and here you can see your individual score.

Awesome. Awesome. Now, you were talking about the top eight strategies that would give us an extra 24 hours or 24 hours, 24 years to live. What do you put in those top eight?

That is a big American study from American veterans from the army, from the surveys. And they have studied like 700,000 of them and followed them for like more than 10 years. It's quite big study. And they have found that if you do the right choices that are more or less exactly the same as I have in the Pulse cure, then if you do that from your 40 years old, you will live 24 years longer than the one who does not do those good things. And the really good thing is that if you change your lifestyle at 60, you will live 18 years longer. So you will more or less double your expected lifetime if you do these choices. And that would be getting enough exercise, eating healthy foods, abstaining from, from tobacco or smoking, having little stress in your life, drinking little alcohol, and also not using opioids. I don't treat that in my book because that's probably more an American, you know, problem with the opioid crisis. Sure. So. And also good relations. That would also be important. Wow. And that you. And that you can see. You know, there's so many people telling me that when they go on holiday with their best friends, their heart rate variability improves. And on the other hand, if they, if, if they go to work and they have a certain colleague that is, you know, giving them trouble, then they can see that in their heart rate variability and stress curves in, in the moment. You would not. And this is what. You could not see any oura ring or whoop because they don't give you the, from hour to hour measurements like Garmin does. So this is what you could only see in Garmin actually.

Got it. And how on, on lowering stress or measuring stress, you're gonna, you're gonna measure that in a heart rate variability of being in a very high heart rate variability. This is after a person has got a, a month long of calibration, they start moving some of these levers. As far as things that can increase heart rate variability. What are, what are some of your favorite ways to increase someone's heart rate?

That would be breathing slowly, you know, breathing maybe four seconds in and six seconds out is my favorite or something close to that. You know, the coherent breathing is, you know, will be a little bit different from each person. So often it's the, the breathing that you feel really good about that would be more or less in that area. You know, with four seconds in and six, six seconds out. And cold, cold showers, cold water immersion, you know, cold blanches is also very restorative and that is why athletes use it so much to dampen the inflammation in the body.

Yeah.

After a rough exercise you will get inflammation in your body and, and it could be a good thing to keep it down actually.

Awesome. What with regards to how long would somebody, how long would you recommend for the breath work? Like is that five minutes of breath work a day or somebody doing that for multiple hours?

I would think it depends on the person. Ideally, you know, you would probably try to get like 15 minutes. But I think it could also be more effective if you do it multiple times during the day. Maybe for a short time, maybe half a minute, a minute between meetings and between calls or before you go in the door when you come home to your family. So that it gets almost like a routine that you do all the time. Maybe in the conversation when the other person starts talking, you breathe more slowly to, to calm yourself down. You know, maybe if there is discussion in the boardroom or, or such things that it becomes almost automatic that this is the strategy that you use all the time to calm yourself down. You know, because of the breath is always there, it's always accessible.

I love it. I love that as. As a leading recommendation too because everybody, you know, of course the silly joke is don't forget to bre.

It's.

It is accessible to everyone no matter where they are. Dr. Farrow, I, I really love this. We're going to get the Pulse cure your book and I'm going to put your. Your links to get that book in the comments because this is, I mean you gave people over 60 years old, 18 years longer, over 40 years old.

You.

You've doubled their life expectancy with the, the information in your book. And this is really accessible to everyone with the.

And it's free. You know, all the strategies in the postgres are free. So because you know, breathing nature, cold, the whole foods, getting abstaining as much as you can from alcohol. You know, this is all free or even cheaper than the alternative. So it's is after that you get sick, everything gets expensive. So this is a kind of preventative medicine instead of reactive medicine. So this is how we have to do it in the years to come.

I love it. Any last parting message for our listeners and viewers.

Now that would be that this is actually fun, this is a fun way of getting healthier and that you can see it it's so much easier to motivate yourself to do the hard choices when you see the results like in in the yellow and the orange that you will see on the Garmin or you can see it on the whoop as a green, yellow and red you know and you can see the effect of your choices makes it so much more motivating and actionable to to change your lifestyle.

I love it. Dr. Farrow thank you so much for sharing your wisdom here with our listeners and viewers of what the health. You all like today's show. Please give us a like get out there give us a five star review. We'd really super appreciate it. You can change a life by sharing the show. We will see you all soon. Thank you.

Thank you.