Immortal Cells, Biohacking Pain, Killing Lyme, Stem Cell Confusion, How Ketamine Works & Much More With Dr. Matt Cook.

I have a master's degree in physiology, biomechanics and human nutrition. I've spent the past two decades competing in some of the most masochistic events on the planet. From seal fit, Kokoro, Spartan, Agoji, and the world's toughest mudder to 13 Ironman triathlons, brutal bow hunts, adventure races, spearfishing, plant foraging, free diving, bodybuilding and beyond. I combine this intense time in the trenches with a blend of ancestral wisdom and modern science. Search the globe for the world's top experts in performance, fat loss recovery, gut hormones, brain beauty and brawn to deliver you this podcast, everything you need to know to live an adventurous, joyful and fulfilling life. My name is Ben Greenfield. Enjoy the ride. Hey, it's Ben Greenfield, and I think you're really going to enjoy today's show. After the show that you're about to hear. The physician who I interview, Dr. Matt Cook, actually oversaw on me a ketamine procedure, the exact ketamine procedure that we actually talk about in the show. Now, ketamine, which kind of gained notoriety as a, as a party drug back in the 90s, is now kind of gaining momentum as this wonder drug for depression. Now it seems to kind of deactivate the sympathetic fight or flight nervous system and activate the parasympathetic nervous system. It's incredible. One single treatment for depression. It's actually classified as a dissociative anesthetic. When I did the protocol, I actually found it to be actually life changing. Not only did I put a recording of it over at my Facebook page, and I'll link to that in the show notes for today's show, which you can get over@BenGreenfieldFitness.com BioReset but it, it literally changed my life. I actually left some baggage behind during the actual ketamine procedure that has made me feel light as a feather, particularly some baggage related to my Yang personality, me being very kind, physical, sexual being. I actually left a lot of that behind on the, on the ketamine table, in my opinion. And if you ever have the ability to be able to go see Dr. Matt Cook and have it overseen by him and his assistant Barb there, I highly recommend it. I can't necessarily vouch for other physicians in terms of their ketamine infusion therapy, but I can tell you that with him, it was, it was literally like everything you would expect from something like electroshock or a frontal lobotomy or something like that without actually having any of that done, pieces of your brain taken out or painful electrical shocks. It was very interesting. So anyways, I digress. You're going to learn a lot more during the show. Hey folks, it's Ben Greenfield. And as promised, I wanted to get for you on the show today one of probably the smartest, most cutting edge physicians that I've met, a guy I've recently become aware of and had a chance to pick his brain, so to speak, last night a little bit at dinner. His name is Dr. Matthew Cook. I'll tell you more about Matt in just a moment. But in one single dinner with him just 12 hours ago, I learned about how he's using the popular nootropic methylene blue for solving a difficult medical case, how he's upgrading stem cells to make them far more potent, how he's treating DEP depression very effectively with ketamine. But not just ketamine. Ketamine blended with kind of a host of super nutrients that we'll dive into in today's show how he's reversing a lot of musculoskeletal damage and disorders using something called hydrodissection, which we will take a dive into today and a whole lot more. Matt and I are actually sitting at his office right now near San Jose, California. It's called BioReset Medical. He's the president of Bioreset Medical. He operates this as a regenerative medicine and pain medicine pract. And you're no doubt aware of the increasing interest amongst folks in anti aging and longevity. And Matt is also kind of at the forefront of that and stem cell therapies. His experience in the past is he's a board certified anesthesiologist, has over 20 years of experience with that. He's still the president of California Anesthesia Interventional Pain Management and Regenerative Medicine and medical director of the National Surgery center in Los Gatos, California. And in addition, he sits on the SC advisory board of several companies, one of which you may have heard of, BM Doc Fremetica Vasper Systems, which I've done a podcast with in the past. That's the ungodly exercise device that's also incredibly efficient that combines cold and earthing and grounding. And I think that one of your patients we were with at dinner last night swear he's only exercising like five minutes a day and he's doing it with the Vasper. Anyways, what the reason that I wanted to get Dr. Cook on the show was because I have a list of like a million questions that I want to ask him. And this may even wind up being, as I've already warned Matt, part one of a part two series, because we could probably do a whole podcast on just cannabidiol and all the different analogs of that that you know about, or a lot of the ancillary therapies you're doing here. We just walk through a clinic and you've got not just a lot of these physical procedures like IVs and ultrasound and ozone and MRI and a lot of the things that we'll talk about, but then you've also got sound healing and yoga and spiritual healing and a lot of the metaphysical. So you're kind of firing on all cylinders down here. Welcome to the show, man.

Thank you so much. It's just totally a pleasure to be here.

Yeah, there's a lot of places that we could start, but I figure why not just start easy and delve into this whole methylene blue thing? Because we were talking last night and I've mentioned on the show before that I'll occasionally use a dropper of that as a nootropic. And besides turning your pee blue and dying your mouth blue, it also gives you a real cognitive pick me up almost in the sense that you cannot nap or sleep if you take it too late in the day. And you described how you were using it for something altogether different.

Sure am. You know, super interesting experience for me. Essentially, I'm either teaching at meetings or going to meetings almost every weekend of the year. And about a year ago, I was at an NAD meeting and there was a guy who was presenting there, super intelligent. And I always ask people the question, is there anything that you're amazing at that everybody else is terrible at or that I like that can't be fixed question. And I kind of just threw that question out there. And he goes, yeah, I'm really good at interstitial cystitis, which is a super challenging problem. And interstitial cystitis is this syndrome that causes extremely painful bladder. So something that we're aware of in pain management practices. And my friends that are the urologists who are the people who are supposed to take care of it, don't even like to take those patients because there's really nothing that can be done. Now, interestingly, I've actually been aware of it because I've done IV mesenchymal stem cells for it and had some results and was happy, but it wasn't really a home run.

So you've treated interstitial cystitis with these stem cell MSCs?

Yeah.

Okay.

And so, but I'm not where I need to be on that topic. And so that's kind of part of the reason to be out there continually searching. And so this guy tells me, oh, I have methylene blue compounded in a compounding pharmacy so that you can put an iv.

And this wasn't like the fish tank cleaner that. Because I should warn people, don't go and buy methylene blue off the aquarium website. Like, you need to get, like, pharmaceutical grade or have a pharmacist in your case, create methylene blue.

Exactly. And, you know, interestingly, I've been using methylene blue for a decade because in the old days, we would actually inject it as a dye to be used surgically when we're like, breast surgeons will use it to localize lymph nodes and such. So anyways, this guy has this protocol where he gives you methylene blue iv and then there's an LED light that they then put over the bladder and then shine over the bladder for about half an hour to 45 minutes. And the idea is that there's actually a microbiome in the bladder, just like there's a microbiome in the colon and our skin.

Or the skin. Yeah. Or anywhere else.

And so what happens is the methylene blue goes into the bladder and it starts to get absorbed into the wall of the bladder and start to stain. And that's only a temporary situation. But what happens is when we shine the LED lights on the bladder, it causes the light to be absorbed by the methylene blue, and that creates movement within it. And it seems to, if there's a subclinical infection, and there's a lot going on with subclinical infections that we could go into, maybe in the next podcast. But it starts to create a movement of the methylene blue and it dislocates infections from the wall of the bladder.

So the methylene blue actually vibrates in response to infrared light.

Yeah. Well, I'm using LED lights and infrared lights.

Okay. Is it similar like the Joovv lamp?

Similar, yeah.

Because this piqued my interest, because using it as a nootropic, I thought, well, what if I take methylene blue and for examp, put on one of these photobiomodulation head units, or do a full body treatment with a Joovv red and LED lamp and see if that actually enhances the cognitive effect because I don't have bladder infection. Just need to come right out there and say that.

It's so interesting because I was saying last night how important what you do Is because information is sort of getting out there. Like, I heard about this, and I had four or five people in my practice, and so I did this sort of as an experiment and just consented them that this is like a wildly experimental thing that I heard about at a conference. And all of them got like 60 to 100% improvement in their symptoms. So it was really, really kind of unusual. But it's fun to. To be able to do provocative things that help people.

No, I never thought of that before. If anybody's listening in and you actually wind up before I do trying methylene blue. Proceed with caution. Use the right stuff. And I have an article out there somewhere about it. I'll put a link to it in the show notes for this episode. With photobiomodulation, like a joovv or a violite, you might turn yourself into the ultimate cognitive machine. By the way, all the show notes and everything that Matt and I talk about, because I'm sure there'll be lots of things to write down in the same way that I was writing lots of things down at dinner last night. Go to BenGreenfieldFitness.com BioReset BenGreenfieldFitness.com Bioreset is where the shownotes are. You can go check out Matt's clinic's website and everything else that we talk about. But after we were talking about this whole methylene blue thing, I think that was one of the first things we discussed last night. Sitting next to you was one of your patients, and even before you came into the restaurant, he was describing how. I believe it was debilitating back pain.

Correct me if I'm wrong, it was actually groin and testicle.

Really? Okay, yeah. Maybe he was just saying back pain because he just met me and didn't want to get into the testicles.

Probably.

Yeah. That was polite. Anyways, though, he. He described how you have this procedure that you do for musculoskeletal disorders and I believe for joint pain called hydrodissection. I'm very unfamiliar with it. It's not something that you hear talked about a lot. So can you describe exactly what hydrodissection is and why you would.

Yeah, pretty interesting. Hydrodissection is something I've been doing since 2001, when I finished my anesthesia residency. And it's a term that was actually coined by my mentor, Dr. Tom Clark, but it's essentially sticking a needle under direct vision with an ultrasound into a tissue plane in between two muscles. So I'm not in a muscle, but I'm in the fascial plane, in between where two muscles are. Okay. And it turns out in what is in a fascial plane, nerves, arteries, veins, and then lymphatic structures. And then a lot of times there will be tendons flowing through those fascial planes as well. And so what we do is we. And sometimes people can have scarring. They can have scarring of a nerve or impingement of a nerve. And so back in the day, what would happen is if there was scarring, people would make an incision, open that up, and then do a dissection, which is an anatomical term for basically breaking down that tissue. And then they would close it up or opening up and relieving the impingement or the compression or the scar. The problem is often after those surgeries, the symptoms would get worse because there would be further scarring as a result of the surgery. So what was developed is the idea of stick a needle in that fascial plane and then use fluid and just the pressure of the fluid to open up and separate those tissue planes, and then use the fluid to surround the nerve.

Is this different than prolotherapy?

Yeah. And so prolotherapy treats ligamentous laxity or joints. And so prolo actually uses a hypertonic solution of dextrose. Some people use prp. I do. Some people use stem cells. I do. To treat ligaments and tendons to try to create more structural integrity and stability versus the hydrodissection addresses the nerves in the fascial planes that are going to those joints. Now, as an anesthesiologist, when we do a nerve block, we're actually using local anesthetic to surround that nerve. And so that's actually a hydrodissection, but it's just we call nerve block now if we use something regenerative. So I might use prp, I might use platelet poor plasma. A lot of times we use 5% dextrose, and I'm using a ton of placental matrix. And so we're using something regenerative to go into the tissue plane. And the way that I think about nerve, like pain in general, if you look at a knee, some people have pain in the joint. Sometimes they have pain in the ligaments and tendons. Sometimes it's the fascia, sometimes it's the nerve. And so if you just treat the joint and you do prolotherapy on that joint, but they have neuropathic pain in the obturator or tibial or common peroneal or saphenous nerves, what will happen is you're not going to get them better. But if we treat the nerve as well as anything else that's involved, the that's when you begin to really get transformative change.

So you would combine hydrodissection in many cases with one of these forms of prolotherapy, like a PRP or a stem.

Cell or something like that 100% of the time.

Okay, now what has happened in terms of people you work with? Like, where would this be indicated as far as your experience with it?

What I do is I do a peripheral nerve exam. And so I know where all the nerves are, but I cheat because I put an ultrasound down and then I look at the nerve and then I do a couple of interesting things. I actually look at the diameter of the nerve to see if it's swollen. And then I put the ultrasound down and I actually take my finger and I press down on the nerve and I go, how's that feel? And if it feels totally normal and it's not dilated, that nerve is healthy. And so I just leave it alone. And then I proceed and find on. I might find a nerve and I might not. So some people. It's so interesting, and I'm looking forward to doing a quick exam on you because people who do a lot of exercise, especially a lot of endurance athletes, will have almost no nerve pain. The only pain that they'll have will be really sometimes myofascial, but more ligament tendon and then in the joint. And so what I'm doing is trying to very carefully with those modalities as well as often with mri, trying to diagnose exactly what's going on and then develop a treatment plan that's very specific based on what we find.

That's actually important, I think, because. And this has happened to me, I'll go into a medical clinic sometimes, and this has even happened with stem cells where they will generally inject the general area of pain. No diagnostic imaging, no ultrasound, nothing. And then I've been to other places where you literally have up on the big screen, as the needle is going in, exactly where you should be injected. I think a lot of people don't realize the importance of the guided delivery with the imaging.

Yeah, it's the most important. Well, it's kind of like 50, 50, diagnosing what's wrong. So you can put the right thing in the right place is 50% and then putting it in the right place and then interestingly. So how to put it in the right place is this super interesting conversation as well. Because we're now using ultrasound to look at every nerve and then every joint in the body. And then we're also using fluoroscopy, which is basically live X rays. And the state of the art now is fusion. So we're using both, and so that we really know exactly what's going on up front, and then we know where we want to put what.

Is that what fusion means? The combination of ultrasound and X ray?

Yeah. Okay.

Interesting. I'd never heard of that.

That's a cool term.

Okay, cool. So as far as your experience with this, you mentioned something about nationals last year, but we didn't have a chance to delve into it. What exactly did you do there? Or was that with hydrodissection?

So I did almost all the injections for the Washington National Spaceball team last year.

Okay.

And so, interestingly, if you look at when a. If a nerve gets impinged, then that nerve now is pinched and sort of sensing some pain. And in that case, then instead of just being in a situation of sensing what's going on and then managing the motor part of it because it's being pinched, what will happen often is that the muscle bed that it goes to will go into a degree of muscle spasm. And so then that will lead the patient to be in spasm and weak, and then the quality of the movement will be a little bit less. And so then what I'll do is I'll do hydrodissection procedures where I'll actually go in and open up these tissue planes. And then they have an incredibly sophisticated approach of combining that with myofascial techniques to really optimize movement and really improve how the athletes are doing.

So do you do that, too? You do hydrodissection followed by myofascial?

By myofascial. Yeah. And the doctor who's the team doctor for the Washington Nationals is a guy named Dr. Keith Pine. And in terms of the myofascial component of taking care of athletes, he's probably the number one doctor in the world.

Really?

Yeah.

Okay, interesting. And you learned this from him?

So basically, I learned every. You know, I actually, it was funny. I was talking to a pro golfer one time, and I'm explaining, you know, how ground force moves through the body and stuff like that. And he goes, do you know Keith Pine? I go, yeah, he taught me everything I know. He goes, it sounds like it.

Why is that important how ground force moves through the body?

Well, imagine if you made a nice, solid fist and you had good structural integrity in your fist, and then you Punched the punching bag, maybe 10 pounds, that 10 pounds of force would go from your hand straight through the wrist, no problem. But imagine if you lost structural integrity and punched that punching bag and there was no engagement of the wrist, then part of the force would go through to the rest of the body and part of the force would leak out and it would create torque in that joint and your wrist would be super sore. Now, anytime I have a problem with structural integrity or a nerve that's not working, so a muscle that's getting pulled and as force moves through the body, comes through the knee, if I don't have structural integrity there, then I start to get torque leaking out. And anytime that happens, that puts stress and wear and tear on the joint. And so often that for potentially years and years and years, is the thing that was really caused the damage that we're looking at now.

Right.

And so what I'm trying to do is figure that out, do movement exams and try to understand how it's going through and sequence how it's going through and then correct with corrective exercises and myofascial work, how force goes through the body. And then also if there's a problem with the nerves, hydrodissect those. If there's problems with the ligaments, tendons, fascia, or the joint, treat that. But then get them plugged in. So they're actually doing super high quality movement to prevent it from coming back. Yeah.

Do you have any way to analyze movement analysis here? Have you ever thought about doing something like that, like a high speed video camera or 3D video cameras?

So, you know, I went down and studied with Greg Rose down at the Titleist Performance Institute, and they've got. It's amazing. You know, somebody swings.

Yeah, there's a little, There's a little bit of money in golf.

Exactly. And so they'll track and they'll see the wave go from the ankle to the knee, to the hip to the low back, and all the way up and then all the way out to the hand. If you have a problem with structural integrity in the pelvis, typically that's going to either present as an anterior hip, labrum, an SI joint, L5S1 or L4.5 disc or a set joint at one of those levels. And so what we're trying to do is optimize that. So we do movement exams, we do fms, sfma, which are high quality movement. And I want to do that because I think that's the future. And this is where everything's going.

Yeah. When I was in College. My degree was xphys and biomechanics, and I spent an entire summer down at Duke, one year doing a research study on shoulder mechanics and football players in the bench press. And it involved actually attaching the sticky. They aren't electrodes. They're literally just little visualization stickers. And then digitizing with 3D cameras every single movement of the joint. I mean, so for one bench press rep, I'd be sitting there for 10 minutes clicking on the computer to follow the entire range of motion. And then I was down at the Miami Heat facility a couple of months ago. And you just step into this little pod, and it does it all. Does your entire FMS for you. It analyzes all the movements, it does all the 3D digitization. Just super slick. So we've come a long ways as far as the ability to be able to analyze 3D motion. I love this idea of combining it with things like the hydrodissection or the PRP or some of these other treatments that you're doing.

My sort of experience of this was that, you know, I'm an md and I kind of came from that world, and what I had to do is go out into other communities, because the people who know about movement are almost never MDS. So it's like the chiropractors, the. Like Dr. Pine.

Right.

That actually taught me everything that I needed.

Physical therapists. Exactly. Like Kelly Sarrett, you know, for example. Yeah. He knows a lot more about fascia than most docs that I talk to, of course, and how to fix it. Obviously, the big elephant in the room here. And actually what you're widely known for, I think, because you did an episode with Dave Asprey on stem cells on the bulletproof radio. And I know that you've got a lot of interest in what you do with stem cells based on that and other publicity that you've received in the whole stem cell sector. So I really want to get your take on stem cells as well. And we could obviously do an entire episode just based on stem cells. But what I'd like to start with is the approach that. And I would imagine we'll rabbit hole a little bit as we go. But how do you approach stem cells?

That's exactly what everybody asks me. And it's kind of interesting because stem cells is like this sexy topic, and everybody wants to talk about it, learn about it.

It is stem cells, keto, cbd.

Exactly. But my approach is actually to try to assess the patient and try to figure out what's going on. And Then to tailor the appropriate treatment for the appropriate problem. And so we're largely talking about peripheral joints. We're talking about the spine and sort of the totality of back pain, thoracic and cervical pain. And then we're talking about IV treatments. And so then we do stem cells in all of those categories. And so then I try to judge and use the different stem cells, depend on depending or a host of other products that are regenerative, like exosomes and placental matrix.

Yeah, I want to talk about those for sure.

And based on depending on what the actual problem is, for real simple problems. And so then what that does is that starts with the diagnostic workup. So figuring out what's going on, figuring out how many nerves is it, how bad is the problem with the joint? Is this a case of really inflammation? Is it more bone on bone? Are there subchondral lesions where there's actually damage to the under surface of the joint? Kind of like a imagine like a pothole in a road, looking the spine. And so then based upon that, then I'll sort of develop a treatment plan and I'll kind of go through that and explain that to people. And then we make a lot of those decisions collaboratively based, a little bit on cost, and then largely on what I think is going to be the most effective for the cheapest price.

Okay. Now, there are a few terms in stem cell therapy that I think confuse people. For example, the potency. You hear about totipotent and pluripotent, and I believe multipotent is the third in terms of stem cells. In your practice, have you identified certain forms of stem cells that have a higher availability or higher up on the totem pole when it comes to totipotency, which I did not purposefully just use the totem pole analogy for, but I realize it's a very good one. Totipotence at the top of the totem pole.

Actually how I think about sort of all of regenerative medicine. Exosomes, stem cells, there's a profile for each different one. And so depending on what we're sort of working on, each class of stem cell has a profile and then pairing that profile sort of to the patient. So, for example, when we think of.

Mesenchymal stem cells, MSCs, they're called a.

Lot MSCs, and that's the type of stem cell. That's if we're talking about autologous, which is your own, those stem cells are all over your body.

And that would be autologous versus using like Umbilical or amniotic?

Exactly.

Okay.

So those stem cells are all over your body, and you've got them in your belly, especially in belly fat. There's a good concentration of them, and you've got quite a few of them in your bone marrow. But I think of these as sort of like management consultant stem cells. So they have the ability to do something called asymmetric division and roll up on a construction site in the body that is like a real inflamed knee. And so they have the ability to go and come out of the blood, go over to a torn tendon, and then turn themself into a fibroblast and start to heal that tendon.

Okay.

And so this, this idea really kind of piques the imagination of people because there's this idea that there's a stem cell that's in your body that can go and then turn into any type of cell and then do healing right now, which is great. And that certainly seems to happen. However, the other thing that stem cells do a lot of is coordination. So they can also roll up on that site or be injected into that site and then start to secrete cytokines to influence fibroblasts to come in and help do their work. And then they can also secrete exosomes, which is one of the main ways that stem cells actually work. And that can modulate inflammation and also modulate healing.

And those also act as a signaling molecule as well, don't they?

That's exactly right. And so with mesenchymal stem cells, I think of them as kind of an adult professional cell that's able to come in and is able to heal from a variety of different ways. Then there's these cells that people talk about, like V cells, which are very small, embryonic, like stem cells.

Yeah. Before you get into those, can I ask you a quick question? Based on what you just said about mscs, would this mean that, let's say someone is older and they've held off, say, harvesting their bone marrow or their fat stem cells because they consider their stem cells to be old. In that case, it sounds like even if you were to use autologous stem cells, and even if they were to be old stem cells or per differentiate as efficiently, they would still be useful because they can still initiate a proper inflammatory response or act as signaling molecules, or address pain in some other way without necessarily repairing tissue per se.

I think that that is a billion dollar question, and that's the answer that we don't have a great answer for. And the problem is that everybody has sort of a business horse in the race, sort of in the space. And so there's people on all sides who think that their approach is the best and even within the stem cell world. And then there's a whole regulatory overlay on top of it. And so what's going to happen is that studies that are going on right now are going to give us the answers to those questions, I think, over the next one or two decades. But imagine someone, imagine this situation of knee pain that we talked about, and then.

You're killing me with this knee pain analogy, because. Opening the kimono for folks. I'm over at Matt's office right after literally dropping out of a Spartan race with knee pain. It's very rare that I'll drop out of a race, but I could feel myself just destroying my knee. And so I stopped and I happened to be in San Francisco and had the whole afternoon free, so wanted to come over here and do this podcast. So every time you're talking about the knee, it's just making me grip my teeth.

Okay, well, we're gonna fix that. So some stem cells from your bone marrow can migrate into the peripheral circulation and then go over and do that. Now, let's say there is a patient with diabetes that has had chronic illness for 40 years. Their stem cells have been migrating out, fixing things for 40 or 50 or 60 years. And so as we age, the quality and then the amount of stem cells in people who have real complex illness starts to go down. And so then how effective those cells are for those patients versus healthy patients is certainly less. And then as we start to really get better and better staging and grading of injuries, and then we're going to be able to give you a better answer on that. Okay, that makes sense.

You were just about to get into V cells, I believe.

So then there's another category of very small embryonic, like stem cells.

And this one's a little, very small embryonic leg. That's what V cell stands for.

That's what V cells. They're also known as muse cells. And these are cells in the bone marrow that seem to migrate into the peripheral circulation as well. And when they do, they're basically quiescent or asleep, but they're pluripotent. And so they're floating around waiting for a signal to then grow and develop into a actual cell.

So pluripotent, meaning that they can become anything, Anything. Anything within the. What is the three germ layers, skin, digestive system, joints, I believe, are the. So Just about everything a pluripotent cell could become.

And so it might be that this person with this injury has a mesenchymal stem cell that is coordinating the care. But then there are more immature cells. I think of them as kind of kindergarteners that get. That get influenced to grow and develop. And so then now, as I think about the profile, I've got some cells that are very robust and able to do everything, but I think of them more as managers. And then there are other cells that are going to grow into whatever they need to do and just follow instructions.

So are these V cells something that your body creates itself, or is this an actual procedure? Well, for example, I had the exosomes done at Dr. Harry Adelson's clinic, and he actually had those shipped. And we can talk a little more exosomes, too, from Chimaera Labs. And those were then injected into me and combined with bone marrow aspirates. In the case of the V cells, is it something similar? Is this something you can inject, or are you just trying to induce the body to upregulate its own production?

So those are autologous. Those are your own. And then there are a number of proprietary approaches to activating them. And then once they get activated, then putting them back in either IV or.

Okay, so you can take. Well, how would it work? Would you take someone's bone marrow?

So in this case, the great thing about that is you actually take them out of the blood. Oh, so it's much easier than a bone marrow procedure. Yeah.

Less painful, too, I would imagine.

Much, much less painful. And so then I'm weighing. So then as we begin to kind of think about sort of the architecture, vesols are super easy for the patient. There's quite a bit of work for the practice to manage that adipose harvesting is really going through. A mini liposuction, and then a bone marrow aspirator is relatively easy for patients in our office to go through, but it's a big procedure. And so if I have a simple problem, even if somebody wants a bone marrow, I typically will just use exosomes, or I'll use placental matrix, or I'll do PRP lysate. And because I'm tailoring the therapy to the severity of the injury, whereas for complex spine, for really complex joints with subchondral lesions, then we begin to do a lot more in the bone marrow and bone marrow combined with exosomes, because.

You'Re getting more MSCs in that scenario.

I'm getting more MSCs and they're your own. And I'm able to get a relatively large amount because instead of. If you buy stem cells, like cord blood stem cells, you're buying 1 cc.

That would be umbilical.

Umbilical, you're buying 1 cc, which is nowhere near an amount that you need to treat a spine.

What would be the ratio if you were to draw, like, fat and compare it to umbilical? Are we talking like hundreds of times more MSCs or way more than 10?

I know Harry's a fantastic doctor. I've been to his clinic, and what I do is somewhat similar to him. So. Well, you know, we're for spine procedures. We're using in the ballpark of 10 to 20 to 25 CCs versus just if we were buying that from cord blood, we'd have to spend $25,000 to get that much stem cells.

Is there any situation in which you would use umbilical cord blood? And also, I think people might be interested in learning exactly what it is. Like, what this, I believe, is called Wharton's jelly.

Yeah. So in our sort of architecture as we're walking through. And by the way, ever since I started doing the podcast, it made my life about a hundred times easier because, like, when people call, that happens to me too.

I get tons of questions via email. And I actually have somebody now who monitors my email inbox. And, like, half of her replies now are, go listen to this podcast, go listen to that podcast, or go Google whatever Ben Greenfield this or that. Because I have some kind of an article about it. So I hear you.

Okay, so. Generally, so I've got autologous, which is adipose bone marrow, and let's say the blood based ones like V cells. Okay. Then I've got cells that were harvested from. When a woman goes in and has an elective C section, she can donate her placenta and she can donate her umbilical cord blood.

What about amniotic in that case, with the cesarean.

And so when they do that, the typical thing that they'll try to do is they'll harvest everything. And so they'll actually make a tiny slit in the amnion right before they deliver the baby. And then they'll stick a suction device in and suck all the amniotic fluid out as well. So they're getting everything. And then what they do is they have a 200 page questionnaire of questions that they ask the mother in terms of her medical history. The great thing is that they've had her in the hospital, so there's a whole bunch of testing. And then they quarantine all of those samples and watch them for a few weeks to months. And then they continue to retest her to make sure that after she goes out of the hospital, she is negative in terms of a all of the infectious disease that the blood bank requires that you test for. And then broadly within those categories, we've got umbilical cord blood, we've got tissue that came from the umbilical cord wall, and that's called Wharton's jelly. Okay. And then we've got amniotic fluid. And then they can take the placenta and the parts of the umbilical cord and actually put it like in a blender and blend it up. And then when they do that, they can create a injectable fluid that has matrix of the placenta, which turns out is anti infectious and extremely anti inflammatory and very good for nerves.

Yeah.

In particular, as well as joints.

Nature gives us a lot of clues. We have Nigerian dwarf goats that we raise, and whenever they give birth, that's one of the first things mom does, is she eats the placenta. And as a matter of fact, my assistant at home, she also assists with birth and delivery. So there is a frozen placenta, human placenta, in my chest freezer in the garage back home. And I may, I don't know, maybe I'll put a little stevia in there, but I could try making a little shake when I get home. Not an iv. I just drink it.

Yeah. It's the craziest thing in the world to say that, but I've always wanted to do that because there's a company called Sky Biologics which is just the placental matrix that I use. And I probably buy about half a million dollars worth of their product a year, and it's unbelievably effective. And I use that as my treatment of choice when I do hydrodissections. And then within. And so then, so we've got this umbilical cord blood, we've got the Wharton's jelly product, which is the cell wall, and then we've got these, these amniotic fluid in the placental matrix. So I've got all of those products. And so then the idea is what are. And then within the placental matrix, there are some that have stem cells in them, and then there are some that don't have stem cells in them, but they're just very anti inflammatory. And so then all of them are good. And I've used all of them. The word. And Stella products seem to have more structural. They're in the wall of a blood vessel, so they seem to be more promoting structural growth, the umbilical cord blood product. And there's honestly not that many stem cells in the umbilical cord blood. Okay. And there's multiple different cell lines, but those cells, because they're able to go back and forth between the mom and the baby, don't express to the extent of other cells in the body mhc. And so they kind of exist in this no man's land between mom and the baby. And so that's why we're able to use these for treatment. And then I'll just forecast that we've got that final category of the stem cells that we grow in a lab. So within those categories, then we're trying to take go back to this patient centric conversation of okay, what does the ultrasound show? How is the movement exam? Is the nerves, what's involved? Is this just a pure orthopedic problem, or is this orthopedics with Lyme superimposed, with chronic illness superimposed? And so then do I want to do just the treatment of the ligament, tendon, fascia, the joint, possibly the nerve, or do I want to do all of that and then also do some systemic treatment in terms of IV therapies? And so then these are the questions that I'm asking and then the answers I'm getting collaboratively by sort of talking to you and kind of working our way through. And it's to some extent a process of self discovery for both of us.

Yeah, and to a certain extent, and I think when I interviewed Dr. Adelson of DOCERI clinics, he mentioned this part of it just comes down to data where like as you work with more patients and as you gather more data about non autologous versus autologous versus, you know, some of these V cells and exosomes, et cetera, you simply start to learn what works best in what scenarios.

Exactly. And you know, I agree with him on a lot of what he thinks and what he does. And he's been a leader in the field for some time. And in terms of the peripheral joints, they're a lot less complex. And often there's a self limited area that we're dealing with, although it can be incredibly complex. And so in some cases, almost all of our products work there. When it comes to super complex back pain, which is something that we both do a lot of that one is one that where I've really seen bone marrow because of the amount of stem cells that we can get is really our first choice.

Okay, got it. A couple of definitions to clear up. You mentioned briefly PRP lysate. What is that?

So then let's say what PRP is and what that is is that in your. In your blood, there's platelets, which are these tiny little sacks of growth and healing factors that are floating around, and then they can get activated and release those growth and healing factors. And then that's part of the clotting cascade, but it's also part of a healing cascade. And so one thing that we can do is that we can stick a needle in a vein and pull some blood out, and then we can spin down and we can isolate the fraction of the blood where the platelets actually exist. And so when we isolate that, that's called platelet rich plasma. And so the platelet rich plasma is really the heart and soul of regenerative medicine. Because if you look at all regenerative medicine therapies that have been done, the PRP is the most common. So when people are. The majority of cosmetic treatments to the face, hair, penis, vagina are prp, and the majority of orthopedic injections into joints have been prp, one thing that you can do is there's a variety of proprietary approaches where you can actually get those platelets to release their growth and healing. Healing factors, and all open up before you inject them in.

So PRP lyset is you're lysing them.

You're lysing them. Yeah.

Okay, very cool. Yeah, I've actually had PRP done. My wife and I have both had. Had PRP in the face. And then we've done. She's done the O shot in the genitals, and I've done the P shot, which is a common procedure. I think you guys do that Gainswave protocol here as well, right?

Yeah, we do a lot of P shot and always combine that with the Gainswave protocol.

Right.

Which is completely amazing.

Yeah. So you're using acoustic sound wave therapy to enhance the results of a PRP shot to the genitals.

And we're actually starting next month, we're going to be the west coast teaching center for them. So for doctors that are out there that want to learn really any of this, but in particular, all of the sexual rejuvenation strategies, people can come to our clinic and we teach them how to do it.

Cool. I briefly mentioned also Chimaera labs and this idea of exosomes. We've talked about V cells, fat stem cells, bone stem cells, umbilical, amniotic placentals. Where do exosomes fit in?

So I actually have a distributorship, and so I actually represent, full disclosure, Chimaera, and they have the best exosome product on the market by far that I'm using. And so we talked about sometimes if you repeat something, it's worthwhile, because just so we can get this in our head, we've got these stem cells that are our own, and then we've got these stem cells that they collected from, let's say, an umbilical cord when somebody had an elective C section. Now, what you can do is we can take some of those stem cells that we collected when we had this elective C section, and then we take those, and then instead of freezing them and just injecting them back in, we take them to a lab and we start to grow them in tissue culture, and we create an immortal cell line. And so these are stem cells that are culture expanded. And so then when you grow these stem cells and tissue culture, there's one thing that I want to sort of convey to you, and I think from my sort of appeal to sort of the regulatory side of this, is that I think that exosomes really has the potential to be one of the most important treatments of the future, which is why I went to Chimaera and established a relationship with them. But, I mean, I was having amazing results with their products. But if. And you know, everybody loves to talk about ketosis. If we take some these stem cells that are growing in the petri dish and we put them on a little bit of a ketogenic diet, they think Ben's a little stressed out. And so they think, oh, I know what I'm going to do. I'm going to make a whole bunch of growth and healing for them, a little hormetic response, and then heal him. And so then they secrete all of these growth and healing factors into the culture media that they're being grown in. And then after they do that, then you centrifuge. And so you leave the stem cells in the bottom, but just take the growth and healing factors. Now, there's no genetic material. These are incredibly small. And remember when we were talking about mesenchymal stem cells, I said that a lot of the actual therapy that they're doing is probably the cell to cell communication that they do by secreting exosomes. And so then I can take those exosomes and get many of the benefits of a stem cell treatment without giving stem cells.

Interesting. You know, with all of these treatments, the exosomes, the V cells, fat bone, umbilical, amniotic, placental. Why the heck would someone still need to go overseas for therapy? Like, what is it that they're doing overseas that they can't get here?

Okay, so then the regulatory side of this is that. And part of this is, you know, a bunch of guys in the government just came up with an idea, and there was a term that said more than minimal manipulation. And so that term is the regulatory term that we have to adhere to in terms of the stuff that we do. And when. If you take cells and then grow them in a lab, that's considered to be more than minimal manipulation. However, when we take those cells to the lab, I've got two interesting things that I could do. One is I can just use them to farm and create exosomes, which is an incredible, incredible thing. The other thing that I can do is I can grow those stem cells up, karyotype them, test them. I know exactly where they came from. And then I have an enormous amount of. Typically, people are spending a million dollars testing and creating a cell line. So I have a really highly developed cell line, and then from that I can take and create a whole bunch of master ali. Each one of those master aliquots, I can grow up and then create 200 million mesenchymal stem cells. Now, an umbilical cord blood, you know, product might have a million stem cells in it. It might have. Might have more. Okay. But we're in this kind of number.

So again, we're talking about hundreds of times more.

Exactly. And so then when we do 200 million, that is a treatment that we do IV, and then we'll also take, and sometimes take 5 or 10 million cells and put them in a joint. And so I actually have a hospital that I work with in Mexico and local doctors there and have a fully legal, permitted approach where I cells that are. We use there. And interestingly, I've been using them for years and taking people down to Mexico for years.

But that's what I was going to ask you. People need to actually go across the border and get the procedure done down. You can't grow them down there and bring them back into the U.S. no, because this is.

This is a pure FDA thing. And so I actually take people down there as basically kind of a chaperone. But then what happens is they're going to get 200 million stem cells and they're going to get treatment in joints or ligaments or their back as well as IV or systemic treatments. And so then given that we've sort of now discussed that, we've discussed sort of the totality and interestingly, except for one thing which we'll talk about killer cells if you want later.

But.

And so now that has a profile that tends to be very anti inflammatory and have real profound systemic anti inflammatory effects. Because I've got 200 million. Okay. Now if somebody has kind of a, you know, I had a super nice guy who flew in and wanted a stem cell treatment and had a real inflamed knee. And so we did a whole bunch of things, but we just put Wharton's jelly stem cells in his knee because it was a very simple self limited injury. And so I have the profile of that versus the profile of the Mexico treatment versus the profile of the all exosomes and all of these products. And so it's quite a bit to kind of keep all sort of in your head. But then once you have that, it's like this is the palette that we're painting on and then we're discriminating what to do, when to do, who to do it a lot based on physiologically, how are these people doing? What other comorbidities do they have? And interestingly, I work people up for this sort of like I used to work people up to make sure they were safe enough to go through a big complex spine surgery or a heart surgery or. And so then kind of managing in that way.

When you say work people up, you mean collecting questionnaire data on health history, symptoms. Very thorough analysis.

Yeah, super important.

Now what are you doing with the killer cells that you mentioned?

Oh, so then the killer cells are cells that are in our body and what they do is they look for cancer. So they're fighting cancer. They look for senescent cells and they take senescent cells out of circulation and then they fight infections. And so sounds like some amazing cells to have in your body. So interestingly, like when you look at people that have like real difficult cases of Lyme disease, often their killer cell levels be in the tank super low. And so there's a. I don't want to go into that because I'll totally do Arlis, but there's a super complex approach that we take to those patients.

I already actually have that jotted down for part two of our podcast Talk Lyme Disease, because I know you have a very unique approach.

But then with that, what we'll do is once we kind of get them better and get all of their systems working, and this is a Mexico. Only thing also because it's not, and almost none of this is FDA approved, but most of it is consentable as off label. What we'll do is we'll actually take blood out and then grow 1 to 2 billion killer cells and then give them back. Wow. And I'm sort of primarily using that in the chronic infection scenario, but it's actually super interesting because I'm actually referring patients into some clinical trials right now that are looking at culture expanded killer cells to treat cancer, because cancer is one of the things that kill ourselves, too. And so the next decade is going to be, you know, my feeling is like, sort of the. Is a really special time in medicine because of the growth that we're learning every day and getting better and better technologies to apply to people.

Yeah, it's exciting. It's really exciting. There's another topic that you began to delve into towards the end of dinner last night that absolutely fascinated me, and that's this idea of how you work with depression and I believe, to a certain extent, managing pain, nerve issues, et cetera. And that would be ketamine and some of these other protocols that you do. Yeah, go ahead and dive into that.

It's just about, like, my favorite thing to do because it's super low stress. And what's really surprising is that people are doing really, really well. And I've gotten to this point personally where when people come in and they'll have real bad cases of PTSD and depression and often superimposed upon bad joint pain or Lyme disease or back pain. And the traditional model that I had, which is why I didn't really focus on it initially in my career, was that doctors always said, oh, those patients never get better. So, like, don't. You don't want to, like, take care of them? And so. But we started to do a lot of ketamine therapy, and I've been using ketamine as an anesthesiologist since like 2000. And ketamine turns off a depression pathway in the brain, which is the NMDA pathway. And then it also sort of broadly turns on a lot of receptors. It's almost like turning the computer off and turning it back on. And it seems to give people hope. It gets them to a place of feeling connected, emotionally safe, and it gives them a sense that they're going to be able to get better and physiologically or spiritually or emotionally when they made that transition, as they're relying on their journey from being in a place of being kind of dejected and in pain and all of a sudden they felt safe. What I say is it's almost like your mind leaves some breadcrumbs on the way or your heart. And so then tomorrow you remember that you felt for a while like things were going to be okay. It's like we're really trying to sort of win hearts and minds of people and get them to get the sense that they're going to get better. And so now then you say, who are the people that are doing this? And so this is kind of hilarious because it's my people. It's like anesthesiologists. And so the clinics that do it are people like me that know about anesthesia. And so they're like, oh, ketamine is pretty easy for us to do.

My only experience with it is my brother is a paramedic and uses ketamine on the ambulance.

Yeah, exactly. So, so, but when we, most anesthesiologists have clinics in the new ketamine and so they literally know nothing about it, don't do anything else, and they just give ketamine. It's actually surprisingly effective for like drug resistant depression and ptsd. And so then what I said is, I wonder what would happen if you started to give NAD? I give IV Quercetin, I give IV CoQ10. And so I'm giving a lot of products that start to turn your mitochondria on and really get all of the parts of the brain firing. And then after I do that, then I'll give, and sometimes I'll even give exosomes. But then once I've got the brain turned on and everything's sort of working, the mitochondria are there. I found that when you give the ketamine after that it's like more effective. And then afterwards there's almost no side effects. And there's people, people come out very smoothly with, with, without that jangly feeling of you sometimes get after you've taken a drug. And, and so that's kind of the very beginning of, of how we start to use ketamine. But there's a bunch of things that, I mean, I would love to talk to you about that if you want. Yeah, fill me in. So imagine like we're sitting here, so we're kind of, everything is totally chill, we're calm. So we're really in a parasympathetic moment. Now what happens is you go speak for yourself.

I'm incredibly nervous in front of a microphone. This is something that really, really. No, I'm kidding.

Actually. I was gonna say, because I was.

Like, it's almost like second nature now.

I was super impressed because I was like, God, he's so relaxed. And I was actually a little nervous. And then as soon as I started talking to you, what happened is I felt like how relaxed you were, and then I just basically met that. And so talking to you put me in a parasympathetic state.

Right. And we could get into heart medicine, too, and heart rate variability. And how when one person's heart rate variability is very high and their parasympathetic nervous system system is activated, it can actually relax based on the heart's electrical field, other people around them.

So you're doing that to me, which is what I typically am doing to patients. So it's like, oh, this is relaxing. Now then let's say we're finishing up the construction on the remodel, and let's say they blew up the fire alarm. So then we could go into fight or flight, but then we'd kind of come back and rest and relax and kind of chill out and everything is good. Now, when people get a pain syndrome, that sort of comes out of the blue, and it's not following any of the typical rules of engagement, then they're in fight or flight. And then it's kind of like it would be easier just to stay in fight or flight. They go to Afghanistan and sleep a couple hours a day, and everything that's going on over there, they come back and they just stay in fight or flight. But it might be 10 years later. Now, one thing that we do is we give ketamine, and then ketamine begins to sort of reset everything. One thing we do is we do a lot of neurofeedback, where we look electrophysiologically at the different areas of the brain, and we see, oh, this area of the brain is not working that good. Or maybe one of the brain waves, especially the low one, is really loud, and so it's drowning out everybody else. So we start to harmonize that. Then we start to give NAD and turn the mitochondria. And a lot of times that fixes the electrophysiological stuff that improves the brain waves, gets all the nuclei firing, and then we bring them out of fight or flight. Then a lot of times, what we'll do is we'll do something called a stellate ganglion block where we'll actually stick a needle. This is a pure hydrodissection, and we'll actually stick it in between two muscles that are in the neck the longest coli and longest capitis, which is where the sympathetic chain, which is your fight or flight nervous system, is. And we put it to sleep, and.

It'S actually like, shut down the sympathetic nervous system.

We turn it off for six or eight hours. And then what happens when we do that is you get the experience of being in full rest and relax. And so then it would be like, imagine. Imagine somebody that was in just a chaotic, stressful situation, and then we were somehow able to put them into this state. So, like, we do a lot of medical qigong and energy medicine, so we're using that too. And every one of those modalities is good. And so then it's. But they all sort of have a different profile. But the stellate and the ketamine are real profound because they have a fairly big physiological effect. And then what happens is you get this opportunity to integrate that experience. And then a lot of times that resets how people relate psycho, emotionally, or spiritually to their trauma. It also gives them a chance to sometimes reset. And if you get better software or reboot the hardware, a lot of times what happens is people will literally go into back to the factory default settings. And that's kind of. We see that all the time. It's super interesting.

Well, full disclosure for people who want to see what this actually looks like, this whole ketamine IV procedure, we're going to do it this afternoon right here in Dr. Cook's clinic. And so we plan on turning on the video and any footage that we collect. If you guys want to see me guinea pigging things on myself, you can go to BenGreenfieldFitness.com BioReset and I'll put the video right there. And you can also, of course, ask your questions about really what we've talked to, even though what we've talked about, even though we've kind of barely scratched the stage surface in terms of what Dr. Cook does. So just to give you guys a preview, some of the things we didn't yet talk about that you can look forward to for a part two is cannabinoids. Delta 9 THC, Delta 8 THC, all these different analogs of cannabinoids that Dr. Cook has studied up on and how they're blended with something called terpenes. We're gonna talk about hyperthermia and why he thinks that is one of the next biggest things in medicine or one of the next big trends. Very unique protocol he has for treating the gut and breaking up biofilms in the gut. So we're going to talk about that. You already heard a little bit about Lyme disease, but we're going to take a deep dive into that plasmapheresis, anti aging and of course, something I'm getting a lot of questions about now that Dr. Cook is also an expert on. And that's peptides. So you can expect plenty more coming your way from Dr. Cook. But in the meantime, I'm going to leave you with bated breath and you can go grab the show notes for everything that you've just heard, where you'll also find a link to Dr. Cook's clinic if you want toto set up a consultation or phone call and manage some kind of pain or Lyme or do any type of stem cell protocol yourself. He's one of the guys in this industry who I trust and he's well respected. So that's all going to be over@BenGreenfieldFitness.com BioReset just like it sounds like. BenGreenfieldFitness.com BioRoset leave your comments, leave your questions, leave your feedback. Dr. Cook, I think I called you Matt for about half of the podcast and for some reason I'm now calling you Dr. Cook. So yeah, I guess you just, you climbed up the totem pole in terms.

Of I'll be anywhere on the totem pole. Just call me anything, just don't call me late for dinner.

All right, well folks, thanks for listening in. I'm Ben Greenfield. Dr. Matthew Cook of Bioreset Medical in San Jose and also to a certain extent, I guess, Mexico. Signing out from BenGreenfieldFitness.com have an amazing week. Want more? Go to BenGreenfieldFitness.com where you can subscribe to my information packed and entertaining newsletter and click the link up on the right hand side of that webpage that says Ben Recommends, where you'll see a full list of everything I've ever recommended to enhance your body and your brain. Finally, to get your hands on all of the unique supplement formulations that I personally develop, you can visit the website of my company, kion@getkion.com that's getkion.com.