The Most Mind-Blowing Information On Heart Disease You'll Ever Hear: Understanding The Heart (Uncommon Insights Into Our Most Commonly Diseased Organ) - Part 2 With Stephen Hussey.

On this episode of the Ben Greenfield Fitness podcast. And I kind of thought at that point that that was the end of the book. And then you blew my mind.

My whole point in writing this book was to open the conversation about heart disease because clearly what we're doing is not working. And then what happened afterwards reconfirmed for me. This information needs to be out there.

Restores the normal parasympathetic signals. So then again, by taking it, you're shifting the heart back to burning primarily fatty acids and ketones.

That's gonna be a huge game changer for the.

Performance, nutrition, longevity, ancestral living, biohacking and much more. My name is Ben Greenfield. Welcome to the show. Welcome. Part two. Part two. If you didn't hear the the first episode with my guest today, Stephen Hussey, you can go to BenGreenfieldFitness.com Uncle Understanding the Heart. That's BenGreenfieldFitness.com UnderstandingThe Heart to hear that one. This is the next in this epic two part heart health series that I'm putting out for you. I think you're really gonna dig it. Well, folks, we are back. And if you don't know what I mean when I say we or back, what I mean by that is that you are currently, if you're listening to this show right now, listening to part two of a pretty epic podcast on cardiovasc vascular health with the author of Dr. Stephen Hussey, who wrote the book Understanding the Uncommon insights into our Most Commonly Diseased Organ. Now, I'm not gonna make you do this, but I would highly suggest if you have the capability to do so, you press pause, you save listening to this episode and you go back and listen to part one before you listen to part two. Because you're just gonna get a lot more out of part two if you listen to part one first. Although you know you could listen to this episode as a standalone, but I guarantee you will, you will dig it even more and you'll have a better understanding of what Stephen and I talk about. If you listen to part one, which you can listen to at BenGreenfieldFitness.com UnderstandingThe Heart. Okay, that's where all the shownotes are for part one. That's where you can go listen to the audio. That's where you can go and discover our conversation about everything from the naked mole rat and what it can teach us about heart health, the fascinating history, an ancestry of heart disease, all about vagal nerve balance, a ton about the role of ketones and people with heart failure. We dig into structured water, we dig into photonic light, we dig into why the heart is not a pump and really summarize heart failure in that episode, like why the heart fails in the first place. So again, that's@BenGreenfieldFitness.com Understanding the heart now, today's episode, we're gonna keep going, but you can access all the show notes@bengreenfieldfitness.com Understandingthe Heart 2. Like Understanding the Heart, the number 2. So go to BenGreenfieldFitness.com UnderstandingtheHeart for part 1. Go to BenGreenfieldFitness.Com UnderstandingtheHeart 2 for part 2. Where in part 1 you actually get Stephen's backstory. And so I'm not going to belabor his bio too much here, but Stephen is a chiropractor and functional medicine practition, and he just wrote this book, which I consider to be one of the most fantastic books that's been written of late on the heart and a really unique outside the box approach to heart health in general. As a matter of fact, Stephen, in celebration of us recording today, I actually just emerged about a half hour ago from the infrared sauna. I actually did kind of like a slightly higher dose niacin infrared sauna protocol this morning, followed by a little cold soak. And I was in there thinking, thinking about how good what I was doing was for my heart based on everything I learned from you in the past episode about infrared and photonic lights and heat and cold and everything else is great for the heart. So I've already been preparing hardcore for this episode by caring for my own heart.

Nice. Yeah. And I'll say I emerged from Asana about an hour and a half ago, so that's funny. On the same page, what kind of.

What kind of sauna do you use?

Mine's an older model because it was gifted to me. I can't remember the. They don't even make it anymore.

Oh, really?

Sona Spec, Maybe.

Okay, all right. I think I've heard of that. Brad. Is it an infrared.

Yes, definitely.

Nice. Well, anyways, though, we have so much to get into, so I think we should jump right in, man. Because what I want to start today's episode with is a topic we didn't dig into too heavily in the last episode. And that's the whole kind of like diet, cholesterol, fat piece. And. And I would love to unpack your unique approach to this because you have a lot of really good information in your book, particularly about statins. Some things I wasn't aware of regarding statins. And also, it's kind of cool how our heart actually gets first dibs on the fats that we eat. I thought that was really interesting how you outlined why that is. How is it that we have this system that gives the hearts first dibs on our dietary fats? Can you explain that?

Yeah, definitely. And I think that it's important, too, to understand why that is. And so things we talked about in part one will definitely help people understand why I think the heart gets this preference for fatty acids because bad things that happen or that can happen that we talked about in part one.

Right. And I can quickly, very quickly, in probably 30 seconds or less, summarize for people that when we are in a state of rampant glucose oxidation, particularly in heart tissue, you create a scenario very similar to what a muscle would experience during exercise. Glycolysis, lactic acid accumulation, calcium influx, and the propensity for things like calcification, acidity in heart tissue, inefficient metabolism in the heart, and when it comes to the water in the heart. And this is one that you do want to listen to, part one, to wrap your head around, almost like a failure of the proper electrical conductivity of the water in the heart due to the. The oxidants that can build up when you are metabolizing glucose as the primary fuel or producing lactic acid buildup within cardiac tissue. Is that kind of the general overview?

Yeah, definitely. And so since the heart's this really metabolically active and also very important organ, it seems that the body has given it preference for those fatty acids and ketones, but fatty acids, specifically, ways that it does this one is that just the unique way that the body kind of absorbs fatty acids because it packages them into chylomicrons in the digestive system, and then that goes into the lymphatic tissue or the lymphatic drainage ducts from the liver. No, no, directly from the gut. So rather, being absorbed into the blood directly, it goes into the lymphatic system, so to speak. And so that system drains more or less directly into the heart. Now drains in there as like into the vena cava, veins that go back into the heart. And so those are not being used, that blood is not being used to supply the heart. It has to go back through the lungs first, and then it comes back to the heart. And then the first thing it does when it leaves the heart again is it supplies the heart itself. So it's almost as if the heart is getting these prepackaged you know, fatty acids in these chylomicrons and then other various, you know, lipoproteins and things like that getting delivered to the heart tissue. And so it's, like I said, more or less the first place it goes. And so the heart kind of gets first dibs, ensuring that it gets to burn predominantly fatty acids or ketones, if those are changed into ketones later down the road by the liver. But, yeah, that's one thing. And then the other thing is that I came across a study that shows that there's a direct signaling pathway from the heart to the fat cells.

Yeah, that's what I wanted to ask you about, because we know that the lymphatic system is able to take those chylomicrons, you know, all those packaged fats that we eat. And the lymphatic system, because the chylomicrons are too big to get absorbed in the intestines, those get transported through the lymphatic system and then into the heart. So the fatty acids get delivered to the heart. And that made sense. But then you also said the heart has a signaling pathway. You just alluded to. But I'd love for you to unpack that, because I have yet to wrap my head around what that signaling pathway is via which the heart speaks to our fat cells.

Yeah, and it's just this, you know, when you read the study, it justit seems like there's just this link. And the researchers were, you know, kind of unsure of what that link meant at that point. It was a kind of early research. The study was pretty early, but there's no doubt that there is this link. And it's almost like fat cells in the heart are keeping tabs on each other, you know, so it's almost as if the heart is getting forced to burn more glucose than it wants because it's always burning glucose and fatty acids at the same time, but predominantly fatty acids. And if it's getting forced to burn more glucose, maybe, you know, that that direct link, you know, is. Is the fat cells monitoring that, like, hey, it's burning more glucose. Now we need to mobilize more fatty acids so that the heart can have those. I don't remember in the study if they specified, like, if there was any specific location of fat cells, like if it was a location that would, you know, if they got mobilized, the fatty acids got mobilized, it would go to the heart quicker or something. The researchers were seemed preoccupied in that study with how they could affect the heart to influence weight loss, because there was connection to Fat ce. I was kind of like face palming, you know, like, oh, no, guys. This has to do with metabolism, I believe, and the preference for fatty acids in the heart. So it's kind of a newly discovered kind of thing. They haven't fully fleshed it out.

Yeah, well, your citation in the book shows it's like a 2019 study. The alteration of myocardial GRK2 produces a global metabolic phenotype is the name of the study. And if I can hunt that down, I'll link to it in the show notes. But essentially what you're saying is that the heart can actually affect mobilization of fatty acids from fat tissue to shift the metabolism towards that of fatty acid utilization versus glucose utilization.

Yeah, it's almost like these fat cells were. They're like hyper aware of this shift in the. You said GRK2 is what it was, that shift in metabolism. So if it happens, if some kind of alteration and that happens, the fat cells are like, oh, we need to do something.

You know, that's super interesting now when it comes to the kind of the idea of the heart getting first dibs on the fats that we eat. And we know that these fatty acids are the preferred fuel for the heart. You know, fatty acids and ketones. You know, this is obviously related to cholesterol. And you obviously have a vested interest in cholesterol because you get in the book into the fact that you are what is called a lean mass hyper responder. And can you explain exactly what a lean mass hyper responder is?

It's a person. And these are just basically observations. And there's, you know, there's one guy who's, you know, really looked into cholesterol, who's kind of dubbed people that this happens to lean mass hyper responders. I wouldn't say that it's a, you know, a medical term that, you know, doctors use to describe people, but it's basically what happens when, you know, someone goes on a very low carb or even. It's common people on carnivore diets and things, they go on that type of diet and, you know, all their biomarkers, you know, get really, really healthy and they see all these positive things, low inflammation, all this good stuff, low triglycerides, but their LDL and total cholesterol pretty much skyrockets. To me, that happens for a few reasons. One is, studies have shown that just the act of fasting, more like prolonged fasting, like more than three or four days, but even, you know, smaller amounts of fasting leads to increased ldl. And the theory is that your body is trying to deliver more energy in the form of fatty acids because you're restricting other forms of energy that it may need. And so it creates more LDL there. And so people on these types of diets tend to eat less, they're more satiated because they're very satiating diets. And so they end up fasting more than others. But also the very process of making ketones, if you go on a low carb diet, your body's gonna start taking some fatty acids and making ketones. And the very process of that is very similar to what the liver does when it makes cholesterol. And so by default, the same pathways are happening, and just at the end, it shifts from ketone to cholesterol, you know, and it makes those changes, but we're getting more cholesterol production in the process of that. And then the third one is that, you know, since there's more cholesterol around, the liver shuts off its cholesterol receptors, leaving more LDL lipoproteins in the blood rather than reabsorbing them. So we get this effect of seeing higher ldl. So that's. It tends to happen in more fit, say, lean people. So lean mass hyper responders. And that's kind of what happens.

Yeah, yeah. Which is kind of paradoxical if you think about it. But if you have more fat mass versus lean mass, there's less need to kind of like traffic fatty acids globally since your target tissues have more available locally. But, and so as you gain fat, your cholesterol paradoxically may decrease a little bit because there's more tissue available to store fatty acids. And this is also kind of interesting that the person who you're referring to who kind of coined this term lean mass hyper responder is a fellow named Dave Feldman who has a website@cholesterolcode.com and he actually has some tips on there for people who are going to go get health insurance screening and are concerned that the cholesterol that they've actually kept somewhat high while keeping other risk factors low, such as glucose and inflammation, etcetera, Is going to kind of affect their ability to get a good deal on health insurance. So he says, well, if you want to lower your cholesterol in the few days leading up to something like a health insurance test, then you can decrease your fat intake, particularly your saturated fat intake, increase your carbohydrates. And he has multiple case studies and a ton of data on his website showing a significant drop in LDL when you actually go basically like higher carb, short term reduced saturated fats, it's probably not a long enough period of time before a health insurance panel to gain fat mass. But essentially you see this drop in LDL and sometimes triglycerides when you do that, which is kind of interesting, even though that shouldn't necessarily be something you should be trying to do. It's, it's a pretty interesting idea, this fact that the body can, in response to dietary intake, especially dietary intake of fat, if you are a lean mass hyper responder, actually respond essentially increasing triglycerides and LDL dramatically, but not in a situation that would actually put you at risk for heart disease. Right.

Yeah. And so you want to look at it as, you know, and that's the thing is people freak out when they are these lean mass hyper responders. The LDL goes way up, but triglycerides go down, inflammation goes down, HDL goes up. And that's the kind of situation that would lead to ideal health. And they're feeling healthy most time they're losing weight if they needed to. And so it's just kind of this paradoxical thing and you know, the medical doctors would freak out and they're ignoring all these healthy things that's happening to the person and they're focusing on this one biomarker. Yeah.

And of course statins are commonly what are, what are prescribed to prevent the production of cholesterol. You actually have a pretty interesting section of the book where you tackle what's going on when someone takes a statin and some of the downstream implications of that. Now I've talked before on the podcast about how statins can actually reduce the availability of an important enzyme called CoQ10 in the body. And that can cause fatigue, it can cause cardiomyopathy, like disease of heart muscle tissue can cause muscle wasting and that severity of, of coenzyme Q10 depletion causes like some pretty system wide muscle impairments in both cardiac tissue and skeletal muscle tissue. And that's something that I think a lot of people who are tuned into health are aware of regarding statins. And it's a reason that if you are on a statin, which is something that most people in my opinion should not be on, supplementing with CoQ10 or even for example, eating heart, or taking a desiccated organ capsule that contains heart, like I have the ancestral supplements, heart capsules, for example, that can be a good way to get your CoQ10 back up. But there are some other things that happen when you take statins beyond that. So I'd love for you to quickly explain how statins are working and what some of the other issues in addition to stripping away coenzyme Q10 would be.

Yeah, and this is something that I dug into quite a bit because I was recommended a statin before I was a lean mass hyper responder just because I'm type one diabetic. And the standard of care for anyone who's been type 1 diabetic as long as I have been was to put them on a statin, even though this was before my cholesterol went up and before I had any repercussions from diabetes. It was just kind of interesting to me. So I dug into it and yeah, so statins work by. There's this big 20 step long process and in the book I put half of those steps, like the main steps, just this little diagram that goes through it. And so it takes fatty Acid does this 20 step process to make cholesterol. And so what a statin does is it inhibits that process by inhibiting one enzyme that stops the conversion to one molecule to HMG CoA. So it basically stops that right there. And that's like the second step or third step or something like that. So it's very early on in the process. And the problem with that is that a, you're preventing the production of cholesterol, which your body needs for things like sex hormones and cell structure integrity and muscle function and things like that. But also there's lots of things the body uses all those intermediate things that were being all the little steps to making cholesterol it uses. It doesn't just use those things to make cholesterol. Sometimes it uses them for other things I go into in the book, like some of the things that it uses those intermediates for. Like one of those intermediates is used to make what's called dolichol, which is really important for the health of insulin receptors.

What did you say it's called?

Dolicol, Dolichol. Okay, I forget which one. Are they intermediate? I think it's isopentyl pp. I think that one is used to make dolichol. And then dollycol is really important for the health of insulin receptors.

So it's actually Farnesil PP that's used to make dolichol.

Yeah. So if we don't get that happening, thenour insulin receptors struggle. So it's no wonder that there are studies that show that people who take statins are way more likely to become insulin resistant and develop diabetes.

Oh yeah, it's like a 30% increase in some of the study groups.

Yeah, yeah. Something crazy too. So, yeah, there's that. And then, and then I think the isopentyl is maybe the selena proteins one where your body uses that to make selena proteins, which are very important for your body to be able to make its endogenous antioxidants like glutathione and superoxide dismutase and things like that. And so, you know, that's incredibly important for maintaining, you know, balance in this oxidative stress that we call which is a normal process that happens, but needs to be kind of mitigated. And so if we don't have that intermediate in that process of making cholesterol, then we don't get enough antioxidant production. And so it's interesting because statins, one of the different effects that it has, it has this pleiotropic effect of lowering inflammation, but it also has this effect of preventing antioxidant production which can increase inflammation. And so it's kind of like, it's great. It has this little anti inflammatory benefit, which is probably the reason we see, you know, a small benefit, really small benefit in statins, but at the same time it's preventing your body from decreasing inflammation because you can't make those endogenous antioxidants.

Arguably you could, you could be on a statin and supplement with like I mentioned, coenzyme Q10. And then also, you know, if you're blocking that isopentanyl PP pathway, that's going to allow for the production of seleno proteins, which would allow you to make glutathione. You could also supplement with glutathione. But then there's more, because the isopentyl is also responsible for the conversion of vitamin K1 to K2. And K2 is incredibly important for preventing arterial calcification.

Exactly, yeah. Because vitamin K2 is responsible for taking minerals and placing them into bone and making sure they don't end up in places they shouldn't, like the lining of an artery or even into a muscle or anything that can get calcified in the body.

Hmm. Now, is the statin actually affecting the LDL receptors as well?

No, that's more of a PCSK9 inhibitor, which is a newer type of drug. Okay. Those things are, you know, because there's PCSK9 which keeps them closed so that the LDL will stay in the blood. And so if you inhibit the PCSK9, it opens those up and then the LDL comes into the liver but there's already been some early trials with those drugs that show that they result in people being deficient in certain fat soluble vitamins, which makes sense because those are transported in LDL receptors. And so if those are all getting hogged up by the liver and out of the blood, then the body doesn't get the delivery of those fat soluble vitamins.

Okay, so that's not the statin, that's the PCSK9. That's going to affect the LDL receptors and decrease your availability of fat soluble vitamins.

Exactly. Yeah. In the early days, I mean, who knows what else they'll find? But, you know, very early studies have not been positive, in my opinion, on those new drugs.

Right. And there's a small population, I think it's in, for example, men who have a previous history of heart attacks who may benefit from statins in terms of reducing the reoccurrence of a heart attack. Right?

Yeah, they seem to be secondary. Prevention seems to be a little bit better as far as that goes.

But long story short is with the benefit of cholesterol, and as you noted, all the different metabolic pathways that cholesterol is important for, if you're simply shutting down its production or blocking LDL receptors, you're going to create kind of a metabolic firestorm downstream, when in fact, cholesterol is not. Not necessarily the issue here. It's something that is often present in cardiovascular disease, but not sufficient as a cause of cardiovascular disease, as opposed to many of the things that we talked about in the previous show, like elevated blood glucose, hyperinsulinemia, extremely high triglycerides, high inflammation or high C reactive protein, high blood pressure, poor vagal tone, et cetera. That's the issue. And if your cholesterol is high, those are the type of problems that you should be tackling.

Yeah, exactly. And cholesterol has been this giant distraction from Western medicine, focusing on the actual causes of heart disease, which makes sense, I think, because it's pharmaceutical based and that's a pharmaceutical they can sell and they're selling a lot of. But we're definitely focused on the wrong thing. And so there's associational studies that show that higher LDL creates more heart disease or there's more incidence of it. But those are associational. You can't really prove causation with those. And there's lots of problems with epidemiology or associational studies that they shouldn't be used that way for. But there's also associational studies that show that people with higher cholesterol live Longer have lower rates of infection, lower rates of heart disease, cancer, better cognitive ability. So it's like, which association of studies do we believe? You'd think that if cholesterol was that bad for us, we would not see those associations of better health long term.

I personally keep my cholesterol between about 200 and 300. I get concerned if it drops below 200 because I note things like decreased testosterone, lower energy levels, sometimes higher amounts of my inflammatory markers like CRP or another couple are the cytokines sometimes elevated, fibrinogen and homocysteine. I simply feel better because I do a quarterly blood panel when my cholesterol is just slightly, what many elements of modern medicine would say, elevated. But I also keep my blood glucose very well controlled, keep inflammation low, avoid vegetable oils, avoid high amounts of glucose and starches and sugars, thus reducing a lot of those factors that would cause the higher cholesterol to be problematic. Statins are one piece of the equation here. And these I always blank ON the abbreviation PCSK9. These LDL receptor blockers are another problem. But what about aspirin? Aspirin is talked about a lot. I'm curious what your take is on aspirin, because that's something that's often recommended, and I'm curious if you could explain why that's recommended. And what's your take on aspirin?

Yeah, so aspirin, it's a pain medication. It helps reduce pain, and it does that by blocking or interfering with prostaglandins. Prostaglandins are a metabolite that's. That's released whenever your body needs to repair something. So, like, if you sprain your ankle or something, you probably got a lot of prostaglandins being released. That release and what the prostaglandins trigger to, like, repair causes pain, you know, so it's painful. And so people, you know, reach for the aspirin to block the plane or the pain by decreasing the prostaglandins at the same time, they're interfering with the healing process, I'd say. So there's interesting, you know, studies that show that when we get sick, our body's secreting prostaglandins and inflammatory things so that we heal, fight off this pathogen or whatever it may be, or toxins. And so there's studies that show that people who take aspirin recover less quickly than people who don't take it, because, again, we're blocking that body's healing pathway when we're doing that. Now I'm not going to yell at anybody for taking aspirin if they're in pain. That's not fun. But my beef with it is that it's been recommended, you know, small, low dose aspirin, you know, every day to prevent heart attacks. To me, the research does not suggest that that works. And it's actually based on just one major study by the Physicians Health Group where they used it and they saw a lower incidence of heart attack. However, what they didn't advertise when they were, you know, in the media for the study was that it was buffered aspirin, which also had a lot of magnesium with it. And so was it the aspirin that was preventing things or was it the magnesium? Because magnesium has definitely been shown to be a thinner of the blood, not necessarily a blood thinner, but it definitely decreases viscosity of the blood as well as, you know, helps muscles relax or decreases blood pressure and things like that. So there's murky water there in their conclusion in that study, but the recommendation is largely based off of that. And so, you know, my issue is that aspirin taken long term can have GI issues, you know, GI bleeds, kidney issues, which for me, as a type 1 diabetic, I have to, you know, be wary of that. So, yeah, I do not think that that's a good approach, I would say, to preventing heart attacks. There are way more things you could be focusing on that are better than that without the harmful side effects.

Yeah. And another guy who I recently interviewed on my podcast, I don't know if it will have been released when this episode comes out, he recently wrote a book called the mineral fix. Dr. James D. Nicolantonio, and he has a wonderful paper that he published a few years ago about magnesium. And I think in this case it was magnesium glycinate, if I'm not mistaken, for the prevention and treatment of cardiovascular disease and found that it actually is something that's effective not only for congestive heart failure and cardiomyopathy, but also for hypertension and cardiac arrhythmias. And, you know, it seems to be because of the damage that aspirin may potentially have on the gut, as you've alluded to. Something that could be a pretty reasonable alternative to aspirin.

Yeah, exactly. Yeah. But the problem is that you can't really profit as much on it. You know, a pharmaceutical company can't profit as much on it, so it's likely not going to be the recommendation that Western medicine gives.

Hmm, interesting. Okay, now there was another one. I Think it was in the discussion where you talk about aspirin. You mentioned something else called. I don't know if I'm going to pronounce this right. Wabane.

I say wabean.

Okay. Wabin. What's wabin?

Yeah. So our body actually makes wabin, or people call it strophanthus as well.

Oh, strophanthus. Yeah. When I interviewed Dr. Thomas Cowan, he refers to that as the insulin of the heart. And it's kind of cool because it actually looks. You look at the. What's it called? The doctrine of signatures in nature. How when you cut open a pomegranate or a tomato, they kind of look like the little atria and ventricles of the heart. And they can be good for cardiovascular function. Or walnut looks like a little brain or an egg when you crack it open in a pan, looks like an eye. And certain things in nature are good for specific organs. And this wabane or this strophanthus, when you look at it, it looks like a bunch of little blood vessels coming off this white flower.

Yeah, it's pretty fascinating. And our body actually makes a version of this. It's from the adrenal glands. And there's a saying in Chinese medicine that's like the kidneys nourish the heart. So obviously they knew something around the area of the kidneys was communicating to the heart. And so its main thing is, what it does is that it increases parasympathetic signaling to the heart or it does things that would help other mechanisms increase parasympathetic signaling to the heart. And so it's been shown to be really effective. It's also created in this plant, like you were mentioning. And so we can use an extract from the seeds of that and get the same effect for people who are struggling. One of the things it does is by increasing that parasympathetic, it helps people with angina. Because angina, to me, is like we were describing in part one. When the heart is forced to burn more glucose than it wants to, it starts building up lactic acid. And that can create the burn, the same kind of burn you feel in skeletal muscles when you go for a run or whatever. But it's just happening consistently in the heart. And so we're getting this angina, this chest pain. And so when we decrease the parasympathetic signaling by using Wabin or Strafanthis, then the body, the heart's not getting the signals or stress response signal telling it to, you know, burn more quicker glucose or burn more quicker Fuel source, you know, and so it stops doing that, starts burning more fatty acids again and the angina goes away. And it has huge impact on patients who are struggling with those types of issues.

Yeah, and I find this fascinating because it kind of goes full circle. In the previous podcast we talked about how poor vagal tone and a shift of, of sympathetic so called fight and flight signaling to the heart can cause that shift towards glucose utilization and thus the buildup of a lot of the issues we were talking about a few minutes ago, like excess oxidation and a shift away from the preferred fuel substrate fatty acids and ketones for the heart. But then if you increase parasympathetic signaling via not only some of the vagal nerve toning modalities, that would include meditation and yoga and singing and humming and gargling and chanting and vagal nerve stimulators and all these things we can do to improve parasympathetic signaling. But the swabane, it appears, restores the normal parasympathetic signals. So then again, by taking it, you're shifting the heart back to burning primarily fatty acids and ketones.

Yeah, and that's going to be a huge game changer for the heart.

Do you think that that particular compound would be useful for people who don't have cardiovascular disease or have not, say, had a heart attack, but simply want to improve vagal tone or improve hrv? Have you seen people just using it more preventively?

I suppose, yeah, I have. And I do think that it's very relevant to be using because we live in a world where it's very hard to control our stress response. There's all these unnatural stressors around us. And so I think it can be used proactively like that.

Is that an over the counter.

The only place I know to get it is from Dr. Cowan's website.

Oh, interesting.

Yeah.

Huh.

Yeah.

I wonder where he's getting it from. He has weird things he recommends. Like another one was for a completely different issue. I think this was for, if I'm not mistaken, it's like it might be lime, I'm forgetting, but mistletoe extract. You know, he talks all about that in his book, but you can only find it from one like fringe organization in Canada. So he's got some interesting strategies up his sleeve that they sometimes have to dig to find, but they're, they're just fascinating. Now there was another modality that I think is probably near and dear to your heart and so I wasn't surprised to see you mention it in the book. Although this was the first time I'd seen this referred to in correlation to heart disease. And that's chiropractic therapy. How would that have something to do with the heart?

I actually debated. This was the last chapter I added because I debated on whether or not I should put it in there. People are going to think, well, what does chiropractic got to do with it? And it actually has a lot to do with it. I mean, people think that chiropractors are treating pain. And it definitely has research that suggests that it's very good for treating back pain, neck pain, and headaches. But we're actually treating the nervous system. We're correcting the structure and function of the spine. And in the spine is housed the central nervous system. And so that has a huge impact on balance in our autonomic nervous system. And the studies on chiropractic and affecting heart rate variability and just the balance in our autonomic nervous system. There's so many. I didn't cite them all because it was just gotten redundant. I brought it up because, I mean, not only that, but there's studies that show that chiropractic adjustments can increase the body's ability to make endogenous antioxidants like glutathione and superoxide dismutase. But also by suppressing sympathetic signaling, it can also help the body be more metabolically flexible. Because when we're in that sympathetic state, we want to burn glucose all the time. The body's thinking is in this stress state. So by calming that down, we can help it be more metabolically flexible. So it kind of of covers all three bases there as far as heart health. But I brought it up because. And it's something I do want to mention because there's this negative connotation to chiropractic and I'd say vascular health because of reports that a cervical adjustment causes strokes. When you look at the research that's been done on this, and this idea came from an actual committee that was put together by the American Medical association way back in the day, its main purpose was to basically discredit and get rid of chiropractic. And later on, a judge ruled that committee unconstitutional and told them to basically disband. But one of the things that came from that committee was, hey, chiropractors caused stroke. And so then we can fast forward to modern day. And all these studies have been done that show that because there are reports that someone's having a stroke and they report coming from the chiropractor or they got adjusted a few days ago. Like that does happen. They end up in the emergency room with the stroke. But it's not because they got an adjustment. Because what the studies show is that, A, the studies show that it's impossible to get enough force in the artery of the neck, which is the vertebral artery, to cause a dissection, which is, you know, which would cause a clot and a stroke. It's impossible to get enough force to do that with a chiropractic adjustment. But B, people have neck pain and headache, which is the most common signs of stroke, and small strokes when they start, you know, it's neck pain and headaches. And so they've done like three or four different studies that I cite, all in the book that that basically say that whether someone goes to a chiropractor because they have neck pain and headache or because they go to their pcp, the likelihood that whatever treatment they got from either one, that they later end up in the emergency room with a stroke is the exact same. So it doesn't matter. It's if the person's having a stroke and they get some form of therapy, whether it's from their PCP or from a chiropractor, but then later they end up diagnosed as actually having that stroke, whereas it wasn't recognized before. Does that make sense?

Yeah, it does make sense. And I think that it is interesting how in the book you get into the fact that this dysfunction in spinal joints contributes to the heart issues, because joint restrictions have an effect on that whole vagal nerve tone and autonomic nervous system that we were talking about. And so these pain signals generated from the nerves that are basically coming off the spine. I think you call the fibers, in the case of the discs of the spinal cord, the fibers that break down these annual annular. Is that how you pronounce it? Annular fibers?

Annular fibers. Yeah, yeah.

That surround the nucleus of the disc. Those nerves that go to those annular fibers have these pain receptors, these nociceptors that detect pain and that sense motion. And so when a joint is restricted, and that's what chiropractic does in many cases, is it frees up these joints. When the joints are restricted and those chemical changes in the joint tissue are relayed from the joint to the spinal cord, you then wind up having a stimulation of the sympathetic nervous system and a drop in vagal tone. And again, coming back full circle, a shift in the heart towards that same metabolic scenario that we wouldn't want it.

To be in yeah, it's just another stimulus in our modern day lives that stimulates too much sympathetic. And it's a constant stimulus because the joint stuck, it's not moving. And so I tell people all the time, you know, we chiropractors, we find joints that don't move and we create motion. It's a big deal because the disc doesn't really have a direct blood supply, especially the middle of the disc. It relies on motion to push fluid in and out. Kind of like a sponge, you know, soaking up fluid and then squishing it out. Every time we move our spine, it squishes fluid out and new fluid comes in, new with new nutrients. And so if that motion is not happening, the disc cannot stay healthy and it starts to deteriorate those annular fibers you're talking about, and then that starts sending this constant pain signal through the nerves, through the spinal cord. The place where those signals are received is right next to parts of the brain stem that would also signal sympathetic or be more likely to irritate that area and signal sympathetic. So we get this kind of constant signaling of sympathetic, which can contribute to this imbalance in our autonomic nervous system.

Has anybody ever done a study on heart rate variability and chiropractic therapy and seen if you see an increase in heart rate variability or vagal tone in response to chiro?

Oh, yeah, definitely. And like I said, there's. There was too many to quote in the book or to cite in the book. That's actually one thing that I've toyed with as far as on my initial exam, when patients come in, what I want to look at is heart rate variability because I can show them another benefit to chiropractic care.

Well, that's something that I do every week. As a matter of fact, I'll go in tomorrow. I go to Valenti Chiropractic here in Spokane. I just do a quick head to toe adjustment and I always walk out of there feeling not only 2 inches taller, but I have this surge of energy. I'll typically do it on a Friday going into the weekend and just this absolute amazing surge in energy. It's kind of like my 1, 2 treat to myself during the week. I'll often get a massage on Thursday night. And then when everything's kind of soft and loosey goosey, going to the Cairo on Friday morning. And I mean, I don't do it for my heart, but I definitely feel like there's an impact on my nervous system as a whole. I just walk out just in a.

Better Mood overall, people come to us for neck pain, back pain and headaches. But oftentimes they end up coming in and say, you know, I'm sleeping a lot better, or I used to have indigestion or acid reflux and I don't have that anymore. And I'm not saying chiropractic treats that, but that's what the effects we start to see with it.

Well, I mean, coming full circle, you have a fantastic section in your book that outlines some of the main things you would do if you wanted to live with a healthy heart. And a lot of it is pretty intuitive, like avoiding vegetable oils like corn and soy and canola and safflower and palm oil, avoiding processed sugars and being careful even with things like grains and legumes and sticking closer to whole foods. But some things people might not be aware of, like really being super picky about your water, like clean, pure, filtered, even. We talked about this last time, considering even something like structured water. You get into some of the different forms of exercise, particularly highlighting the fact that chronic cardio and extremely high intensity interval training that just, just gives you burst after burst of glycolytic activity is not as favorable as like very short, like 10 to 30 second burst training efforts combined with some form of strength training. And in my opinion, people with heart issues ideally benefit from something very similar to Dr. Doug McGuff's body by science protocol, which is super slow training, which is actually fantastic for blood pressure. You see this short term increase in peripheral blood pressure and then a really nice drop in central blood pressure. And folks with hypertension respond really well to that. So like, you know, very, very short 10 to 30 second intervals with long recovery periods combined with super slow training and, you know, maybe some yoga in the sauna. You definitely get into things like the infrared sauna, you know, getting a lot of sunlight, walking barefoot outside, you know, then this autonomic nervous system balance, which we've, you know, talked extensively about all the different things on these two episodes that could increase the autonomic nervous system balance. You even get into something I've discussed in the past with several holistic dentists about how the health of the mouth directly affects the health of the heart and how to care for your dental health properly as well. And I'll link in the show notes if folks go to BenGreenfieldFitness.com UnderstandingTheHeart2 to previous podcasts that I've done on holistic dentistry, in which I actually describe in more detail the link between dental health and cardiovascular Health. And so that's a fantastic section of the book. And I kind of thought at that point that that was the end of the book. And then you blew my mind, dude. You get into in your afterword, a section that you actually call and folks are going to understand why you called it this. And I think this might be a little bit shocking to folks, but you call it Two Faced Medicine. That's kind of like the final chapter in the book. And I realize this might be a little bit of a rabbit hole to go down, but I found it absolutely fascinating what happened to you after writing this book on the heart and heart health. So can you get into what happened, tell me that story?

Yeah, Definitely. So on January 5th of this year, 2021, you know, about three or four weeks before I was planning on releasing this book, I actually had a pretty massive heart attack. A 100% blockage of my left anterior descending artery, which only 12% of people survive if they have it outside of the hospital setting. I'll clarify that though, that it was not stenosis. It wasn't a plaque buildup. It was a somewhat spontaneous kind of clot that formed, just giant clot that formed. You know, I am incredibly thankful for modern medicine as much as, you know, we've kind of bashed it in these two episodes that it can do things like go in and intervene in that situation. Otherwise I would not be here. That's the good side of western medicine. That's why the. This section in the book is called Two Faced Medicine. Because I was laying there in the cardiac ICU going through everything I know about the heart and all the research I've done and thinking, how could this have happened to me? I was incredibly demoralized and defeated. Pretty much decided that I was not going to release this book because I didn't think I had more thinking to do or something. I was sitting there and nothing that I went over in the book did I feel was the cause or was wrong. You know, because I had a heart attack. And I came to realize that the information I put in there wasn't wrong because I had a heart attack. And I couldn't find any problems with what I. With what I wrote. And so then, you know, I was still sitting there thinking, like, I don't know if I can release this. You know, it's probably like a low point for me, especially because no family and friends were allowed because it was Covid stuff and it was just, it was kind of bad. But then what happened over the next three days in the Hospital, while they were observing me, completely changed my mind. I decided that the information in this book is critical for people to have because of what I experienced. So without going into all the details.

What I'd love to hear you unpack is how a guy like you, after having written this book, navigates winding up in a medical center and navigating kind of allopathic medicine with what you know and just kind of how that all fleshed out.

I want to get into that. And then I just. I should probably give people, though, like, my opinion of what I think happened to me and why. Because I've consulted with, obviously, the doctors in the hospital, which weren't very helpful. And then I consulted with, you know, more say, natural or in the know, cardiologist across the country. And so after consulting with them and everything, I think there's two things that play with what happened to me. One is the fact that I've been type 1 diabetic for over 25 years now. And probably half those years, like my high school and college years, were not well controlled whatsoever. I had a 1Cs of like 12 at some point, you know, consistently. And so there was. There was definitely damage done during that time. But there's also research that, you know, it's very clear that type 1 diabetics, even well controlled type 1 diabetics, are way more likely to be insulin resistant and struggle with that, and are also way more likely to have imbalance in their autonomic nervous system. My whole point in this book was to draw attention away from this cholesterol conversation that's dominating heart disease and draw attention toward the autonomic nervous system, insulin resistance, and that kind of stuff. It's almost like I unintentionally did that in having this heart attack. But the other thing is that 2020 was very stressful for everybody. And I'm not saying that, you know, it was more stressful for me, but there were situations for me that were happening that were making my life feel like it was out of control. And the studies are very clear that that stress that makes you feel out of control is way more damaging to your health. And that uncontrolled stress can contribute to increase in clotting factors and also, you know, spontaneous clotting and things like that. The two big ones were that I, my wife and I had been living apart because she got a job opportunity in England, and that was fine. In 2019, we traveled to see each other a lot. It was actually kind of cool. I got to go to Europe quite a few Times. But then in 2020, obviously, that all shut down. It was like, I don't know when I'm gonna see her again. And so. And then it was getting crazy over there. Like, I didn't know if she'd be able to leave ever. And so that was stressful. But then also something very stressful. A close family member of mine went through something very stressful. And I'm not gonna, you know, reveal the details of that, but it. It definitely hit me. And it was a day and a half later after hearing that news about her that. That I had a heart attack. So I think that all those things combined explain that. And then what happened afterwards. Basically told me and reconfirmed for me this information needs to be out there. The first night in the ICU, they checked my blood sugar and it was 300, which for me is just unspeakable. You know, it's usually as a type 1, it's always below 150, which sounds high to people, but for a type 1, that. That's pretty good. And the thing was, is that I had checked it earlier that day before having the heart attack, and it was 87, and I ate nothing between then and when I checked it at 300. So that just shows what inflammation can do to blood sugars. But, yeah, so then they, you know, gave me some insulin and it didn't work. I was likely insulin resistant at the time because I was in a very inflamed state and very stressed. But in my experience, if that doesn't work, you don't wait till the next meal or the next scheduled time to give insulin to do it. You get more aggressive with it. And no matter what I asked them to do and told them, like, look, I have well controlled diabetes. I've been doing this for 25 years. Let me take control. They wouldn't let me. Here I am supposed to be healing, and my blood sugar is crazy out of control. So that was the start of everything. They were prescribing medication after medication after medication. I was open to taking some because I just had a heart attack and they put a stent in, so I knew that wasn't something my body would recognize. I was open to taking them, but no one was explaining to me why they wanted me to take them. I was familiar with a lot of these drugs and what they did, but no one was telling me, like, coming in and explaining to me, and I was like, whatever happened to a formed consent? You know, like, I'm being expected to consent to these things without any information. I took the blood thinner because, you know, that seemed important because the stent was in there. I didn't know how my body would react.

So. So was it. Was it aspirin or some other blood thinner?

Well, they came in and told me they wanted me to take a baby aspirin and a blood thinner the rest of my life. And I said, well, can we talk about that? You know? And I said, well, I'm concerned with aspirin because I'm type 1 diabetic. I already have to watch out for my kidneys, and that can definitely cause kidney damage. He just said, there's some early studies about that, and that's. It's not true. And I was just like, well, that's not a good answer. And then he was talking about the blood thinner. And I said, well, what about magnesium? He said, what about it? Like, I know that if it's low when you test it, you should take it. And I said, well, I mean, as a blood thinner and as being effective, and I wasn't sure that it was going to. That magnesium would be enough to mitigate any clot forming from a stent in an artery. I was asking his opinion. I wanted to know if he knew anything about it. And he basically said, magnesium is not a blood thinner, which I knew to be false. He basically got agitated with me because I kept questioning what his recommendations were, and I wasn't aggressively questioning him. I wasn't being rude. I don't think. I'm not a rude person. But when I started doing that, the conversations were always cut short, and they would walk out of the room. And I said, well, I had a lot more questions about the other 11 medications you recommended. You know, and so I never really got to have conversations like that. And so when I looked it up later, there are actually studies, all of them done in animals, pigs and in dogs, that show that after a stent placement, that magnesium sulfate is just as effective as blood thinners in preventing clots.

No kidding. There's magnesium sulfate.

Yeah. Which you have to take intravenously. And these studies were done. They were doing intravenously, but it's just like he wasn't aware of that. And it's not to say that we should not take them or not do what our doctors say. And none of this should be medical advice or anything, but I wanted to have the conversation about those studies that he was unaware of. And I didn't know they were there either, but I just wanted open conversation. But that was the first thing. And then the second thing Was that they prescribed two blood pressure medications, which I eventually got them to tell me was because they wanted to take pressure off of my heart from getting signals to increase blood pressure so that as it healed, it wouldn't be forced or wouldn't be likely to remodel, you know, and get bigger or remodel in a poor way, like the tissue that was damaged. But initially they prescribed two, and I took one of them. As I describe in the book, I got up in the middle of the night to turn the heat down and almost passed out because my blood pressure was, what was it, like 98 over 50 or something, which is extremely low. And I didn't take the tube because I knew that my blood pressure normally is lower on the low end, like 112 over 72 the last time I checked it before the heart attack. So, yeah, if I had taken two blood pressure medications, I don't know what would have happened. I told them about those things, and they just kept dismissing me. And they said, your body will get used to it, blah, blah, blah. There was never really any open conversation. That was my big issue, is that as soon as I started questioning things, the conversation was shut down. And my whole point in writing this book was to open the conversation about heart disease. Because clearly what we're doing is not working. You know, the recommendations that we get to prevent it are not working. And so kind of the last thing is that, you know, the cardiac rehab nurse came in and I asked them if they used infrared sauna, you know, of course not. She didn't even know what that was. Or infrared light in general. The heart failure nurse came in and talked to me about what diet would be best to prevent heart failure. And she basically told me to eat a processed food diet.

That's literally what she said. Eat a processed food diet?

No, not literally, but when you look at the list of the foods that she gave me to eat, 90% of them were processed foods. The only things on there that would be good for me that she mentioned were the whole food. Vegetables. She said lean meats, But I would even argue that full fat meats are best for us. Then the rest was all about decreasing your salt intake and that kind of stuff, which I talk about in the book, how that's a big myth as.

Far as decrease your sodium chloride intake, arguably, but not your overall mineral intake.

Yeah, it was just, you know, one disappointment after another. And so it was almost as if, though, like, going through that as a patient just reaffirmed what the information in the book that it needed to be out there because there's, you know, countless numbers of people who are going to go through that unfortunately like I did, and they're not going to have the information I had.

Oh yeah, I see your list now in the book. Canned fruit, fruit juices, instant breakfast, margarine, mayonnaise, tofu, all breads and cereals, cornstarch, sherbet, sugar, jellies and jams, graham and animal crackers, cookies and fig bars. Was your recommendation for your heart healthy diet?

Yep, that was only what I can include in my, in my diet. And so basically I was fasting for pretty much the entire time I was in the hospital because of what they were feeding me. No one could bring me food because of COVID which was ended up probably being good because I was likely in ketosis, which is going to be great for recovery of the heart. You know, those ketones available. But I ended up only taking one of the medications which was the blood thinner because of the stent. And that was on the advice of a cardiologist that is way more in the know of what creates health. And it's more like you and I, you know, we have these ideas about what creates health. And I'm only going to do that though for a little while. Not near as long as they said. But my unconventional approach without the medications. I'm happy to say that my heart has made it 100% recovery, which kind of, I guess shocked some of the cardiologists. When I got my three month echocardiogram, my ejection fraction, which, the part of the heart that was damaged in my heart attack was the septum, which is the middle between the two ventricles. And it was severely akinetic at that time, meaning the signal for heart contraction was not being conveyed through that tissue. And now it is only mildly hypokinetic. And that's just at three months. Usually they say recovery can take up to six, so. So I'm hoping that it's good there. But then my ejection fraction, which I don't know what my normal ejection fraction was before the Sabbath, never had it tested, but after the heart attack it was down to like 35 to 40%, which normal is like between 50 and 70. And at the three month echocardiogram I'm up to 55%. So I'm pretty excited about that. And I will tell people that I, you know, I use the sauna, I use Sufanthus or wabine, I used lots of nutrients that have been shown in research to Help the heart prevent remodeling, but also recover and heal. These are nutrients found largely in animal foods, things like carnitine and taurine and carnosine, things like that. I've been using magnesium, lots of different, more than I usually would. And then also the sauna, I had gotten away from that and I'd gotten away from a lot of my stress relieving practices too. So that likely contributed. But now it's the sauna five or six times a week recovering and all those situations that were going on are getting better and better every day. So, yeah, I'm optimistic.

You didn't take the Xanax for your stress that the nurse practitioner recommended to you?

Yeah, I talk about that in the book, how that first night in icu I was pretty stressed, especially with the high blood sugars that I had no control to. Correct. I was pretty stressed. And I described to this one doctor, this resident that came in, the stress that I had been under and the events that had happened and everything that was contributing that I thought. And she prescribed a Xanax for me and said, try this and go to sleep. And then later I requested all my notes and all my chart notes and everything. And nowhere my chart notes was that whole story. I probably spent like 15 minutes describing what I've been going through to that, that resident in the hospital. And there was no mention of stress anywhere in my, in my chart notes.

Unbelievable. Wow. Well, I mean, first of all, kudos for including that in the book because obviously, as you noted, based on the title of that chapter, it could kind of appear as though, you know, you're somewhat two faced writing an article about how to manage the heart in a healthy fashion. And then you're the guy who has a heart attack. Yet, as you note, I mean, the fact that you were able to recognize the reason for the heart attack based on everything that you learned and adopted in writing this book, and then furthermore, were able to affect some pretty impressive recovery from the heart attack as well as experience some of the potential failures of modern medicine in terms of the way some heart attacks are managed or measured. I think simply lends the book, if not more credence, at least a much better kind of like in the trenches approach to how to manage, you know, what you of course call in the subtitle the world's most commonly diseased organ. So, you know, I appreciated that you wrote that. So, you know, I understand it was probably a courageous move. It would be like me writing, I guess, like my book Boundless, that has a bunch of interesting information on longevity and then, I don't know, kicking the can when I'm 60 or something like that. Maybe not quite that bad, but ultimately it's just a fascinating take. And I think that that chapter alone was just a real page turn. I mean, the whole book is excellent, but it's just fascinating that you went through that experience, Stephen. So, yeah, what I want to say is, because I know we've definitely gone through a lot here, but a, we haven't really tapped into everything that's in this book. And I really do recommend that anybody who has a heart own this book and read it. So again, it's called Understanding the Heart, and I'm going to link to it@BenGreenfieldFitness.com UnderstandingTheHeart2, which is where I'll also put all the shownotes and the studies for this podcast. And then@BenGreenfieldFitness.com UnderstandingThe Heart, you can listen to part one. And Steven, I want to thank you so much for coming on the show, for sharing all this with us, for writing the book, and anything else you want to add in the time that we have left.

Yeah, just people kind of are starting to see me as this influencer. I'm kind of getting a little bit. But I want people to realize that I'm in the trenches just like everybody else. I'm not this perfect person, and this heart attack reflects that. And I'm struggling just along with everybody else. And I wrote this book, not to say cardiologists are wrong in everything. This has been the culmination of my kind of lifelong approach to figuring out what the heart is, why it's there, how to keep it healthy. And clearly there are things beyond my control sometimes that I wasn't able to, but I think that the information is useful. And that's all I wanted to do, was just put it out there so people could have it. Because it's information that is likely not going to come from a typical heart health source. That's all it really is. It's not me trying to fly in the face of any profession or any. Or anyone. It's just me laying out information.

Yeah, I'm on the same page. I mean, I went and worked with traditionally trained allopathic medical doctors, well versed in cardiovascular disease. When I went down to LA and did all the different panels for my heart that I report on, it would actually be a good podcast for you guys to listen to. I go into ultrasound echocardiograms and blood flow meters and Calcification scores and EKG and stress tests and whole manner of different batteries I went through for the Heart down in la in terms of wanting to know what can a man in middle age do if he wants to know everything there is to know about his ticker? From a quantification standpoint, it was incredibly helpful and I very much value that type of measuring that modern medicine can do. But I think that that type of measuring, when combined with a lot of the, I guess, less pharmaceutically driven and more holistic approaches that you present in the book, can result in some really impactful, impactful information for people who really want to care for their, for their heart health. So, you know, I'm just, I know so much about the heart now, and I'm just super grateful for guys like you out there writing books like this and, and doing the research that you do. So. So thanks for coming on the show, man. I really appreciate it.

Thanks for having me.

Yeah, yeah. Word. And again, folks, part one is @BenGreenFulfitness.com UnderstandingThe Heart part two is @BenGreenFulfitness.com UnderstandingTheHeart2 the podcast I did from LA is @BenGreenfieldFitness.com HeartHealth the name of the book is Understanding the Heart by Dr. Stephen Hussey. And until next time, I'm Ben Greenfield along with Dr. Stephen Hussey signing out from BenGreenfieldFitness.com have an amazing week. Well, thanks for listening to today's show. You can grab all the show notes, the resources, pretty much everything that I mentioned over@BenGreenfieldFitness.com along with plenty of other goodies from me, including the highly helpful Ben Recommends page, which is a list of pretty much everything that I've ever recommended for hormones, sleep digestion, fat loss, performance, and plenty more. Please also know that all the links, all the promo codes that I mentioned during this and every episode help to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So when you listen in, be sure to use the links in the show notes, use the promo codes that I generate because that helps to float this thing and keep it coming to you each and every week.

SA.