AMA #16: Sleep, Vertigo, TBI, OCD, Tips for Travelers, Gut-Brain Axis & More

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life hello everybody and welcome I want to thank all of you premium hubman Lab podcast subscribers for joining this is an exciting one even though the backdrop here looks very much like the studio back in the United States I am doing this AMA live from Sydney Australia where I and the huberman Lab podcast team have been for well over a week we were in Melbourne and we just did two live shows here in Sydney and we're headed off to Brisbane tomorrow and it's been absolutely delightful we've had so much fun talking science learning from people it's a wonderful place I want to get right into your questions and do my best to answer as many of them as possible as thoroughly clearly and succinctly as possible over the next hour so I'm going to dive into those in just a moment just one last important thing before I do that which is that I want to thank everyone for being a premium subscriber and let you know that we based on your contributions to the premium channel have already as you know supported four Laboratories at Stanford Columbia University sulk Institute and Elsewhere for important projects on humans that are already leading to important therapeutic breakthroughs that we will soon share with you on the hubun L podcast but that this year 2024 we were fortunate enough to secure no fewer than three dollar Ford dooll match donors who have generously agreed to match our contributions from the premium channel to additional projects uh those are going to head out to a number of different universities and researchers working again on human studies so no animal studies human studies on important projects everything from novel treatments for mental health issues headache and migraine um some interesting stuff on immunology and cancer mindsets and immune system function and much much more also nutrition physiology exercise physiology Etc so your contributions to the premium channel really do make a difference I can say this uh because I'm familiar with the challenges of raising funding for doing truly breakthrough work and getting things quickly out to the general public so thank you thank you thank you and now without further Ado let's get to your questions the first question was is how are you managing to achieve your key Health pillars while in Australia and any other place you've enjoyed doing so all while working so hard well thanks for the question I'll answer this question in the context of what I think we all can and should and um really will do um because if you're a premium channel subscriber I'm certain that you're taking your health seriously so uh first off um I think there's a bit of a misconception about the protocols on the hubman Lab podcast being that um we are all including myself super super regimented about them to the point where we don't enjoy other things in life and that's simply not true so I view the protocols of the hubman Lab podcast as science-based actionable low cost zero cost minimal cost in almost all situations there are a few exceptions to that but really designed to mesh with the rest of life and enhance mental health and physical health which of course means remaining social staying on typical sleep schedules Etc so the big ones for me when arriving here were of course to get morning sunlight um as often as possible uh saw a beautiful sunrise this morning over Sydney but even on the overcast days we've had a few rainy overcast days to really make it a point to get outside and to get that morning sunlight also uh our crew did travel in with uh a red light not a red light panel although I do have a couple red light panels uh those little portable ones um that I use from time to time the red lights I'm referring to um in reference to answering this question are the red lights which are just red light bulb that we I actually travel with a little um red light bulb unit it's just like a small you know screwing unit you plug it in here uh with an adapter of course and then in the evening we've Switched Off the Lights in the place where we're staying and it just brings the overall levels of cortisol down low very quickly and it makes it very easy to get to sleep each night it makes a big big difference and this is a very lowcost tool you could essentially purchase any red light light even red party lights and put those up and then switch off the regular overhead lights it makes a big difference it's probably even cost-saving uh We've also stayed fairly regimented about exercise so this morning took a great jog down to the ocean jumped in the ocean if you don't have access to an ocean on vacation just getting outside and getting some movement early in the day can help shift your Rhythm really the quadfecta of Shifting your circadian rhythm in a new place or becoming an early riser if you want to do that is morning sunlight movement social engagement and in my case caffeine although some people would opt for eating breakfast I just happen to prefer to eat a little bit later in the day so when you combine those things you are really amplifying that morning cortisol increase that I've talked about on the podcast morning catac colomine release so dopamine epinephrine and nor epinephrine and those act in Synergy to create more early day and daytime mood focus and alertness and enhance the transition to nighttime sleep but of course that dimming of the lights and maybe even red light in the evening really really can help and so those are the biggies and then of course if you want to shift your circadian rhythm really quickly to be on a local schedule it helps to hop on the local meal schedule but for me that always means skipping breakfast I'm not a big breakfast eater I like lunch an afternoon snack sometimes and dinner so when you do all of those things makes it very easy to stay with the health pillars and of course Stress Control is important we're doing lives there's a lot of work to do so there's a daily for me non-sleep deep rest or yoga NRA protocol by the way um you may be familiar with on sleep deep rest in yoga Nedra terrific zero cost practice for reducing stress replacing or replenishing dopamine and mental and physical Vigor I've talked about this and the studies that support this on the podcast there is a uh huberman nsdr script on YouTube um that's again zero cost but while down here we recorded a 10 minute 20 minute and 30 minute nsdr script with a view of a beautiful um Sydney Sunrise those should be posted to our hubman lab Clips channel in the not too dist future probably in the next couple weeks um and then you can have different duration and SDR scripts that you can use again completely zero cost anytime you like uh We've recorded also some additional meditations and um we're considering putting out a uh Spotify album if you will of n SDR and meditations that are science-based of different duration so if you like that idea maybe um just uh give a shout into the internet and hopefully we'll hear it or put a comment on the latest um episode of The hubman Lab podcast on YouTube and if that sounds like a good idea to you we will do more of that these are again zero cost zero to access tools for enhancing mental health and physical health so combining all of those is really what we've done um next question was is I have followed your sleep advice and I have seen a huge Improvement great happy to hear that wonderful um but I still wake up at night and only get five or six hours is that enough can you please give more advice if possible um well first of all thanks for um tuning in to to the the Sleep advice um so the question of whether or not five or 6 hours is enough really depends on person context and by context I mean it can even change across the course of the Year by life circumstances the criteria for insomnia are very clear insomnia is excessive daytime sleepiness due to lack of sleep at night excessive daytime sleep sleepiness due to lack of sleep at night so if you're not falling asleep during the day and you feel reasonably good throughout the day maybe only need a brief 10 minute to 30 minute nap in the afternoon some people nap some people don't like to nap doesn't matter but if you feel pretty good throughout the day and you have enough mental and physical energy and focus to complete the activities you need to complete then I wouldn't worry so much about 5 to six hours and I wouldn't obsess over you know these um kind of scary things that we hear oh if we're not getting seven to eight hours that we get dementia Etc because that's not necessarily the case everyone has different sleep needs the other thing and this is perhaps the most important thing for everybody listening to this really to think about is qqr r t which is quality quantity timing excuse me quality quantity regularity and timing QQ RT QQ RT uh which is an acronym coined by the great Matt Walker author of the book why we sleep he has our own terrific podcast in his own right has a series on the hubman LA podcast coming out soon qqt is what you really need to think about when you think about your sleep so you want to think about the quantity how much are you getting well you Rema um who asked this question are getting 5 to 6 hours a night okay what about the quality of that sleep is it consistently 5 to 6 hours with no breaks or is there a break in the middle one trip to the restroom in the middle of the night is considered normal and healthy for most people if you're making multiple trips to the restroom in the middle of the night you're waking up multiple times throughout the night on a regular basis that's something to try and overcome so the quality piece is important also whether or not you remember your dreams or you don't you want to make sure that you're getting ample amounts of slow wave sleep which dominates the first half of your sleep night and rapid eye movement sleep which dominates the second half of your sleep night because they have different roles in recovery of brain and body namely slow wave AKA deep sleep is responsible for growth hormone release rapid eye movement sleep responsible for know the unpacking or the uncoupling of emotions to Prior day and previous day experiences and in that way acts as a kind of a a scrubbing out or a therapy for your emotional state so are you feeling emotionally rested when you wake up as a good indication of whether or not you're getting enough rapid eye movement sleep some people like sleep trackers using their aid sleep or their whoop or their Aura ring or something like that I'm a fan of sleep trackers but I think that relying too heavily on sleep scores can be risky there are data from Ali crumbs Lab at Stanford showing that if people receive a poor sleep score even though they sleep well their performance will drop if people get a good sleep score even though um their their sleep was lousy um their performance is maintained or even enhanced so you don't want to take any one sleep score and over interpret it you want to look at the average and compare that to your subjective experience of sleep maybe I would say go about halfway through your day if you can bear to do it before looking at your sleep score and see how you feel then look at your sleep score as opposed to the other way around that might be a good way to adjust for that um belief effect I just mentioned but if you're getting enough quantity let's say you get five to six hours and quality you're sleeping through that bout um maybe with one um Epoch of waking up and then the regularity of your sleep is that you're going to sleep more or less at the same time each night plus or minus an hour on let's say five to six days per week because sometimes we like to stay up on a weekend night and have some fun or something like that and then the timing you know where that sleep is falling in your 24-hour schedule is really key and here's what we're learning as a field that for many people who are early to early to rise types if they go to bed around 900 p.m. 9:30 and they only get 6 hours of sleep they feel great whereas if they get the equivalent amount of sleep but go to bed at 11:00 p.m. or midnight they feel lousy similarly if you're a night owl you're somebody that really prefers to go to bed around 1: or 2 a.m. and wake up around let's say 10:00 a.m. if you take that equivalent amount sleep and you go to bed earlier you're going to feel not so good so getting the timing of your sleep in the 24-hour cycle correct and fairly consistent that's the r part of Q qqt uh correct is going to be beneficial so I wouldn't worry so much about 5 to six hours only here's what I would do Rema I would take that five to six hours and before getting out of bed each morning I would do a 10 to 30 minute nsdr non-sleep deep rest protocol which will allow you to feel deeply rested and frankly to recover whatever bits of sleep that you perhaps Miss during the night I found that to be a tremendous ly beneficial practice waking up if I don't feel thoroughly rested doing a 10 to 30 minute nsdr then getting out of bed and continuing the day and if you don't have time to do that do that 10-minute maybe 20- minute nstr later in the day at any point and I think you'll see terrific results not just because you're recovering some sleep that you lost perhaps during the night or maybe you just need five to six hours but also because you'll get better at falling and staying deeply asleep through the practice of nstr in the morning or at some point throughout the day um I wouldn't recommend anything else elaborate unless you're feeling really exhausted during the day in which case then I would move to some of the more advanced sleep tools I've had vertigo I should announce this is a question I'm not just telling you about my vertigo I've had vertigo on and off and wonder what causes it is it hormones adrenals autoists moving around ah this person knows about the ca hydration virus exposure zenana I think is how you pronounce your name forgive me if that's not the correct pronunciation Zana so vertigo is very interesting um unfortunately it's uncomfortable but we can learn a thing or two right now that should be able to help you Zana and others even if they haven't had vertigo so vertigo this perception of falling or dizziness needs to be distinguished from Li headedness so if you're ever feeling dizzy it's worth stopping and sitting or if you can't sit standing and closing your eyes and asking yourself a question do I feel like I'm ready to fall straight down or do I feel like I'm going to spin and fall down because in answering that question you can determine whether or not you are lightheaded that would be the straight falling down or you have vertigo which is you're dizzy which is that you're going to spin and fall down now do this in a safe place please you can do this while bracing yourself against a wall or that's why I said ideally see so you don't actually fall but in most cases if you're feeling that spin if you're feeling truly dizzy you're feeling vertigo and I'm moving my head around on purpose then chances are you've got some issue in either your visual system or your inner ear okay so since this is being recorded on video I can display what I'm about to say so your visual system and your inner ear system for balance have some really important features I'm going to make this a very quick tutorial your head as you move through space is experiencing visual images going by all the time your retinas your eyes are essentially exposed to a lot of what's called visual slip imagine you're walking and you're trying to take a a picture on your iPhone or if you have an Android phone on your Android phone and you're moving it's going to be blurry right well there's a stabilization process in your body and brain it's a magnificent one that Frank is built in into all jawed and animals whereby your head because it can move forward so think nodding right so this is pitch for you Pilots right yaw moving from side to side this would be the no this would be the No No so pitch yaw and roll which would be like the puppy look right pitch yaw and roll pitch yaw re those are the three major angles of visual slip and in an absolutely magnificent set of things your inner ear has three hula hoop like shaped structures one that's arranged vertically so up on its end one that's at an angle of about 45 degre to that and another that sits like a hula hoop flat on the ground and inside of each of those little hula hoop like tubes there are little stones called aoli okay you heard that word earlier that roll around on the bottom just like marbles at the bottom of a hula hoop such that when you pitch nod the marbles in the vertical hula hoop slide back and forth when you say no the marbles in that hula hoop lying essentially parallel to the floor move around and then the one at 45° when you roll your head from side to side those move and each of those sends neural signals that Converge on the neural signals coming from the eye and get this when you move through space there is a precise offset of whatever visual slip you happen to be experiencing by walking images are moving you're looking up you're looking at building as you're looking around you're talking to somebody they're moving their head and your eye is making little tiny movements little microd on the millisecond time scale that act as a perfect image stabilizer so what this means this is by the way called the vestibulo ocular reflex vestibular system oculo reflex and it's meated through a structure called the cerebellum in the back of the brain this is why when you're on a boat when the Horizon is tipping back and forth I have to be careful with this because I have such a prominent seasickness based on a prior experience that if I think about this too much I might get nauseous when that Horizon is moving around your system becomes uncalibrated because you can't really keep the system jolting about in a regular way have to be really careful here I'm getting dizzy um notice I said dizzy not lightheaded um and you will end up disrupting that slip process and you'll essentially overcompensate which is why whenever you feel sick on a boat they say look at the Horizon fixate to something at a distance okay so if you have vertigo almost certainly there's something going on in your inner ear yes it can be caused by viruses yes it can be caused by hormones these things tend to be transient but the most important thing is going to be to Anchor the visual part of the vestibular ocular reflex so what you're going to want to do is you're going to want to fixate on a point maybe 3 or 4 feet away and then you're going to actually want to move closer to that point or if you don't have access to it you would want to look at your hand you your finger out in front of you and then slowly move it in toward your nose at some point you'll feel like you're going to go crosseyed and you can stop at that point then move out again then in again what are you doing when you're doing this what you're doing is you're overriding the error signals the incorrect error signals that exist in your kind of default setting at that when you have vertigo and you're forcing the visual component to dominate and then your inner ear mechanisms will adjust to that so this is a very powerful tool if you ever feel nauseous or seasick it's a very powerful tool if you're ever like me you sit in the back of an Uber and the Uber is too small you get out and you're like walk into a building where there are no windows you're like I don't really feel good get outside and look at a fixation Point some distance away this actually happened the other day we went to the gym we went inside this gym we'd been in a in a van and then went inside and weren't feeling well so we decided to get out and just take a walk and fixate to the longest distance possible the fresh air probably helped as well but when doing that you are anchoring the visual part of the vestibular ocular reflex now that's far and away better than trying to avoid moving your head to not get those little Stones moving around in the semicircular can canals lots to say about this um I could go on and on but hopefully you learned some biology and you learned to how to be nauseous um if ever you feel dizzy or nauseous based on movement motion sick and we could talk about why you get motion sick but it's through the vagus nerve etc etc but this is a very useful tool and if you're ever just not feeling well you know unless you have a fever or something like that I recommend getting outside and looking at the furthest fixation point with your vision that you possibly can and then walking toward it as far as you can safely if not by actually just doing a few of these um exercises of looking at your finger up close close that's going to be very good for anchoring the vestibular ocular reflex and not every time but many times people report feeling better especially if you've moved from one closed environment to another closed environment to another closed environment and so on okay next question is what can be done to improve brain function for people that have been negatively impacted by things such as poor sleep poor diet and TBI early in life James yeah this is a great question and I get this a lot I think that um it reminds me that a lot of the conversation that we had have on the podcast is about the good things that happen when you do things right and the bad things that happen when you do things wrong and while I think that's an important conversation what I've frankly failed to do uh enough and that's why I'm grateful for this question um because it gives me the opportunity to talk more about the fact that your your system is very robust there is neuroplasticity and also you know as my graduate adviser used to say you know time machine's broken which is not to say you know you're out of luck but I wouldn't spend any extra energy thinking about how many seed not seed excuse me um how many I have to be careful the seed oil debate is still a debate it's unclear how many uh trans fats uh you were exposed to in childhood you know we know trans fats are bad everyone agrees they're bad governments agree they're bad this is perhaps one of the few things everybody agrees on in the nutrition space trans fats are bad um when I was growing up trans fats were abundant in Foods um there were probably fewer of certain things that we have more of now that are bad but you know we ate lot of trans fats we had margarine in our fridge um there were other things that were probably weren't good for us that we consumed and every once in a while I'll think gosh you know if I had only been eating you know grass-fed meats and fruits and vegetables and um and healthy grains as I do now back then imagine how much healthier I'd be but I really don't spend too much time on it and I don't think you should either I think the most important thing to remember is that biological systems unless they're really damaged you know you're talking about you know a major injury um um and even then they're very robust you can overcome years decades of poor use or misuse of those systems that said if you have the opportunity to take care of them now I highly suggest you do so for instance if you haven't slept well for years Now's the Time to get it right I wouldn't worry about the past truly you can always rescue some of your health and health span and lifespan U poor diet same thing just it's a just do it kind of thing just Hop On Hop on the train of getting things right 80 to 90% of the time TBI traumatic brain injury well the episode of the hu Lab podcast is out right now with Dr Marc despasito he's an MD a neurologist uh originally trained at uh University of Pennsylvania now at University of California Berkeley we talk about TBI you know there are a lot of different forms of TBI um different Origins um you know everything from Bomb Blast to car accident to construction work to just you know slipped down the stairs at a party I know someone that slipped on on some wet floor at a party and you know has a brain injury what what do we know well you get back to the basics sleep is going to be important but there are some things like transcranial magnetic stimulation certainly things that reduce brain inflammation like glymphatic outflow so glymphatic outflow is this washing of the brain at night that removes debris very very important um in the weeks and months after traumatic brain injury to get adequate sleep for that reason but then there are things that also seem to perhaps improve outcomes from traumatic brain injury such as hyperbaric chamber so hyper oxygenation treatments if you have access to those even things like elevating the feet slightly when you sleep by about 5 to 15 degrees is known to increase lymphatic flow during sleep which Can We Believe by way of increased clearance of a bunch of basically debris reactive oxygen species within the cells but also debris outside the cells the extracellular space so between neurons there isn't just empty space there's all this um like heavily glycosilated stuff which basically just means this kind of like spongy carbohydrate stuff that fills in the spaces the clearance of some of the uh metabolites and some of the debris that's accumulated there by just sleeping with feet slightly elevated definitely not falling asleep in a chair upright that's the worst thing for lymphatic flow things like that some people go kind of Bonkers on all things anti-inflammation they start taking tons of curcumin and they kind of get obsessed with inflammation as as the enemy I wouldn't do that in fact there's some negative effects of things like curcumin um turmeric if you take it in high doses like limiting the amount of dehydrotestosterone production which is not good you don't want that um male or female you don't want to take too much turmeric or cumin um they real issues with that um to say nothing of the the studies that have showed lead contamination in a lot of turmeric so you want to check the sourcing very carefully if you do consume any turmeric a little bit is probably fine cooking with it is fine but we're here we're talking about supplementation and and you know just really not trying to turn inflammation into this terrible thing to the point where you're starting to do other things that are potentially damaging there's some really interesting evidence that five grams maybe 10 grams depending on your body weight of creatine monohydrate per day can enhance creatin phosphate metabolism in the forbrain and enhance brain function under conditions of high altitude or TBI I Take 5 to 10 gram of creatine just creatine monohydrate powder frankly any creatine monohydrate powder should be sufficient there are other forms of creatine they are not any better creatin monohydrate is the least expensive fortunately um that mixed in water you take it with or without food some people ask does creatine make your hair fall out no it does not make your hair fall out but some people do experience an increase in DHT with with creatine monohydrate and there can be a DHT hair loss link so if you think you're losing your hair from taking creatine then stop and see do the control experiment it should grow back but 5 to 10 grams of creatine monohydrate something to explore hyperbaric chamber something to explore excellent sleep definitely do that and I just wouldn't obsess over past ills or wrongs to the extent that um it impacts your ability to try and correct those in the present I would say that about most everything but then again I understand that as humans because we can remember the past the present and the future that sometimes um you know it's difficult to let go of the mistakes of past that we made but that's just simply um Being Human and I don't have a solution to that are we any closer to finding the cause of OCD well I think we know what causes OCD I think um it's pretty clear that OCD is some form of miswiring in the basil ganglia the structures of the brain that are involved in go action and noo withholding action type uh behaviors um and some uh Mal wirring of those structures to the dopamine reward system because here's what's interesting about OCD OCD involves obsessions obviously that's the O and OCD compulsions the actions that's the C and OCD but in a kind of weird Twist of the neurology OCD is a situation where the compulsion does not remove the obsession rather it exacerbates it okay the compulsion does not remove the obsession it exacerbates it so unlike an itch that you scratch with OCD the scratching of the itch makes it worse which is actually what we experience when we have mosquito bite which by the way I've absolutely loathe mosquito bites it's one of my like least favorite things in life um I have about 3600 and Counting pet peeves that's definitely high on the list of those the obsessive compulsive disorder is one that really needs to be treated frankly neurologically it's one for which there are behavioral interventions but it's clear that adjusting the pharmacology of the neural circuits involved in OCD really can help there again there are behavioral treatments but for severe cases of OCD it's just very very clear that interventions which include ssris which have been demonized a lot of people say oh Ser selective serotonin reuptake Inhibitors are terrible blah blah blah um you know the serotonin hypothesis of depression isn't true well listen the reality is this that all treatments for depression that are effective which include ssris in some cases cognitive behavioral treatments all of these sorts of things which have shown efficacy are all about what they're not about serotonin they're about neuroplasticity that's why some anti-depressants Center on dopamine and norepinephrine others Center on serotonin they're about neuroplasticity they're about changing neural networks they're not about a neurochemical per se but the neuromodulators such as serotonin allow an access point they are a wedge into the neuroplasticity process now with OCD in order to overcome these these Mal wirings it's very important to get plastic how do you get plasticity well you in my belief you work with an excellent psychiatrist who can prescribe the appropriate dose of drug to release the appropriate amount of neuromodulator then and this is really key you have opened up the window for plasticity but then it's really important that the proper behaviors are engaged in and when I did an episode on OCD I talked about what some of these are for instance the person is exposed to the stimulus that causes the obsession or maybe this Obsession arises spontaneously they feel the impulse to complete the compulsion the behavior and they resist with the support of a therapist but they're doing this in the context of having elevated levels of Serotonin or some other neuromodulator that then allows fewer Trials of resistance fewer times of needing to withhold the the the behavior that this person so badly wants to perform because it's coming from within it's this compulsion literally then they are able to achieve plasticity more quickly perhaps also trans cranial magnetic stimulation so a conjunction of be correct Behavior the withholding Behavior maybe a replacement Behavior that's often used use a replacement Behavior with the appropriate neurochemical milu is the solution to OCD okay next question is if I'm just going to New York City from San Francisco how do I control shifting my circadian rhythm by only three hours so if you're going in New York City from San Francisco the best way frankly would be to get up an hour earlier 2 days before you head off to New York and then another day you might Trend shift by two hours before you go and then head to New York and do the last shift on the last day um most people won't do that it's just you know takes a little bit of work but um they just don't have the the time ability or your discipline to do that but it is perhaps the best way I would say the best thing to do is to know your temperature minimum and I'll try and keep this this uh pretty simple if you typically wake up at 8:00 a.m. let's say just by way of example that means that your minimum body temperature is at 6: a.m. which means that if you want to get up earlier in the days where you travel to New York well in the couple of days before you leave anytime between 6:00 a.m. and 10:00 a.m. get some bright light in your eyes even if you go back to sleep so for instance get up at 6:00 a.m. set an alarm clock I know you normally like to get up at 800 a.m. get up at 6:00 a.m. get some bright light in your eyes from artificial sources or from sunlight maybe 5 10 minutes then go back to sleep until 8:00 a.m. you do that again the next night and then you head off to New York you'll find the shift to be much easier now here's what you don't want to do you want to make sure that you do not view bright light before 6 a.m. so in the middle of the night if you get up you need to use the restroom trying to use dim lights as dim as as safely possible Etc and what are you doing when you're doing this yet I could I could get into a long description of the science behind this and I'll probably do a podcast all about this at some point but really what you're doing if you get up at 6: a.m. and getting some bright light exposure is if you think about it you're kind of looking at a New York Sunrise of sorts okay if it's not a sunrise you're getting some bright light that mimics sunrise at least to some extent nothing's quite like Sunrise but to some extent so in that sense even if you go back to sleep what you're doing is you're sending the light signal the zeit Gaber the time signal to your circadian clock of your hypothalamus that it should shift that you need to get up earlier and indeed that will happen over the course of about 2 3 days the other thing you can do and I know this is um this is kind of uh rare these days to get an answer like this the other thing you can do is just fly to New York and force yourself to get up and just drink caffeine and get out and exercise and use the social Rhythm of the activity of the city in order to get up earlier but you will feel lousy late morning and so you would only want to do that if you could access a brief nap of anywhere from 30 to 90 minutes late morning and then you'll feel fine but my suggestion would be to some something back there like some animal or something likes that answer so much so like that yeah would be to just try and do get a little bit of light exposure a couple hours before your normal wakeup time then go back to sleep in the two days before you head off to New York City and of course everything here was set in the context of the New York City uh flight from San Francisco New York City but the but the principle the logic holds and if you have any questions about this temperature minimum and wake up time you want to get your circadian clock right for travel check out the episode that we did on jet lag and shift work and I'm realizing now as I say this and I'm my team's here and they're listening um that I will do a video on the Hub lab Clips Channel where I explain temperature minimum and how to plug in your wake normal wakeup time in order to essentially arrive at whatever time shift you want we should probably put that out as a newsletter too which it's a little chart where it says I currently wake up at 8:00 a.m. and then which means my and then it'll say subtract 2 hours my temperature minimum is 6:00 a.m. and I want to travel to whatever it is I don't know Sydney Australia on this date from this city and then we know the time change and then I can tell you exactly what to do for a couple days I've done this um for various military groups I've done this for people in uh close friends and who travel a lot and it works fabulously well I can't eliminate jet lag for you don't I wish I could just eliminate jet lag I can't do that but I definitely can have the time that it takes for you to shift maybe more hi hi I love the Sydney show thank you thanks for coming out thanks for coming to Australia thanks for having us I take fish oil but I'm not sure I'm getting the dose right what are your thoughts on fish oil and dose I have lots of thoughts on fish oil I think it's a terrific tool I think every time I see a study or an news article saying fish oil not shown to I just go oh gosh all right well listen whoever's wrote that article you know I um I take no pleasure in um your declining Health span or lifp fan but whatsoever but um the rest of us are going to be taking fish oil um and here's why there's just oh so much evidence that getting enough omega-3 fatty acids is great for brain health body health and I think that the the issue around fish oil is typically around contaminants so you want to make sure that it doesn't have loads of mercury so things like sardines cod liver oil Etc you can get those from natural sources except there's one problem I hate sardines and I don't want to slurp down a bunch of cod fat I'm just not interested in that so if you eat a lot of fatty ocean fish and it's really clean fish great I don't most people don't so I believe in taking a high quality fish oil there are a lot of different sources of these in fact in the episode that we did with Dr Ronda Patrick there's a link in the show note captions I believe that takes you to a chart of the different fish oil sources and their relative levels of contaminants Etc but most of the reputable Brands out there are not going to have any contaminants because they've been cleaned out it's been checked for so um I take the fish oil from ag1 or for momentus that's just me there are a lot of other great sources out there but I will say this that's when I'm traveling and I take capsules typically I like to take it in liquid form and I will take the take it in liquid form I have no Financial relationship to the to the liquid non- capsule forms of fish oil and I get the one that has a lemon flavor to overcome the absolutely disgusting flavor of cod liver oil I guess I don't know presumably Cod like the taste of cod liver oil but I don't so that's what I do I'll take a tablespoon of that once a day in a protein shake it tastes like lemon it doesn't taste like cod than goodness and when I travel I take the capsules from ag1 or momentus or they're excellent ones from other sources okay lots of great sources out there now what are we trying to do when we take fish oil yes it can reduce inflammation yes it can do a number of different things but that's all by way of omega-3 fatty acid intake right most people get far too much Omega 6 right this is why there's a seed oil debate we're not going to have that debate now we put us all to sleep um frankly the key thing is to get enough Omega-3s and they're hard to get unless you're eating Krill so unless you're a large you know bowling whale um you're probably not eating that much krill um if you're getting fatty fish great but when you take an omega-3 fatty acid in the form of fish oil or you eat sardines for that matter what you're getting essentially is the substrate for for a lot of other important building blocks not the least of which is the lipid by layer that surrounds the neurons of your of your of your brain and so basically the omega-3 fatty acids provide the substrate for some key building blocks of nerve cells and other cells in the brain and body and and this is perhaps the most important reason I can think of when you get out past one gram of the EPA form of Omega-3 okay one gram of EPA form of Omega-3 per day it's clear there's a either mild to moderate anti-depressant effect so much so that one can in some cases talk to your psychiatrist or psychologist partially offset the dosage of any anti-depressant I am not telling you to go off anti-depressant medication and go on to fish oil that is not what I'm saying I'm just saying that there's some impressive clinical trials showing that fish oil if taken at dosages of 1 to three grams of EPA per day can have a mild to moderate anti-depressant effect and I don't know anyone that wouldn't want to have better mood so I take 1 and2 gram of EPA which is not to say 1 and a half grams of fish oil you need to look at the package and see how much fish oil but then look at how much EPA and typically it's less than one gram per serving so you may have to take two servings some people say well is it safe to take two servings I don't see any reason why not um and then of course there are the high potency fish oils for which there is certainly one gram or more of EPA keep in mind that all this discussion about fish oil might sound kind of Health Food hippie store um forgive me hippie um health food store kind of stuff but the reality is that EPA High concentration EPA is actually a prescription drug in the United States and elsewhere um prescribed often for enhancing mental health enhancing cardiovascular health and on and on so you know we're not out on a limb or out on a fin as it were when we're having this discussion we're actually just talking about something for which there's a lot of clinical evidence there's a lot of biochemical evidence there's a lot of mechanisms so I take anywhere from 1 to two gram of EPA per day even if that requires taking six rather than the suggested three capsules per day or taking a full tablespoon or even two tablespoons of fish oil and frankly most people are getting too much omega-6 fatty acids and not enough omega-3 so um shout out to the fish oils what is the recommended protocol for measuring hormone levels H interesting how frequently do you advise monitoring these levels to accurately determine their typical range and I just have to try and pronounce your name vad res nenko what a cool name vad resen I'm a big fan of like two syllable first name all right so vad re shenko um thank you for this question and the opportunity to try and pronounce your name so hormone levels I think a good thing to do is in the absence of any apparent or suspected endocrine dysfunction right so we're talking about you feel pretty good you're wondering if you're good under if I say good under the hood that just sounds like weird it Rhymes so if you're feeling pretty good I recommend getting your hormone levels checked once if you can if you're still in your teens in your late teens after you've gone through puberty to establish a sort of Baseline most people won't do that because it's too late I didn't do that once in your mid 20s again we're talking about no suspected or apparent endocrine dysfunction okay in your mid-20s so you have a baseline something compared to when you were in your say 18 to 20 and again when you're 25 that would be ideal and then again I would say when you're 30 and then start once a year starting when you are 40 or older I think that just you know just logically I would love to know what my hormone levels were when I was 25 when I was 30 maybe when I was yeah when I was 18 25 30 35 and actually 35 is when I got my first blood blood draw for just getting a look under the hood like what's there what what what are my estrogen levels what are my testosterone levels what are my growth hormone levels this kind of thing and then once you're 40 and older I think once a year minimum and I realize that some people out there are going to say well that's ridiculous what are you going to do with that information well you're going to do a lot with that information you're going to figure out whether or not your LDL cholesterol is in healthy range you're going to figure out whether or not your alt is in healthy range you're going to figure out whether not your apob is in healthy range you're you're you're going to figure out a lot more than just whether or not your testosterone is you know 400 600 800 or or or 1200 and I think we also need to be careful about overinterpreting results of hormones because a lot of it has to do with the ratio of testosterone to estrogen or the ratio of free testosterone to testosterone both in men and women so for instance if your testosterone level is 900 but your free testosterone level is two well then you have a problem whereas if your total testosterone level is 500 or 600 but your free testosterone level is you know 15 well then you're probably doing pretty well so I would say getting your hormone levels checked once a year after age 40 and prior to that once every 3 to 5 years starting at about age 18 would be ideal but most people don't do that they either don't have the disposable income I certainly didn't when I was 18 20 25 and I at that time it was really hard to get that measured unless you had a clinical problem now if anyone has a clinical problem that they suspect or is real then obviously more testing I think great sources for endocrine profiling are things like inside tracker full disclosure they are a sponsor of the podcast but they do an excellent job they'll even come to your house the fim botus will come to your house if you want or you can go to a clinic so they make it all very easy um but there are other sources as well right I'm I'll never make these amas or anything else about spefic spefic compan is for for its own sake I just think inside tracker does a great job there are a number of clinics like mer health and others online clinics that will do that but it's part of a more comprehensive package of of agreeing to work with them at least that's how I understand it I hope I didn't get that wrong but check and see nowadays it's pretty easy to find um ways to get your hormones checked but I would um suggest that the following things at least beond there growth hormone or igf-1 rather igf-1 testosterone estrogen this is true for women and Men um by the way so igf-1 testosterone estrogen it'll show up as estrad on there free testosterone dihydrotestosterone cortisol keep in mind morning cortisol is always elevated relative to afternoon cortisol um it will be impacted by food so you want to go in fasted in the morning um ideally get this done early uh your creatinine levels which by the way will be elevated if you're taking creatine or you're exercising hard your doctor will say your creatinine levels are elevated and you say well great well my cre intake is elevated too so you know um take that um it's not going to be a problem necessarily do check with your doctor um LDL cholesterol apob and um there probably a few others that that would be good to um to have in there for um men and women sex hormone binding globulin SE shbg and for women especially progesterone and prolactin um and pro and any of the progestins are going to be important and of course for women the trick is going to be when you get your blood taken with respect to your hormone cycle your ovulatory cycle and to try and make that at least consistent from test to test not necessarily having to go in both during the follicular and the ludal phase of your cycle but always going in during you know mid follicular or mid ludal and that can be challenging to do perhaps but that's going to be important because of course those are widely flu fluctuating levels across across the cycle but um unless you're really obsessed with your uh hormone levels um and analyzing them taking them at multiple times throughout your menstrual cycle probably not necessary unless you're starting to think about conceiving or there's some issue um PCOS or other issue okay I find that I need to do nsdr after working out any thoughts on this um yes well first of all I'm glad you're using nsdr zero cost tool known to replenish mental and physical Vigor works oh so well I think it's great I think it probably is accelerating your recovery I think this tells me that you're probably working out really hard um and hopefully not too long if you find that you work out in the morning and then you're really really sleepy in the afternoon and the next day you might be working out too long or too hard so maybe ratchet back the intensity a little bit or the duration it's amazing how great we can feel when we work out to like 80 to 90% of our maximum output um and duration we did this the other day we you know you know we we went out for a little jog run bounding skipping uh jumping jack thing and stopped at like 80 to 90% of Maximum and then went about the rest of the day and evening feeling great if you do this you know consistently you'll find you have more energy and there's actually a lot of solid physiology and physics to support why that is as opposed to if you go to the gym and you do every set to failure or even every exercise you include one set to failure and you're grinding out four straps or you're I don't know what kind of exercise you're doing or you're running more and more distance each day or with more intensity you know it it's understandable how one gets kind of um drawn to or addicted to that burn or the effort but keep in mind that is stress you're you're stressing the body to produce a certain kind of adaptation either endurance or strength or hypertrophy or Etc adaptation so you know there's there's real Beauty in learning to love working out hard but to leaving the gym or ending the run with 10 to 20% of the gas in the tank and knowing that you can come back and do more and you actually kind of want to do more there's it increases Vigor as opposed to taking yourself over that Cliff even a slight 10 to 20% and then finding that you're you're kind of depleted and this is something that we don't hear enough about because we uh most people that are into fitness are into pushing themselves it's also true for work I think some of the best advice I ever got in the professional landscape was when I was a graduate student at UC Berkeley and an excellent neurologist by the name of bob Knight said the key is to figure out how much can you work each day cons consistently if that's 4 hours a day fine if that's 8 hours a day fine we're talking with weekend breaks because that was in the Euro of weekend breaks maybe a weekend every once in a while where you have a deadline but by thinking about what you personally can really do consistently while maintaining sleep and mental health and physical health you're going to go a lot further than doing like for instance what I did which is being a maniac and working 100 hour weeks as a graduate student and then ending up sick four times a year and missing out on a bunch of days when I could have been in lab so these days I try and get a as much focused work done as possible but try and make that as consistent as possible if not from every day to the next over time you know figure out what those averages are and don't be ashamed of those averages I would say declare those averages to people so they know what to expect and the fact that you can do more does not necessarily mean that you should do more because I think one of the best pieces of advice I ever got in the world of Fitness is more important than training hard more important than doing any particular exercises more important than anything is to not get hurt hurt because if you get hurt you can't train so I love that you're doing nsdr after training I love that you're um making that part of your practice but maybe also throttle back a little bit because you said I have to do it after training maybe throttle back a little bit on the duration or intensity of exercise and see how you feel what can we do to optimize the function of our gut brain axis that's very simple get enough sleep in addition to that avoid excessive intake of antibiotics but if your doctor prescribes them take them I amab lever and antibiotic itics okay before the internet jumps I mean I'm not antibi I'm not anti- antibiotic I always want to say that I'm not anti- antibiotic I am not pro- antibiotic but I am Pro probiotics I'm probiotic so I think you should ingest one to four servings of low sugar fermented foods per day so SAU kimchi NATO or kefir or otherwise whatever you like and fits with your nutrition preferences and plan I think it's also very important that you don't overuse antiseptics like antiseptic mouthwashes and hand rinses and all that stuff this was all discussed on a podcast episode I did with Dr Justin sonenberg on the hu Lou podcast which is just to say that Justin who's a professor at Stanford and is amazing even said that he lets his kids eat lunch when they've been playing outside without washing their hands before eating lunch because he wants the probiotic makeup of their gut to be diverse including from outside now I'm presuming that's not a public park I'm assuming it's their yard so we're not talking about about um gross stuff being on their hands we're talking about a little dirt here and there turns out owning a pet increases the diversity of your microbiome um lots of things like that I mean you don't want to go around you know licking people's pets it's okay to let them lick you depending um on what your preferences are but don't lick them but when you interact with people you shake their hands your pets you're you're increasing the diversity of your microbiome when you eat low sugar fermented foods you want to make sure also you get enough fiber both Prebiotic and probiotic fiber so fruits and vegetables the fiber debate to for me just like makes me roll my eyes I mean it's so clear that fiber is good for us for gut motility and for offsetting cancers of the gut I mean I realize there are the people out there who are really into elimination diets where they just only eat meat but I mean there's just so much good data on fiber um especially from fiberous vegetables it just seems like what yes I mean it's almost silly that we have the debate frankly but I'm sure someone out there who's pure carnivore will be um shouting but guess what you're shouting and you're constipated last question regarding the subject on tongue cleaning from the oral health EP episode can you please share a bit on brushing tongue scraping tongue and generally how best to clean the tongue so tongue cleaning came up on the oral health episode I talked to four different dentists and a periodontist in preparation for that episode almost all of them remarkably extraordinarily converged on the same advice except for some slight deviations around frequency of flossing it's kind of cool right a field where almost everybody seems to agree I realize that isn't the hugest sample size but I pick them from diverse locations backgrounds trainings Etc every one of them said brush and floss your teeth every one of them said antiseptic alcohol-based mouthwashes are bad and every single one of them said that brushing your teeth before sleep is especially important important because at night you produce less saliva and you want to be able to remineralize your teeth that is fill in cavities that are starting to form while you sleep so brush your teeth floss ideally as well before sleep but at least brush and of course in the morning too for everyone's sake but if we're talking about tongue brushing and scraping it was clear that the tongue scraping was advised if done correctly okay because there are certain bacteria that grow on the tongue that you don't want there and that scraping can help with the turnover of healthy bacteria there in addition to removing some of the bad bacteria but that most people scrape their tongue too hard and rather it would be wise to brush your tongue gently with a soft toothbrush and by the way you should also use a soft brush for your teeth but not the same one that you use for tongue brushing so the takeaway that I was told and makes a lot of sense to me based on what I know now about the biology physiology and care of the mouth is that that you want to use a different soft toothbrush to brush your tongue than the soft brush that you use to brush your teeth and that you do not need to use anything on it but if you wanted to put a little bit of salt and baking soda that is perfectly fine a lot of people wonder whether or not baking soda scrapes the enamel off the teeth it actually is low on the abrasion scale dentists have believe it or not an abrasion scale with a list of things of how much enamel it scrapes off at a given pressure these dentists have done their work it's really really cool um I can't say I always liked dentists I didn't like going to dentists they always seem like nice people but now I have newfound respect for dentists they really care about their craft and oral health has been kind of pushed to the backseat of the different aspects of Health I consider it one of the major pillars of mental health and physical health because taking care of your teeth your gums your mouth including your oral microbiome is critical for cardiovascular health it's critical for brain health one of the bad bacteria streptococus mutans that can proliferate in the mouth especially after sugary eating sugary Foods um can make it through the blood brain barrier and maybe it's thought one of the causes of dementia can disrupt your neurons your brain and body is a system everything is talking to everything else and so yeah brush your tongue but use a separate soft brush to do that and replace it every few weeks to months I that can I suppose get expensive but probably not as expensive as some of the other health issues that were just described so I appreciate that question uh we didn't talk about oil pulling on the podcast a lot of people asked about that some people like to swish oil and then spit it out as a way that's oil pulling um for oral health and all the dentists I spoke to said nah not big fans of oil pulling but none of them said it would be particularly bad but um you know uh so if you enjoy it or you think it works for you great but um none of them really pointed to any uh clear evidence that it was going to be beneficial so I was told that was the last question and we are coming up on the hour again I want to thank everybody for joining this AMA I'm doing this from Australia Sydney Australia what's interesting down here is um because we are below the equator everything is reversed right so this was actually sh it's being presented to you upside I was I'm actually upside down but they turn the camera so I would appear right side up to you I also when I'm down here I drink my ag1 normally I Swit it counterclockwise but I know it's here reflexively I'm swishing it clockwise so anyway lots of interesting stuff going on we'll talk about that how that all works it's not through the vestibular ocular reflex it turns out but maybe on a future episode of the podcast about the relationship between um location relative to the equator and neural functioning and I'm just kidding but what I'm not kidding about is they appreciate that you tuned in and last but certainly not least thank you for your interest in science [Music]