Debunking The Internet’s Biggest Health Myths - Dr Karan Rajan

why should you never hold in a fart you know what uh a patient did once ask me this and this was an inspiration for me to make a statement or an explanation about this and you know fart is a gas you know it's a chemical it's a bunch of chemicals and when you hold in a fart there's a percentage of that fart Vapor which will diffuse through the walls of the colon through the walls of the intestine and eventually it will go to your blood bloodstream and all the blood circulates and eventually goes to the lungs where the waste products are then exhaled out so there's a tiny percentage of your fart which if you hold it in will go to your bloodstream go to the lungs and then be exhaled out so you will have breathe it you're going to breathe it instead of farting it if you don't fart it you will exhale fart so you will literally breathe out fart fumes if you hold it in it's physiology it's science science baby this is what we're here for uh I've always thought this where does the gas from burps come from and why does it never go away you know like you keep needing to burp over and over again so what if I'm not adding any gas in there is that gas that you breathe in that somehow uh a lot of the burps are a byproduct well there's a couple of ways uh a byproduct of air swallowing so if you chew a lot of gum you are swallowing lot of air you drink a lot of sodas and fizzy drinks you're again swallowing a lot of air and the sort of carbonated gas that you're in sort of ingesting and lastly there will be a percentage of gas that your bacteria or the various microbes in your gut microbiome will produce and they can May their make their way Upstream as it were and they could also be a result of acid reflux as well so if you have acid reflux there's basically a floppy sphincter between where your stomach attaches to the first bit of your small intestine and you get reflux of some of the gases and juices and you get sort of excessive burping yeah it does seem you know if you've eaten a little bit too much or a little bit too quickly and you're a little bit full it's like it this is just not stopping I just keep on burping over and over again it's just going to happen until I guess I've my stomach levels finally settle down yeah and there's actually a couple of hormones uh one hormone in particular called kyin we can call it cckk for short and cckk actually delays gastric emptying and slows down how much your stomach empties into your small intestine so that hormone is increased if you eat foods that are high in fat or spicy foods so if you eat spicy foods the chemical capsacin in spicy foods or chilies actually increases the production of cck chosy ainin so there's more stomach content and there's more likelihood that you can burp or have reflux same with fatty foods that stimulate cck production more burping more reflux presumably with the spicy food that is because your body doesn't want to transport too much of a very spicy thing through your digestive system too quickly and with fat something similar yeah so it's just the nature of the fat molecules which slow down digestion so it has more time for your body to digest it but the case with chili is different capsacin our body reacts so weirdly to capsacin in so many different ways so capsacin is processed by our bodies essentially as sometimes a toxin because it irritates the cells and your body doesn't realize it's just spicy food it doesn't have a spicy receptor you only have receptors for you know sweet sour Umami and Savory Spice is not a receptor so it actually interprets that as heat because capsacin triggers and stimulates the heat receptors so it thinks something is burning inside so it wants to say like oh hang on I'm not going to let you digest and it stays up there and so our body is a bit of a flawed machine you know yeah that's interesting what do you think or what do you wish that more people knew about how digestion works so if you think about digestion most people just think about the stomach people would assume that the stomach digests everything like a big blender or a washing machine and then that's it it's done right and the sof the food pipe is just like a a big waste pipe everything goes down but actually the stomach doesn't really have much to say in digestion the digestion mostly occurs in the small intestine and you've got a number of organs inside your abdomen from the gallbladder to the pancreas to the liver and all of these various organs actually interplay and interconnect with each other and each step in that factory line of digestion is as crucial as as the last one so it's not just the stomach in fact the stomach is essentially a mixing bow where things are mixed together and it's later on the enzymes and the bacteria and everything kick in to really have a role to play in your digestion so actually digestive health or gut health as people love to talk about gut health these days is more than just one part you know the sum of the parts is the real thing here what's I'm I keep reading about IBS being on the rise is gluten intolerance being on the ride food food intolerance is increasing what do you think is going on from your perspective so IBS irritable bowel syndrome it's surprisingly quite common and a lot of people think IBS is one thing it's an umbrella term IBS has lots of different subtypes people can have things called ibsc ibsd where actually they're triggered by different foods and one person's IBS trigger for example a type of fermented food can be non triggering for someone else and we don't really 100% understand the causes of IBS because we don't really understand the human body to its fullest potential and certainly there is an interplay between the microbiome and what are the symptoms and manifestations of IBS and with that in mind the rise for IBS why is that happening certainly there is a huge role to play in the microbiome we know that the microbiome is influenced by the diets we in so certainly we are having increased number of ultrapress foods which can influence the microbiome negatively maybe a more sedentary lifestyle we know that lower exercise more stress less sleep again these factors can have a role to play in negatively influencing the microbiome and all of these things can trigger a number of digestive issues and IBS irritable bowel syndrome is one of them what's your thoughts on probiotics and colostrum supplements prebiotics all of that stuff so I think there's a lot of these buzzword thrown out these days prebiotics postbiotics probiotics and as a surgeon who deals with bowel cancers and a lot of intestinal issues I have perhaps prescribed probiotics medical grade probiotics two or three times in my entire career probiotics the ones you can go to the supermarket pick up off the shelf you know Yule Dan on whatever it is for the average person it's not going to make a huge difference because the strains contained within these mostly unregulated off-the counter or off the refrigerator section supplements they're not going to be present in high enough concentrations or bacteria units to actually have a significant role to play it's just like pissing in the wind and they're not going to be effective enough in colonizing your gut which is what you want them to do they will be wiped out by your digestive processes the stomach acids and they won't be able to compete or integrate with the existing bacteria that are in your gut actually you can get more of a benefit from probiotic rich foods foods that have natural live microorganisms cafir kombucha Greek yogurt live yogurt which has strains um things like that you know or sauerkraut pickled vegetables these are more effective than supplements supplements do work for a narrow range of conditions types of pediatric um gastrointestinal issues someone's had antibiotic Associated diarrhea post uh bowel surgery sometimes so it does work for a very limited scope of things yeah it's interesting I um I went to a place called Fountain life in Dallas here in Texas about four months ago and they are a preventative medicine clinic and it is full body MRI heart angiogram brain CT scan I had an hour and 20 minute MRI of everything a Balan scan good microbiome analysis full body Dexter scan everything everything everything everything then they run all of that through a ton of AI to try and work out predictive factors when all of this data is put together and that is a training set that trains everybody else's etc etc and um I found it really instructive thankfully there was nothing dangerous or whatever in there um but they did find for me a little bit of leaky gut syndrome and um that was something that again like another like that didn't exist 10 years ago I'd never even heard anyone say that 10 years ago uh so since then I think I've been using a a colostrum product uh armor which is I actually really like uh and just trying to change up the diet but dude kefia is like just upgraded yogurt drink it's for the people that don't know it's kind of like a milk like a thick milkshake I guess yeah like a fermented Shake but it doesn't taste fermented like fermented makes you think it's going to be kind of sour like gone off milk but it's not you can get some really really nice ones and I'm massive fan so I'm team cafia as well for the digestive system and you can make it at home it's relatively easy to make it home if you've got some Cafe that you've bought over the councel or you've bought from the supermarket if you save some of the cafair you can use some of the old cafair to make a new batch from home where you get a bit of milk or something like that and you add the old cafir to that and leave it to ferment overnight and you've got a new batch of cafir M how funny yeah that's like a pineapple like chop the head off it turn it upside down you grow yourself another pineapple yeah do you mentioned there the fact that you're a a surgeon I think most people's understandings of what a surgeon does will be from some combination of doctor strange and like a I don't know 24 hours in A&E what is the reality of a typical day as a surgeon like reality of a typical day so I would wait wake up around 5:30 uh and I'm in work by around you know 7 7:15 because the work starts probably 45 minutes to an hour before the actual surgery happens I need to go and see the patients review their scans consent the patients so take them through what the operation will entail tell them about the risks of the operation and then you know that's not counting the night before or the day before me reviewing all of their information their medical charts their records to make sure I know the exact steps of what I'm going to do for that patient specifically they may have some complicating factors and it's also essentially running simulations about the surgery the next day before surgery just like an athlete would plan whatever route they're going to take or how they're going to combat an opponent it's sort of running through how am I going to combat that strange Anatomy for this patient and on the day of the surgery as well it's again sort of briefly before knife to skin thinking exactly what I'm going to do and I see it as a sort of uh algorithm in my head a tree of different consequences if this happens I do this if that happens I do this and you know have you seen the Queen's Gambit no I haven't but I know that I should watch it so there's this weird scene in the Queen's Gambit where she essentially this prod prodigious chess player sees all the outcomes she hallucinates the outcomes on the wall of all the chess pieces moving in different ways in a somewhat slightly less genius way than that I'm envisaging what's going to happen if I do that if I cut that there and it goes wrong what can happen how do I avoid that so I'm running all these stimulations and algorithms at a very basic level in my head and you know you just keep doing that rinse and repeat again and again and again and the surgery doesn't really end once you've closed off the skin the surgery only ends once the patient goes home and is well for a few days because complications can happen you know anywhere from during the surgery to 10 days posttop so there's never really rest bite where you're like okay everything's gone well wow yeah what are the most intense and long surgeries that you do what's the thing where it's on the docket you go right okay I need a couple of extra caffeine pills before I get started with this uh probably um when you have to do bowel surgery when someone's got bowel blockage or bowel obstruction and they've had multiple previous surgeries when I read someone's surgical history and they've had lots of previous abdominal surgery that basically means it's going to be several hours of operating because they're very likely to have lots of scar tissue what we call adhesions and these adhesions are cobwebs of scar tissue that line the abdomen and it's a forest in there and you have to slowly unpick all the scar tissue and that is quite fraught with danger because you can accidentally Nick a bit of intestine and then you need to fix that and it can take literally 10 12 hours sometimes and that is okay this is a big deal wow is that the longest that you've done 12 hours uh the longest surgery I've ever done was probably closer to 15 hours and it was probably one of the worst days of my life as well I missed my birthday missed my birthday dinner with my parents from essent around 9 a.m. till midnight is when I operated and it was when I was assisting my boss years ago uh we essentially removed everything inside the person's pelvis we remove their bladder their ovaries their rectum their uterus there's some tissue in their pelvic lining and it just took forever 15 hours it was brutal what a fantastic way to spend your birthday I know right and I couldn't even unscrub to tell my parents I'm not going to be there oh of course yeah you don't even what I mean there's got to be I need a a bathroom break do you just you've got to hold it in for 15 hours I need you've got to be HDR someone come over with a little squirty water bottle like you're a rugby yeah they do they uh they'll come over under your surgical mask and they'll put a straw under there and you drink it and occasionally they will lift your mask down and maybe pop a Haribo or something in there just to keep your energy level Elite nutrition for the exactly yeah how funny man yeah we had a when we were flying from Dubai to Vancouver when I was on tour with James the videographer that James brought with us ET his birthday began when we departed Dubai so he had a 36-hour birthday which was the opposite of you but he also spent 17 of those 36 hours flying on a plane so you know swings and roundabouts yeah exactly what's the truth about your gut having more serotonin in it more feel-good chemicals being more determinant of your mood than your brain is what's sort of real and what's BS there uh there there's a lot of new Nuance behind the gut brain Axis or the gut microbiota brain axis your gut has you know produces lots of Serotonin you know 80% or more serotonin is produced in your gut but that serotonin doesn't cross the bloodb brain barrier so that serotonin produced in the gut doesn't directly influence your mood so there aren't certain foods that you eat which will produce serotonin which will then improve your mood however that serotonin which is produced in the G has a role to play in how well you digest food its peristalsis and contract ability so it sort of coordinates the contraction of the intestines but the food you eat can influence either positively or negatively your microbiome and those gut microbes and those gut microbes can as a byproduct of whatever you do to them can then release certain neurotransmitters which can then induce neurochemical signals via the vagus nerve the information Highway between your gut and brain which can then influence your mood so in the future my prediction is that we will come up with specific medications called psychobiotics which will you can eat or you can supplement which will directly influence your mood because of their impact on the microbiome it's called MDMA Karen uh if the NHS is listening or watching I canot condone that but yes you know uh there will be I think for Consumer grade for the average person I think we're probably around 10 15 years away from that I remember a very traumatic New Year's Eve when I was working at one of our events in Manchester so I was at the bird cage we'd sold this thing out and it's about two and a half hours to drive back home and I noticed about an hour into the event maybe half N I was being really short with everyone super Snappy very agitated and I took myself to one side and had a word with myself I like what's wrong with you like what what's going on as I was doing that I got a text from my business partner saying mate I'm trapped in the toilet in our other event which was in Riverside in Newcastle and he says I like it's not good things aren't pretty for me right now and uh it turned out that there was Nora virus going around at his son's first birthday party that we both attended the day before and I thought oh no this isn't good so I'm two and a half hours from home only one hour into a 6-h hour event that I'm event managing and my business partner is away he's in Newcastle strapped to a toilet so he he's definitely can't he can't even help the people in Newcastle let alone the guy that's in Manchester so I'm like right okay I'm going to be in for the Long Haul here and then other stuff happened dude when I think back to some of the things that I had to try and fix in my nlife career we booked this guy for New Year's Eve to come and play it's very amongst DJs it's very highly high demand period obviously they charge a lot blah blah blah and before he came through he' asked do you have a microphone because we needed to make sure he's got his own PA yeah and he arrived and I said all right mate did you bring your own microphone he said yep yep got it here and I started talking to him what through my gritted teeth of not wanting to throw up or [ __ ] myself I started talking to him about an hour before and I was like all right mate can we start to spin up some of the the what we would call drops so him like one hour until New Year's Eve it's 30 minutes and he's like oh I don't use the mic well hang on I asked could you bring your own microphone yes I can bring my own microphone but I'm not a DJ that uses the mic like well all right so any that happened and then dude we we the power thing that set off all of the pyrate Technics that wasn't working so I had to connect two 9volt batteries together like that like sort of one into the other to get a sufficient volts to like and I'm shortcutting like trying to like oh Jesus yeah to try and set off all of this stuff at countdown and I'm doing the countdown and then anyway I drove home uh and did two and a half hours like pinned into my seat desperately trying to not throw up and uh then got home it was the worst way to start a new year but my point to that disgusting story my point is my mood knew that there was something up way before I did and I I took myself to one side to say why are you being so short like what's up with you and if I ever have a little bit of sort of indigestion or some sort of digestive discomfort the first thing that goes and the last thing that comes back is my mood oh absolutely you you know interestingly you'll find this interesting uh at the University of cork they did these uh feal microbiota transplant studies where basically [ __ ] transplants where they took the microbiome from someone who is clinically depressed and transplanted that into a normal Mouse and that Mouse after a period of time was observed to display signs and symptoms of depression they repeated the same thing with a human who had autism confirmed autism transferred the fal microbiome to another normal mouse that didn't have any conditions and then that mouse that rodent study started to display signs and symptoms of autism uh which is fantastic so that shows you how well connected the gut is to our mood and the Brain that's incredible that's absolutely wild I I have a friend here in Austin who is a uh like poo donor a very highly paid Pooh donor so he's had to go through I think four stages of screening uh genetic testing uh lifestyle diet scrutiny all this stuff but they he sends off he literally shits money and yeah he sends this off and they Recaps sule it and people use it to help with their uh digestion and and I'm not I'm don't know what is it a suppository that they do would they literally be eating poo capsules what are they going to do either the way so you can actually get um powdered poo capsules that you would just swallow like a vitamin D capsule or it can be inserted as an enema or during a colonoscopy they can actually put that microbiome in the colon for you which we do medically uh for inflammatory bowel disease treatment we use poo transplants in the NHS you might have used one of my friends he might have imported it from Austin Texas and it could have been inserted by you your friend is a unicorn because you know that's the point not one% of people are the golden Poopers heard and yeah incredibly lucrative I've heard yeah yeah yeah yeah and he had to go through all of these these test and now he makes I mean he's like a successful business guy I'm not going to say who it is he's like a guy that like a lot of my that is the life yeah dude literally shits money crazy absolutely crazy all right so he talked about digestion another Horseman of the health apocalypse sleep a lot of conversations on the show about sleep doc Dr Matthew Walker's book I'm a massive fan of that and that kind of really redpilled me on the importance of of focusing on sleep but what are some of the other things what are some of the less unknown things that you wish more people were focused on or or understood about sleep and its impact yeah and similar to you I mean I took a greater interest on sleep because of the negative consequences of my own sleep early on in my career as a doctor so definitely that you know sparked an interest in looking into the research and evidence and you know there's this sort of fallacy that everyone needs to sleep eight hours the eight hour sleep myth everyone thinks okay you've got to sleep this amount of hours and that drives a certain degree of sleep and health anxiety when you don't hit eight hours and we have within every cell in our body clock genes and clock proteins which determine how much individual sleep you need as directed by your individual DNA so your required sleep may be seven seven hours or seven and a half hours mine maybe 6 and a half or 8 and a half I think there is a spectrum in which most of the population lies somewhere probably between 6 six and a half and eight eight and a half the mass concentration will be in there there'll be some outliers who may get by physiologically on 5 hours and some may need nine hours uh but certainly the8 hour one-size fits all sleep Dogma is incorrect actually and that's been proven by science the likelihood that you have that actual gene mutation where you can survive on I think it's like closer to four or three three and a half hours sleep I I remember reading this a while ago the likelihood that you had because a lot of people go oh no I'm sure I haven't had my testing done but you know I I'm fine 4 hours sleep I'm sweet man um the likelihood that you have that mutation is the same likelihood as you being hit by lightning twice that's the same that's the same number of people that have got that particular gene mutation the deck two gene mutation very unlik yeah DEC 2 gene mutation supposedly Margaret Thatcher had it Nicola Tesla had it Einstein uh what's it called poly poly poly phasal I think or basally she slept oh yeah so sort of in two chunks of sleep y That's How well H victorians slept as well they would have a normal sleep during the night and then they would briefly wake up in the early hours of the night to do work and then they would sleep again uh but the basic sleep pattern is Not Unusual and the modern version of the basic sleep pattern is probably what happens in a lot of Mediterranean countries where they have cestas because if you look at our 24-hour cycle there is a natural dip in energy and fatigue that arises post prandy so after some lunch or some food around 12 1:00 there is a dip in energy level there's also a slight dip in our temperature levels because our sleep is very closely linked to temperature so actually if you do have a nap around 1212 p.m. that is fine and that's in keeping with our normal physiology so naps are science have you got any idea about why my mood is so disregulated when I wake up from a nap and James how long do you nap for uh I would guess with these ones I'm talking like more than 15 minutes so I'm actually getting into a into a proper sleep cycle um there's been a couple of times we did it on tour you know when we're trying to just grab 60 minutes here or there because we know we've got to get straight off to this thing but there was a few times where me and James would wake up and we didn't want to speak to anyone we're thinking God I got to get up on stage and actually be likable and whatever and you do after a little bit of time people bring you out of yourself but I I certainly notice in myself that if I nap I wake up and my mood can be very discom ulated so is that the kind of like groggy slightly hungover feeling you're describing yeah and then it it tends to actually impact kind of my my positivity and my energy as well and there's a I would say kind of an electric feeling to my body that that's sort of anxious in some regards maybe yeah I think you know whenever I've experienced that if I've over egged the nap or underere egg the nap it's that sleep inertia feeling where perhaps you've gone into two deep asleep cycle or asleep phase and when you wake up you're dredging yourself from the depths of a deeper asleep cycle so there's not that gradual gentle Awakening that you'd have if you naturally woke up and that sleep inertia where there's still some sleep hormones percolating slightly stressy anxiety riddled kind of emotion what's your protocol for naps the all that I know is once you push it past or supposedly once once you push it past about 20 to 25 minutes you're really getting into this is actually sleep and not a nap and if you're going to do that if you can try and hit 9 so that you can get yourself into and back out of a phase have I missed anything there no that's absolutely spot on I mean I I'm if I nap on a weekend for example that's the main time I have to nap um 90 minutes would be my go-to because I want something that's substantial enough that would help me consolidate my memory make me feel refreshed at the end of it and I find it's easier to stick to 90 minutes than go in and out of 20 minutes because for me my sleep induction time is longer if I told if I told myself I was going to nap for 20 minutes it would take me too long to actually get into the nap first of all so 90 minutes is preferable for me yeah my my sleep latency has been all over the place this year uh I don't know what it is I I think a lot of people feel this as well you know if you're busy during the day and even if you try and do the digital detox thing that 321 rule I think is really nice actually if you're familiar with that 321 uh is that the 3 hours before bed 2 hours before bed yeah yeah so 3 hours before bed stop eating 2 hours before bed stop drinking 1 hour before bed stop using screens which is funny that screens have been placed in with food and hydration is like you know like the the mandatory bottom of Mao's hierarchy of needs that people have um I think that's been really great and it's so funny like I know that meming healthc care stuff is kind of a bit cheesy and it it's almost a little bit Juvenile and simplifying things down but that's what helps people retain principles so true yeah 321 rule I would maybe sometimes if you're really struggling with sleep add a 10 before the 321 for the coffee because the halflife of coffee is upwards of eight hours so if you were a habitual coffee drinker you know and you were having cups of coffee at 2:3 p.m. and your bedtime is 11:00 p.m. there's still likely to be a decent percentage and concentration of coffee in your bloodstream when you're going to bed which is going to disregulated your sleep I'm a fast caffeine metabolizer that came out from some of the tests that I did interesting I get stealth caffeine on an evening time by ordering a Diet Coke and forgetting ah and someone will bring a Diet Coke over and it's I think it's only maybe 45 migs of caffeine so it's not very much but if you knock two of those back that's you know not far off an espresso and you thinking [ __ ] it's like 700 p.m. at night and I've just done that but yeah I can feel it man and here's another thing right is there any evidence between phases of the moon and quality of sleep um I think the evidence there for that that's published that I I've not seen any evidence linking the two but certainly if there are times when the moon is more luminous and brighter than usual and you don't have blackout curtains and the Moon is shining through your window so there's enough light getting into your room that's affecting your sleep potentially you could see mechanistically where there could be a way that that would affect your sleep but if you're in a blackout room you got blackout curtains which you know I certainly do I'm not influenced by these external light sources so no would say you would think the same thing uh and yet there's been a few times where it's everything is normal routine is as normal and can't get to sleep until 3:00 or 3:30 in the morning and there was a a day when we were all in Dubai everybody's sleep was wrecked people that we'd been with people that we hadn't been with people who'd gone to bed at 8:00 people who' G gone to bed at 2: in the morning everyone was [ __ ] and sure enough full moon so I'm non conspiratorial when it comes to the horoscopes thing but I reckon there's I think there might be something there one other thing I was having a conversation with a friend uh this weekend who's a DJ and we were talking about hearing and improving and protecting your hearing is there anything that people should be aware of when it comes to that yeah the the hair cells which help us transduce sound and then in basically translate the sound waves into electrical signals which our brain then interprets as sound those are directed by the hair cells in our ears and we've got around 16,000 hair cells you are born with all the hair cells you'll ever have once you destroy them that is it uh and they detect various frequencies so you know that feeling where you go to I don't know a cricket match or a tennis match or a concert or a very busy place where there's this constant hum and then you go somewhere quiet and there's that ringing feeling in your ears that is your hair cells being bent by the sounds and they are kind of unbending that is that sound and that's the process you are experiencing and if you party hard for long enough you know nightclubs and loud music all the time if you're in a band you're singing you're going to concerts you can long-term damage those hair cells or those old rockers of the 6070s and 80s they've got a lot of hearing impairments like Aussie Osborne is essentially deaf because he never wore those ear plugs that would protect his hearing and that is the risk with these hair cells where you know unexpected sources can damage those and once they're gone there is no you know reprieve at all but wild yeah my old business partner my former business partner Dave had a hearing assessment done and I think he lost 15 DB off the bottom end and 10 DB off the top end so he he'd really damaged his hearing from you know he stood inside or outside nightclubs for a decade and a half and he's still going and none of us had nicely molded earplugs that would not be a [ __ ] on to take out when we went outside and whatever and now you can get get custom molded ones with a tiny little filter it's like a weeny little straw that filters through so that it means that if you do go outside to go and speak to people you can still quite easily hear what they're saying without it sounding like you're underwater um but yeah yeah I do I mean thinking back to my nightlife career and some of the sound boots that we used to be in and DJs would just want more monitors they want to hear with full richness what's happening out in the club and also they're partying they're with their boys or they've got like chicks in the booth of them they don't want it to be why can't we hear the music out there why is it only coming through your headphones oh don't worry about that I'm actually protecting your hearing like that's not a big rockar thing to say um exactly but yeah what was that thing about uh plucking your nose hairs speaking of hairs inside your head yeah so when you you've got different types of nose hairs uh you've got the deeper longer vicy um and you've got other types of nose hairs and they do a lot of jobs and the main jobs of the nose hairs uh apart from looking out of place is that they actually filter microbes dust particles and potentially infectious causing agents getting into your delicate moist inner Linings your Airways and when you pluck those you obviously increase the risk of things getting in and you're removing that filter system that's there but actually you can increase the risk of microabrasions every time you pluck something just like when you pluck a hair on your hand or somewhere else you create a small opening a microabrasion or a micro cut through which things can creep in bacteria from your skin you know Stafa coccus species from your skin can creep inside the bloodstream and that region of your face the triangle on your face from the bridge of your nose to the tip of your top lip and a triangle which forms there that's actually known as the danger triangle where there's a very close association between the drainage the Venus the vein drainage to your brain and the nose as well and there's something known as the cavernous sinus and if you get a bloodstream infection in the cavernous sinus that can lead to all sorts of very horrible things like menitis clots um and in rare cases death although that is quite rare I mean the average person plucking their nose is not going to die but it's not a 0% chance of that happening I was in Dubai to do that live show a couple of weeks ago and I needed a haircut so I spoke to one of my friends George who lives out there and I said who who usually does your hair so he sends this girl over and she was like you know perfectly like nice and and cutesy or whatever but also was a boxer so she was like kind of Hardcore and she's from Lithuania like interesting chick interesting chick but she had gone full Habibi mode with the the so she's getting the little like the wax putting the wax on the in on the inside of the the eyebrows she's got wax in the ears like doing the wax in the ears and the wax wax in the nose and she's like pulling it out and uh yeah that was that was a real a real experience so maybe not to be done again and if I do have my haircut from her I can actually say my doctor a do not my doctor a doctor told me I'm not allowed to have this done because of my my fibres or whatever it was called vibrasi yeah you got to you got to protect the vibrasi I am I'm trying my best what about people who can deal need to deal with pain more effectively have you got any tips for how people can can deal with it you know a lot of the time in the clinic I see people with chronic abdominal pain or other sorts of chronic pain and I've found anecdotally and actually looked it up and it's evidence based as well when you explain something to someone explain how something works for example in the case of pain if you explain to a person why they're getting pain the scientific physiological reason why they're getting it that simple Act of them understanding their pain actually increases their pain threshold and lowers their pain perception as well which is almost like a Jedi mind trick you know you just almost dampen down their pain and the interesting thing about pain is that there isn't a direct correlate just between tissue trauma and the amounts of pain that you will perceive because a lot of the pain it's modulated by what you think so if someone is getting an injection or you know a vaccine or whatever they're getting if you ask them to look away from the injection that will elicit less pain than you watching the injection go into your skin so again that is visually you're not getting the signals and that's dampening down your pain perception because you're not getting the visual input so there are lots of things that you can do mentally to dampen down the pain there was a interesting case report from many years ago of some a person who was admitted to the emergency room like a doctor wrote this case report Port up he sees a man in the emergency room and he's he works in a construction site and he's got a big nail that's going through his Boot and presumably skewering his foot so he's screaming in agony like I've got this nail in my going through my foot I'm I'm bleeding I'm going to die and what they do is they remove the boot first of all to see you know the damage and see what's happened and it turns out the nail is not going anywhere near his foot it's stopped by the boot itself so actually his foot is completely fine just that perception of it was going through was enough to cause that pain and it's almost like a placebo and nosbo effect that you create in your head about pain so you know similar to cold water exposure initially it may be painful because you're expecting expecting it to be horrible but if you expect it to be nice and you're going to enjoy it you can actually improve that experience erence there's something interesting about cold exposure I learned from huberman that is you can be relaxed when you get into the tub and that will make your experience much more enjoyable than being stressed about it but what you actually want to try and elicit is that stress so his advice is to go in with a sense of aggression as opposed to a sense of relaxation so for me my favorite way to do it is to just slowly sort of lower myself in get up to my neck put my hands in and then just very gently breathe through my nose and count down from 180 if anyone wants to know how to actually stay in a b a cold tub for 3 minutes just count down from 180 it'll be difficult between sort of 150 and 60 and then after the first bit's fine and then after that you're fine as well but what he's saying is that part of the Cascade of responses that he wants to have happen or that would be optimal to have happen is something that's a little bit more fear-based and and uh sort of activating I suppose and um we did NAD we did an NAD drip this week so me James and my housemate Zach Have you done one do you know what that feels like I've not done one I've given um an ad to someone but not I've not had it myself okay so it's not very comfortable um anyone that's had it will say it's not it's not an enjoyable experience at the time it's a very unique category of pain so um they give you is it Fran zran anti an anti- nausea um so they give you that because you can sometimes get nausea with it um it's a unique category of pain because it's one that you think or know is making you better and it's one that is not associated with damage and is time bounded so you know that as soon as that bag's finished it's done you know that you're doing it in service of you being better and it's not because something's snapping or breaking or going to going to be be ruptured or whatever so your relationship and the story that you tell yourself about the pain is very unique there's not many categories of discomfort that can be like that you got a pain in your stomach oh my God like it's it's my appendix it's going to blow or whatever um but yeah I just I really enjoy from a mindfulness perspective I really enjoyed playing with that sensation what does this mean to me what's the story I'm telling myself about this pain like how can I find more Intrigue in this sensation it's a very unique opportunity for me to be able to see this and not layer it with fear and concern and worry and stuff like that it's very very interesting yeah that that will certainly fear will amplify your pain perception so you yourself it's hard to do but and especially people dealing with chronic pain but you can upregulate or downregulate your perception of pain depending on how you put your spin on it that's interesting what about Eye Health how can people keep their eye healths optimized well ey Health now more than ever there's you could say there's a myopia epidemic a shortsightedness epidemic because people are just on screens constantly all the time and when you're on screens all the time laptops mobile phones TVs whatever you've got watches you know smart watches our eyes the muscles which help our eyes focus on nearby objects are constantly activated and that actually over time changes the shape of the eyeball uh it you know becomes less round and more rugby shaped and this can affect long-term Eye Health causing eye strain eye fatigue um so I I genuinely think people do need to look up from screens a lot more I know it's pretty ironic us saying this and us having conversation about ey Health whilst uh you know being virtually having a chat but yeah I think we are we are addicted to smartphones and constantly craning down and you know wearing our eyes out what is a good protocol for people to try and offset that you know me personally I've spent a lot of hours reading revising for surgical exams over the years and pouring over you know textbooks and various things and I found that just breaking it up and doing something called the 202020 so every 20 minutes you have a break from whatever you're doing uh and you you know just 20 minutes and you get up and you look somewhere 20 feet away and then you go back into it after another 20 minutes and just giving yourself a bit of a break or you know just every 20 minutes you should have some sort of eye break uh where you are defocusing your eyes you're not so intently focused on one thing and you look into the distance into a horizon into a broader Vista or a broader view allow your eyes to almost you know defocus and defocusing your eyes and looking at a broader picture helps to activate the parasympathetic nervous system where you're sort of you know downregulating your stress response because when you are focused on something whether it's closely looking at a page on a piece of paper or closely looking at a moving object that's close to you that is some sort of stress response your adrenaline is spiked at that point and defocusing offsets that somewhat one of my favorite triggers is to remember that you have all of this on the outside of your vision and that if you're looking at something or anything and a really easy parasympathetic activation is to just allow your focus to kind of ease out onto the sides even if you're remaining focused on what's in front of you being short but allowing the width of your vision to kind of come into view and to be a part of your uh like salience Network I guess you'd say and that's just so nice it's such a lovely trigger that and a nice slow breath out is about as quick of a way to just I'm down regulated a little yeah and and what exactly what you describing there is known as optic flow so you know when you're cycling uh around and and you're constantly seeing both what's in front of you but also all these things passing you or if you're taking a hike through nature you've got this broad Vista so you've got both a combination of a broader View and it's a moving broader view as well uh which further stimulates the parasympathetic nervous system there's something about lateral eye movement downregulating a migdala response isn't there I I think I mean I'm no expert specifically on the eye but you know the eye and the retina is part of the brain so there are a lot of things to do with the eye that directly impacts the brain and you know I have no I wouldn't be surprised if there were certain triggers or certain types of movements that did influence your perception or fear or anything like that as well I think optic flow is probably one of the big movers for what I'm talking about but I seem to remember learning from hubman again that there's something specific that occurs as you're moving through an environment things are coming past you and you're looking from left to right and I remember it's so cool man when you test stuff in your own life and then science comes along I guess science was probably already there you just didn't know about it someone comes along and informs you about the science and uh for years and years I was doing this morning walk thing and sometimes I'd wake up and I'd feel a little bit kind of anxious in my body or in my mind or I'd have thoughts that I just percolating in a way that I didn't want and I'd find that after 15 minutes of a the same loop I used to do in Newcastle I'd get back and i' just feel a lot better like the world was kind of the world was a bit Rosier and uh I remember just really enjoying that experience to the point where I think a morning walk is the most consistent thing I've I've done from a habitual perspective over the last maybe 10 years and uh then yeah I hear optic flow and this sort of down regulation of the amigdala and oh wow that was maybe part of what I was feeling yeah absolutely and and I think the routine is key as well I mean it sounds like when you went on your morning walk in Newcastle there was a moment where you were by yourself uh just with your own thoughts and I think sometimes the act of just doing nothing helps to spark creativity and just it's a it's a form of mindfulness whether you acknowledge it or not just being with your own thoughts uh you know is quite calming what about slowing cognitive decline I know that Alzheimer's Parkinson's dementia General cognitive decline is kind of a another Hot Topic at the moment what's the 820 from that yeah I mean that as a doctor that is genuinely one of the diseases that scares me the most I used to think it was cancer and as someone who deals with cancer and removes bowel Cancers and other types of cancers I think the human race has gained some sort of foth hold in the fight against cancer with various trials and medications that we've got coming out but Alzheimer's still seems to be the Outpost that we haven't quite got to yet and figuring it out although there are some interesting trials about monoclonal antibodies which can reverse potentially Alzheimer's rever you know our brains are all slowly turning to Mush whether we like that fact or not how can we slow down the Decay and for me it's very basic things that we need to start setting into our habits now because the clinical signs of Alzheimer's they don't start until maybe you're in your 60s 70s and 80s but the first seeds are planted in your late teens 20s and 30s so our sleep habits notoriously bad when people are in their teenage years or 20s and sometimes even 30s especially nowadays with Netflix and various streaming services and you know endless Tik Tok uh you know scroll holes so poor sleep and chronic poor sleep can prevent the amount of brain wash that happens during those sleep cycles you know we have this cerebral spinal fluid which wases the washes the brain of uh all the toxic protein buildup that doesn't happen in such an efficient way if you don't sleep well and those toxic proteins the amalo beta plaques and the towel proteins can accumulate and actually cause neurod degeneration over time same thing with if you don't exercise enough you don't get enough regular blood flow to the brain um again diet has a role to play as we know the microbiome its interaction with the brain and the gut that has a role to play but also social contacts as well if you look at these Blue zone areas where people live to 100 cenarius and sometimes even longer they have great social networks and social contacts and you know we are humans are social creatures so We crave on a physiological level some degree of uh Network loyalty and Community as well one of my friends Johnny talks about uh like Keystone decisions he called them getting a dog is a keystone decision for him it's a an individual decision Downstream from that there are a ton of other things that end up coming along for the ride so you're going to get more steps in and your wake sleep and wake cycle is going to be up and you're going to have to have an externalized sense of ego because something else is dependent on you so on and so forth and um I think that you know pushing to spend as much time on an evening trying not to eat on your own trying not to eat with a screen you know really relatively Simple Rules 321 rule you know this is something easy for me to follow Sean Stevenson taught me about this this year he has a rule where every meal that he has on an evening time has to be with someone it has to be with somebody even if he's going to like call on the phone uh with his airpods in or whatever because he's in the house on his own or he's traveling or whatever and um yeah you know it's such a key St decision to think Downstream from the relationships that you have what have you got well you're out of your own head you're talking a little bit more you're probably eating more slowly even from a digestive perspective maybe the person that you're with says hey why don't we go for a walk and you go oh yeah why don't we go for a walk and going for a walk after you've eaten fantastic for digestion insulin response etc etc blood blood uh sugar uh yeah that's that's a that's a big one finding finding people that you can eat there's a a meme going around the internet at the moment that guys can't eat lunch without YouTube on so this dude's phone's run out of battery and he's absolutely starving but he has to wait for the phone to boot back up before he can start the lunch which is already in front of him but it's true it's it's a meane because it's true because of how many people can't choose to eat in front of screens and I'm you know I in my less disciplined days I do it to yeah and if you if you look at a lot of these Mediterranean cultures and even uh you know the sort of Asian cultures African cultures they're all about big shared meals right whether it's lunch breakfast or dinner you've got the Elders of the family the grandparents you've got the mother and father you've got the grandchildren you've got uncles and aunts and it's like a big occasion where everyone is there with each other and even in um Japan in Okinawa the island of Okinawa you know you've got people you know who are friends with each other for decades you know they're friends for over 50 years and they have the little tribes called the mawai and you know they help each other when they're in financial struggles emotional struggles stress in their lives so that that support network even something as simple as just a meal with someone has a you know significantly huge impact on your health and this is you know not just wishy-washy Bro Science if you actually look into the evidence of companionship and heartbreak when someone one loses someone they loved they can actually die of a broken heart and this is called tacot soos's cardiomyopathy your heart changes in a way where it causes such a significant that that huge negative event in your life so your I don't know wife of 50 years passing away the flood of stress response chemicals adrenaline cortisol and various other things has such a huge impact on your physiology of your heart that it causes a type of a heart attack and you die of literally a broken heart that's wild my mom's my mom and dad's dog two years ago two years or three years ago I can't remember um passed away uh it was super ill and and there was two dogs one that was Ill another one that was old within 5 days I think or 10 days of the first one dying the second one had died as well well there you go yeah companionship and increase in stress and and all of that what about stress you know it's kind of a again another buzzword that people throw around what well when I think about it it's the I understand that chronic stress is the thing that we need to be concerned about that stress in small doses is that but how do people know if they are stressed on a daily basis you after a while that's just life to you you know yeah I think you know it's interesting so a lot of people do think that maybe stress is just a psychological state that it's something to do with your mind and you you'll obviously be stressed if you feel bad or whatever but actually stress invokes a physiological response as well and stress affects so many different organ systems uh for example stress can cause breakouts of various skin conditions it can exacerbate a lot of skin conditions like eczema dermatitis rosacea you can get a acne breakouts with stress it can disrup regulate your gut as well we know the brain and the gut are intricately connected and intertwined so if someone's got certain types of inflammatory bowel disease like ulcerative colitis or Crohn's or even irritable bowel syndrome states of stress can cause diarrhea or in some cases the other way and cause constipation or abdominal pain a lot of autoimmune conditions like rheumatoid arthritis stress worsens the symptoms of that so actually every organ system you look at from your immune system when you're stressed the number of natural killer cells the type of white cells which help you fight off cancer and viruses actually plummets if you're stressed because stress itself is an immunosuppressive response what's that I remember reading about this that during periods of high stress it's often people sometimes don't get ill but that as soon as the stress finishes as soon as they have hand in the dissertation as soon as they complete the project for work they rebound and find that they get incredibly ill have you got any idea about what the mechanism is that's working there if I had to have an educated guess it would probably be some sort of compensatory response by your body that just needs to survive you it's on survival mode where you know um you hear these reports of people being in accidents and somehow they've managed to lift a car so someone's leg can be pulled off from the car they display superhuman strength for that particular scenario and that can be explained by increased amounts of stress response chemicals I suspect it would be something similar in the case of you know you're facing a deadline or chasing a deadline and that stress response keeps you afloat but actually you're about to break and as soon as that event is over you are broken and those cracks they start to appear That's what I would yeah hypothesize I I think it's not I seem to remember that it wasn't far off you know it's kind of like a protracted hesis response thing that you've got going on um with regards to the lifting cars off of children and legs and and stuff like that another interesting thing that it sounds like science fiction but we have a um like a rate limiter on what our brain will allow our muscles to do because if our brain just allowed our muscles to do whatever they wanted you would snap your [ __ ] significantly more fre we and I ruptured in Achilles 3 years ago so I know how how frequently we snap our [ __ ] um but yes and if you think Eddie Hall tells this really cool story have you heard him tell the story about when he first lifted 500 kilos so he's going for the deadlift world record and he talks about the fact that he for however long before in his warm-up routine envisioned a car on his daughter and he walks out and you know does this thing but he gets he does this one lift it takes 10 seconds I guess to do this thing and he's immediately put on a a ventilator his blood pressure is off the chart his heart rate's through the roof his eyes turn blue people can go and look at the video of him he's got he hasn't got blue eyes but if you go and watch the video of him his eyes turn blue it's crazy so yeah those single formative extreme sort of stress driven adrenaline controlled instances of people doing stuff wild [ __ ] comes out of them yeah I think you know you're right I mean there is a certain degree of stress that we need and that hormesis that you mentioned it's the same as when you're eating vegetables right um a lot of people talk about there are various bizarre people online who talk about how vegetables are bad for you and you should cut them out because they contain antinutrients or defense chemicals in the plants and yes they do and technically at a very microscopic level they are poisonous for us because those defense chemicals do poison us but actually it's such a small amount that it's actually beneficial for us because it is that process of hormesis just like cold exposure that small amount of stress is beneficial for us and allows the body to respond to that and eventually grow over time and improve talk to me about the role of awe in well-being oh yeah so I mean this is another thing which can help to offset or delay neurod degeneration and brain atrophy and it's just that profound sense of potentially doing something new seeing something new and just experiencing new things and that is all it doesn't have to be always you need to go and see a wonder of the world it can literally be you going out into nature and being exposed to awe and being inspired by something by someone something an act uh either yourself or seeing something else and you know these are all positive emotions which ultimately are good for you it's so strange to think about all as an emotion no one talks about it people talk about all manner of emotions but all dread even dread which is kind of the I guess in some ways the opposite of all um people talk about that I think it's kind of been repurposed as anxiety or fear or or whatever um but yeah all's just it needs a like we need to make all great again it's it needs it needs a brand um there's a a part of my garden in between we have two houses here and in between the main house and the the other house when I'm walking through there's this really clear view of the night sky and it was so clear in in Austin here last night even just that tiny little bit of looking up at the sky so lovely it's it just again the same as the I went on a morning walk and it made me feel better I can't explain the mechanism I don't know why is this just woo like look ultim Ely if it makes you feel good and you know that it's not destructive it's not making you feel good because it's crack or because it's processed foods I I I reckon just like rinse and repeat yeah all of these things if you really look into it and you boil it down to something and you want something tangible to label it as it's a meditative experience it's it's a form of mindfulness or bringing calm to your body right uh whether you're just walking like you know your your uh walking routine your morning walk and Newcastle or looking at that night sky it is a form of not focusing on nothing but also focusing on everything at the same time that is the art of mindfulness and that is what you're doing sometimes unintentionally when you're AED by something nothing else is in your field of focus except that one or inspiring act H yeah Karen let's bring this one home where should people go they want to keep up to date with you and check out all of the stuff that you've got uh you can check me out I'm like a virus I'm everywhere I'm on YouTube Instagram Tik Tok Facebook wherever you want to find me new book as well yeah this book May save your life we you know we cover a lot of the things we talk about here and hopefully more to hopefully save your life amazing Karen I appreciate you thank you man thank you Chris if you enjoyed that episode then press here for a selection of the best clips from the podcast over the last few weeks and don't forget to subscribe