Red Light Therapy Benefits/Protocols: Simplifying 10,000 Studies

So my main goal with this database is to compete with these usual scientific search websites because with my PBM database the studies are very kind of easy to find and they are categorized neatly and uh if you go to the part with for example the Alzheimer's disease studies they are all next to each others. And there's one row for one study. And on each row you see the study title and from which country the studies and when it was published and what is the study methodology and uh if it was actual like animal or human trial. You see at least some of the parameters also. So you can see like in 1 minute you can see stuff that you may need half an hour with the um traditional ways of searching for information. Hello everybody. Welcome to the light therapy insiders podcast. Today I have a very special guest Vladimiran who has a database on photobiomodulation or red light therapy. I have been referencing that database for many many years now and almost every article or video that I make uh references through it his database basically because I use it as research and there are like 9 and a half thousand plus studies in there right now. Welcome to the show Vladimir. Uh thanks so much for being here. First of all like can you tell me a little bit about your background and how this whole massive project I will say it's truly a massive project because cannot imagine how much time goes into this uh how this all got started how you got into this PBM because I understand that PBM is not your formal education background right >> yes uh thank you for inviting me over yes I've been doing uh like PBM related things for maybe 12 or 13 years now. I'm 34 old. Uh I'm a dentist living in Finland and uh I have a pretty would I say random background to health things. When I was in high school, like something like 17 years old, I suddenly got very interested in internet discussions about health and I had a plenty of free time that I spent online reading like health blogs. Uh I used an R RSS is it called RSS feed reader uh to follow maybe more than 200 different health blogs. Uh there were mostly about nutrition and u I thought that many of the authors had kind of interesting takes on how to improve health in different ways. I read about like there were this ancestral nutrition things and stuff about different vitamins. Sometimes I could have like spent an entire week only browsing through vitamin D research discussions and other things. And then there were a lot of different gurus who had their like very how do you say deep world views on various health things. Um one of these uh guys that I followed was Raymond Pet and u he has some pretty interesting views on nutrition especially. He claims that uh basically almost all unsaturated fats are undesirable and that sugar is healthy and it's against the common sense in many things. And he also said that red light has a stimulating effect on metabolism and that blue light has an opposite effect. And I even though he has some pretty interesting and uh contradictory the his views are strongly like they oppo they're they are how do you say in opposition to the mainstream views. uh I found his views on amino acids very interesting when I was maybe 20 years old. He wrote about glycine and collagen and gelatin like proteins or amino acids and their possible effects on health. And then I started reading about those things and found that his writings were pretty maybe credible on those things. So then I thought that maybe he has some maybe that could be worth investigating that claim about red light also. And um at first I couldn't find any evidence for his claims. So I kind of gave up and uh I gave up and decided that maybe this rape is wrong about red light. But then a couple months later I did my search again and then suddenly I found [snorts] hundreds of studies like supporting health effects of red light and near infrared. So, I found a keyword low-level laser therapy, and I know this that I found out that there were like at least 2,000 studies showing health effects from red light or near infrared light, mostly from laser light sources. And at the time, while I was reading health blogs, I had also started my own health blog and it had some popularity in Finland. So I decided to write a lengthy article about the stuff I could find about red light therapy. I found the article cited maybe 100 or 200 studies on photobiomodulation and different diseases like balding and hypothyroidism and osteoarthritis and various various things. And that was in 2013. The reaction was pretty how do you say most of the people were not interested in the my content. I even tried to reach many medical researchers in my country and many new newspapers to show them that hey there is some interesting research about red light. And basically I got very little attention. And uh that actually was the basis for my idea of creating this database because I thought that if I could just pile up all the evidence, then maybe people would believe me that this red blood therapy is a worthwhile topic to maybe investigate or talk about or maybe even use in some situations. So that is like my background. First of all, I when I was in high school, I started reading health stuff. Then I ended up hearing about red light benefits on metabolism. And then at the same time, I was writing a health blog and I tried to like raise uh attention for this topic. And because nobody seemed very interested, I tried to kind of how do you say increase my intensity by creating like more content through this database and after that I went to st study dentistry also. So basically I had this health interest first and then later I went to study health sciences or dentistry. >> That sounds good. and understandable and I I get what you mean with the whole development through rapid red light red light near infrared what was the year that you started the database Vladimir >> started in 2016 so it's now 10 years old and maybe 4 months >> I remember I I think like you you started out with maybe what I remember like 3,000 studies because I hear that number coded over the years right like 10 years ago it was like 3,000 studies Then a few years ago, people were saying like four or 5,000 and now I I I checked again before this interview and I think you're over 9,590 studies are in there right now. >> Yeah, because like last year I guess uh almost 1,000 studies were published. If you go to the database and you use the Ctrl and F search function and just put the year 2025, it gives almost 1,000 results. So yeah, the output is increasing. So we probably if we look like six years backwards, maybe it was like only half of the current number of studies. And why do you think that is that it's so I think even you have some historical chart where it shows like it's almost exponential the curve right why do you think that is >> I think that uh if you look for many different uh subjects in pubmed from almost anything and the research output gets faster and faster so it's not only PBM but of course PBM maybe when it got becomes more popular and more kind of how do you say believable for researchers maybe they have a lower threshold for like doing some of their own research also and devices when there are more available and maybe cheaper so it's easier to conduct research and of course I think when there is more basic like original studies then there is like more sense to write review articles so I guess the rate of new review articles is probably a little bit higher than the like increased rate for of original studies. So for many PBM related like subjects there are a lot of systematic reviews and meta analysis published nowadays because there is so much original research already to be summarized in this reviews. So there are probably many reasons why the pace is increasing but anyways I think the increased rate is still kind of how do you say true that we are getting relevant information at an increasing pace and it seems like a good thing for example myopia did I pronounce it correctly uh nearsightedness Um for example there was almost no research about PBM and myopia maybe 5 years ago and um during this last maybe four years or something the research output from China has been just unbelievable like they're publishing so many huge trials about prevention of myopia in children that is pretty nice to see. So we 5 years ago we had almost nothing and now we have like research data like with probably thousands of patients already. Can you tell me for the people who are not so familiar with your database what exactly you do because for each study you have like a few you have two categories right a more broad category and a or specific categories or the broad category maybe I health and then this more specific goal maybe myopia or age related macular degener degeneration and there's a year a title and then you have all the PBM specifics right like the wavelength if there's a device specific device used you list at power output the treatment time etc. Can you tell me for the the people who are not so familiar with your database? Most people I think even on our website and our YouTube channel have not seen your database. So can you give like a simple explanation of >> Yeah, actually it would be probably a good if this uh podcast would have some kind of a short video insert or like embedded part because it would demonstrate it visually. But um uh my point is that um for those people who want to know about the actual scientific research about photobiomodulation uh there is a lot of it and uh we are talking about almost 10,000 studies and if you look to you look if you look use the usual ways to search for this research it's like uh these websites like pub PubMed or Google Scholar and it's very difficult through those websites because um for if you want to learn for example like PBM and Alzheimer's disease you get so many search results and you only see the titles and not actual content and uh if you use the keyword photobiomodulation and Alzheimer's disease you might miss some studies that because some studies for kind of forgot to use the right keywords so you may not find them easily. So my uh main goal with this database is to compete with these usual scientific search websites because with my PBM database the studies are very kind of easy to find and they are categorized neatly and uh if you go to the part with for example the Alzheimer's disease studies they are all next to each others. And there's one row for one study. And on each row you see the study title and from which country the studies and when it was published and what is the study methodology and uh if it was actual like animal or human trial. You see at least some of the parameters also. So you can see like in one minute you can see stuff that you may need half an hour with the um traditional ways of searching for information. So my point is to make it easier to find information about PBM in large amounts and also because it all of the studies are in one place, it makes it possible to kind of get this large overview about PBM because if you go to PubMed and you want to know how many studies there are that have been studied and indic application for PBM therapy. Um, I have a my database has a tab for that summarizes all all of the possible indications. I found like 300 of them. But it's almost an impossible task to get this large overview from PubMed because you would have to go through like hundreds of pages of search results and create your own tables and notes. So I guess those are the main purposes. So it's kind of a library for PBM studies that is easy to use. >> Yeah, that makes sense. And I can tell you from experience because I often go I through many of these topics whether it's like Alzheimer's disease, Parkinson's or yeah even a specific eye health safety or eye health condition that it helps a lot the the overview right because you can just very easily see see whether there like five studies on on like a given topic or maybe I think like I went through wound healing recently a few months ago and there was like 300 so yeah I had to limit myself but and Then for each of the studies you see the the wavelength and the the intensity of the light that is applied and how long it is applied etc. >> At least that's my goal. I have a lot of data like missing because I've been a little bit lazy. I should make it more complete. But uh that's goal for the future. But I can tell that yeah, if I if I had to go through all of these studies myself and collect read read the entire paper, make sure that I find all the information. Of course, you get quicker with it in the time you so you can you could probably do it very quickly. But if every paper is written a little bit differently and then it takes a lot of time to find what device is used, how is it used, what participants were included, what is the study setup, etc. I think you've done the the whole industry great service with this the this database because it makes searching for different topics so much easier. You also mentioned you had some tabs right that's also included such as some research stats uh PBM links etc. Can you tell me a little bit about that? Yeah, for example, there is a tab called research stats. Uh the point was basically I was I had a Finnish profess professor and we wanted to write a review article about PBN to a Finnish language um medical journal and I wanted to say that kind of give a short summary of the uh PBM research in our review article. I wanted to tell how many studies there are about PBM, how many randomized trials there are, how many different study animals have been used in those trials and what are the main like most important countries of PBM research, how many studies are being published each year. So all kinds of this kinds of meta information about PBM research output. I guess for researchers it's probably interesting to know like who is doing the research and what type of research is being done. I guess that's just something many people would like to know. And if we had a school textbook about photobiomodulation, I think we would have that information like how many human studies, how many mouse studies and so on. So the research stats tab just contains information about that although it's outdated so I should update it. Yeah, I was planning to talk about the other tabs, but if you want to ask something about research stats or comment, please go on. >> Yeah. Well, we can talk about the other tabs as well, but I know that you've also collected data about which countries have most of the publication, right? I think it would be like USA, China, and Brazil would be near the top right now among others. So, that's also the type of information that people can find in that database if you go through the tabs. just like an inter interjection. But yeah, I'll I'll let you continue uh leading people uh through the tabs and of course we we will show them on screen as well because the video editor they can pull it up and and really show it the things that you're explaining right now. >> And yeah, the top one country seems to be Brazil and then United States is the like the second one and then China and Iran are also pretty major countries. But then the we have like dozens of different countries. So it's a pretty like how do you say it's maybe distributed or divided pretty evenly in like many places on earth. Uh but yeah then earlier I wanted to make this tab PBM in high impact journals because when I talked to doctors about PBM 10 years ago like many people were saying that I have never heard about red light therapy uh it's probably not published in good journals. So I made a kind of task for myself to see what kind of medical journals are publishing PBM research. And I found a lot of high impact journals from the like- with very high ranks in those medical journal rankings also publishing PBM research and then a lot of how do you say mid tier journals. So my the point of that dab is just to demonstrate that PBM is not something that is completely unknown to a scientific community but instead it is something that is really present in a lot of good journals. >> And why do you think that is that people outside the PBM community don't seem to really be aware of the amount of research that is done here and also high quality research? hard to say. In general, maybe in general people often have narrow focuses and maybe they read like newspapers more than scientific journals. So even though there is like PBM research being published all the time uh if you don't follow the research output in medical journals all the time you may miss it like I know one professor who specializes in light and health and he has written books and articles and still he missed BBM entirely for like many years because I don't know it's when you go to scientific library you have can see like thousands of books or maybe tens of thousands of books and journals. So after all maybe there is so much stuff in medicine that's easy to miss like uh some singular topics and of course maybe in public discussion like maybe doctors are not have they have been a little bit maybe afraid of talking about these kinds of therapies because for example in my country we had this Uh, have you heard about the ear light? The the uh LED lamps that are put in the ears and they were supposed to help with depression. At first we had a lot of hype for those that product and u people were buying those ear lights and they bed paid maybe €200 for those or something like that. But then maybe two 3 years later the reputation of that product went like very bad. They like for example the Finnish skeptic organization gave them this like how do you say quackery prize for being like unscientific product marketing. So in my country after that ear light people may be especially like skeptic skeptic uh when it comes to red light therapy also because it seems as if we were fooled by this ear light thing and we don't want to get like fooled again. So I guess now we are we want more solid evidence on red light therapy before we accept it. So uh for many years it's been very rare to see very uncommon to see PBM mentioned in Finnish newspapers. They have a lot of articles about health and nutrition but very seldomly about PBM. But maybe this year and last year the situation has changed a little bit. Maybe because these are LED masks for skin health. They have been become so popular and they have probably pretty good sales nowadays. So I guess that's shifting the maybe the narrative a little bit. >> Vladimir, if we take a step back and look at like your entire like the body of evidence of 10,000 studies almost of course we cannot go into specifics because the specifics are very very complicated with many different biological mechanisms etc. But where right now in terms of evidence do you think that it's best for for now for PBM and moderates and where do you think there there's not so much evidence now if can you give a broad overview of that because you went through so much research of course >> if we start from the basic mechanism things like I've been doing some summer job in mitochondrial mitochondrial research group and uh what I see is that if we look at ba basic research on mitochondria, there are like very uh high impact research groups around the world with huge funings publishing research on various like mechanisms related to mitochondria, how they function in the cell and how for example circadian rhythm or vitamins or nutrition affects mitochondria and then then these results are being published in very high impact journals like nature or science or cell and when it when it comes to PBM we don't see anything like that so in for PBM the basic research we have a lot of individual small studies various research groups with probably much lower funding ing uh levels uh are doing studies with cell cultures and investigating the effects of light in different situations. But I think we are still missing the highly funded major research groups doing their best research on PBM mechanisms. So I guess that we have a lot of theoretical background on how PBM may function, but I still wish it could become a scientific topic that is like investigated by these groups that have a long history of doing impactful research on cells and mitochondria. And that hasn't happened yet. Of course, we have this Dinoarus uh theory of PBM function on cytochrome C oxidase. We have data on light having effect on nitric oxide um release from compounds that store nitric oxide. uh we have some like even more how do you say elegant studies. For example, we have this study showing that PBM has some effects on cells even even on those cells that have this knockout of cytochrome C oxidase. So we have maybe I would say from the scale 1 to 10 maybe the level of our knowledge for PBM uh basic mechanisms I would say it's maybe something like five or six or seven but it's far from 10 we need more basic research I think and then that was about the primary mechanism maximum the first effects in the cells. Then when it comes to what else happens after PBM, uh we call them usually secondary mechanisms. For example, in many diseases and situations, PBM seems to lead to increased energy metabolism in cells. It seems to [clears throat] lead to decreased pro-inflammatory signaling. It seems to lead to various kinds of changes in cellular cellular functions and gene expressions. So this um we have thousands of studies from various animal models and cell culture models kind of repeating the same message. We have probably like hundreds of research groups showing that PBM decreased inflammation or that PBM upregulated some energy metabolism related things. So I think those secondary mechanisms are pretty solid. I would say we can talk about eight to eight or nine out of 10. So just because the mass of research is so high and we have data from so many countries, so many research groups and so many different animals, species and different models of disease. And it seems to, for example, when it comes to like anti-inflammatory effects, it's being demonstrated in more than 100 different and models of different diseases like heart diseases, brain diseases, skin diseases. So I think uh that kind of type of that level of knowledge is pretty strong probably and then the most important for us and for actual treatment of humans is of course the uh clinical research. So the study data data that we are obtaining from treating actual humans with actual diseases and uh for clinical data um I would say that maybe for some diseases we already have a plenty of uh useful information for example for cancer patients with this for example radiotherapy related oral oral mucositis. uh of course we have just maybe I don't know maybe 100 clinical studies I would guess that's anyways it's a huge amount I don't remember how many and uh then we have quite a lot of research for pain mus how do you pronounce muscular um skeletal pain like for example like we have studies on neck pain, shoulder pain, back pain. Uh um what else? Heel pain. Uh I'm probably missing something. Fibromy and then other pain painful conditions like fibromyalgia and osteoarthritis pain. I think um we are already having quite a lot of research on those things. Then there are some clinical indications that we have maybe I would say the level of evidence is maybe low to moderate or at least promising. So maybe diabetic food foot alers are something that we are starting to have maybe a good amount research at least maybe not yet but gradually and maybe Alzheimer's disease also we have many studies showing benefit over placebo and maybe uh age related macular degeneration. It's maybe not solid yet, but it's not we have something like not not bad data. But then we but anyways PBM is being researched for so many different indications and uh we have only maybe would I say maybe a handful of these indications where we can talk about pretty strong or moderate evidence and then another one or two handfuls of research where we have kind of promising to moderate level of evidence and then a lot of indications where we have just maybe a couple of uh in clinical studies that do not uh kind of that are not enough for a solid evidence base. So now when we are talking about 1,000 studies being published every year, I think if we wait for 5 years pro I assume that we are going to be in a much better situation and that's maybe one of my motos that let's just wait a little bit so then we can give more confident answers about red light therapy effectiveness on many things. >> That makes sense. And maybe out of my own cur curiosity, Vladimir, uh, when people say that this is something that you probably also see a lot in many of these research papers is that there's such so much hogenity between studies, right? Even if you have like many different studies on like the well unlike Alzheimer, that may be a good good example or Parkinson's disease for the brain. Yeah. that the treatment parameters are all over the place and some people when will then make the argument like this this device uses 1060 nanometers or this study and the other study uses A10 and the other 904 for instance so we cannot really compare them but how would you respond to that? Yeah, that uh BBM is quite a complex treatment when you compared it to like painkiller drugs. When you t like study ibuprofen, you can like of course there can be a v variety in dosing. You can have like one or two doses or three doses per day and it can be a different amounts of milligrams. But for PBM one research group is using entirely different wavelength power density fluence or for example the how do you say the rhythm of the treatments. One group is giving and the command to patients to use PBM twice daily and another group asks patients to use it once per week and um the there are many parameters that differ between uh different research groups. So that also makes how do you say the evidence much more difficult to summarize. And then we when one research group has a positive result and another gets a negative result then we cannot infer very easily that like what is the reason why this one result was positive and the other one was negative. has it something to do with wavelength. For example, this 1,60 seems to be maybe more often associated with positive results than maybe 850, but uh we maybe don't know if it's causalone, but um and then yeah, it's it makes it so frustrating for to PBM researchers that we are not going to get those uh answers. quickly. We probably just need a lot of more data accumulating and then some I don't know sophisticated analyszis and I don't know >> that's a very good answer. I'm also struggling a little bit with this topic because I completely agree with you there that we need more data on the one hand but on the other hand also it makes it very I I I think the whole PBM research is much more difficult by because these studies have so many different parameters and variables that make it very difficult to compare and on on some topics that where we do have like 30 or 40 studies now it is kind of used against the whole industry and the whole research field, right? Because people say, okay, even though you have maybe 30 or 40 studies on the topic, that study uses A10 and four times five times per week and this study uses 1060 maybe once uh once every week. So kind of almost like the evidence-based medicine people who really want like three randomized control trial with with the exact same variables that confirm like an outcome. They seem to be Yeah, it it seems to make them more skeptical towards PBM even though I can see it going both ways basically. >> Yeah, I understand like for I have been so frustrated by how complex it seems. So it's probably like happening to a lot of people who try to understand PBM and evaluate it critically. It's so difficult to be confident at least like the situation is improving in the I almost I always think in the context of like um well how do you say reward versus risk and uh at least for PBM the risk is becoming smaller and smaller all the time because the devices are getting cheaper. So at least if you cannot get complete confidence on whether PBM may be beneficial for the thing you are trying to use it at least it's much cheaper to try than before. >> Yeah that makes sense and you're probably just confirming but you're probably alluding to that there are so many consumer devices on the market right now and many LED based. I know that you also have some publications on that right with professor Hamlin uh led versus >> oh I just wanted to say that uh I haven't written like anything during the last couple of years that was maybe eight years ago but my when I was a blogger and when I wrote those articles usually I had some kind of viewpoint in my mind some perspective that hasn't had not really got enough attention in the field and there really was no good article comparing LEDs and lasers and there were so many uh PBM authors who seemed to believe that you need lasers for photobiomodulation. So I was very happy that we ended up writing that review article about the topic. So it kind of demonstrated pretty well that there are a lot of head-to-head comparisons between LEDs and lasers and in most of those comparisons they seem to be uh equally effective. So um it's kind of at least I personally believe that uh LEDs seem to be pretty good light source for PBM and uh maybe even sunlight and um maybe even incandescent or hogen lights broadband lights probably work as well although we don't have that much research on them >> that Makes a lot of sense. Yeah. My question is after going yeah so many years through all of that research is there anything that really surprised you cuz you now have like collected almost 1000 studies? >> Let's see. There are like maybe various kind of how do you say type types of surprise for example like if we consider like some treatment indication like diabetic foot ulcers and PBM one of things I was surprised was that even though we have a lot of uh like quite many clinical trials there are so many bad ones. So that's one thing that I'm pretty annoyed by that some studies have really huge difficulties just even reporting basic parameters maybe doing some uh just usual uh like reporting of results and everything and there's a lot of bad methodology out there. So even though we have like almost 10,000 studies, if we remove the poor ones, we are left with a much smaller number of good studies. So maybe that and then there are like some studies have spin. By spin I mean that some studies report negative results but in the conclusions they write as if it was positive. Well, when people talk about medical research, often people have very high they think very highly of medical research and especially clinical research, but actually I think only part of it is good and then there are is maybe too much of the bad quality out there also. So maybe that's one thing that I don't know if it surprises me but um at least something I wanted to mention. Let's see something else. I know I need to think probably probably there are many things but I just can't get in my mind. Uh one is maybe this is also maybe just something very subjective but I've been always looking at the whole picture. I guess I I'm interesting interested in PBM and everything related to PBM but it's just so funny that very often researchers take some very very narrow like point of focus and then they do all of their research about that one specific thing. It can be like PBM and healing of scratch wounds in cell cultures or that could be PBM and Parkinson's disease, PBM and Aculus heel. So it's something very specific. I don't know my kind of in my ideal world I think all research researchers should spend maybe five years just reading studies and going to actual research after that when they have already kind of spent enough time to get a good overview on the things they want to focus on. that would probably help to plan useful research um methods or kind of research settings. Uh think about the most important things to spend your resources on. It's sometimes funny that we have like maybe I don't know 100 studies on PBM and the Achilles heel of rodents. Of course, they are usually measuring slightly different things, but I don't know in my ideal world, we would have almost only well done like high quality human studies that are run randomized and binded and well reported and pre-registered and uh with sufficient sample size. And then we would skip most of the animal studies just because they are often so poorly translated to humans. So it's not that useful after all. But I don't know that was some kind of um what do you say criticism of the research culture but I don't know if that was the best answer to your question about surprises but >> it is something I also see and uh yeah I go to some of these conferences uh one one of them I was like one and a half years ago the world's federation of laser dentistry in Brazil actually where you see people who have made entire careers of 10 20 years of only light therapy for peroderal titis for instance or denton hypers sensitive or or uh implants or what whatever I will say that generally the the people who focus on such a topic don't seem to be aware of the entire dynamics that light therapy can have on many different outcomes. If we take a step back and uh talk about that distribution right you just mentioned animal studies there's also of course a lot of in vitro uh petri studies etc or more broadly foundational research and there are human studies yeah and I emailed you about this a few years ago and actually you had the same argument like that the animal studies don't always translate into the same outcome in human studies can you tell me a little bit more about that and also about what your ideal research would be yeah you do manive Of course, human studies with sufficient participants pre-registered so that people can like fetch outcome afterwards or yeah that you at least have accountability that it needs to be published. Yeah, I imagine that would reduce like publication bias and some other criteria. >> Yeah. Um okay, let's see. Uh I think I just have to the question was uh hey um >> yeah on the distribution between in vitro animal and human so yeah >> uh so I'm not an expert in this uh subject of translational gap but it's very well known in medicine that for many uh diseases say maybe Alzheimer's disease Parkinson's disease is stroke. Yeah. Especially many brain conditions, we see that we can we may found even like 100 different drugs that seem to be beneficial for mice with the animal model of this disease. But then suddenly when we get these clinical trials in humans then like basically all of them fail and we are left with no drug for Alzheimer's disease because all of them failed. So that's a big issue in medical research and uh I'm not really sure what is the like list of arguments why is this so huge like this difference between rodence and humans which would explain like what are the explanations why so many drugs and treatments seem to work in animals but not in humans but it's a I suppose it's a subject that you may find a lot of information from the literature and nowadays you can use AI to maybe ask for some [snorts] knowledge about this thing. Um and uh basically when you talk about if you talk with people who write treatment guidelines that um I think if you want that some treatment is utilized in like actual health care usually happens in a way that the guidelines are written and then they notice that oh we have good evidence for maybe I don't know PBM and uh PBM and myopia and um but if we want to end in that situation where some those groups writing the guidelines conclude that PBM is beneficial for myopia or Alzheimer's disease or diabetic food ulcers. We need to have solid evidence and basically the evidence they look at is only only randomized trials. They don't care at cell trials or m mouse trials or rat trials or rabbit trials at all. They also don't really care about um single arm human trials with no comparison group. uh basically they care about only proper randomized trials and uh then if we I don't remember the actual numbers of studies for each indications but if we think maybe PBM and diabetic foot ulcers and uh group starts evaluating the strength or the certainty of the evidence of BBM M for diabetic foot ulcers they first do the literature search and find all the relevant studies and how many they will find I don't know maybe 25 studies that are randomized it could be maybe less I'm not sure I don't remember uh but if we now cons maybe if we assume it was 25 they will go through various types of checklists to evaluate the risk of bias in these studies. They see if the randomization was described well in the paper. They uh go through to see if the group allocation was like truly blinded. There are like a lot of things that can go wrong and in the if we consider the whole medical evidence that we have like the tens of thousands of randomized trials published in medicine. The not many trials are actually low risk of bias. Most randomized trials have issues that could be corrected just by kind of having maybe some methodologists in the research group that really make sure that the study is well done and that really doesn't happen that often. I think that's one of my criticism that uh if we want PBM to be a part of actual like treatment guide guidelines for diseases we really need to focus on doing good quality studies and some of the research groups are doing it but so many are not. So uh I hope there actually there are like there is this uh field called meta research that kind of there is it's like study doing research about medical research and uh there has been research evaluating the long term like longtime trends in medical research like whether the quality of clinical studies is improving or not. And I think the what we can conclude is that the number of good studies used to be like okay the proportion of the good studies used to be pretty low but it's increasing. Uh so probably if we look five or 10 years to the future, we will have pretty high quality uh studies on average because the trend is towards positive like better quality. But still we are far from perfect. And uh the thing is that uh maybe 10 or 20 years ago the guideline groups were not as critical as nowadays. But nowadays they really notice all of the like mistakes and all of the limitations of the studies. They are they have become much more critical nowadays. So it's not so easy to how do you say introduce a new treatment because the requirements are higher and yeah there is this one study about this research trends I actually found it's written by Mario line Catalan in Brit British medical journal open in 2019 and it had pretty interesting data on on this issue. I sent you a link so it can be >> we'll include it in the description below as well this study and show it on the screen. What what's in it that study Vladimir? >> This study I sent the link it analyzed it is a study that analyzed uh 20,000 randomized trials starting from 1990 and ending in 90 ending in 2015. So it's a like uh how do you say duration of 25 years and it looks at how the study quality improves over time and uh basically it shows that methodology improves but it's still far from perfect. So basically in 1990 how to say 1990 the only 2.6% were of adequate methods like and uh in the end of that followup it was 10.3%. So only 10% of the student the most recent studies were evaluated as adequate >> and for the people listening that matters a lot because yeah of course there's going to a huge amount of funding towards medical research and ideally we want studies that have a good setup because then would set up good methodology because then we're able to use them for medical treatment guidelines right if I understand your argument correctly flammir then by creating so many ma maybe yeah arguably too many animal studies right now in in the PBM field and because these animal studies don't always translate well to the human study so you don't get the same outcome in the animal study as a human study it can be viewed as a yeah a waste of resources basically because no matter how many animal studies you do you still need to do the human study to get the real outcome right >> that's the point so if we get 1,000 studies each year so maybe only I I don't know 30 or 60 of them are really useful for us and the rest are maybe useful in some ways but not in this direct way of kind of impacting guidelines. So what we need is more of human trials and not any human trials. We need good quality human trials. A related question to that I have about the methodology is that in the PBM you already mentioned this but in the PBM fields retinal therapy often many parameter treatment parameters are also not mentioned right such as for instance they don't measure well they may may mention with a laser how many jewels of light goes in there but not the really get you may not get like a real measurement of like the the light output in mill of centime squared and or you may not get the treatment area for instance and that also severely limits how much how useful studies are even if they're they're promised >> and yeah so for the is it repr rep how do you pronounce reproducibility or something uh yeah you need all of the relevant data so the other research group could create a similar study and get this um how do you say um it's not repetition um replication of your trial. It's and uh then I think there could even be like factors that we do not even how do you say take into consideration. So what if the time of day matters? What if it's a different thing to give PBM in the morning or in the afternoon? It's almost never reported. But if it's very relevant, we may have like almost 10,000 studies that miss something very relevant. So we still may uncover some contextual factor factors that can be very relevant at least. Uh I don't know you know Glenn Glenn Jeffrey I guess. >> Yeah. Yeah. I was just about to bring that up because he seems to think that in the morning or evening it it's a different effect, right? What do you think about that? And of course, I know you cannot give me the answer because we don't really have this we don't have the exact data to determine that. I think uh right now to say it's it's this way like it really matters or it doesn't matter. >> Yeah, I think that Jeffy's group had some results that kind of uh point to the direction that morning PBM could have better in better in effect and then afternoon PBM. But I think Russian researchers focusing on this brains drainage system, they compared maybe night to night PBM and day PBM or something. And I think they had something some different uh conclusions also. I I cannot say what is the kind of whole picture that we can paint from the research at the m moment. I just don't remember. I think they may be reporting some benefit from night PBM but I'm I may misremember >> and even then even if they had reported it still on the back of my mind there would be the idea like I still would would have wanted this to be tested with different devices also on different treatment parameters in different times of the day right maybe there's an effect with one device but if I use like a V light device on the brain during the morning or evening maybe there's a difference or with these whole uh body panels what the effect would be there uh if we try to measure it with the morning or evening. So even if there are a few studies, there's the whole issue of that there are so many variables that still difficult to draw a super solid conclusion. But I certainly understand what you mean here. Yeah, with the the timing of the day aspect. >> Yeah, it's difficult to plan for like what would be a good direction in PBM research and what should we kind of try to do with all these different parameters because I don't know I don't have a good idea. Of course, we need a lot of comparisons, different doses, different wavelengths, different beam sizes. Yes, I think recently on social media I read that of course in many PBM studies you we have been using very narrow very small beam of light and then we have all these like p very large panels and also that have very huge beam of light and does it matter? There was somebody that had this idea that um it's maybe more beneficial to have a small beam of light directly pointed to that specific part of body you want to treat. So the body would kind of how do you say direct the blood stream and resources to that place and not everywhere else. So that's a good hypothesis. Although all we do have full body PBM results with positive result full body PBM studies with positive results as well. So I think there is a strong kind of point for full body PBM as well and it seems very if we consider our evolutionary history of getting sunlight it seem it makes sense also. Yeah there are many factors that we can speculate about. >> Yeah. Do you have an opinion about that? The sunlight versus PBM or >> I wrote the article about sunlight and that's one thing I was surprised like PBM researchers don't know much about sunlight and sunlight researchers don't know much about PBM. So it's two research communities that kind of they should overlap, they should communicate, but they basically don't know each other. So when you read articles about sunlight, they never seem to mention PBM or okay just sometimes they do but very very seldom. It's very weird. This is like the end result of this system where we are so narrowly focused. >> I do know that your database it has a specific header for sunlight right with sunlight studies which I think are very very important. Yeah, I think the sunlight is correlated to many good things. So I think it's relevant to keep in mind when we talk about PBM and it's also probably good to keep in mind. For example, PBM seems to be bene seemed to be beneficial to maybe multiple sclerosis in some mouse models and at the same time sunlight seems to be correlated with less multiple sclerosis. So could the beneficial effect of sunlight okay we don't know if it's beneficial effect or only correlation but uh if we assumed it was a a beneficial effect of sunlight uh would it be mediated by red light maybe it's something that PBM research could be useful to give some answers because we could study red side effects on multiple multiple sclerosis development or or progress of that disease. >> Yeah, makes sense. And what I know I wrote an article about the multiple sclerosis and PBM or red therapy last year and there's also the issue of the heterogeneity of the studies. So basically right now all of the most of the studies they have a very different treatment protocol which makes yeah makes it a lot more difficult. >> Yeah. And that's one of the indications where we basically do not have sufficient research yet. Maybe in the future >> because I think like some of them use like acupressure points for treatment with lasers and then there's another setup completely different treatment area and different treatment methods and another study etc. Then switching to another topic Vladimir what about studies with like no effect or even negative effect which which is I think maybe even more important. Let's go into that one first right now and there's a lot of discussion about around this right now. What do you think that are the most most important side effects or potential side effects or even proven side effects that are out there for PBM? >> Good question. First of all, I have um I have seen very little negative effects from PBM. So in general it seems to be like super rare to get any uh big negative effects from PBM. Uh I have a part in my database that is about safety of PBM. And if I go through it I see a couple of negative results as well though some of those seem to be cell culture studies. And of course, of course, we know that some cells can be vulnerable to very high doses or and for example, eyes can be vulnerable to light induced damage. Although they are much more sensitive to blue light than red light. And it seems that red light can even protect eyes a little bit from blue light induced damage. But anyways, of course, we know high doses can be harmful in in some contexts, but we I cannot recall much data demonstrating real harms and we have a lot of null results. uh in which PBM did not have any notable effect compared to control group or placebo group. But uh actual negative results very very difficult to remember the only thing that I can now like that I have in my mind is maybe mice and tumor growth. So there are studies where they uh how do you say in um make tumors grow in mice and then they report what happens if they also gets PBM. Uh in some studies PBM increases tumor growth which is probably bad and uh in some studies they showed like decrease into more growth. So the results are mixed. If I had a cancer, maybe I would not irradiate the that cancer area. I don't know. And of course, maybe some endocrine glands could also be sensitive to light. testicles. Maybe there are some negative results in animals that high doses of red light can maybe cause some tissue damage to testicles. But then on the other hand, thyroid gland, I guess we are mostly seeing beneficial results on hypothyroidism. So maybe I would consider PBM as a positive as a possible uh treatment for thyroid problems instead of possible harm possible source of harm. >> Yeah, but that makes a lot of sense and I would agree there very often people like ask in our Facebook group about the cancer and red light therapy. That's like the only topic I Yeah, of course I'm also not willing to make a commitment there and tell somebody like go use red light therapy because I don't want to be responsible for the consequences there. But I think that's a very good guideline that if you have cancerous tissue somewhere not to use red therapy directly on it. If you could create maybe one or two or three studies in an ideal world and you would unlimited funding, what would you like to see research because you have so much Yeah. background knowledge now about the different options that we have and do not have. More importantly, >> I would probably want just to have a good replications on many different indications. When I became interested in PBM, I was so interested about the possible effects on hypothyroidism. uh people are eating thyroxine T4 hormone for life and then there are studies demonstrating that people could maybe even get rid of the um lifelong medication. So I if I had a money I don't have any like super um how do you say um grand plans I but that would be one thing I would want to research and I would also like to study the dynamics of the effects like I would like to know if you give red light to thyroid does it lead to any acute effects on thyroid hormone secretion over 1 hour or 24 hours. I guess we don't have sufficient research on that then uh I would maybe just support the Alzheimer's disease research because there have been so many individual small studies reporting like in improved cognitive test results over placebo. So it seems that maybe PBM could be beneficial for mild dementia and it would be a huge thing if that was true. So and uh yeah one of the things I would actually want to resol search that is not actually PBM but it's P PDT photodnamic therapy is there was one study in which basically people had very severe um uh diabetic foot ulcers and one group had had uh just usual care and one group had red light and metallium blue. So this combination is basically photodnamic therapy and in this group basically everybody uh could keep their feet and in the usual care group basically everybody was amputated. it was a huge uh difference between the groups but as far as I remember it was not a properly randomized trial and it had maybe I don't know maybe 35 participants so I would like to see a good study like replicating that uh same setting with good methods and let's see if there's something else. It would be nice to see more of those studies where they just add near infrared light to office lighting like and see if it has some minor maybe beneficial effects. I think we had one study uh maybe one two years ago or something. Do you remember what I'm talking about or do? >> Yeah, I think Dr. Glen Jeffries also has some studies on this. Now I don't know I don't remember the exact year but I think also with adding some incandescent or halogen lighting in inside the office space with very positive effects. >> I think I need more than like one minute to find that study but anyways I think it would be just because it may be a little bit boring for people to grab that PBM light and do their 5 minute or 15 minute therapy session. It would be nice to see more of the research on this loweffort things like invisible near infrared that you get maybe automatically from your desk and you >> I know that that was one of the original uh recommendations of Dr. Ray Pets, who you of course started with in the introduction of this interview because he's a big proponent of having the well he always mentions like the incandescent lighting and I think he like back in the day recommended like six 500 watts incandescent over light and just activating them for like 1 minute even if every hour or so. Len Jeff has I think with the incandescent lighting at the desk that showed some benefits instead of the yeah the more blue blue light dominant LEDs or flu reset lighting in office set. >> I think Ray Pet had a few arguments for that point that long short days are associated with problems. So, if you kind of could uh make the night a little bit shorter, for example, by introducing a little bit of extra light, extra red light, it would be good. But yeah, it's been so long so since I've been reading Pete. But yeah, but yeah, unfortunately I have a my personal document with a list of possible like good uh studies I would like to see, but most of I have like four 30 or 40 maybe no actually even 50 study ideas but only five of of them are something to do with PBM because um yeah as a matter of fact I read about PBM and I do this database but I really do I'm interested in many other topics as well. So PBM is just maybe one of my major points of interest. >> Yeah, that makes makes a lot of sense. Then we'll wrap it up here. Vladimir, is there anything else that you would want to share or maybe an important topic that I forgot to mention? Of course, we'll be including the link to your database below. look at it and yeah there many of the tabs are on the bottom right so that you can go to the specialty or to the statistics etc but it's a little bit overlooked by some people I think but yeah the the tabs are also very important there >> yeah uh maybe two points uh the one is about negative results that in the past there was this like article it's been a long time since he wrote this but Yan Tuner from from Sweden published this analyszis of many negative results in PBM and showed that it was quite commonly related to some like very low dosing and so on. So he could find some kind of plausible believable explanations for some of the negative results. But then and uh nowadays some meta analyszis do subgroup analyszis. For example, they compare um studies with higher doses and studies with lower doses and try try to find if for example if higher dose is associated with more benefit results more beneficial results. But I think we are still far from understanding all these contextual factors. So I hope that maybe during the next five years we learn a lot about that. That was the point one. And then the second one, it's about the PBM database. I do it as a hobby. And uh maybe two or 3 years ago, I spent a year where I added all of those emojis and uh a lot of extra information and so on. But maybe for one or two years, I've been like uh very lazy with this PBM database and I'm hoping to get back to a good good pace. I hope I it's after 10 years of doing this as a hobby, it's becoming a little bit boring. Sometimes I add 100 studies during one weekend and I still I feel like that like I didn't see anything new. I've seen this all before. So then nowadays I read about so many different topics like I try to learn social dancing and music skills and um so I hope I can still re keep my uh eagerness towards PBM up so that I can do this after my work because I do like whole full full how do you say full week work as a dentist? Um and um then I've been thinking also if a artificial intelligence will have some effect on this whole thing because uh maybe in the future this database could be replaced by AI because the it's becoming increasingly good at browsing through the studies and probably even now if you use the deep research you can get a lot of useful information about for say let's say for about PBM and Alzheimer's disease. So I'm not sure what is the future of PBM database if the AI becomes very good. Um it could be that I can use AI for updates of database or maybe it becomes entirely useless at some point but I think it will not happen during the next one year may or maybe even two years. So I think I'll keep on updating it until it be maybe becomes less useful for people because so far I've heard many researchers saying it's useful for them. So and lay people as well. So I guess it's probably worth keeping it up. It's interesting that you mentioned AI because I just one or one or two months ago shot a video comparing the AI deep research and really try trying to make my search term I make the search term completely visible on in in the YouTube video and then the results and then my own manual methods and results and then on three different topics. So that will come out on the on on the light therapy insiders uh YouTube channel and yeah I'm very curious to see where your database is going in the next u few years. Is there any help that you need with that? I know that our mutual friend Aaron Rogers is already sometimes chipping in there but yeah I know that it's you doing most of the work. We are talking about some collaboration ideas now between I and Waltz W the world um world organization for BBM but uh yeah I've been thinking about the collaboration for many times but when it comes to adding new studies basically I want to go through through the new studies so I see them and it's quite difficult to keep it uniform if somebody else does it differently. So it would require a lot of kind of um time doing it together first. But it of course it could be possible. But I haven't felt it as kind of necessary. But for making the database more dense with information, it would be useful if somebody would help. But yeah, I don't know. I haven't been thinking about that too much so far. And other people also have their kind of projects. I don't know. For me, it's kind of exciting to have this one person massive projects. But if somebody had an assisting role, how long they would do it eagerly until they felt like it's not kind of exciting enough? Because people usually, I don't know, may don't want to do just help somebody for hundreds of hours for free. It starts to feel like work. >> Yeah, that makes sense. And I think it is yeah you deserve a big huge thank you from the whole community because you've been doing this as a hobby or as a form of charity almost I would say uh towards the whole community. So thanks so much and I know I'm talking from from the perspective of many people that use your database almost every day or sometimes people weekly but in my case it's probably several times a week that I get in there. So thank you so much and again people check out the the PBM database below in the description. Thank you so much for all the work work that you do. >> Yeah, thank you and I'm very happy to hear that you found it useful and work like using regularly and thanks for the talk and um if you feel so we may talk again at some point in future. >> We certainly will I think. Yeah. Thanks so much. >> Yep. Oh, okay. Bye.