Here's the diabolical thing. The risk of dying early if you have bright nights goes up immensely. There have been a lot of studies on people after 6 p.m. on devices getting artificial LED exposure. They live shorter lives. Cancer rates go up. They're metabolically unhealthy. But here's the really scary thing. We have a generation of kids that are metabolically sick. They cling to their iPads. They're on devices. But the problem is the most things are designed to make people do less of what's good for them. And we don't talk about this enough.
And Andrew, you're one of the most trusted voices in health today. And we've waited many, many years for this, Protocols, an operating manual for the human body.
These 10 protocols are well established. They're the ones that are going to move the needle the most in terms of one's mental health, physical health, and performance.
Okay, so let's get into it. So protocol number one, you want to get sunlight because exposure each day to the skin increases testosterone and estrogen in both women and men and is important for libido. And then the second, and this is really key, is to reduce stress fast. And I'll explain how to do that in a moment. And then number three, working out with weights for 45 minutes, taking your sets near to failure. It will triple or quadruple your cortisol levels. But a lot of people have been told, don't spike your cortisol. It's the stress hormone, but it's a preparation hormone. You're preparing for adversity, but also great things. The next thing, and this is one of the most valuable skills, if you do it for 5 minutes per day, you will experience a significant improvement in mental and physical health. And then sleeping on your side, very important for offsetting dementia, getting rid of bags under your eyes. But Stephen, the number one thing that you need to know about is the moment I started, my life got so much better and I really started to see what I could only describe as miracles.
Andrew, I have this outstanding question that I have to ask you. You don't really talk in depth about supplements.
So, you can only do five for the rest of your life.
Oh gosh. I highly recommend getting a...
This is super interesting to me. My team gave me this report to show me how many of you that watch this show subscribe. And some of you have told us according to this that you are unsubscribed from the channel randomly. So favor to ask all of you please could you check right now if you've hit the subscribe button if you are a regular viewer of the show and you like what we do here. We're approaching quite a significant landmark on this show in terms of a subscriber number. So if there was one simple free thing that you could do to help us, my team, everyone here to keep this show free, to keep it improving year over year and week over week, it is just to hit that subscribe button and to double check if you've hit it. Only thing I'll ever ask of you, do we have a deal? If you do it, I'll tell you what I'll do. I'll make sure every single week, every single month, we fight harder and harder and harder and harder to bring you the guests and conversations that you want to hear. I've stayed true to that promise since the very beginning of the Diary of a CEO, and I will not let you down. Please help us. Really appreciate it. Let's get on with the show.
Andrew Huberman, we've waited many, many years for this and now it has arrived. This is your long-awaited book called Protocols, an operating manual for the human body. And inside this book, I counted roughly 50 different protocols split across seven different areas: sleep, exercise, stress control, nutrition, light, focus, motivation and learning, and personal growth. You've written 10 of the protocols you want to focus on sharing today. Can I ask why did you choose those 10?
They're the ones that are going to move the needle the most in terms of one's mental health, physical health, and quote unquote performance. Your life will be so much better if you do them.
And do they cost a lot of money to do the 10 that you've picked?
No, they could be done either at completely zero cost or on an existing budget.
And do you do these 10 things every day?
Every day. There's one on there that I don't do every single day. I take off one day per week, but every single day without fail.
And when you wrote them, did you write them in order of sequencing?
Yeah. Throughout the day, from start to finish throughout because this is the other thing. Protocols synergize. They ratchet together. How well you slept last night is dictating how well you feel now.
These are gears in a larger system. One moves, the other ones move. And while there is a place for pharmacology and supplements and things that you take, ultimately these gears fit together based on what you do.
Okay. So, let's get into it. What was the first thing that you drew? Because I saw there was a picture there.
Okay, so in my inelegant drawing, but I am a, you know, biologist, so we're allowed to do this. I mean, this is essentially a plot of where you wake up in the morning and then where you go to sleep at night, you know, and these are not hours of the day. These are the different protocols. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. Okay, so this line represents the healthy cortisol curve. Most people don't realize that, but you wake up because of a rise in cortisol. It's literally called the cortisol awakening response. If you've ever woken up 1 minute before your alarm clock, it's because the cortisol awakening response is heavily entrainable, meaning it can be matched to external stimulus. You want this peak in cortisol as high as possible in the first 60 minutes of your day.
Everyone thinks you want low cortisol, but here's the deal. High cortisol in the early part of your day is what provides for elevated mood, focus, attention, your ability to learn. It's also what establishes low cortisol in the afternoon and at night which is a requirement for falling and staying asleep.
So this peak sets up this trough. So you want high morning cortisol, low nighttime cortisol. These represent melatonin, the hormone of sleepiness. As we know, if you slept the night before, then melatonin essentially is low at morning. And the dashed line is adenosine, which is a downstream product of the use of ATP in your cells. The more you're awake, the more activities you do, the more you think, adenosine builds up. That's why you get sleepy.
So, what's very interesting is that when you spike your morning cortisol, and I'll explain how to do that in a moment, and you do that within the first hours of your day, you also establish a case where these little blips are stress, stressful text, stressful event, but they're brief. We always hear that cortisol is bad, but our ability to have big inflections in cortisol, stress out, and then they come back down to normal is very, very good. If this peak was high, if this peak is not as high, and this is kind of like a medium or flat, what they call a flattening of the cortisol curve, you see shorter lifespan, less recovery from every kind of illness, and the stress bouts last a very long time because they're riding on a higher baseline. So if your morning cortisol level is lower or flat,
right, then if I get that stressful text during the day, it will be a longer cortisol spike, more stress,
And not only that, but there's an indirect but very important interaction between cortisol and melatonin. Your sleepiness hormone doesn't come on and function as well, and so sleep gets very disrupted. So a lot of people think, 'Oh, I don't want my morning cortisol high.' And a lot of women in particular have been told, 'Don't spike your cortisol. It's going to lead to excess visceral fat, moon face, etc.' There's a condition called Cushing syndrome, which is a massive overproduction of cortisol. Very rare condition. I mean, it happens, but most people are not dealing with that, right? Most people's morning cortisol is too low and their afternoon and nighttime cortisol is too high.
How do they know this stuff? Like, how do they test this?
This healthy curve, as it's called, was measured through just consistent blood draws around the 24-hour cycle. And then it's been looked at in response to everything from caffeine to cold plunges to exercise to sunlight. So protocol number one is hydrate.
Your mind is exceedingly more sharp when you're well hydrated. And it actually helps boost your morning cortisol. There's a very interesting interaction between the bladder being emptied, as usually after people wake up, they use the restroom, they urinate, and then hydrating. And there's an, I'll talk about this a few times, but there's an ascending pathway along the vagus nerve that serves to wake up the brain. And part of that has to do with hydration first thing in the morning. You awake from bed to urinate in the middle of the night because of an arousal phenomenon of hydration and the bladder being full.
When you say hydrate, do you mean electrolytes or just water?
16 to 32 ounces of good clean water is fine. If you want to add electrolytes, great.
How much is that? Is that a cup or is that...
This is 16 ounces, maybe 18 ounces.
Okay. So, like a big mug.
You want to consume about 80 ounces of water throughout your day. It's a lot, but basically everything you want to do in the early part of the day, you want to do less in the evening part of your day. The next thing, and this is really key, it could have gone first, but you want to view sunlight or 10,000 lux artificial light. I could spend 3 hours talking about this, but I'll keep it really brief. When you view sunlight, there's this beautiful phenomenon. It activates these melanopsin intrinsically photosensitive ganglion cells. You know, the major focus of my work for many, many years. So I'll resist saying more. They literally extend physical wires that we call axons into your hypothalamus. Your master circadian clock resides there. We call that your suprachiasmatic nucleus. And when you view low solar angle sunlight, sun low in the sky, there's an abundance of yes UV, but it's lower when it's low in the sky. You actually can look at the morning sun more easily than you can the overhead sun. Why? The morning sun looks more yellow, orange, or even some red tones compared to the overhead sky. Well, the light coming from the sky is the same, right? But the specific wavelengths of light, as we call them, that are coming from the sun when it's low in the sky are the optimal stimulus for these melanopsin intrinsically photosensitive cells that tell your central clock it's time to wake up. The day is beginning. Okay.
There's also something incredible that happens if you get bright light in your eyes in that first ideally 30 minutes, but even 60 minutes of your day, which there are two pathways by which your brain circadian clock wakes you up. One is it sends signals through peptides it releases and neural signals, but it's able to activate what we call the HPA axis, hypothalamus, pituitary gland, which sort of hangs outside the brain, and then adrenals, you release adrenaline. There's a unique window that passes after about an hour following waking where your suprachiasmatic clock can trigger an alternate pathway that literally goes down your spinal column and triggers your adrenals to release additional cortisol. In fact, viewing sunlight in the first hour of your day takes this peak. Here's what it would look like if you didn't view bright light in the first hour of your day. It would be here, which is bad. And your stress responses then would be bigger and longer.
This increase in cortisol is driven by viewing sunlight. Now, when I say sunlight, people say, especially in the UK, they'll say there's no sun where I live. Okay, this could easily say daylight. Why? Because there's always daylight out. If you look at how bright it is on an overcast day in the middle of December, even in the UK at 8 a.m. versus midnight the night before, it's different.
You know, it's obvious when there's overcast skies, less of the long wavelength light, the oranges and reds are coming through. But you want daylight in your eyes in the first hours of your day. Go out on your balcony if that's all you can do. If you're in a car, roll down the window. It's not good to try and do this through a window or windshield. There's so much data showing that spiking your morning cortisol this way establishes low cortisol and high sleepiness hormones, let's call them, at night, which is great, buffers stress, and moreover kickstarts your immune system to protect you against bacteria and viruses you can encounter during the day. It is great for your metabolism, mood, ability to learn, and on and on. And in the book I explain a number of different ways how this peak relates to this trough if people are interested. But if you don't have access to sunlight or daylight,
using a 10,000 lux artificial light can be very beneficial. These 10,000 lux lights have been shown to significantly offset the symptoms of seasonal affective disorder, etc. But what we're finding from this huge study from the UK Biobank is that you want bright days and you want dark nights and they're additive. So having bright days is great for your mental health and physical health along a huge number of parameters. Significantly improves them. But having dark, even if you were in dim light all day, making it dark at night, people are healthier. The risk of dying early, if you have bright nights, goes up immensely. And we don't talk about this enough. If you don't have access to enough daylight, like you wake up before the sun comes out and you're up for 2 hours, let's say, before the sun comes out, I highly recommend getting a 10,000 lux artificial light.
And last time we spoke, you took me outside after the conversation and you had an app on your phone,
right? Light meter. I have no relation to the app, but I use it. And that is able to tell you how much lux of light you're getting at the moment, but it's additive. So, one thing that's important to note is let's say you miss a day, right? The next day, get outside for twice as long.
How long should you do it on a very clear morning with the sun rising?
And by the way, you don't need to see the sun cross the horizon. You can just wait till it's elevated, but it's low in the sky. People who are concerned about UV damage should know that when the sun is low in the sky, the UV index is much lower. And there's a reason for that. And it's a phenomenon called Rayleigh scattering. Sunrises and sunsets are very beautiful and colorful. When the sun's overhead, it's hard to look at. It's this big ball of light. It's so bright because you're getting all the wavelengths, the UV all the way out to the infrared coming at you in more or less equal intensities. When the sun is low in the sky, the UV is, it's not completely scattered, but not as much of that is reaching your eyes. Much lower risk of sunburn, much lower risk of eye damage, and so on. So, here's the diabolical thing. Your screens are not nearly bright enough to kickstart this increase in cortisol in the morning, but they are very capable of increasing your cortisol levels at night because this low level of cortisol makes you vulnerable to big increases in cortisol. It's a little bit of a detail that I explain in the book, but...
I was going to say on this point, is it just exposing my eyes to the light or does my body need to be exposed to it?
Great point. And one of the protocols in there, it's not one of the 10 I listed, is about the importance of getting sunlight on as much of your skin as possible as is socially appropriate. Beautiful work from Glen Jeffery's lab at University College London. You know, I can believe this. They do a glucose tolerance test. So, they fast people, they have them drink a glucose drink, they measure how fast a blood sugar rises. And if they shine red light, so long wavelength is red is long wavelength light...
Yeah. Like this would be medium wavelength because it's yellow. A red would be, so this is probably, I'm guessing somewhere between 500 and 600 nanometers of light and red would be probably somewhere between 580 and 700 and then infrared goes out further, you know, into the 800s and thousands. The sun emits all of those. Okay, so this is long wavelength light. Okay. So, they shine a long wavelength light on people's backs and they do the glucose tolerance test and they observe a more than 25% reduction in the peak and they also look at the rate of rise of blood glucose. It's buffering blood glucose rise, which we know is a good thing.
Just to summarize, they shine red light on someone's back while they have a glucose shot and their glucose spike is lower.
That's right. And you can do this onto bare skin or you can do it through a t-shirt. Turns out that these people's metabolism rose significantly. Why? How? Well, long wavelength light can actually go into and through your body. It gets absorbed and it can go about eight centimeters into the body. Red light. Long wavelength light of infrared can pass all the way through the body. They show that beautifully in this study. So that's not good. No, it's fantastic because along the way it makes conformational changes in the way that your mitochondria handle the electrons. Basically this long wavelength infrared light that comes from the sun, the heat that you feel from the sun or from a long wavelength light device, is so amazing. It actually allows your mitochondria to function more effectively, more efficiently. Now, it's not to say that short wavelength light, blues and greens and ultraviolet light are bad. We need ultraviolet light. We need it on our skin to make vitamin D. What you want is full spectrum balanced light, but not so much UV that you get a sunburn. And you don't want a lot of short wavelength light in the absence of long wavelength light. Best way to do that, sunlight in the early and later part of the day because the UV index is low. You're getting the full spectrum. Indoor LED lights like this, which we all spend a lot of time under, there's now evidence from Glen Jeffery's lab and others that it actually may damage the mitochondria.
We talked about melatonin coming from the pineal gland that makes you sleepy at night. You also have melatonin in most all of the cells of your body and there it doesn't make you sleepy. It serves as an antioxidant, but it's sort of captured. And the way to liberate it is through long wavelength light. So you have a protective mechanism that's kicked on with long wavelength light that protects you against the oxidative stress and damage to cells.
And this has many, many positive effects. So Glen's lab has done experiments where they literally take in a light like this and they have people look at it like this for one to three minutes a couple times a week. They look at people of different ages, different eye conditions. He's a serious vision scientist, right? He's not a biohacker. He has no interest in commercial products actually, although sometimes I wish he did. People over 40 who experience age-related vision loss, we all do a little bit, experience improvements in vision when they do this simple thing. And why would that be? Well, it turns out that your photoreceptors, which absorb light and convert it into electrical signals that allow you to see, are the most mitochondrial-rich and metabolically active cells in your entire body. Now, biologists love to play this game where they go, 'Your tongue is the most metabolically active.' Then they go, 'No, you're...' Everyone makes a claim on this. The photoreceptors, my friends, are the most metabolically active cells in your entire body. So, they have a ton of mitochondria, and they need to protect themselves against the oxidative damage that comes with generating a bunch of downstream products from ATP. So, long wavelength light is what protects us in this. So you can see significant improvements in vision for people that view long wavelength light a couple times a week, but only in people older than 40. And get this, only in people that do that in the first three hours of their day.
Yes. Your eyes and your body and brain are not the same at this first third of your day versus this middle third of your day versus the last third of your day and at night. They're not. Your sensitivity to bright light causing bad effects on you after sundown increases, not immediately, but it increases gradually. Your need for bright light in your eyes in the early part of the day is immense. You need this. You want this. And if you miss a day, get out the next day and view some more light. You asked, will light to other parts of the body work? Not for setting this system in motion, but it's a great idea to get out two to three times per week when the UV index is low. You can just look on your phone, what's the UV index? And in general, be the early or the later half of your day when the UV index is lower and to get out and get some light onto your skin. You don't have to be naked or in a swimsuit. Great if you are and that's appropriate, but you can also just wear a t-shirt because the long wavelength light will go all the way through. So Glen Jeffery and Robert Roger Schwelt, he's a physician who talks about the immense benefits of getting sunlight onto the skin for getting over disease, for enhancing immune system function, and on and on.
Can you, because there's going to be a lot of people right now that are going to go buy a red light lamp.
No. Sunlight. Pink Floyd. Pink Floyd album.
Pass sunlight through a prism. It bends the light and you see the rainbow: red, orange, yellow, green, blue, indigo, violet. But also in that sunlight is ultraviolet light, some UVB. Exposure each day to the skin increases testosterone and estrogen in both women and men and is important for libido. It actually reinforces romantic relationships for reasons other than sexual interactions, attractiveness, etc. Strong effects. So sunlight has it all. What you don't want is to go outside when there's so much UV that you get a sunburn. And you don't want to think that, you know, red light's the only light you need. You want that warmth from the sun. And it gets better because, and notice I'm sort of like, 'it gets better' like a salesman. I'm selling nature, okay? I'm telling you, when you go outside and there's a lot of greenery, greenery reflects long wavelength red and infrared light. Throw on some infrared goggles. You're not going to do this, but you look and all that stuff would be glowing white in those goggles. Greenery reflects down infrared light. How do you know it reflects light? I'm stealing Roger's words as I say this, but where's the coolest place to be on a hot day? Under a tree. Why is that? Because it's reflecting the heat, the infrared light. But when you're out in greenery, you're getting all that long wavelength light and it bounces around and it goes through you. So get out into nature, walk outside. If you work and live in a city, get outside. Take off a brimmed hat because you do want the sun getting down onto your face. People are so terrified about accelerating aging based on UV. But we're not talking about baking yourself in UV light all day. The health benefits of this are immense. There's a Swedish study that actually showed that the more sunlight people got, the longer they lived. In fact, smokers who got a lot of sunlight, this isn't my favorite study, but we have to admit it's there, lived longer than non-smokers who didn't get enough sunlight. And there are other things too like exercise, etc., but don't smoke, but get sunlight.
There'll be a lot of night shift workers listening.
I have a section specifically for night shift workers because here are the two scariest things. Night shift workers live shorter lives. Cancer rates go up. They're metabolically unhealthy. And it's very hard to mitigate. But I provide some tools specifically for night shift workers and for jet lag, by the way, because people travel. Here's the really scary thing. You and I qualify as night shift workers because the studies on night shift work, barring some of the more extreme ones, was most of them were on how many people after 6:00 p.m., right, are on devices getting artificial LED exposure or doing activities besides eating and socializing with their family or in bed. If you work at night at home, you're still a night shift worker. You don't have to work all night to be a night shift worker. So, we have a generation of kids that are metabolically sick. And I don't like to be one of these fearmonger people, but here's the cool thing. I'm going to skip because we're on to this. I'm going to skip to number six.
Okay. As the sun is going down, you don't have to watch the sunset. That would be cool to watch the sun. Everyone loves sunsets.
But try and get some daylight in your eyes in the late afternoon or evening. If you're going to be working indoors from like after lunch until nightfall, try and get near a window. Do your best. Go out on a balcony, take a quick walk around the building, do what you can to get some sunlight in your eyes without sunglasses. When you get some sunlight in your eyes in the late part of your day, let's just say in the last third of your day, and the clock times don't matter here, because we all get up and go to sleep at different times, you buffer those cells in your eye against the negative effects of artificial light at night. This is your Netflix inoculation, as I call it. Like you can be on your computer at 9 or 10 at night without it damaging your melatonin levels quite as much, without it disrupting your blood glucose levels and your sleep if you get some bright light in your eyes in the later part of your day. But there's one population of people for whom this doesn't work. And it seems to be adolescence. You can't buffer them against the negative effects of screen light at night. What happens if you view screen light at night? You get big bumps in cortisol. And people say, 'Well, I can fall asleep just fine after being on my iPad or screen.' True, some people don't have as much of a negative effect from blue light at night, but the blood glucose effects and the next morning cortisol effects are the problem. Remember I said high cortisol sets you up for low cortisol?
Low cortisol sets you up for high cortisol. So, you've got a population of people, kids, who have their cortisol is slightly but significantly higher in the evening and at night because they're on devices and the next morning their cortisol levels are struggling to get up.
You know this is a tough one because teens socialize that way and you don't want to take their phones away and they cling to their iPads like, you know, like my new bulldog Strummer clings to a chew toy, you know, it's like you take it away from them but like they hate you for it. So I said view daylight because you can't always see the sun but even if it's overcast just get out for a few minutes and take a walk, your sleep will be better.
I feel like I'm giving a lecture in class.
That's amazing. That's what I want.
So we said hydrate, sunlight. And then number three, I know everyone's heard it, but if you can exercise in the first three to four hours of your day, you could do it in the afternoon without problem, but there's a huge advantage to doing cardiovascular resistance training in the first three hours of your day.
Cardiovascular or resistance training.
Yeah. And in the book, I devote an entire chapter, chapter two, to exercise. And I explain what I think personally is the best way to structure an exercise program for somebody who doesn't want to be the most jacked, but wants muscle and definition and strength. Somebody that doesn't need to run a marathon for a record time, but wants endurance. Somebody who wants to be able to sprint reasonably fast and has middle distance ability, too. And it's basically structured. You either lift or do cardio on alternating days, three days total of lifting, warm up reasonably, low volume of work sets, two to three work sets per exercise, emphasizing compound movements. So, not like a preacher curl or a tricep kickback. Those are fine, but you're going to get a lot more bang for your buck if you're doing pull-ups, rows, dips, multiple muscle presses, multiple joints moving at once as compound. Some hip hinge movement. So, could be squat, hack squat, some deadlifts, and I talk about how to get specific aesthetic effects in there, too. I mean, I'm by no means an exercise physiologist, but I've been resistance training since I was 16. I'm now 50. I'll be 51 in a month. So, I feel great. Cardio at the start if you're doing resistance training or not at all.
I warm up for five minutes of cardio and then resistance train. But I do the cardio on alternate days. Three days total of cardio. One day of cardio is long and slow for about an hour. One is about 30 minutes at moderate intensity. One is a short one like I did this morning. Jumped on the air bike. Pedal easy for a minute, then go all out for 30 seconds, easy for 10, 30, 10, 30, 10, 30, 10, and then you're off the bike. Basically max heart rate training. And the day after leg day, if you do your legs right, take a rest day.
Yeah. But here's the interesting thing about exercise. You notice I didn't say deliberate cold exposure.
You want to blow some minds? I will go toe-to-toe with anybody on the internet or off the internet. Deliberate cold exposure does not raise cortisol. This much. It's amazing to me that the same people that are suggesting moderate to high intensity exercise are saying that deliberate cold exposure raises cortisol. It's simply not true. Not true for women because a lot of people said, 'Is your book going to be for women and men?' I distinguish between data when there are data showing that it's different for women and men. I acknowledge when there's no data in women and the data are very clear in women and men. Trivial increases in cortisol, magnificent huge increases in adrenaline, norepinephrine, and dopamine from deliberate cold exposure. And those so-called catecholamines are great to have rolling into your day. They're the things of alertness and focus. The appropriate stressor for cortisol, appropriate meaning the one that you want, is a psychological stressor. We know that.
Working out with weights for 45 minutes, taking your sets near to failure, going for a run for 30 minutes. So, the point being, if you do this exercise in the first three hours of your day, you're getting a big inflection in cortisol. Again, this is what you want. Now, some people can't exercise first thing in the day. They either don't want to or they can't by way of schedule. And if you go into exercise in the later part of your day, that's fine. Your cortisol will come back down. You can do some long exhale breathing to slow your heart rate. Andy Galpin talks about that. Take a hot shower, which paradoxically lowers your core body temperature. And then helps you sleep. When you heat up the surface of your body, you have a thermostat in your brain called the medial preoptic area, and it goes, 'Oh, the surface of my body is warm. I should probably cool my core body temperature down.' And you fall asleep better. You know, this is like the putting socks on effect or the hot bath effect, right? I assume a massage or something like that also.
Great. You have access to that in the last hour of your day. Like, we need to learn more about your life.
My fiance used to be a masseuse for many years. So she...
So when you exercise for a few days early in the first three hours of your day, let's say you do that two times. The next morning you wake up feeling a little bit more willing to exercise. Did your willpower change? Well, in some sense, yes. But what happened was your cortisol entrainment mechanisms changed. Your suprachiasmatic nucleus all day is clocking what you're doing. Let's say you eat like 9, 12, snack at 3 and 6:30. You have a food anticipatory signal. You have ghrelin is secreted, makes you hungry. We are clocks and the synchronization of those clocks is very, very important. When you exercise at roughly the same time of day early in the day, you will have more energy to exercise in the first 15 minutes before that. You'll notice you kind of start stirring around. Yes, part of it is cognitive, but a lot of it actually is your brain is anticipating exercise is coming. Oh, cool. That's why I teach neuroanatomy, so this is fun.
I have a brain here in front of me. It does open up in case you want to open it up. But you just reminded me of something.
You reminded me of something that I saw you talk about, which was the anterior midcingulate cortex. And I think you described this as being one of the most interesting discoveries of neuroscience.
So cingulate cortex, I mean, it's not directly exposed here, but the anterior midcingulate cortex would sit somewhere like there. This is an amazing structure, right? I mean, just to remind people, like when we feel some sort of pressure, social pressure, physical pressure that we hate and we decide, 'I'm going to lean into this,' like I'm going to compete or I'm going to push through this internal or external resistance, neurons in the anterior midcingulate cortex are just firing away. And if that area is stimulated, my colleague Josef Parvizi at Stanford showed this, he's a neurosurgeon, people say, 'I feel like a challenge is coming on and I'm going to lean into it.' This is the brain area of tenacity. And the amazing thing is it has connections all over the brain with reward systems, etc. So it's collecting information about when it gets activated, what's going on in the world that makes you feel pressure, when you feel like pushing back, when you don't. But the best part is it is highly subject to plasticity. People who diet successfully, their anterior midcingulate cortex gets bigger and more active. People who embark on a new exercise program adding some component of exercise, for me it's mobility work because I've got a little stiff over the years. I know. So when you do something that you don't want to do, that you don't reflexively do, your anterior midcingulate cortex gets bigger and more willing to engage in challenging things going forward.
So, that's the key point, which is that sets you up to be able to do more challenging things in the future.
That's right. Why would you do deliberate cold exposure? I'll tell you why. Because your ability to sit calmly or even not so calmly when your system is flooded with adrenaline and norepinephrine, and to be able to trigger that with cold water safely, like cold shower, getting into a cold ice bath, it's safe as long as it's not so cold, as long as you're not hyperventilating beforehand on purpose. That carries over to your ability to keep your head straight when other things trigger adrenaline. You don't get 10 stress systems. You get one. And stress looks like your adrenaline goes and it comes down slowly. There's a hallmark of stress. Cortisol goes up, goes down. Right? So you are prepared, my friend. My goodness, you should be a university professor. You want to teach with me at Stanford. So I came up with a model for arousal. Right? People hear arousal and they think, oh, it's got to be romantic arousal. It can be. Arousal is really just how alert or sleepy you are. So you can be really sleepy like in a coma or you can be in full-blown panic. Nobody wants that. But a seesaw is the right analogy here because we have this thing called the autonomic nervous system. And the autonomic nervous system is made up of two parts: parasympathetic and the sympathetic nervous system. They're in different parts of the body. They both connect to most every organ. But in general, when you are relaxed, that's what we call the reflection of parasympathetic tone going up. When you're stressed, it's the reflection of sympathetic tone going up. But as you get sleepy, your parasympathetic nervous system starts to dominate a bit. And as you get really sleepy, it dominates more. When you wake up in the morning, and then if you do the right things like hydrate, get sunlight, and some exercise, well, then your cortisol goes up and you're going to be more alert.
The ability to navigate stress of all kinds depends on your ability to do what I call is control the tightness of this hinge. When you train your ability to think, breathe, stay calm, when your system is flooded with adrenaline and that happens later in a way that was nonvoluntary, something happened that you didn't want to happen, your brain immediately flits to the understanding of that place and you are able to maintain thoughtfulness. You can know to not speak. That's often the best thing.
You can do. You know, to react or not react. In fact, when you get into a cold plunge, one of the beautiful things about cold is that your prefrontal cortex, that's involved in strategy setting and making meaning out of what's going on, its activity is greatly suppressed for the first 20 to 30 seconds. We know this about every stressful circumstance. In the first 20 to 30 seconds, you are brain damaged. You are brain damaged. You're, you are in that mode of like you could react physically. Sometimes that can save your life, but most times you just don't want to do anything. Step out of the way of the car, get away from the aggressor, whatever. But most times you're best off not saying a darn thing. And then your prefrontal cortex slowly starts coming back online. And then you're back again because you ruminate, you know. And this is good relationship advice. Very good relationship advice. [laughter] I wish I had learned it long ago, right? Actually, last night I looked on Twitter and I saw something that was both perplexing and a little bit upsetting to me. And I went to sleep like, I know how to deal with this, some long exhale breathing, which will slow your heart rate. And we'll talk about that. But I woke up this morning, turns out it was a complete misunderstanding and everything was reversed. But last night, I thought about sending a text, but I thought later at night, the prefrontal cortex is already diminished. This is why stress feels so much harder to deal with at night. And prefrontal cortex, we should describe that thing, logic and stuff.
So, um, frontal cortex. So, here it's logical. You have the frontal and motor areas here. And your prefrontal cortex is basically a big patch of real estate behind your forehead that in humans is greatly expanded compared to in other mammals. I don't like calling them lower, but they have less prefrontal cortex. So, they're more driven by their impulses. One of the most incredible things that every child and adult needs to develop is what's called top-down inhibition. You feel an impulse, but you resist the impulse.
In fact, the way I've mostly trained my dog, Drummer, cuz it works, is I taught him at 9 weeks of age, put down a piece of food. Of course, he goes for it. He loves food. And you teach him wait. And he sits there and you teach him to look at you. And then now he, I can have him moving toward a piece of food. And I say, 'Wait,' and his nose can be this far and he'll just stop. He has great top-down inhibition. Is it about food? No. Am I trying to torture him? Of course not. It's so that if I say, 'Wait,' he can suppress his arousal.
This is one of the most valuable skills. And people with frontal damage show an inability to do that, which is why sometimes they're violent or they say inappropriate things. People who are tired, stressed, drunk, prefrontal cortex activity is suppressed. Get in a cold shower. First 20, 30 seconds it's kind of fun. You're, you're like, here I am with less of a brain than I had getting in, and then 30 seconds later you're like, I can do this.
This explains why you should do things tired.
Don't do things tired. Don't say things tired. [clears throat] Impulse control is way worse.
So when I heard you talk about the anterior midcingulate cortex and that there was this part of the brain that was kind of like the willpower, or you described it then as the tenacity muscle, it completely changed my relationship with hard things because it made me realize at some sort of, like, I guess some conceptual level, that every hard thing I overcome is better equipping me, like when I, you know, curl weights in the gym, to do harder things tomorrow.
Yes. When I heard, oh, there's like a neurological, I'm making a neurological investment in my future. And then you talked there about doing voluntary difficult things like the cold plunge, whatever, or learning a new language. It can be cognitive in nature. It can be learning to dance if that's stressful for you. And it can be anything that creates some resistance for you, internal resistance, anything of that sort. This is a beautiful structure because it's wired into cognitive capacities and our ability to build them and challenge all of that with that to emotional challenges.
We're kind of optimizing our lives towards comfort though, aren't we? That's like a winning formula is more comfortable things.
I think Jack Dorsey said it best. There's this great video of him online. It was, it was a small lecture that he was giving where he said anytime we exchange ourselves, our money, our time for convenience, we are almost always giving up something that's like fundamentally useful for us neurologically. And it's okay to do. I order food on DoorDash because there's great food and I don't have a lot of time to cook. I'd like to devote my time to other things. I'm trading for convenience. But if you're aware of the trade-off, you're much better off. And the real question is what you're going to do with that additional time. While I'm against, you know, overoptimization to the point that it pulls you out of life, like it diminishes life, I am all for striving and optimization, quote unquote, in ways that allow you to lean into the rest of your life with more vigor. I think Arthur Brooks says it best. You know, I mean, we are wired and meaning comes from striving, and within striving is some struggle, and within struggle is also the release from struggle, and that's also very, uh, satisfying.
Here's the overoptimization thing to me in a nutshell, which is there are people for whom doing two of the things I described for 5 minutes each per day will experience a significant improvement in their mental and physical health. There are people for whom they're sort of like junkyard dogs. They can live on anything. They have a ton of vigor. And they'd be like, 'Yeah, I didn't feel that much from like drinking some water and getting something.' Cool. I got you. You're one of those people can fall asleep in front of the screen, get up, and just keep going on a, you know, a sugary muffin and something like, great.
But everyone can afford to take a look at what they're doing now and try and move the needle toward more vigor, well-being, happiness, peace by doing certain things.
Do you become more sensitive to the thing when you stop doing the thing?
Depends on the thing. So, for instance, if people, like I talk about nutrition in there and all we, it's one of the cards. I actually cover everything from the all meat diet to vegan diets to, I really go into the literature so people can choose. But really, if you look at what most people could benefit from doing, and you could do this with vegan or vegetarian, it's a little harder, but the best diet is going to be the following, right? Not too many calories, not too few. That's individual. You can calculate that. It's an easy thing to do, but I provide a way to do that. You need to get what's, what are high complete protein to calorie ratio proteins. This is a concept I came up with because if you look at the literature, yes, we need the essential amino acids. So that's a complete protein. But you can get that from beans and rice, but to get 30 g of complete protein from beans and rice, you're going to consume about four to five times as many calories as is required if you get it from a chicken breast.
So this is the, the factor that's kind of obvious, but no one ever talks about. So you want to eat some high complete protein to calorie ratio protein. So you know, eggs, lean meat, fish, and then everyone knows you need fiber, right? So vegetables and fruits. But what I will say is that many people who remove starches entirely, or remove vegetables entirely, will find that they, their autoimmune issues resolve, and there are reasons for that, and we have to acknowledge that. But most people should be eating some vegetables and fruit for micronutrients and fiber. Low sugar fermented foods. It's very clear, Justin Sonnenberg's work from Stanford, very clear, lowers the inflammation.
Fiber for many people, inflammatory markers went up. No one likes to talk about that, especially not the vegans, but too much fiber can be noxious for some people and pro-inflammatory. So low sugar fermented foods like sauerkraut, kimchi, beet kvass is delicious. Problem is they tend to be expensive, but you can make your own and there's recipes online to do these things. I don't want to get into the seed oil debate. Just eat, just use olive oil. It's delicious. It's relatively inexpensive nowadays to get real olive oil. Small amounts of butter. Okay? Like, like why are we even debating seed oils? It's so dumb. It's like the, the seed oil debate is like the fastest way to kill neurons that I'm aware of. You know, it's like so dumb. It's like because the studies are not well done. You're comparing a processed food diet that includes seed oils versus, or you're talking clean seed oils versus a high meat diet with processed meat. It's a, it's a mess. It's like as a scientist, you just look at this and you go like, this field sucks.
Like if someone wants to have a magnificent career in science, go into the field of nutrition and do some really good studies because the studies are lousy. 90% of them, like you can look at it, you don't even have to be trained in nutrition. You go there, five different variables here and four over here. It's like what you would call a bad experiment.
So, olive oil, the data are great. It's impressive. And then starches are great for fueling muscles and glycogen and brain, but you don't want to overdo them. And the way that people tend to overdo starches is by eating starches combined with a lot of fats. So, sourdough bread is great. Sourdough bread with butter is even better if you ask me. Sourdough bread with equal amounts of butter and bread, you're starting to get into problems. It's very hard for people to go from like to overeat starches unless they have a lot of fats with them or sugar with them.
On starches, is there an impact? I think I've heard you talk about an impact on your sleep with what you eat late at night.
Many people who don't eat enough starches find that they have sleep issues. And there are reasons for this because we talk about comfort foods. Typically, people think junk foods when they think comfort foods, but foods that increase glucose lower cortisol. Hm, that's weird. Starches lower cortisol, and you want your cortisol low at night. Helps you fall and stay asleep. Now, you don't want to eat too close to bedtime. You also don't want to have gnawing hunger at bedtime. We talked about that. But here's the interesting thing. What is cortisol? We, I should have mentioned this earlier. What is cortisol? Is it a stress hormone? No. It's a hormone that's released during stress. But cortisol's job is not to deal with stress. Cortisol's job is to mobilize energy in the body.
When cortisol goes up, glucose is mobilized and other fuels too. So when you eat starches, you buffer cortisol. There's a very clear relationship here. So people who are not eating enough starches who then allow themselves that bowl of rice or a bowl of pasta in their final meal of the day, or a little bit at lunch and at dinner, maybe even a bowl of oatmeal at breakfast, they feel more even psychologically. They have more physical energy. Sometimes people with chronic stress issues notice they stop shaking. People with autoimmune issues sometimes resolve those because your cortisol is buffered, because your blood glucose is elevated and so your body isn't tapping into the survival system to try and mobilize glucose.
So I have this outstanding question that I have to ask you. It goes back to the picture that you drew of the graph. Where is that? You said high cortisol in the morning is a good thing. Yep. So, what if I pick up my phone first thing in the morning and I look at my worst emails? In some sense, from the perspective of spiking your cortisol? Like, it's a good thing, but can you do it outside while getting sunlight? I was wondering if it matters like how the cortisol comes because what if I stress myself out in the morning?
It really doesn't matter. The problem is the rumination that comes with stress, right? So, you know, the nice thing about physical stressors that we control, like a workout or a cold plunge, is that they have an onset and an offset. And yes, they start faster than they end, right? You have stress and it kind of carries over, you ruminate. But psychological stressors tend to bang around in our brain a lot and late at night and they tend to come back. I will say this, I think 2027 is going to be the year that we close the coffin on this cortisol is bad thing.
So, how should I think about cortisol? Because right now I think of it as the stress hormone.
It's to mobilize energy, okay? So, you can use it, okay? And if you're going to sleep at night, you don't need to mobilize energy so you can use it. You need to rest and reset your body, okay? Cortisol is an energy-promoting hormone.
So, if I walk up on stage, my cortisol level, like before I go up on stage and there's a big audience, whatever, my cortisol level is going to go up then.
Yeah. If you're stressed about it, maybe a little bit more, but it's, it's, it's a preparation hormone. You're preparing for adversity but also great things. There are these beautiful studies from a guy named James McGaugh and Larry Cahill which showed, do you know that if you want somebody to learn something, you know what you do? You spike their cortisol before, during, or after that thing should work. Why not? Trauma does that and you never forget. All you do is work on trying to remove the emotional load of that traumatic thing.
Wait, so if, does that mean that someone who's listening to this podcast right now in the gym is going to have better knowledge recall of what we talked about than someone who's listening in bed?
Great question. So I have a chapter that's all about learning, motivation, and plasticity. And we've all heard exercise makes your brain better. How? Why? Turns out it's very important to understand there are two ways it does it, or at least two. One is it raises your levels of arousal. Exercise doesn't make you smarter. Exercise makes you more alert coming out of the exercise so you can go learn things because turns out you have to be alert to learn things. In particular, you need adrenaline and cortisol elevated to learn things. So when people say, you know, weightlifting is good for your brain, cardio is good for your brain, turns out long slow cardio, my endurance friends aren't going to like this, not that great for your brain. It's not bad for your brain, but it's not that great for your brain. Turns out an intense weightlifting session or high-intensity interval training session in the 4 hours after that, you are primed for learning. Why? You got a lot of stimulatory molecules in your body and you can focus better.
What about if I'm a podcaster and I want to be able to ask good questions and use my mouth and my brain in that context, not necessarily just learning but performance of my sort of cognition?
So the performance curve basically is inverted U. If you're not alert enough, you can't do what you need to do. If you're too alert, you can't do what you need to do or learn. So you want to be at the top of that inverted U. And a lot of what learning is about and a lot of what the anterior midcingulate cortex is about is getting from 'I don't want to do it' up to the top of that U. Then it's usually about not getting too stressed. Now I learned the best trick for this, like the two best tricks, and in fact that will take us to number five, you can use any time of day, which is use physiological sighs to reduce stress fast. Okay, so I have a chapter on stress mitigation and it's got essentially two components. One is how to limit stress in the moment. Okay, very, very important to know how to limit stress in the moment. And here, why is it so important? Oh gosh. Because meditation, great night's sleep, massage, social relations, being well-fed, hydrated, all of that helps you buffer stress. But when something happens and your heart rate is too high or you're shaking, and you can't organize your thoughts in the way you want, none of that helps. You've gone over the line, you're too far on the arousal spectrum towards alert.
And it was about 2016 that I realized I'm going to take a significant portion of my lab and work on this problem. I want to find real-time tools for mitigating stress. So I started hanging around with people from special operations who sit in ice baths and cold water, and they don't actually do ice baths, by the way, in the SEAL teams. They spend a lot of time in cold water during their training. And I started talking to people in performance fields, in particular neurosurgeons, people who deal with life or death circumstances for many, many years and maintain immense calm. One of my closest childhood friends, he's, you should have him on this podcast. His name is Dr. Eddie Chang and he's a neurosurgeon at UCSF. He's the chair of neurosurgery and he's brought people out of locked-in syndrome to speak through AI. He's also a bioengineer. He's also been my friend since we were 7 years old and we talk three times a week these days about science. And I've actually visited his laboratory and got to see him take a golf ball-sized tumor out of a guy's forebrain while the guy was awake. Wow. Eddie is the calmest guy you'll ever meet. Why? Because a movement of less than a millimeter in the wrong direction for him could cost a patient's life. People have ways to calm down in real time.
So I teamed up with a colleague, his name is David Spiegel. He's our, at that time he was our associate chair of psychiatry and he studies hypnosis, but clinical hypnosis for smoking cessation, pain management, and anxiety. And I should say mainly Melisse Yil Balban in my lab did a study. She built this stress lab with VR and stress and that's a whole other thing. And then we did this study where about a hundred or so subjects were fitted with trackers that measured heart rate and heart rate variability and sleep. And people were in one of four groups. They either meditated for 5 minutes a day or they did box breathing. Inhale, hold, exhale, hold for 5 minutes. Okay?
Like 4 seconds each or something.
There's a way you can measure it which is the carbon dioxide tolerance test. How well you can control an exhale will tell you a little bit about how stressed you are. When you're stressed, you tend to blow off carbon dioxide very quickly. And when you're less stressed, it tends to shift towards long exhales become easier. So, one of the groups, and then I'll say what the mechanism is, did cyclic hyperventilation. Some people call this Wim Hof breathing, Tummo breathing, pranayama breathing. It's big inhales, passive exhales. Repeat it for five minutes. [snorts] [sighs and gasps] Massively spikes adrenaline, which isn't a bad thing. You're controlling it anyway. Does not spike cortisol very much, incidentally. And when you do those exhales, you're blowing off a lot of carbon dioxide. So, it shifts your internal state and tends to make people very alert.
Or there was a fourth condition where they did a double inhale, long exhale, repeat, the so-called physiological sigh. So Jack Feldman at UCLA and some other folks in the 1930s had observed that animals and people when they're very relaxed would do this kind of strange pattern of breathing where they would go [sighs] [gasps and snorts]. It's a double inhale, long exhale. Jack's lab discovers there's a brain area called the parafacial nucleus which is specifically there to generate this double inhale-exhale pattern in animals and in humans. Wild. Well, nature doesn't make mistakes like that. Okay. Turns out there are two breathing centers. One is called the pre-Bötzinger complex, named after a bottle of wine. [gasps] Pattern of breathing where you inhale, exhale, what that, you alternate. This other structure, the parafacial nucleus, which we all have, is involved in anytime you double up the inhales or exhales, and it's involved in breathing while you speak or sing or eat.
And it generates these physiological sighs, which it turns out get triggered in environments where there's not enough oxygen, or when you get claustrophobic, or when you get very stressed. Carbon dioxide goes up. Your brain senses that and it triggers the gasp reflex. That double inhale maximally inflates the millions, hundreds of millions of little sacks in the lungs, and then when you exhale you offload the greatest amount of carbon dioxide. So if you just go, you're not offloading as much carbon dioxide. But if you [snorts] [sighs], that second short inhale takes these little sacks in your lungs, which are like balloons at a kid's party, and they're empty but they're fluid-lined on the inside, so there's some surface tension inside them. They're sticking together. So you go, it's the double inhale that opens those up and then you offload the carbon dioxide.
Now that's great. But the real magic of deliberate long exhales is that they slow your heart rate down through a process called respiratory sinus arrhythmia. This is like the most important thing for anyone interested in stress, exercise, sleep, and wellness. Because the wild thing is we have this vagus nerve. Everyone likes to talk about the vagus nerve. It's a massive nerve bundle that collects sensory information and chemical information from the organs of the body and sends it up to the brain. Cool. And it's classified as parasympathetic, calming. But you know what's funny? Neuroscientists, when they want to wake up a person during an experiment, like a neurosurgery experiment, they stimulate the vagus. A treatment for depression is to stimulate the vagus. Guess what that does? Makes people more alert. So it's a mixed nerve. But the really cool part about the vagus is that it's not all ascending.
The 85% of the information is going up from the body through the vagus. But there's another pathway too and it goes down and it goes down to your heart and it controls the slowing of the heart rate when you exhale. Heart rate variability is the slowing of your heart rate when you exhale. You want to increase your HRV, do a few deliberate exhales during the day. People go, 'How do I get my HRV up?' Well, yeah, you do some VO2 max training, right? Like, you know, obviously you do some max heart rate training, some HIIT workouts, etc. You really want to increase your HRV in sleep and while waking, just do some deliberate exhales during the day because that's the parasympathetic, the calming arm of the vagus, pushing down on your heart rate.
And all of the groups I described saw benefits, but it was the people who did these physiological sighs that benefited the most. So then I started exploring, well, how fast does heart rate slow down with physiological sighs? And it turns out you don't need to do it for 5 minutes. You do it once. You just go, okay, you're feeling stressed. You're going on stage. You're waiting for a diagnosis. You're, you don't feel, you feel too alert relative to how you want to feel for whatever reason, good or bad. You're about to get married, right? You whatever. You just [sighs] until your lungs are empty. And it's immediate.
And for me that was immensely gratifying. Yes, because it's fun to publish papers. We published it in Cell Reports Medicine and Melisse gets, let's, the lion's share the credit for that. There were other people on the paper but she did so much hard work from that and analysis. I was so gratified because I'm like, ah, finally, like if I didn't sleep well or if I'm something stressful even though I slept well, I can calm myself down like, like that. I thought real-time tools for stress are what we all need. The interesting thing is that you can also raise your stress threshold and a lot of the stress mitigation chapter is also about how to do that. We need to train for discomfort so that the little things don't feel so big.
This is also important in survival situations, right? You need to be able to think very clearly about what order of operations to take, what direction to escape through. This is not about like setting yourself to tolerate more pain and abuse. This is about the exact opposite. So, this is about safety. This is about self-protection. This is about noticing when you're, when we're alert but calm, we can notice the subtle ripples in people around us. Who needs our attention? Who we really don't like, but we never really realized it. You can notice that stuff.
A lot of people, they wake up at like 2, 3:00 a.m. in the morning, in the middle of the night, and they don't really know why. They don't know how to get back to bed. They start worrying and ruminating.
Very, very common. Yeah. So, what they can use this as a tool in that moment. Definitely 10 long, long deliberate exhales. There's also this really crazy trick that I put in the book has indirect scientific support. You want it, like best way to fall back asleep. You want to hear this crazy, this is so nuts. To fall asleep or to fall back asleep, you need to stop thinking about your body position. Hm. Turns out there's a direct relationship through a, through a few steps, but there's a dedicated circuit, I should say, between your eyes, their movements, and your cerebellum, which is involved in proprioception and balance and a number of other things. We call, we call the cerebellum the mini brain, but it's this, this guy back here. We really get nerdy at these hyperfoliated lobes back here. Foliations are just folds. It's just nerd speak for foldy, bumpy. It's involved in balance. It's involved in learning. It's actually very important for generating and responding to the error signals between what you're trying to do and what you can do. That error signal turns out to be one of the most important things for generating learning, to make errors through genuine attempts, and your cerebellum is critical for that. It's also involved in timing.
So you need to kind of turn off your recognition of your own limbs to fall asleep. How do you do that? You know what works with babies? Walk back and forth at a particular pace. And this was defined in this Japanese study, and have people swing the baby back and forth just gently as they do it and the baby falls asleep. Guess what? Parents figure out the exact cadence with a very small margin of error through trial and error to figure out how to get their kid to sleep. It's like a natural experiment. It's been looked at in the lab. Turns out when you rock back and forth, your eyes move. This is a very, very ancient system that exists in all jawed animals including us that as we move through space, walking, running, swimming, whatever, the world is gliding by what we call optic flow. You would see the world blurry, but you have a compensatory eye movement that unbeknownst to you because of a connection between your eyes and these brainstem areas whose names aren't important right now and your cerebellum creates a visual slip error and your eyes automatically offset that error. So when I go like this, the world seems stable.
And it turns out there's a pattern of eye movement that can shut down the proprioceptive circuits in the cerebellum, make you forget your limb position, and it greatly facilitates the speed at which you fall back asleep. Okay. You're going to close your eyes. Great. You're going to move your eyes slowly to one side underneath your eyelids, then to the other side. Then up, then down. Now you're going to move them counterclockwise in a circle-ish and then clockwise in a circle-ish. And now still with your eyes closed, you're going to kind of point them towards your nostrils. You're not going to cross your eyes and you're going to do a long exhale.
Great. That done two or three times generally has people waking up the next morning and like, wild. What happens? What happened is your proprioceptive circuits are shut down. Now, that's kind of fun to do and you'll see and it costs nothing and it generally works. Some people, if they're really, really stressed, it might not work, but this is what I do if I wake up in the middle of the night. I usually go to the bathroom, get back in bed, do long exhale breathing, and I do that and I wake up the next morning. It really works well. So well, in fact, that there's a company based on work done from two MIT scientists. They have a sleep mask that generates this pattern of eye movements through a little electrode behind the ear. It just like, and it stimulates the extraocular muscles in just the right patterns. And I tried it and you fall right asleep.
No, you know, we monitor REM through like an Eight Sleep or a Whoop or some other device through changes in heart rate and breathing. This is direct monitoring of REM. It's wild. And it can control your, I assume, to induce more REM if you want more REM. There will be a time very soon, like within the next 12 to 14 months, when because of devices like the one they and others are making, when you're going to be able to say, you know what, I want 2 hours of deep sleep. I want 2 hours of REM across a 6-hour night because I can't afford to sleep my full 8. And you will be generating those eye movements during sleep in order to facilitate, not force, but facilitate those patterns of sleep.
I've spent the last decade building and investing in companies. And so often the conversation around marketing budgets follows the exact same pattern. The budget gets approved, but then the results don't come back. And most of the time, the creative pitch and the offer is fine. The problem lies with the audience. Ads reach people who will never buy or refer, nor do they have the power to sign off anything at all. And this is why so much budget gets wasted. LinkedIn Ads, who are a sponsor of this podcast, lets you reach them specifically by job title, seniority, company size, industry, the skills that they have, and much more. You're no longer hoping your ad reaches the right person. Instead, you're defining exactly who sees it. And LinkedIn Ads drives the highest B2B return on ad spend across all major ad networks. Give them a try at linkedin.com/diary. And if you spend $250 on your first campaign, you'll get a $250 credit for your next one just by going to linkedin.com/diary. Keep this to yourself. Terms and conditions apply.
I want to speak to the business owners listening and watching right now. I know what it's like to be personally responsible for every decision. I founded my first company at 21 years old and honestly the pressure can be immense. It's the kind of mental load that takes its toll below the surface. I recently did some tests through our sponsor Function which got me thinking about that invisible impact. I found that I had low levels of omega-3s. I had deficient levels of vitamin D probably because I sit inside this dark room all day and that has totally changed how I construct my day going forward. I get up in the morning and the first thing I now do is I go for a walk outside in the sunshine, in part to help my vitamin D levels increase, but also because it helps to reset my circadian rhythm. With Function, you can check your brain health, your aging, your stress, and so much more. They provide over 160 lab tests for what is equal to a dollar a day and member pricing on advanced imaging. Head to functionhealth.com/doac to join and use code DOAC25 for a $25 credit.
Did I hear you say that there's a peptide that can help your REM sleep?
Yes, I have no affiliation to it because it's called pinealon. I will tell you in the book I do not talk about hormone therapies, peptides or psychedelics. The book is about what I know for sure. Hormones, peptide therapies and psychedelics are at the front edge right now. I'm very much involved in looking at the research, talking to the people that are doing these things. And yes, I dabble in these things, right? I'm very interested. I experiment on myself and I'm an adult. I can do that. So pinealon is very interesting because I found that if I took an itty bitty bit every third night, I tried this experiment for about a month, I got massive amounts of REM sleep that night but also on subsequent nights. I hosted a Dr. Abu Bakri on my podcast who's, in my view, is the most knowledgeable physician on the topic of peptides.
Oh, I saw that episode. It's amazing.
He's amazing and I think you guys would have an even better conversation frankly. But in any event, he tells me that pinealon is potentially involved. There are some data supporting its use for encouraging pineal health. So the actual health of the pineal gland. Yeah. The pineal gland which makes melatonin and it does other things too. So I think pinealon is a great tool to use sporadically. I don't use it regularly.
You know, as long as we're talking about peptides, I do think that there's, I mean I'm peptide curious as you know I'm from the Bay Area, called peptide [laughter] curious. I have not tried any GLPs yet, but I'm getting curious about very, very low dose tirzepatide or retatrutide.
I'm peptide curious, but I'm scared.
Yeah, I'm scared because I don't, you got to inject most of them, right?
It's a tiny little thing, you know.
What's your take on peptides as like a, it's a big category, isn't it? Bloody everything seems to be a peptide these days.
Here's my opinion. It will be popular with some people, unpopular with others. But obviously, as with hormone therapies or anything else or supplements, like sleep, hydration, sunlight, exercises, nutrition, like you need all that stuff. The behavioral tools are the foundation. Great things can happen when you build on a foundation. Okay, things can happen when you build on non-foundation, but it doesn't last long. But the combination of the two can be pretty awesome, especially if somebody has the means and the interest. So the GLPs, which are the weight loss drugs. The weight loss drugs. I think retatrutide is amazing. It's not just a GLP. It also hits the glucagon and GIP pathway. This is the one that Eli Lilly invested hundreds of millions of dollars if not more into researching and it's went through phase three. People lost approximately one-third of their body weight in about a year or so.
Is that a, is that a good thing for everybody?
No. So what's happening is people are, okay, so the psychedelic community talked about microdosing, that microdosing phrase has been now incorporated into GLPs and people realized they could bypass a lot of the side effects and the cost by microdosing GLPs. These are anecdotes so I want to be clear and I'm not pushing peptides or selling peptides. I say quite comfortably. I have a friend who's very, very skeptical about anything that's not fully FDA approved. 'I don't want to hear about your biohacking nonsense,' this kind of thing, but she has chronic fatigue syndrome. And she talked to me about like, what can I do? She's seen all these physicians, mind you, these are physicians at Stanford. These are physicians at UCSF. Like she's, and she's a very smart, nuanced person, but she has a wall there. She started taking a very low, very low dose of tirzepatide once every 10 days.
It's one of the GLP drugs, like so we could talk about Mounjaro, but it's, it's not, it's not touching GIP or glucagon. It's mainly just increasing levels of glucagon-like peptide which is this thing that suppresses hunger and appetite but also seems to lower inflammation. Yes, there are concerns about vision loss in people who have certain structural abnormalities of the eye. Yes, there are concerns about apathy if people take too much of them. You know, it seems to reduce alcohol craving for people that like alcohol and sugar craving more generally. And it can reduce craving for everything if you take enough of it.
Yeah. Keep in mind these drugs are ramping up levels of GLP a thousandfold or more. Thousandfold or more. The body has never seen this level of glucagon-like peptide in the history of humans. And remember this whole thing was discovered because a smart biologist was studying why Gila monsters, these reptiles that I think are ugly, he probably thinks they're beautiful, only have to eat a couple times a year. It's because they make a peptide called exendin, which turned out to be homologous to glucagon-like peptide one in humans. The reason these reptiles don't have to eat very often is because they always feel satiated. Why? Because they have very high levels of glucagon-like peptide circulating. We don't. And it works through two mechanisms. Tells the brain mechanisms for satiety to ramp up their activity. And so your brain is telling you, I don't really want food. And it also makes people feel full, which is the basis of some of the side effects of nausea and other things.
She will tell you, 'Oh my god, my energy's back. My inflammation markers are way lower. I'm not cured, but I feel so much better.' Very, very hard to dispute that kind of experience if you're the patient. We could talk about safety and sourcing and, you know, etc. But anyway, so people are starting to realize they can microdose stuff, but you won't see randomized control trials that are going to push this kind of notion. You can tell it's terrible for business, right?
So then there are things like pinealon for sleep, epalon perhaps for DNA repair. I haven't dabbled with that one yet. And then there are the so-called growth hormone secretagogues. So we're talking about tesamorelin, ipamorelin, CJC-1295. These will promote more growth hormone release and sleep. They will have a negative feedback effect where they're going to shut down some of your own production, and people get a bit leaner and they claim their deep sleep is better and it can increase insulin sensitivity. I'll tell you, I've tried ipamorelin. I've tried a few of these other ones. They nuke my REM sleep. They give me a ton of deep sleep. I don't like them. I've tried pinealon and I'll take it now and again. I don't do it right now. And BPC is the one that gets everybody talking because body protection compound 157 is made in the gut. People claim, and I do think their claims are accurate, that they feel—notice what I said right there—is they feel as if their recovery from injury was accelerated. And I believe them because I've spent a lot of time with the animal data, whether it's an Achilles tendon transaction or nerve regrowth or tendon or ligament regrowth and vascular. Yes, it does seem to accelerate healing across the board. But the concern is you could vascularize tumors. Now, would I take it? No. I don't have an injury right now. I don't have any reason to take it. So I don't think people should say, 'Should I take peptides?' You should ask what effect in your life are you trying to achieve, right? And then maybe BPC makes sense. Maybe it doesn't. You're not going to find many clinical trials on it. It has a very, very high, maybe infinite, you know, LD50, meaning no one has really figured out how much can kill you. But that's not a good kind of way to run your life. And, you know, it's somewhere between a drug and a supplement.
I think this is one of the concerns or one of the conversations I often hear around GLPs at the moment is that they've just not been around long enough for us to know the side effect profile over a long period of time. Is there any truth to that?
Well, do you want to be in the experiment or out of the—you want to be in the control group or you want to be in the experimental group? Well, for somebody who has like serious obesity issues, the tirzepatides and Mounjaros and Ozempics and Wegovy could potentially save their life. Okay. Vision loss is a serious consideration. Although I'll go on record, you know, vision is my home and I'll just be direct. I don't tap dance at all and I'm not trying to start any battles and David and I can talk about it directly. David Sinclair recently went on Rogan and said, you know, the amount of blindness caused by GLPs has doubled, which scared everybody.
But there's a structural abnormality in the eye of a subset of people for whom that's true. And it's a great idea to get your eyes scanned. But yeah, so as the eye comes apart.
Oh man, this is fun. It's a good thing I only come on here every once in a while because I do this—I'll do this all day, every day. So, you know, light obviously comes in. And you got that cornea on the outside of the eye and the lens focuses the light onto your retina, which is this pie-crust-like structure that lines the back of your eyes. It's an amazing structure, you know, three cell layers thick, catches light, absorbs light. The photoreceptors turn that into electricity through phototransduction. Amazing. Then that electricity is cast forward to a set of cells that line the inner part of the retina that we call retinal ganglion cells. And then they send their wires, their so-called axons, out the optic nerve into your brain. They course along the bottom of the brain and they enter your brain, including your circadian clock. You get vision. You get sleep-wake rhythms. You get hormone regulation by light. It's just incredible. Well, where they exit the eye is called the optic nerve head. And if the optic nerve head is a nicely shaped and sized tube for them to exit, great. Too big, that's not good. But too tight's not good either because those wires get pinched off. This is part of what happens in the disease glaucoma, which is the eye pressure goes up and those axons die away. These cells die away and people—it's the second leading cause of blindness in the world. So in some people who have a structural abnormality, a structural feature of the optic nerve head here where these wires leave the eye, it does seem that the GLPs put them at greater risk for causing some cinching off of those cells and there have been cases of blindness. But the thing that wasn't really cool, David, is this. He is developing some very potentially impressive tools to rescue vision in glaucoma, etc. But meanwhile, GLPs are not making many people go blind. Okay? You know, that's about as true as masturbation is making people go blind. I'm not saying you should do either one. That's your personal choice. But the point here is that he scared the daylights out of people, pun intended, telling them that they can make you go blind. But everyone should get this area of their eye imaged. And it turns out it's very easy. You can go to your ophthalmologist or optometrist, ask for an eye pressure test. Usually insurance covers it, but definitely worth paying for.
We got into peptides. Yeah.
Yeah, we've done a question.
Good thing we're not talking about psychedelics. We'll do that another time.
We won't do them another time. Um, I don't do psychedelics publicly.
Listen, I'm open-minded. I did DMT. I didn't care.
Not as open-minded as you'd be if we do psychedelics. No.
Uh, you took DMT in a faraway land where it was very legal, because, you know, I sit here and talk about these things and psychedelics. I actually did work in a psychedelics company for about a year, but it was deeply, deeply fascinating and the reason I was compelled by it is the efficacy as it relates to mental health and the studies being done out of London around things like, you know, psilocybin and ayahuasca and DMT treatments. And I just thought, wow, you know, it's unbelievable some of the clinical data. I'd love to learn more. So I did a—yeah, psilocybin and then I did DMT and it was really just—
No, no. I've done clinical MDMA and psilocybin. I think I'm done with that. Not because I had a negative experience, but I got what I wanted out of it. And I found it to be immensely beneficial.
The combination of therapy going in, therapy during, and therapy coming out of a combination MDMA—
