Today we return to the topic of detoxification. A simple and universal lever everyone can use in the quest for better health, detoxification is a worthwhile endeavor whether you suffer from a chronic disease or are an athlete seeking to gain a performance edge. Previously on The Quantified Body, we looked specifically at toxicity issues surrounding mercury and lead and today we are going to look more broadly at other metal toxins and chemical toxins which are all around us in our everyday lives. We’re going to look at testing methods and discuss several case studies that reveal the types of impacts toxins can have on your health.

We covered Mercury and Lead detoxification in past episodes – you can see all ‘detoxification episodes’ here.

“Let me scream this from the rooftops. We all have a toxic burden. Period. We all do. We’ve all been exposed to toxins.”
– Kara Fitzgerald, ND

Today’s guest is Kara Fitzgerald. Dr. Fitzgerald received her doctorate of naturopathic medicine from National College of Naturopathic Medicine in Portland, Oregon. She is the lead author and editor of Case Studies in Integrative and Functional Medicine and contributing author to Laboratory Evaluations for Integrative and Functional Medicine and the Institute for Functional Medicine’s updated Textbook for Functional Medicine.

She is also on the faculty at the Institute for Functional Medicine. She previously held a position in nutritional biochemistry and laboratory science at Metametrix, one of the big functional medicine clinical testing laboratories, now merged with Genova. Currently she maintains a private practice in Connecticut.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • Dr. Fitzgerald discusses her perspective on the distinction between integrative medicine and functional medicine (5:20).
  • Where detoxification currently falls within the spectrum of functional, conventional and integrative medicine and Dr. Fitzgerald’s basic approach to addressing toxic burden in patients (8:34).
  • Typical signs and symptoms of toxicity (11:30).
  • The connection between toxins, oxidative stress and toxicity symptoms (13:37).
  • How and why toxins accumulate in the body (15:20).
  • How lab results differ between a healthy person with acute toxic exposure and a chronically ill person with detoxing difficulties (16:20).
  • Genetic mutations that contribute to poor detoxing ability (18:39).
  • Dr. Fitzgerald discusses diet as the foundational work and the most important first step for any detoxification program (22:20).
  • Water filtration: charcoal vs. reverse osmosis (26:05).
  • Discussion of lead exposure and toxic metal detection (27:35).
  • Chelation challenge with oral DMSA, n-acetylcysteine or glycine (34:16).
  • Importance of establishing adequate nutrient status prior to beginning detoxification therapy (35:53).
  • Specific detoxifying nutrient minerals to focus on: selenium, magnesium, zinc, calcium, chromium, vanadium (38:10).
  • Preventing disease and optimizing athletic performance through nutrient testing (41:20).
  • Relative binding affinities of DMSA and other chelating agents (46:50).
  • Standardization of laboratory measurements: chelated vs. non-chelated ranges (49:20).
  • Testing for volatile organic compounds (VOCs), PCBs, pesticides and other chemical exposures (50:35).
  • How your  life history can reveal important clues to toxic exposures (53:40).
  • Weight loss as a detoxification strategy (57:35).
  • Kara Fitzgerald tracks the status of all of her nutrients, her toxin levels and mitochondrial function on a yearly basis to monitor and improve her health, longevity and performance.

Thank Kara Fitzgerald on Twitter for this interview.
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Kara Fitzgerald

Tools & Tactics

Treatments

  • Charcoal Water Filters: Remove impurities without demineralizing water, as occurs with reverse osmosis type filters. Dr. Fitzgerald recommends Multipure Damien mentions that he uses Berkey Filters.
  • DMSA (Dimercaptosuccinic acid): An organic molecule that contains four sulphur groups – active sites that bind to toxins and remove them from the body. The presence of multiple binding sites makes DMSA a strong chelating agent by comparison to other compounds, such as n-acetylcysteine, that have fewer binding sites. DMSA can be ordered through a physician.
  • EDTA (Ethylenediaminetetraacetic acid): A strong chelating agent mentioned by Dr. Fitzgerald as being a good detoxifier for lead. Dr. Fitzgerald mentions that EDTA is most effective when administered intravenously, which can be done at a medical facility. EDTA is also available as an oral supplement.

Supplements

  • Selenium: A trace mineral important for production of antioxidant enzymes. Selenium also helps convert thyroid hormone to its active form. Found in small quantities in a wide range of plant foods as well as fish, shellfish and animals fed selenium-containing grains. Selenium has an affinity for mercury and is used in mercury detoxification protocol. Dr. Fitzgerald considers selenium to be one of the three most important detoxifying minerals and one she often uses as a standalone nutrient for detoxification.
  • Magnesium : A nutrient mineral found in green leafy vegetables, nuts, seeds and legumes. Important for bone health, energy production, nervous system function, blood sugar control and reducing inflammation. Dr. Fitzgerald considers magnesium to be one of the three most important detoxifying minerals and one she often uses as standalone nutrient for detoxification. Magnesium is discussed in greater detail in Episode 17 with Dr. Carolyn Dean.
  • Zinc: Dr. Fitzgerald considers zinc to be one of the three most important detoxifying minerals and one she often uses as a standalone nutrient for detoxification.
  • Calcium: Insufficient quantities in the diet can lead to toxic metals gaining entry into the body by attaching to transport proteins intended for calcium. Adequate calcium levels can outcompete toxic metals and prevent them from being absorbed. Dr. Fitzgerald mentions calcium as a second-tier detoxifying agent and discusses the importance of adequate dietary sources, with additional supplementation, as needed.
  • Chromium: Dr. Fitzgerald mentions chromium as a second-tier detoxifying agent.
  • Vanadium: Dr. Fitzgerald mentions vanadium as a second-tier detoxifying agent.
  • Molybdenum: Dr. Fitzgerald recommends molybdenum as a second-tier detoxifying agent best obtained through a multi-mineral supplement.
  • Greens Powder: Mentioned by Damien as a whole food source of essential minerals he has used for detoxification. There are many brands with varying levels of quality and breadth of foods combined, he uses a HealthForce brand one.
  • N-acetylcysteine: A precursor to glutathione, the body’s primary antioxidant enzyme. Dr. Fitzgerald uses n-acetylcysteine as an alternative metal chelating agent for individuals who are too sensitive to tolerate DMSA.
  • Glycine: An amino acid that also functions as a brain neurotransmitter. Dr. Fitzgerald mentions it as an alternative metal chelating agent for individuals who are too sensitive to tolerate DMSA.

Diet and Nutrition

  • Brassica vegetables: Mentioned by Dr. Fitzgerald as part of the detox protocol used to reduce PCB levels in one of her research colleagues who had been consuming large quantities of farm-raised salmon, which are known to contain high quantities of PCBs. Broccoli, kale, cabbage, collard greens and mustard greens are a few of the many brassica vegetables. All brassicas contain compounds known as sulfuraphanes and indoles that boost the body’s detoxifying abilities.

Tracking

Biomarkers

Note: The benchmark levels in ppb below are taken from the lab test Kara Fitzgerald recommends for testing whole blood metals at GDX.

  • Whole Blood Mercury – Toxic metal obtained through mercury amalgam dental fillings, fish consumption, vaccines and some older paints. Toxic to the nervous system, heart, lungs, kidneys and immune system. Dr. Fitzgerald references a case of mercury toxicity in a health-conscious patient who was eating an organic diet but had been consuming sea bass on a daily basis for some time. Levels should ideally be below 4.3 parts per billion (ppb) in whole blood.
  • Whole Blood Lead – Toxic metal obtained through exposure to lead based paints (prior to 1978), old plumbing (prior to 1930). Neurotoxin associated with poor brain development in children, memory loss, peripheral neuropathy (numbness and tingling in the extremities), fatigue, elevated blood pressure, kidney dysfunction. Accumulates in bone tissue. Levels should ideally be below 18 ppb in whole blood.
  • Whole Blood Cadmium – Toxic metal used in production of batteries, pigments and metal platings. Fish in areas where cadmium-containing products are manufactured contain high levels. Tobacco leaves accumulate high levels of cadmium from soil. Cadmium displaces calcium from bone tissue. Long-term exposure weakens bones and causes kidney and lung damage. Levels should ideally be below 0.60 ppb in whole blood.
  • Whole Blood Arsenic – Toxic metal found naturally in high quantities in drinking water in certain geographical locations including some areas of India and China. Mining activities, coal burning and the use of geothermal power increase exposure. Arsenic is also a component of some pesticides. Chronic arsenic toxicity causes peripheral neuropathy, weakness in the hands and feet, headache and confusion. Levels should ideally be below 5.1 ppb in whole blood.

Lab Tests, Devices and Apps

  • Whole Blood Metals: Fundamental screening tool for toxicity that Dr. Fitzgerald uses in her practice to measure current exposures to mercury, lead, cadmium and arsenic. The whole blood toxic metal test offered by Genova also evaluates aluminum. Genova’s laboratory reference ranges for toxic metals can be found here.
  • Lead Swabbing Kit: Use to swab household items such as ceramic dishes to determine the presence of lead.
  • Toxic metal chelation challenge: Measures total body burden of toxic metals. Person consumes a substance that chelates (binds) heavy metals, such as DMSA, and exports them through the urine.
  • Toxic Effects Core Profile: The broad spectrum chemical toxins screening panel that Kara recommends. Measures levels of a variety of industrial and agricultural chemical toxins in the blood and urine including PCB (Polychlorinated biphenyls), chlorinated pesticides and volatile solvents.

Other People, Books & Resources

People

  • Aubrey de Grey: biomedical gerontologist and Chief Science Officer of SENS Research Foundation a non-profit organization dedicated to combating the aging process. Mentioned by Damien in regards to his research showing how oxidative stress accelerates the aging process. Listen to Damien’s interview with Dr. de Grey here.

Organizations

Other

  • Doctor’s Data: The lab Dr. Fitzgerald mentioned in addition to Genova that offers a range of toxic element testing.

Full Interview Transcript

Click Here to Read Transcript

[Damien Blenkinsopp] : Kara, thank you so much for joining us on the podcast today.

[Dr. Kara Fitzgerald] : Well, thank you for having me. It’s great to be here and I’ve just enjoyed talking to you for the last ten minutes about all things toxicity. So I look forward to jumping in and talking to your audience.

[Damien Blenkinsopp] : Absolutely. Yea, I don’t know if it’s a passion of yours. It’s been a little bit of a passion of mine. Toxins and everything. I heard you on a detox summit and it was a great interview you did there. It was one of the better ones on toxicity. That’s why I reached out to you. It would be great to have a discussion with you about it. So, how did you first connect with the topic of toxicity? Where did it come around for you? Is it something you came across in your practice a lot? How did that whole interest start for you?

[Dr. Kara Fitzgerald] : That’s a good question, Damien. I did my post-doctorate training at Metametrixs Clinical Lab in Atlanta Georgia. Metametrixs was later, not too long ago, it was purchased by Genova. If you are familiar with Genova, they’re running Metametrixs suite of testing. Metametrixs, it was studying the toxins from a laboratory perspective; and also being part of the medical education team. Not only lecturing, but speaking. Doing consultations with doctors all of the time about the toxic burden. Incidentally, I was also in my clinical practice, and have been all along, so using it in practice. But, I came into the study of toxins from opposed to stuck in a lab.

[Damien Blenkinsopp] : Great, great. In your practice, is this something that you come across quite often? You’re in integrative medicine. I should just take a step back a little bit. We haven’t really talked about integrative medicine. We had Jeffery Bland talking about what functional medicine is. What is integrative medicine in comparison?

[Dr. Kara Fitzgerald] Another really good question. It’s always important to define terms. I imagine you could ask twenty of us who say that we’re integrative or functional and you’ll get little variations of definitions. So, integrative is sort of an over-arching definition that I think acknowledges the value in all forms of medicine. I am trained as a naturopathic physician. We do indeed prescribe medication when it’s indicated, but my core training is in taking a natural approach. As we used to say, removing the obstacles of cure. Working in foundational wellness and health and healing and nutrients and so forth. And then, if medications are indicated, you step in. Or if surgery is indicated, you step in. An integrative approach really quite simply; is acknowledging the value and when to use all of these systems of medicine that we have. A traditional or a conventional western approach, a traditional naturopathic approach. You can pull in paradata. You can pull in traditional Chinese medicine. As you are trained, and as it’s indicated with a given patient. That’s integrative medicine. Now, within that, is functional medicine. For me, functional medicine is a way for us to practice systems medicine. Most functional medicine practitioners would say that they’re integrative. That’s the larger picture. And then, you drill down into particular approaches. For me, functional medicine is a model of being able to practice systems. It’s a way of data capturing, of analyzing the patient that enables us to step back. Actually, Dr. Bland, Jeff Bland, has said “from telescope to microscopes”. You want to look at the being and their environment and then you want to drill down to the molecular level. That’s an incredibly careful and detailed history. To actually be able to capture that, you need a good structure. So, the institute of functional medicine has the matrix and this is a fabulous tool that you use in your chart note. The matrix for capturing systems medicine. Of course, actually; let me go over here and tack on to that what Jeff Bland said. Obviously, you are looking at the being and function and you’re correcting those imbalances. You’re correcting the dysfunction to restore wellness.

[Damien Blenkinsopp] : Basically, you come from two schools. The traditional medicine schools that we know is hospitals and so on, and you’ve also studied the functional medicine and some of our naturopathic and alternative sides as well. You just try to use whichever tool you think is relative to the situation. That sounds like the best of all worlds. Sounds like the best approach. I would say that’s really the kind of approach we like to get covered on here. Where it’s just taking whatever works and whatever context without any allegiance whatever to any. There’s a little bit of politics and fan stuff going on as always does go on in health. There’s all these different modalities which fit different situations. It sounds really like the best of all worlds. In terms of toxicity, when you’re addressing that, is it more on a functional medicine side? Or would you find a bit of a mix of everything?

[Dr. Kara Fitzgerald] :Addressing toxicity. What do you mean from a functional perspective?

[Damien Blenkinsopp] : What I’m just trying to understand how you approach the whole thing. For instance, when a patient walks into your practice, and you typically decide that there’s some element of toxicity involved in their problems. Where would that come from? Would that come from one discipline or is it like a bit from everywhere?

[Dr. Kara Fitzgerald] :Well, I would say that, conventional medicine. The conventional western model, doesn’t acknowledge the influence of toxins in the disease process. Sufficiently, yet. The data are completely irrefutable, so there’s some movement towards that. It would be as a functional medicine doctor. Baseline, anybody walking into my office has a toxic burden. That has been well established. Anyone coming in to my practice, I know, has a toxic burden. That toxins are influencing the course of disease that they’re presenting with. Most of the individuals that come to see me in my practice have something complex and chronic. I know that toxins are playing a part of that, but the question becomes, for me, as the clinician, in my analysis. My detailed analysis of the patient. Both history and lab, is to what extent are toxins influencing this person’s disease process. Therefore, in terms of our treatment, how immediately and how aggressively are we going to address them? Always a toxic burden, always influencing the course of disease. In fact, when you restore it. When you take a functional, sort of a systems approach, to treating somebody. You take care of their diet and you make sure their nutrients are appropriate. Those extremely fundamental steps are helping release the toxic burden. Toxins are always addressed in my practice. All of those foundational things are addressing the toxic load that we all have. But then, the second piece becomes, once we go in there and do that foundational assessment and treatment. Do we need to then, chelate… move into a more aggressive detox protocol? Do further laboratory evaluations and so forth. For all of the folks who come to see me, incidentally Damien, I do assess, as I talked about on the detox summit. Everybody, I look at whole blood metals and it’s a screening tool.

[Damien Blenkinsopp] : So you do that test with everyone who comes into your practice?

[Dr. Kara Fitzgerald] : Yea. I sure do. I’m always screening for stuff. You know that whole bloods are reflective of current exposure; going on in their life now. But it’s a screening tool. Then, we’ll go on and do further assessment as I deem appropriate from taking the history.

[Damien Blenkinsopp] : So, that’s kind of your baseline. Okay, great. You are saying basically this applies to people of chronic, complex conditions which you tend to treat. Would you say that there’s other people who should think of this also? I’m thinking how far should it go? Like if someone’s athletic performance isn’t as good. Or if their mental performance isn’t as good. Or if they’re just someone normally who’s a bit tired these days, but it’s not, they haven’t classified themselves as actually ill yet. Or, are not going to see doctors about it, but they just don’t feel in top form and are not doing so well in general. Are these the types of symptoms or are there specific symptoms that anyone who doesn’t feel like they’re in a chronic condition yet should look at? As a pointer that this may be something that they should look at.

[Dr. Kara Fitzgerald] : Yea. Absolutely. Let me underline it. Let me scream this from the rooftops. We all have a toxic burden. Period. We all do. We’ve all been exposed to toxin. We’ll have an influence in the course of our wellness. We want to consider them. Now, in my practice, most of the individuals who see me happen to have complex chronic disease. That’s just, that’s my training. That’s who I work with.

[Damien Blenkinsopp] : Right, right.

[Dr. Kara Fitzgerald] : Those individuals, absolutely have a toxic burden. We all do, and there are steps that we all need to take to ensure that we minimize our toxin exposures. As well as our body’s ability to detox. I would say an emphatic yes. To optimize athletic performance you would absolutely want to consider the toxic burden. Or to a little bit of brain fog. So, going back to your question to me. What are some typical signs and symptoms you might see? Certainly, fatigue. Actually, fatigue would be a piece of the puzzle. Brain fog is a pretty classic first type of sign. Allergic disease. When you look at the literature on the impact of toxins, you will see allergies screaming. A lot of the organo- toxins- BPAs, phthalates, parabens, etc., etc. A lot of those, the first reaction is some sort of allergic reaction. That’s because the body wants it out. You’re exposed to something toxic, you sneeze. Or you develop a rash. It’s this reactive response to some bad thing trying to come in.

[Damien Blenkinsopp] : You are saying. Would that be like rashes, would that be some tiredness responses to foods? Could it also be like sneezing, like hay fever kind of things?

[Dr. Kara Fitzgerald] : Yes. Yes, yes, yes, and yes. They’re broad, and generally speaking, they’re non-specific. Endocrine disruption is another potential reaction. Hypothyroidism, hormonal irregularities. Estrogen dominance and so forth. All of these things can be influenced by toxins. Really almost any symptom can have a toxic burden. This is because when you drill down to the molecular level. When you look at what toxins are actually doing in the body at the molecular level. One of the fundamental lesions is increased oxidized stress. You are causing that fundamental imbalance in the mitochondria. In tissue. Towards different tissue. They’re just doing this fundamental damage process. But, depending on the type of toxin, you can get some idea of symptoms. But, they’re still broad, Damien. I hope that I’m making sense.

[Damien Blenkinsopp] : Yea. It’s still an area we’re investigating and exploring. One of the ways I look at it, is like, these are basically molecules. The only reasons they’re toxins is because they are unnatural to our body. Our body’s made up of certain types of molecules and atoms. These come into the body and just because of the way chemistry is. Biochemistry is, they connect with, they disrupt, and they change in some cases, how things are working in our body. Because instead of selenium we have some other toxin which is binding to something in our body which it shouldn’t be. It’s kind of like distorting how our bodies are supposed to work. Therefore, they start to work in different ways. Which means we get some kind of symptoms we’re not used to. Which you’ve referred to many. Is that a fair way to explain it?

[Dr. Kara Fitzgerald] : I think that, yea, absolutely. That’s nice. That’s a really nice snapshot that’s easily digestible. Yes. What’s interesting, just leaping off of that, is the idea of polycarbonate biphenyls, or PCBs. Talking about an unnatural compound. Something that the body doesn’t recognize. Often times, we store these compounds in our fat. We want to get them out, and PCBs, certain metals and so forth; the body is smart enough to say I don’t know what this does. I’m getting it out of here. The safest place to dump it is in the fat. You’ll see it accumulate there. The half-life, the time these toxins can stay around in the body, it moves into the decades and decades. Because, our body isn’t equipped. We didn’t evolve with these exposures. They are synthetic, as you said. They’re man made. We sequester them, and they stick around, which is a drag. Which is unfortunate. Which is why we would like to minimize our exposure.

[Damien Blenkinsopp] : That’s great. I’d just be interested; have you tested yourself? Have you run these whole blood, for instance, screens on yourself? Or other people which are more normal and haven’t come into your practice at a chronic disease level? In comparison, how do they compare to the chronically ill? Are toxin levels lower, or how does it look in your profile versus someone else’s?

[Dr. Kara Fitzgerald] : That’s a great question. It depends on what we’re looking at. For instance, if you have a water soluble toxin that our body can get rid of. You might see periodic high levels in an individual. Say that you just purchased a carpet. That carpet is off gassing petroleum derivative molecules that your body can eliminate. You might measure some of those compounds and you’ll see a lot of them in your urine. Then, you step away from the carpet. Your body turns it over pretty quickly if you have good detoxification systems, and you will see them normalize. You can see that in a healthy individual. One of the signs of that, we all have these toxic burdens. In a healthy individual, they’re able to detox and remove and get on with their life. They might notice when they’re in the carpet off-gassing. When they’ve got a little bit of a runny nose. Or maybe a slight headache or a cough. Some of the signs. But then they get out, they deal, life goes on and they are no longer bothered. In the toxic person, yeah, you could absolutely see higher levels. In the person with the complex chronic condition. Part of this is that their body isn’t able to get rid of them so well. They just might have detoxing difficulties. Be it phase one, the first step in detox or phase two. For myriad of reasons, we can have challenge. Maybe we don’t have adequate nutrients to detox. Glutathione, I’m sure you’ve talked to your folks about it before, is really one of the major players in our ability to detox. We actually waste it. I shouldn’t say waste it. We don’t recycle glutathione when we use it to detox. In that complex chronic disease patient with a large accumulation of toxins, they may have spent the glutathione and they have not adequately replenished it yet. Glutathione comes from three different amino acids in the body. That’s how we are able to make it. But, if you’re chronically detoxing, or attempting to detox, you could run out of glutathione. One mole of glutathione detoxes one mole of toxin, be it mercury, or be it any number of different organic toxins. We also can have mutations in our ability to detox. We can have genetic mutations that might slow us down. Make us vulnerable to accumulation of certain toxins. We see that in complex chronic patients as well. In those cases, we make choose to look at those genetic mutations. When we find them, we really want to support those particular areas all the more aggressively. A lot of people have mutations in the glutathione s-transferase enzymes. The glutathione s-transferase enzymes are, as you can imagine, as the name implies. They’re major players in our ability to detox across the body. Not just in the liver, but in the skin,(and) in the kidneys, (and) in the gut, (and) in the brain. We can have mutation in these enzymes and therefore, when we see it in our patients. When we know they have a toxic burden. We need to get in there and really support it.

[Damien Blenkinsopp]: You’ve outlined many different ways in which our detox system may not be able to cope with the flood of toxins we are getting these days from many different synthetic sources. Carpets and heavy metals and so on. Is this something, I guess something I just want the audience to understand, is: Are issues with your detox system pretty rare? When we talk about mutations, sometimes, genetic mutations. It sounds like it could be something rare. One in a hundred, or one in a thousand? But my understanding is that a lot of these mutations today are relatively common. It’s a bit like the MTHFR, which is extremely common these days. There’s a lot of these mutations and just differences in our make-up which mean that maybe we’re not, we haven’t got a super powered detox system which is really working really, really efficiently in terms of chemical processes. It slows it down a bit, and then when you combine that with the fact that we have a lot of toxins around us today, it seems relatively common that they can crop up for some people. That this is hampering them in some way.

[Dr. Kara Fitzgerald] : Yea, yep you got it. You asked me about the incidents of mutations in our detox system. Are they common, you asked me? Yea, they sure are. We have somewhere in the order of four million single nucleotide polymorphisms. These mutations that you and I are taking about. These single base para switches, like MTHFR, is the most famous of those. We have somewhere in the order of four million. We have tons of them. Loads of them. Many of those aren’t significant. We have backup systems. There’s a lot of redundancy built into the body. We do have backup systems. So, a lot of those aren’t going to be particularly relevant to us and to disease process. But there are also many that are. So, yea, I would say that all of us, we have some mutations in our ability to detox. The question is, what hand of cards were we dealt? How big of a deal is that playing in our disease process? I do look at detox snips in a lot of my patients. It may not be the first thing I look at. It depends on what someone presents with. I do end up looking at them frequently. The glutathione s- transferase system. It’s huge. We have many of them. In different types and in different tissue locations. When you see one, it’s not the end of the world. Yes, we do want to support it, of course. But, it’s when you see multiple or when you see patterns. MTHFR is a big player in detox as well. Indirectly, but significantly. It’s going to help us make the glutathione that we need for the glutathione s-transferase. It’s a big, MTHFR is a fundamental player in methylation. We detox with methylation also. Everything is interconnected and a nice broad snapshot of what are the genetic issues, and how many and then go back to whether or not you think it’s playing a role in whatever the individual is presenting with. There’s a lot of angles we need to look at here, to guide us in our treatments. I want to step out for just a second. So, as not to overwhelm the listener. Really, the very first thing that we can do, Damien. The very first thing. You know, this, I know this and use this in my practice, is investigate what’s going on in current time, and we expose your sources. Any patient coming into my practice will have a meeting with my nutritionist on clean living, clean eating, clean living in the home and so forth. Lowering the toxic burden is huge.

[Damien Blenkinsopp] : Right. This sounds like your foundational work, that you said you did at first. What are the biggest things that you do there, that you feel are important to clear the way.

[Dr. Kara Fitzgerald] : Far and away, the biggest thing we can do is clean up our diet and go as organic as much as possible. I would argue, I would say, that most urgently, we want to look at clean fat sources. Organic butters, organic milks, organic meats, etc. They really almost as important would be looking at organic vegetables and fruits and so forth. Going as organic as you possibly can, using the dirty dozen from the environmental working group as our baseline. At lease achieve the dirty dozen. If you can’t eat organic versions of those, like apples.

[Damien Blenkinsopp] : This dirty dozen are the ones with the highest levels of pesticides and are there other chemicals involved in those dirty dozen? Is it primarily pesticides? And in many forms, in neurotoxins and different ones?

[Dr. Kara Fitzgerald] : Primarily, we are looking at pesticides and their many forms. We could move into discussing, that’s what the environmental working group is testing anyway. They’re looking at pesticides. We could then talk about metals, we could talk about genetic modification, but that would bring us into tomorrow. We would be talking…

[Damien Blenkinsopp] : Exactly.

[Dr. Kara Fitzgerald] : If we go organic, Damien. If we go organic as much as possible, we’re going to bypass all of these toxin issues. To the best of our ability. That’s the foundational. That’s the entry point.

[Damien Blenkinsopp] : I guess, because some people are concerned about cost of organics, so I’m guessing that’s where you introduce the concept of the dirty dozen. Trying to focus on the biggest ones?

[Dr. Kara Fitzgerald] : Yes. Exactly. Focus on the major players. Do not eat non-organic apples. If you can’t find good organic apples, then just skip apples. Secondarily, say you are in a location where you simply cannot find organics at all. I remember in medical school, having a debate with my roommate at the time. “Kara, there are no organics.” She lived in Hawaii. I find it hard to believe there are no organics in Hawaii. “There are no organics in Hawaii’. She argued with me. This was years ago. I don’t know that I buy it. But then, you talk about, ok, how do you clean the food? How do you clean it appropriately? You can do, you can use a vinegar solution. You can soak your fruits and vegetables in there, and you can reduce the pesticide load that way. That’s not optimal, but it’s a whole lot better than not doing anything else. A 10% white vinegar solution that is the cheapest vinegar off the shelf at the grocery store. 10% in a basin of water, and soak the vegetables for three to five minutes. That’s going to reduce the water soluble pesticides. Now, I use the vinegar wash. Actually, I use it all the time for any fruit or vegetable that I’m washing. Because it’s easy. I just have a spray bottle at my sink. I actually just use 100% vinegar. It’s so cheap. I have a bottle of vinegar. I just twist on a sprayer and I spritz it on whatever I need to wash. Let it soak for a period of time. That would be the next best thing.

[Damien Blenkinsopp] : Great. Great. I’ve traveled in many countries, and I’ve kind of tried to practice eating clean. It can be pretty challenging to find organics in some countries. Especially third world countries. I’ve used a similar strategy as you’re outlining. Focusing on the ones that are cleaner. Avoiding the worst ones, and trying to clean. Thank you for that very practical tip. That’s very helpful for people. Once you’ve done this first…

[Dr. Kara Fitzgerald] : Let me just throw in one more tip here. I’m sure you were doing this when you were traveling. You can always bring some extra vitamin C. We were talking about how much we loved that at the beginning. You can bring some extra nutrients to just protect yourself.

[Damien Blenkinsopp] : Right. Absolutely. We can talk about that and the kind of treatments you use which are also helping from that level. Is this the one big pot of your foundational area? Or is there something else you advise your clients to do? Water, or something in the house, or anything like that?

[Dr. Kara Fitzgerald] : Yeah. So the other major things that, guidelines to clean living, yes. You absolutely want to filter your water appropriately. I think charcoal filtration is the absolute way to go. I don’t know what your position is on reverse osmosis, but we can get into big problems if you remove all the minerals from your water. So, reverse osmosis is the cleanest, there is no question about it. But all the minerals are gone. You can develop significant, ironically, dehydration from consuming lots of reverse osmosis if you don’t adequately replenish the minerals. For me, I use, and I recommend, charcoal filtration to my patients.

[Damien Blenkinsopp] : Have you got any specific brands? To make this a little bit practical in terms of recommendation. If someone wanted to go and get something to help them.

[Dr. Kara Fitzgerald] : Yes. My favorite brand has been for years. The Multi-Pure filtration system. You can get that. I think its Multipure.com. It’s easy to get. It’s pretty pricey though. They have a bunch of different systems, so there’s different price points on it. The other one, it’s nice, and it has a much more palatable price point, is Usana. I think both of those are quality products.

[Damien Blenkinsopp] : Great. I’ve been using Berky. I don’t know if you’ve come across them before.

[Dr. Kara Fitzgerald] : I haven’t. I haven’t, but you can send me some information.

[Damien Blenkinsopp] : I will. Just a different alternative I’ve seen. I’m not use how they compare to yours.

[Dr. Kara Fitzgerald] : You go through. You do a whole home assessment with the patient. Just minimize exposure sources in the home. Incidentally, actually, I have a blog. I have a couple blogs on lead. I have a blog at drkarafitzgerald.com, Dr. Kara Fitzgerald.com on lead exposure. It was a case of Parkinson’s disease. This woman was rehabbing a lead house. Lead paint was in this old house they were rehabbing. She ended up getting very, very early onset Parkinson’s disease, and concurrently gave birth to a child who was later diagnosed with Autism. I think both of those were significantly, significantly, significantly influenced by this lead exposure. There are some pretty nifty tools, if you are concerned about lead, with your patients. I often am, if I do a urine, or a blood test. There’s some pretty nifty kits that you can do home lead testing with. You can buy these on Amazon and you can get them at Home Depot or whatever those big hardware stores are in the UK.You can buy lead swab kits and just swab stuff. A lot of ceramics that come in from China and there about, can have lead in the ceramic. You swab this particular lead sticks that I use, and it will change color if lead is present. If you look on that blog, you’ll see. If you scroll down, you’ll see a patient sent in a photo of the positive finding on one of the plates that eats on every day. She’s always had high lead and we needed to do some sleuthing to identify it.

[Damien Blenkinsopp] : Wow. Is this potentially a lot of ceramics? Everything comes from China these days, and having lived in China, I can definitely understand that lead might be in everything. Is lead particles around it, or is this actually they’ve used it in the material itself?

[Dr. Kara Fitzgerald] : They’ve used it in the material. So it’s in the ceramic, and it’s absolutely worth it then. It would be great for you to do this yourself Damien and see what you find.

[Damien Blenkinsopp] : Sounds like an amazing test.

[Dr. Kara Fitzgerald] : It’s handy and it’s cheap. There are more sophisticated and sensitive tests that some of us use clinically. But this is an easy, easy, cheap way to just get in there and start looking now. When we did it, when I first started using these at the laboratory. We swabbed all of our teacups and tea pots and plates that we had in the lab. We all had different plates in our offices that we from. Eve Brolley, the daughter of the former owners of Metamatrixs, had this beautiful tea pot she brought home from China. It was riddled with lead. It was absolutely riddled with lead. Yes.

[Damien Blenkinsopp] : You know, this is really important. Because, if we go back, you said one of the screens you do is the whole blood. The first screen you do is a whole blood test for heavy metals and metals. It would be interesting which metals they are and then you have to kind of go through this detective process. Where is this coming from? When you have high levels of lead or of arsenic and it doesn’t make sense sometimes. Where is this coming from? I don’t know what exposure it might be.

[Dr. Kara Fitzgerald]: Yes.

[Damien Blenkinsopp] : First of all, which metals are you screening for in that test.

[Dr. Kara Fitzgerald] : In my whole blood, and these are all routinely covered by insurance in this state, so it’s extremely easy for me to do. I look at mercury, lead, cadmium, and arsenic. In everybody. Another great example. A mother and a daughter came to me. Actually, daughter was complaining. Her chief complaint was anxiety. She was in her twenties and it was so disabling. Early twenties, she was unable to attend college. She had to withdraw from college because of this. Relatively recent onset of severely debilitating anxiety. In her history, she did mention. Actually, her mom was with her, and they both were putting massive amounts of effort into eating very healthy. They were buying organic, they were eating lots of fish. They were proud of themselves, and clearly they were doing a good job. One of the things that they had, on a routine basis. Multiple times per week, was sea bass. You and I know, sea bass is very high in mercury. When I got her blood mercury, her whole blood mercury, it was off the charts. That was the smoking gun in this girl’s anxiety. She was becoming mad as a hatter. She was in frank acute mercury toxicity from chronic ingestion of sea bass. Of mercury toxic sea bass. We removed the exposure source and we detox her and her symptoms abated. Considerably. She was able to return to school. She does need ongoing treatment and you need to pay attention to what’s going with her regard to detoxing. It was quite useful in that regard. Sometimes, I’m kind of topic jumping here a little bit Damien. You can reel me back in. Sometimes you’ll see, in fact frequently, we won’t see any evidence of toxins in the blood. That’s because the half-life. The amount of time these toxins actually spend in the blood, isn’t long at all. It’s hours, or a day or two. They’re so toxic. These metals are so toxic to us, that our body wants to clear them out. Wants to take them out of circulation as soon as possible. For lead, we store it in the bone. mercury is going in the fat, etc. So, you will get a lot of people who have no burden at all. For those individuals, we need to drill down a little more deep. When I suspect the metals are in, which I really do for most folks. At some point, after we’ve addressed the foundational, we’re going to do what we call a chelation challenge. We’re going to look at the urine level of toxic metals. I’ll give them a compound that will help draw the chemical, the metals, from the body and dump them into the urine. Then, I get an assessment of total body burden.

[Damien Blenkinsopp] : Great. So this is versus the whole blood. Which you were saying, it’s very much on going exposure. I guess, when you are doing that, it’s interesting because it’s the critical. What are you being exposed to every day is more likely to show up there. That’s why it makes a lot of sense if you do that first. Because it could be something that’s going on every single day and making it worse. Versus looking at this urine challenge test, which allows you to see what’s the history, how much have they gotten this burden? When you are doing this, we have spoken a little bit about the urine challenge test before. Which labs do you use? What kind of chelator are you using for provoking challenge?

[Dr. Kara Fitzgerald] : I think that Metamatrixs does a great job. In just being really familiar with their analytics, so this would be going through Genova. I think they do a great job. I also think Dr. Sata does a really good job. Those are the major, those are the two labs that I use for this.

[Damien Blenkinsopp] : Great. Just out of interest, can you compare the two, or basically how they are on different standards? So you have to stick with one. If you’ve got your history with different patients with Metamatrixs, it makes sense for you to stick with that, because then you’ve got this comparison.

[Dr. Kara Fitzgerald] : Yes. Correct. That’s absolutely right. I mean, you can take a, generally speaking, if you see a high in Dr. Stata, you are going to see a high in any assay. You are going to see it in Metamatrixs, but you are right. There’s different units, there’s different methodology, so it’s wise to just continue with whatever lab you did your baseline assessment. It’s wise to continue your baseline assessments with that lab. Just keep the same test. For chelation, remember, going back to the foundation. We need to make sure that individual can detox. We need to make sure their nutrients are up to speed. That phase one and phase two is good. We need to absolutely make sure kidney function is ideal. That they are moving their bowels. They’re having at least one complete BM per day. Once we have all of that dialed in, then we go in and we do a chelation challenge. For most of my patients, I’m going to use an oral DMSA challenge. Generally speaking, the easiest way to go is 1000mg in two divided doses over eight hours. The half-life of DMSA. Some people will choose to do a 24 hour toxic metal measurement, but I think eight hours is plenty because the half-life of DMSA is just under that. The DMSA is going to be cleared out of the body quickly and that’s what you are trying to look at. You want to see what the DMSA, what metals it’s pulling out. So for that reason, you can do an eight hour measurement. You start the collection, take 500mg or there abouts of DMSA and then four hours into the collection, you take a 500mg or there abouts a second dose of DMSA. Then, you collect for another four hours. You take a portion. You mix the urine, take a portion of that specimen and send it into the lab. I think that’s a decent way to assess. Some of my individuals, who are too sensitive, for whom I think the DMSA is not going to be tolerated well, we can use antecedal cystine, glycine. There’s a number of natural compounds that we can use. There are data on antecedal cystine as an effective alpolic acid. Having chelative properties will help pull it out, so we can do that if I deem it necessary.

[Damien Blenkinsopp] : Alright. Thank you very much for bringing up the, you were talking about the importance of doing your nutrient stage first. It’s safety. Because if you are going to use a chelator and pull toxins out. Heavy metals, then, it can be a bit hard on the kidneys and the other detox organs.

[Dr. Kara Fitzgerald] : Incidentally, if you start drawing it out, and they don’t have adequate nutrients. If their detox systems aren’t up and running, and they are very dependent on nutrients. Selenium, and zinc, and glutathione and metholdone, (and) many amino acids. If those aren’t there, ready to do their job, you will make the person sicker. Even basic kidney function has to be intact. Beyond that, they need to have their detox ability really up and running. The other thing is, Damien, this is so fundamental. It’s so fundamental, and that is one of the major roots of entry into the body is orally. We eat toxins. We’re eating these metals in our food or whatever. If you’re deficient in minerals, if you’re deficient in your essential minerals, those transport proteins. The ways that their minerals are taken in to the body. If there are no minerals, or low minerals present, those transport proteins will be high jacked by toxins. This data has been demonstrated. One of the easiest ways you can reduce your exposure source of metals is making sure you have adequate essential minerals in your body. It’s so foundational. Those transport proteins, this has been shown actually very strongly in iron deficient anemia. Padmium, manganese, which can be toxic in high amounts, mercury and so forth. They can, they hitch a ride into those transport proteins that would otherwise be used for iron or magnesium, and actually, they are relatively non-specific. A lot of the essential minerals move into the body using these transport proteins, and if you are deficient in your minerals, which most of us are. Eating a standard western diet, those metals get a ride in. The other huge piece of this, is that these same transport proteins are at the blood brain barrier. Not only are they entering into circulation through the gut, they’re going to have readier or easier access to the brain and the central nervous system. One of the most fundamental things is to make sure you have adequate nutrients and especially adequate essential minerals. Isn’t that, it’s profound.

[Damien Blenkinsopp] : Yea, it’s amazing. That’s part of your foundation, right.

[Dr. Kara Fitzgerald] : Part of my very fundamental, foundation.

[Damien Blenkinsopp] : And amazingly simple. Which nutrients do you focus on?

[Dr. Kara Fitzgerald] : Well, I focus on all of them, but I’m looking at, as you mentioned earlier, selenium. Selenium can actually bind and render inert mercury. Bind it and pull it out of circulation. In the body. So, mercury is highly toxic and selenium can bind it and just allow us to eliminate it. It’s potent. So, if you’ve got a mercury burden, chances are, you’re burning through your selenium. Selenium is used elsewhere in the body as well. So, selenium is a big player. All of them are. Magnesium is a huge, huge player. Zinc is a huge player. I would say that those are the biggest three. You also want to, of course, make sure you have adequate calcium. Lead is stored in bone, it’s going to displace calcium and other nutrients. You want to have adequate calcium in your diet, or take some degree of supplement. Chromium can be useful. Secondarily, zanadium. But really, the major minerals, magnesium, selenium, zinc and so forth are what we want to have in abundant supply.

[Damien Blenkinsopp] : How do you bring those levels up. I guess, because I’ve come across this before. The way I thought about it was that it’s kind of like, because you’ve deficiencies. You’ve got these molecules that have holes. Waiting to pick up something. So, you’re leaving all these holes in your body, basically, waiting to pick something which is a similar molecule. You have the toxic molecule come along. That’s what you were talking about, the bones and calcium and lead seems to basically have a similar molecule. It will just bind there because you’ve left the gap open by having that deficiency.

[Dr. Kara Fitzgerald] : Yea, yea, yea.

[Damien Blenkinsopp] : Yea. I think it’s really great how straight forward it is really.

[Dr. Kara Fitzgerald] : It’s elegant

[Damien Blenkinsopp] : It’s elegant the way it works.

[Dr. Kara Fitzgerald] : You just eat a great diet. Then supplement with extra minerals as see fit. I assess mineral status in my patients. I’ll look at red blood cell status of minerals. Along with my whole blood toxin. Incidentally, Damien, on most of my patients you’ll see generally speaking, higher amounts of toxins relative to their essential minerals. It’s all of the time I see this. The toxins are a little bit higher. Even if they’re not frankly elevated, they’re higher normal or something like that. Minerals are so often in all of us, low or very low normal. Very low. Low normal to very low. You always see this skewed ration. Almost all the time I see this. Unless somebody is really intentionally addressing it. This is the most fundamental thing that we turn around. We’ll get your essential minerals nice and robust and that alone will help drive down your toxins. Then, we’ll do all of the other things. Look for exposures and so forth.

[Damien Blenkinsopp]: For the essential minerals, I don’t know if you use this or not. The thing I’ve used in the past is the Greens powders because they have a broad spectrum of nutrients. Other than just trying to eat a better diet with a greater variety of vegetables is really where you have to start with this. What are your main recommendations? The ways you try to get your patients up to speed with that?

[Dr. Kara Fitzgerald] : Ok, since I’m testing, I’m going to see the degree of the deficiency. If it is high enough, I’m going to supplement them with individual nutrients. I very often use magnesium as a standalone nutrient. I very often use zinc as a standalone nutrient. Selenium, since we don’t need as much or maledium or some of the others, we can use in a complex mineral supplement. I think the Greens powder is great. Whatever company you’re using, obviously you know that they’re ensuring their quality. They’ve tested for metal quantities and so on and so forth. It’s a super clean product. It’s rich in metals, so that’s a nice thing. Baseline. While I’m first starting to work with an individual, and they are really depleted, I’m probably going to use individual supplements relatively high doses to get them up to good levels. Then, after that, we can do a complex mineral formula and obviously, we are working with their diet. For a period of time, we are using individual nutrients.

[Damien Blenkinsopp] : Great. Thus the importance of, even if someone’s not chronically ill, would you recommend they go to a practitioner such as yourself? If they feel this could be an issue for them. It is athletic performance or whatever it is, it’s still worthwhile going for this process with a practitioner to get it done right, right?

[Dr. Kara Fitzgerald] : Oh, yea. I think so. Absolutely. It’s really a lot of fun. It is! It’s very interesting to look at your biochemistry.

[Damien Blenkinsopp] : It’s a lot of fun when you get energy and performance back. You start thinking clearer. All these thing are really exciting.

[Dr. Kara Fitzgerald] : Not only that, Damien, but think about disease prevention. Now, we’re moving into the world of ethnogenetics, which I’m sure you’ve talked to your people about. Not only are you preventing disease in yourself, but if you are going on to have children, you are preventing disease in them and their offspring. On, and on, and on. If you think about ethnogenetics. It’s amazing what wellness will do to us. Not only us as an individual but really globally shifting. The planet and the generations to come, it’s so incredible. I would say that it’s a continuum of wellness. Optimizing athletic performance is not that different from treating the complex chronic disease. You’re still seeing underlying nutrient deficiencies. You might be seeing in the athlete increased oxidative stress. In fact, that’s common because they’ve got tons of mitochondria that are incredibly active. You’re going to be seeing some of those same imbalances. I used to, when I was in medical school, I was a road racer. I did a lot of, in fact, I liked criterium. I was working really hard at building up tons of mitochondria in my legs, in my quads and stuff. I enjoyed doing that at the lab. We had a lot of physicians focusing on wellness in the lab. Looking at data of athletes is so interesting and cool. Working on optimizing mitochondrial status. Making sure their nutrients are extremely dialed in so that you can shave a second or a few seconds off their time. After your season, often time, athletes notoriously get sick. Most students, they finish their intense period of training and then all of their event schedule, they often get sick. How do you prevent that as well? That’s something that we could do. So, sure. I’m more than happy to work on wellness. I think it’s a lot of fun.

[Damien Blenkinsopp] : Yea. Great, great. Would you say that the patients who get chronically ill, stick with it and work on this afterwards? I’m just interested from the standpoint, once they’ve learned about these tools, basically they see the benefits themselves. Just in daily life and being proactive.

[Dr. Kara Fitzgerald] : Yes. It’s like throwing the stone in the pond. There’s this remarkable ripple effect. Then their friends and their family say, “Oh, my gosh. Look at you. You look so much better. You have so much energy. Your skin is gorgeous. You’ve lost all this weight. What did you do?” They have this influence on those around them, just by being representatives of what wellness can be.

[Damien Blenkinsopp] : I’d like to point out, you said the way wellness can be. I do feel that a lot of us are walking around and we feel like we’re normal today, but if we went through these kinds of processes, we’d feel this level of being well. Which we haven’t actually felt before. Certainly the way I’ve felt on my journey. I feel like I’m thinking clearer than I ever have. Things like this. I think it’s a real shame. That we don’t realize that we could be better and that we could feel better. Because we’ve accepted some kind of norm. Maybe because it’s been going on so long.

[Dr. Kara Fitzgerald] : That’s right. We all acclimatize to whatever is in front of us. There’s that analogy where the frog. If you put a frog in a pot of water, you can slowly turn the heat up until its dead. Until you boil it. It will never, it won’t hop out. We get used to the disease process. We get used to feeling lousy. Just like the frog in the water. That’s actually an analogy that I learned from a patient. Who, incidentally, just became so wildly healthy. It just really changed his experience. He was writing to me and he said it’s like the frog in the pot analogy. The other thing is, this whole idea that lean on that we’re aging. Oh, I’m forty I’m supposed to be tired. I’m forty-five now, my bones are supposed to ache. My skin is supposed to look all saggy and gray. There’s this whole notion that we’ve built into the culture. Into the medical system. Because, really, the larger conventional medical model hasn’t had, does not have still, good tools around wellness. Therefore, all of these various signs and symptoms that we’ve been talking about, that are the early disease processes that we can change. They’re always attributed to aging.

[Damien Blenkinsopp] : Yea. Which is a real shame.

[Dr. Kara Fitzgerald] : It’s a real shame.

[Damien Blenkinsopp] : It’s a scape goat. We had Aubrey de Gray on the podcast previously and he talks about how a lot of these damaging processes, basically that are going on. It’s not aging.

[Dr. Kara Fitzgerald] : Yes.

[Damien Blenkinsopp] : We’ve given the name to all of this stuff, aging. But it seems like we’re aging faster because of today’s environment and the things going on today. It’s a shame that we just said “Ah, its aging. It’s normal.” Instead of trying to seize the day. So I just wanted to go back to a couple of things that we missed on your intest. You said you were using different chelators in some patients. Right, because if they are sensitive to the DMSA, which I’m guessing is because maybe they’re more mineral deficiencies. Or their detox system is having a harder time. Does it matter which chelator you’re using, in terms of what shows up in the tests? Are they standardized for DMSA or like so? For instance would anecetalsistine, which you said is a bit softer. Would that only chelate some of the metals. You would get a footprint or a pattern just for some of the metals and not some of the others?

[Dr. Kara Fitzgerald] : DMSA, so there are these, what they call binding affinities. Binding affinities vary depending on the agent that you use. Binding affinities simply means how tightly does that chelating compound bind the metals you want to look at. You can look up tables of binding affinity and see what’s going to hang on to the metals you want to look at most avidly. With the highest affinity. DMSA is really great and very well known for its ability to bind mercury. Less so lead, and less so some of the other metals, but it will bind them. It just doesn’t have as high of a binding affinity. Acetylcysteine is actually a little bit less. Now, it’s not going to bind as tightly as DMSA. Because, DMSA has structurally, if you look at it. It’s got a lot of sites for the metals to bind on. A lot of these Sulphur groups that the metals will bind on. If you look at it structurally, you can see why it’s so good at pulling out metals. Acetylcysteine is different. Structurally, it’s got only a single cell per group, instead of I think four on DMSA. It’s still going to. Acetylcysteine is just used in our body. We evolved using acetylcysteine and glutathione which is made from acetylcysteine to bind many different types of metals. Acetylcysteine is good, it’s just not going to have the same kind of affinity. It’s not going to bind them as strongly as a chemical. Now, DMSA is great for mercury. EDTA is going to be better for lead. Depending on what you do clinically. There are different cocktails or compounds that you can use. I don’t use EDTA in my practice because I don’t do IV. Really, ideally, if you’re going to use EDTA, you need to deliver it IV, intravenously. In order to really have it work. People use oral EDTA sometimes, but the data around using oral EDTA isn’t as good. Whereas the data on DMSA is very strong. It’s been used forever.

[Damien Blenkinsopp] : That’s good to know. I’m guessing the labs, because they ask you to write down which chelator kit you use, they standardize against the different chelators?

[Dr. Kara Fitzgerald] : Well, no. Generally, it’s so challenging. The lab, because they’ll have lab ranges for if you used any kind of a chelating agent. Ranges based on chelating used versus no chelating used. Because when you try to get specific. Like, for DMSA or for a specific ranges for EDTA, then you have to control how the protocol is administered. So everybody needs to use the same amount of DMSA and so forth. There are some laboratories that focus exclusively on occupational exposure. Toxicity in the workplace or something like that. Some of those places will have a very tight protocol that you can follow. Followed by ranges based on that. But, it’s a whole different arena. When you just had a massive cadmium dump in a battery factory or something like that. But for most of us, working with the less than occupational exposures. We’re doing the best we can. That’s what we have. Chelated ranges versus non-chelated ranges.

[Damien Blenkinsopp] : It sounds like its diagnostic enough for you to get your job done and identify the problems, right?

[Dr. Kara Fitzgerald] : Yes, yes, yes. Absolutely. Absolutely.

[Damien Blenkinsopp] : Right. So, we haven’t really talked about the other stuff. We talked a lot about the metals and the whole chemical side. Which we were taking about earlier where the pesticides. How do you approach the chemical side of detecting that? Does that come after the metals? If you’ve gone through the whole blood metals and before you thought there might be some metals you went for the urine, when would the chemicals? When would you start looking at them? Be suspicious that that might be an issue?

[Dr. Kara Fitzgerald] : Yea. Well, again, I’m going to assume that all of my patients have a burden. We really do. It’s been demonstrated. You can go to CDC and you’ll see. The people inside the area, in the farthest reaches of the globe, have some sort of organo- toxins, sadly. So, we all have that, so I always come in with that. Go through the clean living and get the nutrients and do all of those foundational things, and then from there. If what they’re presenting to me with clinically and if their history is compelling, then we move into to looking specifically at the organo-toxins. Genova, Metamatrixs, really developed awesome panels and you can get them now through Genova. You can look at the volatile organic solvents. You can look at PCBs, you can look at coroneted pesticides. You can look at many different toxins, organ toxins and I think that can be incredibly useful.

[Damien Blenkinsopp] : Great. Are those broad spectrum panels or are would you have to decide where you’re going to focus?

[Dr. Kara Fitzgerald] : You can get a broad spectrum panel from them now, that has a good price point on it. I would go there. I would go there because unless somebody gives you a really clear exposure history. For instance, my patient with ALS, who grew up in an orange grove. Unless you can really nail down what likely they’ve been exposed to, given their exposure history. Starting with a broad pattern, a panel is the best way to go. That’s what I recommend and do.

[Damien Blenkinsopp] : What percentage of your patients are you looking at these kinds of panels with?

[Dr. Kara Fitzgerald] : Not as big as I do with the metals. I would say, maybe at this point, maybe 20% of my patients I’m looking at these. It’s not that it isn’t a very useful tool, because it really is. Especially when I’ve got neurodegenitive conditions presenting to me. Where toxins are really. Thinking about toxins with those folks. Like with that early onset Parkinson disease. For her, she had this very obvious lead history. But for people coming out of Florida, or they worked on a farm. Some of these odd neuro-conditions really scream the need to have these kind of evaluations done. It’s another point that I wanted to bring up. This folds into our earlier discussion. That is, sometimes, when you do these foundational interventions and you really get the body functioning. You’re removing the toxins from the get go. Sometimes the body does it. If the body’s detox ability is intact, even in complex chronic disease, you can turn it around. People get on with their lives, and naturally remove them. You don’t have to go toward the more aggressive evaluations and detox processes.

[Damien Blenkinsopp] : So, it’s kind of like you are getting at a lot of things just with your foundation work we were talking about earlier. When you were saying you test for 20% of the patients. I guess these are the tricky patients. Where you are still sorting through it and you’re like, well we haven’t got it yet so we are going to have to keep on looking for the sources. What are you seeing comes up with these panels? Is it very, very different depend on where they come from? Where they’ve lived, like you were talking about. The specific examples there. Or do we all have a bit of these things in ours and how do you treat it? Do you have to be very targeted? How do you get pesticides out of the body, if it’s not doing it itself?

[Dr. Kara Fitzgerald] : For me, exposure history, you are going to get a lot of information. It can give you an idea. Gosh, a patient of mine, who really had some of the worse allergies I’ve ever encountered. Remember, allergies are a potent clue that there’s a toxic burden present. Grew up, literally, with a super fund river flowing through his back yard. Phenomenally. There was so many different toxins in this river. There were tanneries, leather tanneries around. Just all sorts of stuff in Montana. We needed to do a wide sweep. Incidentally, he had massive amounts of triclosan in his urine. Actually, it was by far, the highest amount I’ve seen. Which came from, not this super fund site. We saw evidence of body burden of PCVs and other chemicals in him for sure. But the triclosan came from those hand sanitizers. I’m just thinking of it now. This guy is a physical therapist by training. He sanitizes his hand after every single solitary patient, and he was using it as a toothpaste. They throw triclosan in toothpaste. It’s horrible. He had off the charts levels just from using a hand sanitizer and toothpaste. Just as an inside folks. Look and see if you’ve got triclosan around. If you do, remove it. Not only is it, will it increase allergies. All sorts of new data are emerging around it with regard to it being an endocrine disrupter. So, messing with out hormones and so forth. We can get triclosan out pretty readily. Anyway, Damien, organ toxins. I would recommend a broad sweep investigation to identify it unless there is a clear cut direction in their history.

[Damien Blenkinsopp] : How would you target these things and remove them. A lot of these things you’re talking about are fat soluble. Is that correct?

[Dr. Kara Fitzgerald] : Let me give you a really neat story. When we were, back at the lab when we started to put together our toxins panels, and we were really flooded in the research. So much data are coming out, every hour of every day, around diseases associated with toxin exposures. You can imagine, as we were developing these panels and we were in the research around them, we became really morose. Very, very, very, very depressed. What do you do? Everybody has PCVs and the half-life is decades and decades. What do we do? The research around detoxification is not yet as strong. It will become, because we have no choice but to face this. We got pretty depressed in the lab, just looking at these day in and day out and day in. Just really how up a creek we all were. How screwed we all were. There’s a light at the end of the tunnel. So these PCVs that are in our bodies that we can’t move out. The fact of the matter is, in fact, we are able to move them somewhat. One of the interesting stories was one of the guys in our lab had developed this farm raised salmon on a bagel habit. Every morning for breakfast, he would have a salmon, lox on a bagel. Every single morning. Its farm raised. Taste delicious. Man is it loaded with PCVs. It really is. So, all of us were experimenting on these panels ourselves because we were developing the assays.

[Damien Blenkinsopp] : Tastes great. I used to love that too.

[Dr. Kara Fitzgerald] : He gave his specimen, and his PCVs were really off the chart. They were so elevated in him. Again, it’s depressing, knowing the half-life. Oh my God, he’s stuck with these. What we did with him, was just put him on a good standard detox protocol. A good detox powder, good greens drink, nice super potent high fidonutrient green drink. A handful of various minerals and some brassica. Lots of those good brassica veggies and so forth. Measured a follow-up, and we absolutely saw reduction in his PVC burden.

[Damien Blenkinsopp] : Great. How long afterwards was the follow-up?

[Dr. Kara Fitzgerald] : It was a month. One month. He was moving it. The other thing, this is also sweating, exercise. Mobilizing fat will liberate PCVs into circulation. That is, if you are losing weight rapidly, and you’re not somehow doing a concurrent detox with that, that will become a problem. That’s why some people can feel awful when they lose weight. It’s also an opportunity for us to detox. In the weight loss process, you want to have care to make sure you are able to detox and that you’re moving those toxins that you’re going liberate from fat into the blood, that you’re moving them out. There are ways that we can do this. There is a small bit, emerging pool of research that suggests that we can move these guys out. There’s a group out of the University of Kentucky here, who have shown in animal studies, primarily, that just this. Combating the effects of PCVs which are very oxidative with essential fatty acids and with different fidonutrients, plant based nutrients. Will reduce the toxicity of the compound. Not only can we help remove them from our bodies but we also, reduce the damage that they cause. Those two ways of approaching it, is effective and it’s powerful, and it puts us back into the driver’s seat. We don’t have to be victims of this inevitable toxic burden that we have.

[Damien Blenkinsopp] : Great. That’s a great point to finish with. We don’t want to think. It’s not a great story to say you can take all these toxins in your body and there’s nothing you can do about them. Thank you so much for giving us that point of hope. Actually, that just that our bodies are naturally able to do this, if we work on the foundations we were talking about earlier. Providing what the body needs. So I just wanted to give you one last, quick fire question that we give everyone. What data metrics do you track for your own body on a routine basis? Is there anything that you follow up with monthly or six monthly, or once a year? That you like to keep an eye on for yourself?

[Dr. Kara Fitzgerald] : This is a whole other topic, and we’ll have to schedule me again. I love the nutrition physical exam. A really easy data metric. I should actually not laugh, but in the winter, I tend to get a little bit of eczema and I can track both how clean my diet is as well as how my nutrient status is. My essential fatty acids and in particular I find gamolenic acid to be well. Some of the physical changes that I can see in the winter, in myself, give me a nice picture of what I need to be doing differently. With regard to my own health, I like using, annually, this battery of testing that I do on my patients. You were talking to be about people coming to me for wellness. You absolutely can do it. I recommend it to my family as well as doing it myself. Let me look at all my nutrients, let me look at my toxins. Let me see how my mitochondria are functioning. Let me look at my amino acids, and so forth. You can cast this wide net, take a look at it, and correct it with dietary changes.

[Damien Blenkinsopp] : Great. Kara, thank you. I can see you are really enthusiastic about this, and it’s been a great conversation and thanks for bringing up so much new information and advice for the audience. Thank you very much for your time.

[Dr. Kara Fitzgerald] : You are welcome, Damien. My pleasure.

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Today’s episode is about practical tools that we can use to improve our biology and how we can track those results to make sure we are getting the right answers. This episode can serve as an important source of information about N=1 experiments and biohacking.

N=1 experiments involve a single subject and they are entirely capable of providing statistical inferences about the efficacy or side-effects of treatments specifically on that subject alone. The aim of this episode is to provide very practical tips that are really accessible to you. Some of the topics covered are the Bulletproof diet, intermittent fasting, and the impact of oxaloacetate supplements.

“So we could run the same experiment…and your results can be different from mine, but it doesn’t mean that either are wrong, it just means that we’re all individuals. Our results apply to ourselves and we [need to approach it in] a different way in terms of how we want to improve or optimize something.”
– Bob Troia

Bob Troia’s quest for self knowledge, betterment, and optimization inspired his own self-tracking, biohacking, and n=1 experiments. Some of Bob’s experiments have included glucose hacking and tracking, telomere analysis, bulletproof diet (cholesterol/bloodwork), and central nervous system (CNS) training. He has had the opportunity to give several Quantified Self talks on his glucose tracking experiments. 

Bob is also a successful tech entrepreneur, and is currently working on a new venture, HuMend, which is developing a solution to treat musculoskeletal injuries using 3D printing technology. Bob holds a Bachelor of Science degree from Pennsylvania State University in Agricultural and Biological Engineering.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • Bob’s interest in quantified self and biohacking results from trying to uncover and understand what makes him tick and how to optimize and improve it. (Time 5:58)
  • N=1 experiments are implemented on one person. They are not scientifically applicable to the whole population. (Time 8:00)
  • One of Bob’s earliest n=1 experiments involved a paleo-like diet called the Bulletproof diet. (Time: 9:00)
  • There are a number of online services that can facilitate your bloodwork testing. (Time 12:55).
  • There is a big difference between traditional and functional medicine. The normal ranges for traditional medicine may not be applicable to individuals based on their unique genetic composition. Services such as InsideTracker and WellnessFX may give you a “range” for your results, but you may need a functional medical practitioner to further investigate the details. (Time 14:00).
  • Part of a low white blood cell count is not that your immune system isn’t kicking up; it’s that it’s being suppressed. (21:00).
  • An underactive thyroid is linked to elevated LDLs. Bob was introduced to some programs that support thyroid and adrenal functions, and that was a shortcut which led to improving numbers such as total cholesterol, LDL, and testosterone. (28:00)
  • Bob’s recommendation is to find a medical practitioner with more of a functional medicine background. (29:50)
  • Another of Bob’s recommendations is to find a medical practitioner who has an investigative mindset.(31:16)
  • Bob sees the philosophy of “Quantified Self” evolving into “Quantified Team.” (33:00)
  • Bob gets testing every three months. He is still investigating having more short-term testing, for instance on a monthly basis. (37:00)
  • The biomarkers Bob tracks on a routine basis range from basic panels, cholesterol markers, glucose, nutrients like calcium, magnesium, vitamin D, white blood cells, C-reactive protein, and an MDL test that can check for chronic infections. (38:00)
  • As part of a longevity strategy and to maintain optimal glucose levels, Bob recommends a supplement called oxaloacetate. (48:00)
  • Other recommendations include the Calm app and binaural beats (Holosync) as tools for meditation. (54:30).
  • Bob’s biggest recommendation is to prevent your data from becoming a hindrance. It is ultimately more about how you feel. People have the tendency to over think it, instead of just starting to do it.  (1:34:20)

Thank Bob Troia on Twitter for this interview.
Click Here to let him know you enjoyed the show!

Bob Troia

  • quantifiedbob.com: Bob Troia’s personal self-tracking, biohacking, n=1 experiments, and Quantified Self tools and resources.
  • Bob on Twitter @QuantifiedBob

The Tracking

Biomarkers

  • Cortisol to DHEA Ratio: Cortisol is a stress hormone and DHEA is a precursor to testosterone and estrogen. Both are produced by the adrenal glands. Since they work in an opposing manner, they are more efficiently measured as a ratio. A normal ratio is approximately 5:1 to 6:1. An abnormal ratio indicates a problem with the adrenal glands.
  • hs-CRP (high sensitivity C-Reactive Protein): A marker of inflammation. The hs-CRP test accurately measures low levels of C-reactive protein to identify low but persistent levels of inflammation which is an indicator for cardiovascular disease (CVD), overtraining and other systemic inflammation issues. In a previous episode (episode 19), Dr. Garry Gordon notes hs-CRP may or may not be a sensitive enough marker of inflammation as it depends on the location and type of inflammation. Also, C-reactive protein is discussed previously in Episode 7 for tracking CVD risk.
  • Fasting glucose: Fasting glucose is one of the clinical markers for blood sugar regulation and can indicate a progression toward diabetes. In order to establish a baseline, Bob performed a fasting glucose measurement with eight hours of fasting before each morning.
  • HRV (Heart Rate Variability): HRV is one biomarker that is a good indicator for overall health and fitness. A high HRV shows that the parasympathetic response is dominant, and vice versa for a low HRV. A high HRV score – greater variability in the time gap between heart beats – is a good thing because it indicates a healthy, fit, well­-rested heart. Damien has found it beneficial to take his HRV readings every morning because a dip could be an indicator of additional stress load. We’ve covered HRV in many episodes (see here)
  • Telomere length: Telomeres are the protective DNA structures at the ends of chromosomes. Over time these protective structures shorten and degrade, as a result of the aging process in general for instance. By measuring telomere length, we’re able to identify how short they are against benchmarks, such as the societal norm, or sub-groups, for a typical age and gender, and use as a proxy for the aging process and how we are faring against it.
  • LDL (Low Density Lipoprotein): The traditional measure of ‘bad cholesterol’ that many doctors still use to evaluate cardiovascular risk, but for which research has now determined not to be the best predictor of cardiovascular risk. However, LDL is also associated with other risks can be a useful marker in general – such as an underactive thyroid as mentioned by Bob in this episode.

Lab Tests, Devices and Apps

  • InsideTracker: InsideTracker is a personalized health analytics company with a platform that tracks and analyzes key biochemical and physiological markers, and applies sophisticated algorithms and large scientific databases to determine personalized optimal zones for each marker.
  • WellnessFX: WellnessFX is a platform that visualizes your blood test results over time, as well as detailed descriptions of each biomarker for an easy interpretation of your overall health. WellnessFX also offers personalized consultations with licensed health practitioners for even more insight into your health.
  • 23andMe genetic testing: A service that provides a DNA kit for collecting samples and analyzing DNA.
  • MDL (Medical Diagnostics Laboratories) testing: A one vial test that can expose different pathogens. Bob referred to this test as one that extends more than the traditional panel and can indicate the presence of chronic diseases.
  • LabCorp: Laboratory Corporation of America provides lab testing and services, with expertise in esoteric testing, genomics, and clinical and anatomic pathology.
  • DirectLabs: DirectLabs offers blood chemistry tests directly to you online at extremely discounted prices with results available in as little as 24 hours for most tests.
  • GeneticGenie: Shows your free methylation and/or detoxification profile after sending a saliva sample to 23andMe genetic testing.
  • Promethease: Compares a person’s DNA data with entries in SNPedia, a public wiki on human genetics. Also can use data imported from 23andMe.
  • TeloMe: A company that offers saliva-based telomere length testing and analysis.

The Tools & Tactics

Diets and Nutrition

  • Intermittent Fasting: Involves consuming most of your calories during a very small window, typically 6 hours and fasting the remainder of the day.
  • Paleo Diet A diet that mimics the nutrition of early hunter-gatherers, and consists of all lean meats and fish, fresh fruits, and nonstarchy vegetables.
  • Bulletproof Diet: A diet that involves skipping breakfast, not counting calories, eating high levels of healthy saturated fat, working out and sleeping less, and adding smart supplements.
  • Holosync: A form of audio technology that is said to induce brain wave patterns such as those of deep meditation.

Supplements

  • Oxaloacetate: Oxaloacetate, the common name for the molecule 3-carboxy-3-oxopropanoic acid and synonymous with oxaloacetic acid (depending on acidity.  is an intermediate of the Kreb’s cycle and the stage immediately prior to the formation of  pyruvate (viapyruvate carboxylase) and immediately after the NAD+-consuming conversion from L-malate (via malate dehydrogenase). It is thought to help with glucose metabolism and reduce variability as well as promote longevity due to being an intermediate of the Kreb’s cycle of energy production.

Tech

  • Muse Calm: A consumer EEG device and app that is designed to help you meditate effectively. Damien refers to his use of this.

Other People, Books & Resources

People

  • Dave Asprey: Dave Asprey, Founder and CEO of bulletproof, was mentioned by the guest as someone whose talks on the principles and logic of the “bulletproof” diet attracted him to the paleo-like diet.
  • Jimmy Moore: Jimmy Moore, a previous guest, is an expert on measuring ketones and optimizing ketogenic diets. Moore also spoke about intermittent fasting during his episode.
  • William J. Walsh: Walsh was a previous guest (episode 2) who is an expert on brain-related disorders. He was mentioned in this episode as helping to do certain labs that help assess micronutrient deficiencies or differences that are out of functional ranges including vitamin B6.
  • Ray Kurzweil: An American author, computer scientist, inventor, and futurist. Author of the books on longevity and extending lifespan Fantastic Voyage: Live Long Enough to Live Forever and Transcend: Nine Steps to Living Well Forever. Ray is mentioned in this episode as one of the proponents of solving a problem before going to sleep.
  • Aubrey de Grey: Chief Science Officer for the SENS Research Foundation, a not-for-profit organization funding research into longevity around the world. Aubrey de Grey is featured in episode 14.
  • Tim Ferriss: An American author, entrepreneur, angel investor, and public speaker. The Four Hour Body, authored by Tim Ferriss, is one of the early books that helped Bob.

Full Interview Transcript

Click Here to Read Transcript

[Damien Blenkinsopp]: Hello Bob, thanks so much for coming on the show.

[Bob Troia]: Thanks for having me.

[Damien Blenkinsopp]: How did you get into all of this Quantified Self (QS), biohacking, n=1 experiments? Is this something you’ve been doing for a while? Give us a quick background on what led you to this.

[Bob Troia]: Sure. I’m very different to some of your past guests, in that I’m more like your typical listener. I’m not an expert in a certain field; I’m an entrepreneur who’s been working with emerging technology for about the last twenty years and I just naturally had this curious mind. Even back in the time I was a little kid, it was always about taking things apart and figuring out how things work or putting them back together in a different way.
For me, going back to my teenage years and into college, I was an athlete, so I was always tracking aspects of workouts and training and diet, trying to figure out what had an effect on certain performances and just general improvements, whether it’s trying to gain weight or strength or run faster.
As I got older, out of college and began joining the workforce in the real world, I never got too out of shape, in terms of putting on tons of weight or anything like that, but I definitely wanted to get back into a better shape and I experimented with different diets and training, and again, I was logging a lot of these meals, workouts, and just trying to understand those effects.
So really you went from tracking for performance to getting back to a certain state, and now as you get older, you’re really looking to do it from the standpoint of longevity and maintenance. Because, for example, I had a program I did fifteen years ago where I gained a bunch of muscle and put on some weight, but it was just from a lifestyle perspective, I couldn’t maintain it from playing other sports.
But from a QS perspective, I was always tracking everything, whether it was notebooks, spreadsheets, etc., and about maybe five years ago I found a group of folks—I’m in New York City—like-minded people who were starting a meet-up around Quantified Self. I had never really heard the term before, but when I got together with these folks and they were exchanging stories, I was like, “Oh, these are my people.” I didn’t realize there were other people doing things similar to me in terms of trying to really track and understand and then optimize areas of their life. And so, for me, it really opened the door to this and from the standpoint of, even though we were doing this ourselves, our own n=1 experiments and tracking, when you’re meeting with other people, you can share tips and advice and stories and you can really connect around that.
So you have Quantified Self and then you’ve got biohacking, and they’re very similar but they’re also different in ways. So biohacking, there are people who might be in that school of thought who aren’t necessarily Quantified Self people. They’re just looking to somehow manipulate or get an advantage or optimize a biological impact, whereas Quantified Self people might be tracking non-physical elements of their lives. I found those groups sort of overlap, and for me, it was through some of the conferences that were out there, meeting people—whether it’s the first Quantified Self conference or there’ve been several biohacking conferences.
My interest in this has purely been from really trying to uncover and understand what makes me tick and then figure out ways to optimize and improve it. I’m no smarter, faster, more intelligent than anyone out there, definitely not. I’m still dealing with a number of issues like lingering infections and health issues, but I think it’s trying to achieve that state of being optimal is just something we can all strive for, whether or not we can actually get to it.

[Damien Blenkinsopp]: Yeah, absolutely. And how old are you? Just to give a bit of context.

[Bob Troia]: I’m just going into my forties.

[Damien Blenkinsopp]: Ok, cool. That’s pretty much the same place as I am. That’s interesting. So, just to give you a background in terms of your education and your work because I think that may have an influence.
I came from a business background and a lot of finance, and then management consulting, which is a lot of analytics, so I was doing a lot of this stuff in my work. And just like you, it naturally filtered in to fitness and then it started evolving into longevity and also into health issues when I got some health issues. So I’m just wondering how that compares to your background and if you think it influenced it, maybe your studies or your career? Because some people at home may be thinking, “Well I don’t have a degree in maths,” or “I don’t have an education in consulting or analytics,” or anything, but I think anyone pretty much from any kind of background can get into this stuff and at Quantified Self meetings you see a big variety of different people.

[Bob Troia]: Yes, so my background: I went to a school of engineering, so I definitely have a technical background. I’ve been programming since I was nine or ten years old just writing my old programs. Back in those days, you had to kind of make your own games, they didn’t really exist. So I have a technical background, that helps me from the standpoint of I can figure out a way to solve something, but I don’t have a data analytics background by any means.
From a scientific background we talk about experiments, and there’s a debate about the experiments we’re doing and are they following traditional experimental design? How accurate is the data? And I think when we’re talking about our own experiments, you have to sort of say, “Well look, I’m trying to structure this and control it in a certain way but it’s for me, I’m not trying to release this in an academic paper.”

[Damien Blenkinsopp]: Let’s take a step back, n=1 experiments, I’m not sure if we’ve brought up the term before on the actual podcast, but basically, it’s an experiment just on one person. It doesn’t mean that it’s scientifically applicable to the whole population as in the experiments and studies that are typically done. They’re trying to extrapolate things to say they apply to more than one person and they can be used, but with an n=1 experiment, you’re just trying to see what works for you.
Is that how you’d sum it up or would you look at it a bit differently?

[Bob Troia]: Exactly. So we could run the same experiment, for example, and your results can be different from mine, but it doesn’t mean that either are wrong, it just means that we’re all individuals. Our results apply to ourselves and we go after a different way in terms of how we want to improve or optimize something.

[Damien Blenkinsopp]: So, the reason I contacted you is you’ve already done a lot of different, interesting experiments, basically, and you’ve put those up on your blog, so I wanted to talk about a few of those.
Where would you like to start? Which one was your first major experiment? Was it the diet or the blood glucose?

[Bob Troia]: Yes, my entry point into Quantified Self and biohacking was starting a blog to essentially just share the information I was collecting. I thought maybe it could help other people or inspire them, get feedback on what I was doing.
One of the early experiments I was running was around diet. I hate to use the word “diet” because I wasn’t trying to lose weight. Again, being an entrepreneur, a CEO of a company, and being very active, playing sports, and working out, I got to a point a couple of years ago where I just was basically exhausted; I was broken down. Even though physically I was in shape, I was being successful in my work, everything was great, I couldn’t figure out why I just wanted to curl up in a ball on the weekend and do nothing.
And so I was looking at my diet, what I thought was a healthy diet, meaning there was lots of protein through like chicken, and low-fat, and lots of pasta and carbohydrates and all that, and it was working for me, but as I delved into looking at different diets—and this was when the Paleo movement was taking off and people were looking at rethinking the traditional food pyramid and saying, really you need to incorporate more healthy saturated fats and quality proteins—and so, for me, that was the kind of beginnings of that experiment.
I actually posted about it before I’d even started. I was like, “I’m going to try this and I’m going to post about my first 30 days.” Because you’re not going to see huge changes, but I think even just seeing how you feel as a result of making a minor change, and if it didn’t work, I would just have stopped and done something else.

[Damien Blenkinsopp]: So you set a period of 30 days and you selected a diet. How did you go about choosing the diet? Was it just one you were drawn to or were you looking for something specific, very different from the diet you currently have? I don’t really like the word “diet” either; I think we should really call it nutrition, which is more about what it’s about. But that’s where it is; everyone says diet. How did you go about selecting a diet and the period of 30 days?

[Bob Troia]: In terms of the diet, I was researching, again, the Paleo movement and let’s call it nutritional plans related to the Paleo movement, and I happened to come across the Bulletproof diet—one that I think a lot of people are talking about these days—which is the sort of tweaked version of a Paleo diet.
I’d encountered Dave through various conferences and he himself was running a podcast, so he was talking a lot about the principles behind the diet and the logic behind certain choices and how you structure it all. For me, that’s what attracted me, it was sort of mapped out, there was a lot of information that he had put together and again, it’s similar to a Paleo diet, and I said, “Okay, well let’s look at it. How am I going to change what I’m eating in terms of incorporating protein and protein sources?”
So we’re talking about grass-fed, grass-finished beef and lamb; getting adequate seafood; cutting out sugars and pretty much all grains; no gluten; which interestingly, I realized through blood testing—I had an allergen test and it showed that apparently I was allergic to wheat and barley, not chronically in a bad way, but there was an allergic reaction that kind of went up there, and beer is something that’s my favorite thing in the world.
So just even having to start making changes about what I was eating, people thought I was punishing myself, but I was like, “No. I’m eating this big, great, awesome steak and I’m having butter on it and I’m eating tons of veggies and oils.” So the diet itself, that’s the nutritional side of it, and then there’s also exercise and how do you support that.
Going to the gym six days a week, working out for 2 hours a day, can also contribute to being exhausted. I know you’ve done podcasts on HRV and things like overtraining, that’s very common and so by changing a workout program as well, to something that’s more high-intensity but shorter, you can get a lot of the benefits out of it.

[Damien Blenkinsopp]: Did you do both of these things at the same time? And did you do some kind of control before? Did you take your blood markers before based on your initial diet, which was what you were talking about before, the kind of low-fat chicken, whole pastas? I guess I’d call it the typical body builder’s diet, it sounded a bit like it.

[Bob Troia]: Yeah, I had been getting regular bloodwork prior to doing this so I had some data, not like every month or three months, it was six or twelve months, but I had a good baseline.

[Damien Blenkinsopp]: Where did you get this data from? Where did you go to get your labs? How did you do that, did you do it through your doctor or some service?

[Bob Troia]: A little of everything. The older bloodwork was tied to past doctor visits, physicals; they weren’t as comprehensive but they had some of the basic markers in there. Before I started with the diet, I did a round of bloodwork. There are a number of online services that facilitate your blood testing. You can basically go online and buy this sort of package, then they will set up an appointment. Depending on what state you live in, some of it you can do from home, so you can mail it in; some you go to a lab and they draw it and send it to them.
I used a service called Inside Tracker early on, so that was, I think, for some of the before bloodwork.

[Damien Blenkinsopp]: So that’s very similar to Wellness FX, which is the other well-known one. I think those are the two major ones in the U.S. There’s just a new one in the U.K. that’s trying to follow the same example. But, basically, they’re self-service labs, which try to give you a bit of package of advice with it as well? But you don’t necessarily have to buy that package of advice.

[Bob Troia]: Yes, it will take your results, and when you go to look at them online, they’ll give you suggestions. For example, if a marker is out of optimal range, it will say, “You might want to consider eating more leafy greens,” or some dietary choices.

[Damien Blenkinsopp]: So what’s good about those services is they give you those ranges, which are a bit more functional generally than others. Compared to the standard—if you go to LabCorp or some of the standard things—the ranges they give are probably wider in most cases. Is that what you’ve experienced? I don’t know if Wellness FX try to keep it a little bit tighter.

[Bob Troia]: Yeah, and that’s the big difference between when you talk about traditional medicine and functional medicine. The reference ranges are typically built around our population, which is a generally unhealthy population. So you might be in the optimal range for the general population, but you’re not really… So something like a vitamin D level, you might be considered in range, but a functional doctor might say, “No, you want to be way higher than that.”
The reference range is to some degree—Inside Tracker, Wellness FX—if you’re switching to like a Paleo diet, you might see your total cholesterol number jump up and it will kind of go in the red, but a functional doctor will be like, “That’s not important. What we actually want to look at is your LDL cholesterol and, in particular, the particle size analysis of it.”

[Damien Blenkinsopp]: So this is where even when you do have a service like Wellness FX or Inside Tracker, where they’re trying to provide this online information and support for your understanding of the markers, it’s not necessarily going to give you the best responses. There are, basically, more complex situations like you’ve brought up, where you can have high cholesterol and it’s not an issue at all; it’s just based on the type of diet you’re having, but in other scenarios it might be a problem. I’m sure Inside Tracker is the same, like Wellness FX, is like, “Uh, your LDL is too high,” but in its own conditions, it’s not necessarily so. So this is where it becomes really helpful if you have a functional medicine practitioner working with you or someone who’s aware of this stuff.

[Bob Troia]: Exactly, and I also think—not to single out those services—any service that’s providing just a syloid [check 0:15:39] snapshot of your overall lifestyle health, they don’t have access to all the information. They can show your bloodwork, but they don’t have like for example your genetic information, in 23andMe or something, so maybe there’s an issue there that’s genetic versus tied to a diet. Or having access to other bloodwork is great, but I support it with other types of testing that maybe will be something that was picked up through a saliva or urine or a stool test. So when you have all the information together, and that’s what your doctor will be able to look at with you, versus a service that only has one silo of information.

[Damien Blenkinsopp]: So when you started this, was there anything out of range or something that you focused on from the beginning in your results before you even changed your diet? Or was everything kind of standard and normal?

[Bob Troia]: Well no. Maybe I didn’t go back to the earlier bloodwork and notice it too badly, but when I put it all and tried to look at it side-by-side, things like testosterone were way down, really low.

[Damien Blenkinsopp]: What kind of level were you at?

[Bob Troia]: The 400s.

[Damien Blenkinsopp]: So is that the bottom of the normal reference range?

[Bob Troia]: Yeah, even lower. I probably had it tested and it even dropped below that, but it was considered very low. I think some of the reference ranges I’ve seen, they want you over 600; it just depends on what service you’re using.
I was noticing that my white blood cell count was consistently low, really low. My doctor—I had in my lab results, it showed the white blood cell count and usually they bold something if it’s out of range, to notify you like, “Hey, this is out of range”; it was in red and it said something like, “Bring it to the doctor’s attention,”—he was like, “okay, I’ve never seen that before.” And so that was something that we can talk further about.

[Damien Blenkinsopp]: I had a very similar situation that came up. My white blood cells were basically depressed, but they weren’t crazy out of range; they weren’t acutely problematic. My experience was that traditional doctors didn’t know what to make of that and it was basically, “Well your immune system isn’t responding as well as it should for some reason,” which isn’t so defined. I don’t think, in traditional medicine, if it’s slightly out of range—I don’t know how much you were, if you were just under the reference range or something?

[Bob Troia]: No, it was pretty low. Basically, under 2.

[Damien Blenkinsopp]: Yeah, that is pretty low, pretty severe. It’s interesting because did you discover this stuff when you started testing? Or did you feel like, you said you were feeling exhausted, but it doesn’t sound like you felt like you were sick or anything like that?

[Bob Troia]: Yeah, that’s one of those things where I’m a person who’s never sick, I don’t miss work, I had to function at a certain level every day; essentially, what I was doing was I was getting through life almost with like a parking brake on. When you actually look at the information and see how it can change with time, so a lot of it, you sort of uncover it, but yeah, you might feel great.
I felt good until I was hitting those moments of just exhaustion. On a day-to-day level, I think otherwise—like emotionally and everything else—I felt fine. It was this exhaustion, which we can talk a bit later about, things like addressing thyroid and adrenal problems, which can really tie into that.
But just to get back to the story on the diet, so I did it for 30 days. I got my results and my total cholesterol went up about 100 points; my HDL, which is good cholesterol, went up, it was actually really high which is great; and triglycerides stayed in a pretty good range.
The doctor I was working with at the time kind of looked at it, we did some other testing—this doctor is actually someone who had some background working with people who are eating these sorts of diets and Paleo—but even there he was like, “Well, it’s a bit out of range but we’ll do some additional testing.” They thought the cause was purely that it was a fat malabsorption issue, meaning you’re eating all these saturated fats and your body needs to be able to process them and quit them out, if they stay in your body and float around, it will elevate your LDL.

[Damien Blenkinsopp]: So what was funny about that was when I started the Bulletproof diet—I’ve been following pretty much the Bulletproof diet, with some modifications here and there but mostly that, for about three years now—and I got exactly the same LDL number as you. Mine jumped to 232 and I went to see a traditional doctor to get my results in Bangkok and he was like, “You’ve got to stop eating saturated fat,” and that’s the traditional line on it.
So you had a doctor who understood a bit more about what those kinds of levels can mean. But it actually did freak me out a little bit when it went up to 232, I don’t know how you felt about it?

[Bob Troia]: I wasn’t too worried because I was expecting that to happen and then when we actually went in, this doctor knew to do a more detailed LDL test. There are different types of LDL in your body: there are these larger particles, which can float around your body, they’re not going to cause any issues; and the smaller LDL particles. When you hear about people having heart issues and just chronic heart disease and all that, it’s because these little particles are getting wedged inside of your veins and arteries. So when you look at the LDL particle size analysis, for me, it was completely the large fluffy ones, so it was actually not an issue.
But, when we looked at the white blood cell count, this doctor sent me to a phlebotomist, who’s a blood specialist, and we did a whole bunch of other blood tests. This was a renowned doctor and he looked at the results and saw it was low and started asking me questions about, have you been working around solvents and chemicals?
Part of a low white blood cell count is not that your immune system isn’t kicking up; it’s that it’s being suppressed. There could be something at play that’s keeping your immune system from activating, so when you think about it, well why was I never getting sick? Because being sick is an expression of your immune system kicking into action?

[Damien Blenkinsopp]: Yeah, this is interesting. I think this is something that a lot of people don’t understand. Let’s explain this a bit.

[Bob Troia]: I know people, it’s the wintertime, and they’re always sick, they’ve got a cold or the flu. I never got colds or the flu or anything, and I’ve always thought of it as being a sign of resilience. But really what it was doing is my body just isn’t mounting any response to anything.

[Damien Blenkinsopp]: So if your body’s not fighting, you don’t get any inflammation, you don’t get all the symptoms because there’s no war going on, basically, where there should be a war going on with you trying to beat the thing down.
I went through exactly the same thing, and I haven’t really been sick for a very long time also. But we’re talking about it being a negative, which most people think, “Wow, it’s great that you never get sick.” Do you get sick now? Have you started to get sick yet?

[Bob Troia]: No.

[Damien Blenkinsopp]: I mean, me neither, but I think it’s a good thing. I think it has something to do with all the stuff I’m doing to keep things at bay, although— maybe we could talk about it—I think you were taking reishi, we could talk about that a little later; maybe you’ve noticed some of the stuff I did.
So anyway, you went through this process and after the 30-day diet, was LDL the only thing that changed or was there a whole bunch of other stuff as well?

[Bob Troia]: Definitely there was a difference in testosterone level; it jumped up. There were other reference markers, things like C-reactive protein, which is an indicator of inflammation—I’ve always had it pretty low; that remained low. There wasn’t anything else that was too out of range, other than the white blood cell count after that and the cholesterol numbers changing. And there are a number of ratios. I had done some research and found you can do things like the HDL to total cholesterol ratio, or triglycerides to HDL, or HDL to LDL, and you’ll get a ratio. They’ve figured out certain ranges that if each ratio is below a certain amount, your risk for things like heart disease or other ways of being a predictor of those types of things can be diminished. In those cases, I was in the green for everything. So, even though my total cholesterol and LDL went up, my HDL had gone up so high and my triglycerides were low enough that the ratios were actually good ratios.

[Damien Blenkinsopp]: I think what you’re illustrating is that when someone goes and gets a bunch of these labs or something, sometimes if we find something out of range, if it’s an LDL or triglycerides or something like that, that’s kind of like the first step. Because after that that’s going to be like, “Okay, this is something to look into,” and then you look into more detail of that. So there are different types of LDL, as you were explaining earlier, or there are ratios of triglycerides, which are more important. So, often when we have something out of range, it’s really like a starting point versus a final point.

[Bob Troia]: And then to follow up on that testing, that doctor basically was saying that I had some fat malabsorption issues, so we did some follow-up tests, some stool tests basically, and it did show that there was a fat malabsorption issue happening.
Then we did some microbiology work on it, as well, which shows you your gut flora, certain bacteria that could be good bacteria or bad bacteria in your gut. It showed that, for example there’s a good species of bacteria you often see in probiotics, lactobacillus; I had like none, which basically allows for some other bad bacteria to maybe grow or thrive in your gut.
So you had to then start going back through time, and I’m like, “Well, I probably didn’t receive any probiotics back in the day.” Maybe ten years ago I had been bitten by a tick that I was getting treated for. I didn’t have chronic Lyme disease symptoms, but I spotted the bite mark and I went to a doctor right away and basically, he gave me a bunch of antibiotics to treat it. But those are the types of things that can just wipe out all your gut flora because antibiotics get rid of the good stuff and the bad stuff.

[Damien Blenkinsopp]: So, you decided after this 30-day test to continue with the same diet, the Bulletproof diet?

[Bob Troia]: Yeah, exactly. So I was like, “Okay, I like how I’m feeling, even just in 30 days. Let’s keep doing it.” Basically, I think it’s been a little over a year and a half, almost two years now since that first post when I was about to start it, so I’ve got a lot more history now, I’ve gone down that rabbit hole of looking at different issues and seeing what’s linked to what.
Because what they started uncovering was, we’re looking at things like cholesterol and elevated cholesterol and other things like might show up in bloodwork, but really there was combination of things happening, and it wasn’t diet related. Diet almost uncovered it; the diet didn’t cause it.
Related to some chronic infections that were lingering, as well as some thyroid/adrenal issues, so talking about things like energy and being exhausted, it wasn’t necessarily chronic fatigue but there are tests that can show your body’s response, and like I said, everything is connected to each other. So you kind of go down this path where you start with the bloodwork on the macro-level, and now you’re working your way towards like, “Okay, if we could fix this one thing, that’s going to help ten things.”

[Damien Blenkinsopp]: Yeah. So I’m sure all of the people at home are like, “Wow, that sounds like a lot of different stuff and it’s complicated, and how do you figure out that you have to look at all these things” if you want to either resolve health symptoms or improve your performance?
Just take a step back here, since you went on this journey—so it’s about one a half years ago, maybe a bit more—how do you feel in comparison to when you started?

[Bob Troia]: I feel great. I used that analogy earlier: you always think you feel okay or you have moments where maybe you didn’t feel great, but you still feel like generally, “I’m okay, I’m not getting sick.” And as you remedy some of these issues, you realize that you kind of had that parking brake on, you were getting by. If you were able to be achieving things at that level with those conditions, once you take that parking brake off you just feel even more amazing.

[Damien Blenkinsopp]: I’ve got a very similar story to tell. It’s like I didn’t realize my full potential, pretty much the whole of my life because there were some lingering issues all the way through. As you work through this stuff, you realize that your performance, your functionality, just your general well-being can be potentially at a much higher level than you’ve been used to and you’ve accepted this lower standard, and you don’t realize that you can really feel really great and really operate at a really high level if you get there.
I feel way, way better after—I was talking to you just before about—taking steps up; you fix one thing and it takes you a step up in terms of energy or whatever is lacking for you, and every time you fix one thing it takes you up that other step, and slowly you get more and more out of life and out of performance and everything.
So, in terms of the diet now—you’ve been doing it one and a half years—has that really worked for you? Has that changed other things? You were talking about testosterone; have there been any benefits that you’ve noticed or that have been recorded? And how often have you been tracking your progress with that?

[Bob Troia]: We fast-forward now let’s say a year and a half from when I started, again, we talked about the initial 30-days or so and seeing things like total cholesterol going up a hundred points or so and LDL. After the year and a half, I did a round of follow-up work and my numbers actually went down to levels that were lower than before I even started the diet. Things like total cholesterol and LDL; my HDL still was higher, and testosterone was almost double from before I started.

[Damien Blenkinsopp]: So these are all positive changes by the sounds of it.

[Bob Troia]: Exactly, and this was really due to introducing some program around thyroid and adrenal support because an underactive thyroid has been linked to elevated LDL. It’s almost like that’s a shortcut that I had to spend a year and a half trying to get to because we had to try out and figure out a bunch of different things.
My doctor was basically, “Okay, here’s what we’re going to do. We’re going to support your thyroid while we deal with these chronic infections because it’s putting too much stress on your body and we need to support your adrenals and thyroid,” and sure enough, those numbers went right up.

[Damien Blenkinsopp]: We were talking about this just before the show and how important it is: you found a doctor that could work with the things that you had uncovered. You got these tests that weren’t kind of right and you wanted to explore them and find how to fix them and work on them, probably in quite a bit of detail. You sound like a guy who is really interested in performance and stuff, and you were trying to optimize.
That isn’t normally what doctors are there for, and so most of them would be like, “Well, I don’t normally work on this stuff.” So how did you go about finding a doctor that had the same mindset as you and was going to work with you on the way you wanted to with this?

[Bob Troia]: Yeah, it was a long process. When I first got into the biohacking side of things and looking at getting some of those tests and data, I was working with my local primary care physician, just someone local, and I could do some of the testing but the person wasn’t necessarily experienced in digging into those numbers; they just knew reference ranges. Then I moved on to another doctor.
Through research I was trying to find people with more of a functional medicine background. I know you’ve done some interviews around functional medicine, but it’s basically going from treating the symptoms to treating the causes or identifying the causes. So I found someone that was local, and when I first started doing some of this bloodwork and some of this testing, he was good at identifying certain things, but I think there was a point where that was it, he couldn’t really dig deeper.
Then, just by talking with other people I know and introductions, I came across another doctor who within a 15-minute phone call was like, “Okay, I’ve seen this ten times before. We’re going to test for these things, I’m pretty sure that this is the issue at play,” and sure enough, more just because that person was so used to seeing that.
And what’s great, even with a functional doctor, is they don’t have to be in your town. My doctor is in Austin and I’m in New York. We set up Skype calls every month; we can do a lot of this stuff virtually. We still see each other a couple of times a year face-to-face, if we run into each other at a conference or something like that, but it’s been great.

[Damien Blenkinsopp]: Yeah, I’m the same. I work with several doctors on different issues based on their expertise, so it’s kind of bringing the point that you just referred to, is when they get something and they’re like, “Oh, that looks like something I’ve seen before.” If you have an initial discussion with a doctor and they can get that feeling for it, that’s really good.
The other thing I look for is someone who’s got this investigative mindset because—if you’ve got some just small issues and you’re not sure what they are and there’s no clear answer, or you’re trying to improve your performance or energy levels and you’re not sure what’s there—if there’s not a straight answer, you need someone who’s going to try to sift through the data, have a bit of an investigative approach to it, and maybe even go and check out some research or something.
So I’ve got a bunch of friends who’ve come across problems in their lives and they’ve eventually found a doctor who’s got a bit more of a detective, investigative mindset and will go and do homework and look around and look at different tests until they find an answer, which isn’t necessarily everyone’s mindset when they’re looking at this. I don’t know if you’ve come across that kind of mindset before with someone you’ve worked with?

[Bob Troia]: From the standpoint of having a different experience with different tests?

[Damien Blenkinsopp]: Yeah, just having “I don’t know what the answer is right now,” but let’s investigate and just keep working on it until we find some kind of answer. Because I think the reality is, the world of biology is really complex. A lot of the terms we’ve brought up today and a lot of the things you’ve been talking about, it can be really, really complex to uncover little things that are holding you back in different ways. So it’s a bit like a maze and a puzzle sometimes that you’ve got to solve.
If you just look at the straight tests sometimes, you’re not going to get any clear answer. We were talking earlier about stool tests and I’ve probably done about ten stool tests right now, and sometimes an answer comes out. So sometimes you need someone to look through and dig through the data and keep going for a while, rather than relying on something they’ve seen before.
Whereas you brought up the example where if you find someone who’s had direct experience with your specific problem, I find it’s a kind of specialized approach. If you look at the business world of consulting for instance, they have specialized consultants versus general consultants, and the general consultants are problem solvers, they go in there and investigate, they’re like detectives; whereas the specialized guys really know their stuff really well.
I kind of see the world of doctors as a bit similar. You can find the general guy who’s going to investigate, maybe he’s a functional medicine doctor and he’s just going to keep investigating and looking at stuff, and he’s going to figure it out by problem solving; whereas the guy who will really be specialized in one area will really know it really well and he’s seen 500 different patients, or perhaps they’re athletes, trying to achieve the same goal and helping them with that.

[Bob Troia]: Yeah, where I see everything with Quantified Self going ultimately, is this concept of a “quantified team.” You’ll have your doctor, and your doctor can look at data and give you some information; you’ll have someone who can analyze data, like we were talking earlier, we’re not all data scientists. We can collect this information and have it, but to do correlations and really in-depth analysis, most of us don’t know where to start with that.
Having almost a coach or an interpreter of that information can sit between you with your doctor, or if you’re an athlete or something you can articulate that with other coaches etc., and I do see this idea of almost like a team. Instead of it just being you and your doctor, you’re going to have a group of people that will all work together to be that sort of team, but I think they each bring a different skill set to the table.

[Damien Blenkinsopp]: Yeah, that’s a great way to put it, I hadn’t heard that before, but that really is a great way to put it and it will be interesting how that takes place. I guess I kind of already have some kind of team going, I don’t know about you, but I hadn’t thought about it like that. I guess that’s just the way it’s evolving naturally.
Okay, it sounds like you were just frustrated that you weren’t solving things and you kept on looking and meeting people, and it was more like networking that you managed to meet someone that was relevant to you.

[Bob Troia]: Yeah, in my case it was. For me, I also have a really strong personal interest in understanding how human physiology works. So I’m sitting there reading books, consuming information; I’m not a scientist, I’m not a doctor, but I like to be able to understand. If someone shows me the lab tests, the doctor is going to explain things to me but I want to understand it at a deeper level. That’s just my curious nature. I think a lot of folks probably don’t want to dig that deep, but that’s just an interest of mine.

[Damien Blenkinsopp]: I’m the same way. For me, I kind of see it as my responsibility and, depending on what you want to get out of your body and your life, I see it as a really good investment of time. The more you understand your biology…
When I think back to four years, five years ago, and I was already working on fitness stuff like you and optimizing it with numbers and stuff, but now I have so much control over my body, just all sorts of functions that I didn’t realize that you could control; I thought they were things that just happened. We were talking about energy dips; I have my own adrenal fatigue documented that I’m working with. But when you learn a few tricks and things, even if you do have adrenal fatigue and you’re working on recovering from that, you can actually avoid those periods of exhaustion—which I guess some of your exhaustion you talked about before was either thyroid or adrenal related?

[Bob Troia]: Yes. You were talking about a certain test you take; it’s like a saliva test that, over the course of 24 hours, you basically can plot a curve to show your cortisol and DHEA response. I had a similar situation where it was showing my cortisol levels were actually pretty close to what the reference should have been, it mapped pretty closely, but when you looked at the ratio of cortisol to DHEA, it was completely out of whack. It rings an alarm saying, “Okay, there’s something going on with adrenals here,” and supporting it.

[Damien Blenkinsopp]: I found that a really valuable test and I feel like everyone should do it, especially driven entrepreneurs, anyone who’s just working too hard, basically. Too many hours a week or too stressed, and I think that’s pretty much everyone these days. It seems like everyone is stressed that I talk to, they don’t sleep enough and they work too hard, and often they’re working the weekends or the evenings as well, or in the mornings, if they can fit it in.
So when you think about all of that, I think a lot of people could maybe check that test out and they might find that there’s something they can do there to improve their energy levels and so on.

[Bob Troia]: Yeah, and with regards to the diet, I was also incorporating intermittent fasting. Essentially consuming all of my meals in a six-hour window each day.

[Damien Blenkinsopp]: Just out of interest, we’ve talked a little bit about intermittent fasting with Jimmy Moore a little bit when we were talking about ketosis, but which hours of the day do you choose to eat at and why?

[Bob Troia]: My window for intermittent fasting is probably I’d say between 13:00 and 19:00 or noon and 18:00; it depends. You try to time it so that you start right after your workout, but the way I was doing it was you sort of cheat because in the morning if you do a sort of special coffee, which I’m sure you’ve talked about before, with butter and MCT oil, because you’re getting fats in your body, you’re getting the calories but you’re still in ketosis.
But with regards to intermittent fasting, if you had adrenal/thyroid issues, you should not be doing it. I’ve had to cut it down to a day where it was on a weekend or a day I wasn’t working out because it is stressful on the body, and for me it was like, why add the stress that you don’t need right now until you’ve fixed the other issues?

[Damien Blenkinsopp]: I think that’s an important thing because intermittent fasting has become a bit of a trend. It seems very much in fashion these days, but for some people it’s not right for, or at least not right to be doing every day. Like you could do it from time-to-time, but doing too much of it, like you said, depending on where you’re at, can be a bit problematic as can the type of training that you did.
I was just wondering, how often do you get your blood labs done now? I guess you started to do it more routinely when you started the diet and everything, but how often do you do them? And which markers are you keeping an eye on primarily?

[Bob Troia]: I would say in terms of ongoing testing, every three months. If I’m addressing something more short-term, I can test on a monthly basis, but I would say three months is my good window because if I’m addressing something, that’s usually enough time to get an update and see where my markers are at.
In terms of what I’m checking, so those can range from basic panels, where you’re doing like we talked about, cholesterol markers, glucose, nutrients like calcium, magnesium, vitamin D, all those sorts of micronutrients, then getting into things like white blood cells, [and] C-reactive protein; that’s more of a traditional panel.
When I’ve had to dig deeper, I would do these additional tests. One is called an MDL test, where they can check for chronic infections and stuff, but it’s all done through bloodwork, so you can dig a little deeper. The main issue is these tests cost money. You either need a good insurance plan or you have some way to get those costs down.

[Damien Blenkinsopp]: So is that what you recommend? For you, three months is about right cost-benefit for those sorts of labs?

[Bob Troia]: Yeah, and I think you could basically, there are these at-home services that we were trying to launch that you could draw it every day if you want. Maybe there is a case where you are trying to do a before and after of something, but to go to a lab and do a full panel, for the average person, I think even six months is fine. But if you’re trying to deal with any issues or you need an update, I think for me, three months is a pretty good window.
Also, some of the testings, so Wellness FX or Inside Tracker, they have certain panels and for even the most expensive panel of the highest n=1 they have, there’s a limit to what they can provide. So what I’ve found through my doctor was by him ordering some of the tests, we can do much more comprehensive panels.

[Damien Blenkinsopp]: Had you been using Inside Tracker for those basic blood markers most of the time? What have you been doing for the routine tests you do?

[Bob Troia]: The routines had been on and off with Inside Tracker. I don’t know if you talked about the weird laws that exist in this country about all these testing services?

[Damien Blenkinsopp]: The weird laws that exist everywhere.

[Bob Troia]: So for example, with Inside Tracker, I was using that for the basic panels and when I needed to do some additional things, they would send me to a LabCorp facility, which is like a big chain of laboratories—you go there and they can do it all. In New York State, they can’t do it.
So there are rules about what they can and can’t do. I couldn’t just go there and set up the appointment; my doctor, however, could arrange and say, “Go to this lab,” and he could actually negotiate lower prices for certain things. So you might see on your bill that this bloodwork cost 2500 dollars, but you’re going to pay 100 dollars or something out of pocket, and suddenly you hit your insurance thresholds.
My point is, it’s tough because I love the convenience of those types of services, and it’s just that I happen to live in a state where it’s really difficult.

[Damien Blenkinsopp]: So New York is a bit more difficult. As far as I know, I think there’s one other state. New York always comes up as a specific state where this self testing is more complicated. There are also a bunch of other services you can use, like DirectLabs and other self-service websites that basically you can hit up and order testing. In fact, I found most tests these days I can order.
But as you say, sometimes it’s worth either you working with a functional doctor or someone from your kind of team and he’ll be ordering them for you. There is a cost-benefit to that often, I think, versus ordering them directly. And of course, he’s going to be checking them and looking at them, and he’s got his experience looking at tons and tons of tests of these types and he’s also probably got a mountain of data in all of the tests he’s stacked up over time, which I found this kind of thing is really valuable as we’ve talked about before.
But it is changing and that’s one of the things we’re going to look at in this podcast. Things do change over time and all these new services start coming out more and more.
So in terms of intermittent fasting, that’s something you cut down to fit with your personal situation, where it kind of comes back to an n=1 experiment thing, where it’s really a personal thing and what suits you. How did you know to change that? Was it because of one of your tests? Or was it a feeling and then you looked at it?

[Bob Troia]: No, and in that case, actually, intermittent fasting worked great for me in terms of body composition and I was able to confine my meals into that window and still get everything I needed to eat. It was more just after talking with my doctor, we said, “Hey, let’s do everything we can to support your thyroid and adrenals. Let’s take as much stress as we can take off your body.” And so we decided to cut back the intermittent fasting just for the sake of let’s just remove a potential stressor.

[Damien Blenkinsopp]: It sounds like a great idea, so that’s some of the stuff I do as well, try to reduce all stress. So, that’s intermittent fasting. One of the other interesting things you’ve played about was blood glucose.

[Bob Troia]: Yeah, I was one of the early 23andMe customers, so I know that now if you sign up for them to get your genetic testing done, they don’t give you access to these research and tests that can say you’re more likely to develop this condition or have this response to this medication.

[Damien Blenkinsopp]: So, just to be clear on that because I bought in the early days like you, so I still have the health interface. I think the difference is just the interface they present to you; they don’t present the information summarized about your health, is that correct?

[Bob Troia]: Well I thought they ran into some FDA issues where they can only show people their ancestry information now.

[Damien Blenkinsopp]: I think it’s in terms of display but you can still download your whole…

[Bob Troia]: Yeah, you can download your raw data, but there’s no interpretation of it.

[Damien Blenkinsopp]: That’s right. Basically, we see a health panel because we got in early and they’d already shown it to us so they’re still allowed to show it to us, or I guess they promised us so they made some deal with the FDA that they’re allowed to keep showing us it. But they’re not changing it; it’s just what we saw from the start.
And then you guys, if you do download the data, then you can run it through some open source tools, but they’re not as nice and summarized, you have to do a lot more work with those if you want to get to some of your health issues.

[Bob Troia]: I’ve used Promethease, is one, and Genetic Genie.

[Damien Blenkinsopp]: Genetic Genie is a bit more simple actually, but Promethease is a lot of detail and a lot of work to get through it. Did you find it the same?

[Bob Troia]: Yeah. I thought the Genetic Genie was interesting though because it got more into a methylation analysis, which was for me kind of an interesting set of data that I wasn’t getting from anywhere else.

[Damien Blenkinsopp]: But you can get that from Promethease. You get everything basically from Promethease because it’s a bigger open source thing. The Genetic Genie guys are focused on a few different issues like detox and methylation, so they’re looking at specific panels. And there’s another website Ben Lynch mentioned, which looks at specific panels like that.
Anyway, so there are ways you can use this data from 23andMe and you can get different sets of health issues looked at by going to different sites basically, and putting your diet in there. So the data is still there if you want it; it just takes a bit more work than it used to.
In terms of the blood glucose, you found an issue that you wanted to look at?

[Bob Troia]: So going back to the blood glucose, my 23andMe data showed I had an elevated risk for Type 2 diabetes. It was about a 10% higher probability, meaning the average person has I think 26%, so it’s already a pretty high likelihood, and mine was 36%, and I know I have a few members in the family, like uncles and grandparents, that have developed it over the years. So I just got interested in looking at my glucose response and wanted to understand the effects on glucose and what affects me, and I’m going to take whatever proactive steps I can because I don’t want to develop it at any point in my life. So really this experiment just started as, let me just understand my blood sugar.
I went and bought a 12 dollar blood glucose meter, I ordered it off of Amazon, and you get the test strips and you prick your finger every morning. It’s a little meter that just says your blood sugar level. So I would do what’s called a fasting glucose measurement, that’s basically, I think you have eight hours of fasting before. Every morning, the first thing as soon as I wake up, I would just take a reading. I started establishing a baseline just to understand and get some basic levels.
I was reading up about different supplements and things people have been taking to better regulate glucose, both stabilizing it—so you have less swing of fasting glucose—but also overall, just bringing it down. My fasting glucose was around 85 mg per deciliter which is considered okay, but when you see these organizations like Life Extension Foundation, they actually want people down and closer to 75 – 78.

[Damien Blenkinsopp]: Jimmy Moore, when he was on, he was saying that his is pretty low, it’s around 80 and that’s where he keeps it. So when I looked at your data, what I found was interesting is that’s the blood test you got initially, 85 was it to start off with? And then when you started tracking it, what did you see? Because I was really surprised. I didn’t know that it worked like this when I saw your numbers.

[Bob Troia]: I did a 30-day baseline and in some days, I’d wake up and it could be 80 or so, and then there were other days where I would wake up and it could be about 105, there’s a bit of a swing.

[Damien Blenkinsopp]: Do you think that’s the accuracy of the device? Did you look into it? Because I didn’t expect big swings like that. When I’ve had my tests done in the past, which is just the three-month routine like you, I will have 85 and then maybe there were some times where it was 95, and I’d be like, “Oh, I don’t like that. I don’t like the fact that it’s up there.” But it seems from your data, that it’s actually swinging up and down every day. Is that normal or was that the device? Or is that just kind of how we are generally?

[Bob Troia]: I think in terms of the device, I did a bunch of research and listen, none of these are going to be completely accurate. I think the one I chose was probably within 5% accuracy. Because when you think about it, who are the people who are using these devices? They’re people who have diabetes, typically, so their glucose is so high that whether it shows them that they’re at 160 mg per deciliter or 150, they’re still too high. So the lower ranges that we’re talking about, you know, 5% is still okay, but some of these meters can be 10% or more.
And to your point, yeah I think that if you’re not controlling it consistently each time in terms of I take it almost the same time in the morning and I’m taking the sample from the same location, I’m not squeezing my finger too hard because if you squeeze the blood out of a little prick you give your finger, that can affect it. So I took a baseline and then I started supplementing.
I came across this supplement called oxaloacetate and it’s all natural, it’s part of the Krebs cycle, which is a whole cycle of conversion going into vitamin C, and it’s found in a lot of plants. It’s concentrated into a pill form so you take one every morning. I took one every morning, and over the course of the next 30 days I kept doing those fasting glucose readings, and I actually saw, “Wow, it actually reduced that swing that we’re just talking about. It condensed and the overall trend went down.” So it actually stabilized and lowered, which is really cool.

[Damien Blenkinsopp]: So why do you find this cool? Because I guess we’ve got to take a little step back. We talked about blood regulation with Jimmy Moore, but what kind of benefits were you looking for from this, yourself? Is it because of your genetic profile that you were basically managing your risk as you saw it? Is that what you feel the benefit is for you?

[Bob Troia]: I think long-term, it’s part of a longevity strategy. I can say very easily that today my glucose was in what’s already considered a good range, but it wasn’t optimal. I was trying to understand not just how could I bring it down into an optimal range but also what things affected it. Because once you’ve collected all this data, you can then look at other aspects of your life and go, “What affects these values?”
So for example, plotting your values on a chart over time is one thing, but if I average out what does Monday look like versus Friday, there’s a difference. Monday’s the beginning of the work week, more stressful; Friday’s end of the week; Saturday’s the weekend. For me, I could see it just very visually, there were these trends. I also noticed that if I exercise—I play a lot of soccer—and if I have a soccer match—I usually play in the evenings—the next day, no matter what, even if I went out with the team and had drinks or did whatever, my value the next day goes way lower. I only uncovered that by taking other data from other areas of my life or looking at my calendar and going, “Huh, that’s pretty interesting.”

[Damien Blenkinsopp]: Well you said you’ve got this detective mindset. How did you go about that? Was it you were looking for ideas?

[Bob Troia]: Yeah, because you have the data—now you have this repository of these values—and now you’re trying to figure out ways to correlate it with other areas of your life. For example, I was looking at exercise. I decided to look at my calendar and I superimposed dates that I had to travel cross country, like fly, and guess what? During those windows of time, I was taking measurements throughout the entire process, it definitely spiked. So travel for me is stressful, it actually took a few days to get back to those pre-existing baselines.

[Damien Blenkinsopp]: Wow, because that’s a big deal. And travel is something we say is stressful but it’s not often we hear some data on it. This proves that travel is stressful for you. But that sounds like a pretty clear case for you. An n=1 experiment you could probably say that you are going to be stressed next time and you can kind of prepare for it.

[Bob Troia]: And then with the experiment, I then stopped taking that supplement for example and just kept taking markers for another 30 days and I tried to replicate it, and when I replicated it—the beauty of these n=1 experiments are you often fail or maybe you set up to prove a theory and you fail but you learn something different so it’s not a failure per se—it didn’t work.
What I realized was it was a combination of things. It was last winter, we had gotten a bunch of snow in New York so our soccer season had basically gotten cancelled because we play outdoors all year round and the field is covered in ice and snow and so they were like no games. So that exercise that I was getting, I wasn’t getting. Also I had changed my commute from going into an office and having to walk to the subway and walk to the office, to working from home for a period of time.
So I actually then looked at my step data, not that I ever bothered tracking steps or looking at my step data for a health related reason, but I did notice that my activity was actually decreasing. So what does that say? The low hanging takeaway there is: if I exercise my glucose will go down, which is probably a “No, duh,” kind of thing but for me, it just showed the direct benefit, a short-term and a long-term trend.

[Damien Blenkinsopp]: You’re just making me think of something, and we’ve kind of touched on this before in podcasts, but when you were shown that direct benefit, it makes it clearer for you and it makes you more motivated to act upon it. Now you feel like you’ve got this extra additional motivation—tell me if this isn’t you, just me projecting—but I feel when I understand something a lot clearer, when I’ve seen the data, then it’s a lot easier for me to keep up that habit because I understand it to a clearer point of view.

[Bob Troia]: Absolutely. I think part of the folks like us who are doing all of this, I guess we’re like these A-type personalities and we’re trying to not only understand all this but we want to reduce this to the most simple terms, like what’s the one thing I can do to get to the same result? It’s not about creating more headaches, you’re trying to optimize and gain more time in your life, not take up more trying to do all this tracking.

[Damien Blenkinsopp]: Exactly, yeah let’s talk about it because it probably sounds like a lot of work. Do you feel like it’s a lot of work? Could you talk a little bit about how much time it takes to get the labs or track things or analyze it?

[Bob Troia]: I would say what takes the most time is probably the analysis, just sitting down with the data, because like you said, you have to have this sort of detective mindset often times because you have information until it makes itself clear to you in some way or you want to test out a theory. Most of the things I’ve done are almost in retrospect, where I collected information already and then I’m trying to figure something out versus I’m constructing an experiment and these are the variables. I’m pretty bad at that; I’m almost better at the reverse—here are the results; let’s figure out what created that result and go backwards.
From a time perspective, I think even collecting information, so going for a lab test and getting your blood drawn takes a few minutes; it’s not that big of a deal. For most of my data, I’ll wear a device on my wrist that’s collecting a lot of passive biometric information all day. I think the goal is to not create a lot of burdensome things on yourself.
I know there are a lot of people who track all the meals they eat, like they use MyFitnessPal or something, and they know a lot about the meals and track their calories, and I’ll do that every once in a while for a few days, just as a gut check. I’m not going to do it every day, it takes too much time. For me, it’s a headache. I eat consistently so I’m not too worried about it. Once I do a gut check or a sanity check, I know its okay.
But I think that’s the problem, I think a lot of people feel like this becomes so burdensome and takes up so much time, I think you have to pick your battles. There are certain things that you want to do every day and if it takes you a minute to do it, that’s great. Other things are being done passively, so you’re collecting that data and it’s just a matter of finding the time to sit down and analyze it.

[Damien Blenkinsopp]: There are very few things I do. I saw you noted on your blog, I think, you’re interested in meditation and you were looking at doing some—I don’t know if you’ve done any yet.
I’ve been using Calm for a few months now, I got it in September or something, and so I try to do that every day. I’ve, over time, been able to improve my scores with this EEG device, basically it’s a consumer EEG device and it’s got an app which shows you when you’re in one state versus another. I found it useful because I want to meditate anyway, but going back to what you were saying, I want to make sure I’m spending my time productively, and for me, the extra effort of tracking it has a huge impact in terms of improving my meditation.
Meditation is different for different people, but for me, I’ve been experimenting with binaural beats, which I think you mentioned too, the Holosync one, and I found that’s working for me. But I like to know stuff is working for me before I commit to it and I put that extra energy in it, so I did a few experiments and it seems to be working for me so I’m sticking with it. I’m just trying to give people a mindset in terms of time like you were saying.
But if something doesn’t seem to be working, you just kind of drop it, and then the stuff that does work, you’ll keep it because it’s beneficial. So some of this just kind of works out itself: you’ll keep the stuff that is beneficial, so it’s worth the time. Like I take my HRV readings every morning because when I see a dip, I know there’s some kind of problem coming or I should chill out for a day if I don’t want to get really tired or something.
The things that are beneficial I think you find that they stick and you make the time for them automatically, and the things that aren’t, you just kind of work them out of your routine. Is that similar to the way you found it? Or how have you gone about it?

[Bob Troia]: Exactly the same. I think there are certain tasks you can do that take up very little time. Like I had a little routine in the morning, when I wake up I’d do a handful of things or before I go to sleep, but then there are other things I’ve done where whether it was a piece of technology or I was trying to understand myself better, but once I did the analysis or once I gathered data, I have a box full of devices, you throw it out and you’re like, “Great, that was useful.” I think people get hung up on the gear a lot of time, and I think often you can figure out solutions that don’t require the technology per se. You could take a spreadsheet and something like little body fat calipers can give you a body fat measure and you don’t need a 200 dollar scale to do that.

[Damien Blenkinsopp]: That’s right and there’s all this excitement around the devices and everything at the moment; all the companies are investing in it. Of course because that’s what the market is, but so far, there aren’t any crazy, awesome devices yet; there are a few interesting ones here and there and it’s a thing in progress.
I’ve done some of the similar ones to you, I had the Basis watch. I wore it for a year, it broke and then I didn’t buy a new one because, honestly, I didn’t do that much with the data. It would be kind of nice to know my activity levels just to check that I’m keeping up and it’s a nice convenient way just to know that. Do you still use your Basis watch?

[Bob Troia]: Yeah, I have it on right now, and for me I was looking for something that gathered the metrics, and I felt it had the most robust set of data, even though they didn’t give you the data. We can talk a bit about it—I figured out a way to get to the data and I wrote a script. Given my technology background, I was able to write some code. I put it up on an open source website that people can use to download their Basis data.

[Damien Blenkinsopp]: Yeah thank you for that. I think that’s how I first found you, actually, because I was looking trying to get my data and I found your website, and I was like, “Oh, thank God someone’s solved this.”

[Bob Troia]: For something like that, that’s just passively collecting so I might not look at some of those numbers for a few months. Like right now, I’m actually about to go over all of my sleep data from 2014 and I’m going to do an analysis on looking at trends—how is my sleep by day of week or different sleep stages. I’m going to factor in when I look at things that happened in my life and did it affect my sleep. I don’t know what the answers are going to be, I’m not going into it with any preconceptions so that’s almost for me it’s going to be more like developing more self-awareness. I might be like, “Well look, I have this many sleep cycles but I don’t remember my dreams. What’s going on there? Why am I not remembering dreams?”

[Damien Blenkinsopp]: Has that been happening to you lately? Because I’ve had that a year and I’ve only just recently come across information that’s been helping me to figure it out.

[Bob Troia]: I have no problems sleeping. I’m actually a solid sleeper—I get eight hours a night—I have friends who are jealous of me, but does it mean I have quality sleep? I think it’s good, but for me, with dreaming, it could just be as simple as I started keeping a notebook next to the bed. As soon as I wake up in the morning I would try to think, and it was really hard for like the first week. And then maybe after a week, in the morning I’ll remember some minor detail of one dream, but then in the afternoon, other things will start coming back to me. So you have to almost train yourself.

[Damien Blenkinsopp]: So in your case, it was trainable? You could basically get your dreams back and it was a focus on dreams?

[Bob Troia]: I almost think it has a little bit of intent when you go to sleep of putting yourself in that mindset of you want to dream and then waking up and just being able to recall that information; it’s almost like an attention thing. It’s no different than you’re talking and I’m tuning you out.

[Damien Blenkinsopp]: That’s interesting. So the information I came across was a little bit different. It was through Tess actually. We had this guy called William J. Walsh—I don’t know if you’ve come across him before—on the podcast on episode 2. He does these labs that help you to assess basically micronutrient deficiencies or differences that are out of his functional ranges, and mine came up out of range. One of the things that it shows is an imbalance of B6, and when you have an imbalance of B6 then you tend to stop dreaming. So I think once I’ve rectified mine, it might kind of fix itself. But it’s interesting; I might try the experiment myself with the intent thing to see if that helps as well.

[Bob Troia]: Yeah, let me know how it works. Again, it’s something that I’ve started probably since the beginning of this year. I’ve just been more aware of trying to develop, but I think there will be value in it regardless, and it’s not something that really takes any money or time. You just need a pen and a notebook.

[Damien Blenkinsopp]: I’ve always loved that idea of trying to think of a problem you need to solve before going to sleep. I think Ray Kurzweil does this and he’s one of the guys who says he always does that. Just solving things in your dreams is a great way to do stuff efficiently that you wanted to do.
Coming back down to the practicalities; you’ve been doing this for quite a while now, what are the biggest time wasters you’ve found in the experimentation process about learning about stuff that works for you and what doesn’t, basically, and collecting data? Have you found that there are things that you were doing that are time wasters and you decided not to do them anymore? Or what have you learned about n=1 experiments? What do you do today that might be different to when you started out?

[Bob Troia]: Obviously on the testing side of things, I wish someone had given me the shortcuts and said, “Do this, this, and this.” I have a lot of people come to me asking, “Just give me a list of five things I need to do.” It’s often not that easy because we are all different, so it’s not like it’s a clear linear path; it’s very branched.
For me, it would have been if someone early on could have identified some of the issues, it would have saved me a lot of trial and error just trying to uncover. That was probably why I started doing a lot of it myself in terms of trying to understand it better.
Time wasters, this is more just from the standpoint of looking at your data, everybody wants this hub: “Upload all your data and we’ll be the place for you to access all your information.” The problem is, for most people, like we said earlier, we’re not data scientists; we don’t know how to run correlations, we don’t understand all that. And so, you’re uploading your data to these places but then what? It’s just there.
Or I look at it from the standpoint of, if it can’t collect all of my data it’s useless to me. Take Wellness FX, they might be like “Okay, you can manually input all of your blood lab tests in here,” but maybe I’ve got some additional fields or something in it that it doesn’t support. Well now it’s not my complete record, so now I’m like, this isn’t really valid for me. I feel like I’ve wasted some time going through the process of getting data and massaging it and uploading it to certain places to try to have this hub. So I’ve had to do a lot on my own, make my own little ways of gathering it.

[Damien Blenkinsopp]: Do you use Excel?

[Bob Troia]: Yeah, and I’ve got things imported into databases so I can run correlations against it.

[Damien Blenkinsopp]: But I guess for the people at home, they should stick with even a Google Docs spreadsheet, anyone can use that; it’s very similar to Excel. I have a huge monstrous Excel, which is scary. A database would probably be a better way to do it if I could get my head round that.

[Bob Troia]: Spreadsheets are a perfect way to get certain data. Pretty much anything you collect you can import into an Excel doc or a Google Doc and then chart it and do whatever you need to do with it.
But in terms of time wasters—well it’s not so much time but it’s almost like a money waster I’d call it—there are a couple of things. There’s the shelf-life of a lot of this technology and tools. You buy this new cool gadget or whatever, and it’s like planned obsolescence. You know in a year it’s going to be outdated or someone’s going to come out with something new, or you just wanted to be the first one to have this shiny object.
I got a device that analyzes your posture throughout the day, and it was fun, I did it, it kind of showed me some insight on understanding that better, but at some point I’m like, “I’m done. I’ve used it. I’m done with it. I’m not going to wear this every day.” It happened with the Zeo sleep tracking, they were an EEG-based sleep monitor. The problem with their business was more from a consumer issue, where people were buying the product because they had sleep problems and the device said, “Yes, you have a sleep problem,” but it didn’t really give them a solution so people were like, “Well, thanks.” There’s that level of things and then I’ve also been burned a number of times on these crowd-funding campaigns with companies, and it’s not so much it’s their fault that they were doing anything shady…

[Damien Blenkinsopp]: It’s the nature of it. It’s like a pre-startup situation.

[Bob Troia]: Yeah, and so my policy now is literally I’ll just wait for the thing to come out because you know what, you’re still going to get it if it’s out.

[Damien Blenkinsopp]: So just to outline what you’re talking about; what are the issues that come up when you’re buying those things?

[Bob Troia]: I think there are a number of issues. Like you said, they’re startups typically, so if they’re developing a product, they probably have no experience building a piece of hardware, so they don’t realize all the issues that can happen along that process from manufacturing to distribution, so when they say we’re going to ship in March and it’s January, they probably mean March the following year. Nothing ships on time.
I’ve also had issues where there was a blood testing service that was coming out that was doing blood spot tests, so you have these little index cards and you can put a drop of blood on it and you can send them in at any time you want. I bought the top of the line pack because it gave me three years of blood tests and they started letting us send in our samples and they were collecting them, so I wasn’t doing other bloodwork because I was sending them monthly samples. And then they got into trouble with the FDA, who were basically “You cannot operate,” and so the company has just been in limbo.
There was another company—did you ever talk about telomeres?

[Damien Blenkinsopp]: Actually, I did want to talk to you about that. We touched on it with—do you know Aubrey de Grey? We talked about it a little bit. It hasn’t been published on my podcast, but by the time this comes out it will have been, so it’s kind of time travelling here. He’s been on and we talked about that, and he was pretty pessimistic about the use of this, but I’d love to hear your experience with the practical experience of that because I was wanting to get mine tested, and I think I still will just to see where they’re at compared to the norm.

[Bob Troia]: So a telomere is basically if you look at your DNA strands—just to give an analogy, it’s the one I’ve always been given—if you think of a pair of shoelaces and at the end of your shoelaces there’s a little plastic tip. Think of your DNA strands as having those little plastic tips but as you get older, they’ll fray and eventually fall apart and then your strands will shorten. So it’s kind of a sign or a marker of aging, because at some point your cells can only divide so many times and then they just die.

[Damien Blenkinsopp]: It’s the idea of this countdown. You know those little countdown timers that start at a hundred or something and then it chips away one each time, and when it gets to a certain level you don’t have any life. It’s like losing lives on a videogame.

[Bob Troia]: Exactly, you see the health wearing down. But in this case, this company was providing a service where you basically spit into a tube, you mail it in, and through your saliva they do a telomere analysis.

[Damien Blenkinsopp]: Which company was that?

[Bob Troia]: They were called TeloMe.

[Damien Blenkinsopp]: You say TeloMe; are they not here anymore? Or are they still here?

[Bob Troia]: They’re here—well I’ll get to that part—but basically, there’s a parent company that was more clinical, they would do testing more for labs and all that, and this was a consumer initiative they were doing. So the idea was you would spit in this test-tube, mail it in, and then you get a report and it shows you the analysis of certain telomeres that they’ve identified and it says where you sit in a reference range. So I got my results, the problem is, they can only compare me to other people who have used their service.

[Damien Blenkinsopp]: And who has used this service?

[Bob Troia]: That’s the thing. So I wrote them back, they sent me my results and I was like, “Uh, these don’t look too good. So you’ve got me compared to my age range, well how many people have you had so far that are my age range?” And they were like, “I think five or six.” I’m like, “Great. So you’re giving me results on a small sample size.”

[Damien Blenkinsopp]: Are the markers they’re using—this is something I’m always interested in—that have a lot of research behind them? So you can at least go and look at the studies, or they should be giving you the information of those studies, “In the studies this is shown to be good in healthy populations and bad in people with cancer,” or whatever, some kind of data on it.

[Bob Troia]: Well again, this was a case where I crowd-funded this initiative, which got me like a three-test pack. The idea was that I was going to do an experiment. I was going to send in my sample, do some things, wait a few months, and send in another sample to see if I was able to change the expression, or the markers of aging. When I went back to do it, I found out that the company no longer existed. Well the parent company still exists, they can’t operate in the U.S. though, [and] they got shut down by the FDA. So I was like, “Give me my money back,” and they don’t respond to you. They’re in Europe doing their thing but they won’t acknowledge or give you any information about the testing service.

[Damien Blenkinsopp]: I guess it’s not even the cutting edge, it’s a bit of the bleeding edge of all of these labs. Because the FDA is still figuring out what it’s going to do with stuff and what it’s going to allow, and as you’ve pointed out, already three companies have been told they’re not allowed to do stuff at least for the moment until they figure more things out.
There’s a lot of that going on and so I find sometimes a test will be available and then it’s not available and then it’s available again. That’s happened to me on several occasions, where a place I’ve got a test initially isn’t available there anymore and I have to go somewhere else to get it. It’s kind of like the bleeding edge right now, and if you’re going to get into the more specialized stuff, like telomeres or stuff like that, it’s going to take some navigation, I guess, and expect some of these problems.

[Bob Troia]: Like I said, I don’t necessarily fault the companies all the time because they’ve run into some regulation or things like that, but I guess from my standpoint it’s like you are gambling. Funding these initiatives, they may come out some day, but it’s often not going to be what they were positioning themselves as, whether they pivoted or did something different.

[Damien Blenkinsopp]: We should look at crowdfunding as a bit of a gamble because it’s a pre-startup, it may not come out. And the thing I’ve had it there’s often a huge delay. I think I’ve bought a couple of things and it just took about six months to a year longer than I thought. I got Biomine Basis when they first went to crowdfunding. I don’t know if Basis was crowdfunding or if it was just pre-orders, anyway, it was a pre-order and it took about a year and a half to get it. It was a long time but I got it eventually, and maybe it wasn’t exactly what I wanted.
I think now the way I look at it is it really is the bleeding edge and if you want to play around with some of this stuff, I guess at the moment you’ve just got to consider that’s going to happen a lot. You’ve got to do more due diligence.
We were talking about the markers and the lab tests, the surprise you had with the telomeres, and I think that’s a pretty key thing because you could be getting useless data as well.

[Bob Troia]: Absolutely, and they wouldn’t have told me that unless I asked them, and I think with regards to crowdfunding, I’ve met a lot of great people in the space of QS and biohacking, and if it’s a company that I think is working on something cool and I’m happy to support them. But when there’s something where it’s a new technology or a new service, and it’s almost like do you want to be the first, but does it mean being the first today? You make that payment or crowdfunding donation and then you’re like, “Alright well I’ll see you in a year and a half.” I’d rather just be like I’ll wait a year and a half and then I’ll pay 20 dollars more for it.

[Damien Blenkinsopp]: That’s what I’m doing now. Every time I catch myself going to click on a crowdfund, I’m like, “Look, why don’t you just wait. You can buy it in a year when it’s actually there.” That’s kind of the way I’m looking at it these days, I think it’s from us tried and tested people. I don’t know if everyone’s going to start feeling in that way soon.
There was one called the Omega I was pretty excited about, I don’t know if you saw that one. I don’t think it’s come out yet still because it tracks a few more things.

[Bob Troia]: There was also one called Angel Sensor, which basically is creating a wearable, like a wrist-worn, almost like a Basis, but the entire platform is open source. So it has a bunch of sensors and then you can build your own apps. You can just grab the raw data, and so I was like, “Wow, this is cool,” so I crowdfunded it, and apparently, they were sending out some updates a few months ago about it but I think it’s one of those things were they’re like, “Oh we will be coming out in March,” and then they’re like “We will be coming out in July.” So I think it’s ongoing to come out at some point, but I crowdfunded that over a year ago, maybe a year and a half ago.

[Damien Blenkinsopp]: I guess the other way we could look at it is, this area is going to grow and we’re helping it. If we contribute to crowdfunders, we’re helping it happen faster. Eventually these wrinkles and bleeding edge is going to start calming down as bigger companies get more involved and the environment gets better for these devices as the market grows and so on, and we’re kind of helping to fund for the startup if we’re contributing to these crowdfund campaigns and so on.

[Bob Troia]: Absolutely, and even from a technology standpoint, like you said, it’s moving along so fast. This is what we call planned obsolescence. You buy something now that you already know in a year it’s going to be smaller and better and faster, so you just want to have access to it.
The analogy I use, I’m a musician, so people have home studios and they’re into music and musical equipment, and they can go down this same kind of rabbit hole where they’re buying more gear, more expensive things, they’re like, “If I get that microphone, I’m going to sound so much better,” and I see that happening with biohacking. I see this new gadget comes out or a new tool and they think it’s going to make them better in a certain way. But ultimately, it’s up to them and their behavior that’s going to affect it. So I think sometimes we get too caught up in just the bright lights and shiny things. I think there’s always a simpler way to do it.

[Damien Blenkinsopp]: And even the lab tests, there’s like tons and tons of lab tests you can get down and they can be really specific and complicated, and sometimes it just takes the most basic ones to figure stuff out. And lab tests can start really racking up if you get into specialty tests; you can be paying thousands of dollars just for one lab, so you have to be careful. That’s what I’ve learnt over time as well, I’ve spent a fortune in specialist labs and sometimes I was tracking them too frequently and things like this. We were talking about the cost-benefit earlier; I had to really learn how to spend my money wisely when it comes to those things.
So in terms of other people that you would recommend to talk about practicalities, is there anyone else you’ve come across like you that’s done a lot of this stuff in real life? Or other people that you’ve learnt a lot from in this area who you think would be great people to talk to?

[Bob Troia]: I’ve come across and met so many awesome people over the last few years. Are you talking more about people that have some sort of public presence?

[Damien Blenkinsopp]: Yeah, someone other people could connect with them and find their stuff.

[Bob Troia]: The first place to look would be just going to the Quantified Self website, quantifiedself.com and they tend to show meet-ups from all around the world and they film them, and so you’ll see lots of great talks. Those will typically then link out to that person like they have a blog or a website or something where you can get more information on it.
When I got started in all this, I think some of the early folks that I was reading, folks like Tim Ferriss, Four Hour Body was a big thing for me to kind of start peeling back the layers of the onion.

[Damien Blenkinsopp]: Tim Ferriss is a good guy to follow. He still talks about different stuff he’s doing here and there.

[Bob Troia]: I know he’s got a podcast that deals with a lot of other things, but I was talking more around when I started reading that book, and a lot of people that are out there doing podcasts, they’re branching out into other areas. If you’re talking just on the biohacking/QS side, there’s one guy who basically does nothing but talk about HRV. He’s done all sorts of n=1 experiments around understanding himself through how is HRV affected based on other parts of his life.

[Damien Blenkinsopp]: That sounds cool. Do you know his name? Or we’ll put it in the show notes afterwards.

[Bob Troia]: Yeah, quantlafont.com. I’d have to look up the spelling of that. There’s another guy, [unclear 1:13:16] in New York, he’s got a blog called Measured Me. He’s blogged on and off over the past few years and the thing you’ll see is that different people tend to focus on certain areas, so I think he’s more into tracking mood and understanding emotions and those types of things versus other people that might be getting more into the biohacking, getting into data from the physiology standpoint of things.
In terms of others, are you looking for specific names of blogs?

[Damien Blenkinsopp]: Whatever comes to mind. If those are the ones you’ve come across or if you have other examples that might be useful to the audience basically, if they’re interested to learn more about this kind of stuff.

[Bob Troia]: I think a great resource for understanding this more is quantifiedself.com. They have forums as a community and a Facebook group. I know Bulletproof Executives, so if you go to bulletproofexec.com.

[Damien Blenkinsopp]: So he’s been talking about his diet and his coffee today for example.

[Bob Troia]: Yeah, but there’s a really, really active forum there that’s all broken up by anything you could think of. If you want to talk about any little sub-topic of biohacking, there’s going to be some conversations in there because the community itself is aggregated there. So beyond coffee, you can get some really great conversations there. And those are like the main places. I think look for meetups in your city or nearby; connect with other people that are like-minded. That for me has been the greatest. When you meet people face-to-face, you build those relationships.

[Damien Blenkinsopp]: And there’s a conference, you mentioned you’ve been to a few conferences. So you went to Quantified Self and did you go to the Bulletproof one?

[Bob Troia]: Yeah. Quantified Self tend to do two conferences a year. They do one usually in the Bay Area—I think there’s one this May—and they’ll do one in the fall in Europe, usually in Amsterdam, so that happens twice a year. And then the Bulletproof biohacking conference just happened a few months ago in L.A. I’ve been to the first one was a couple of years ago where there was a group of maybe 30 or 40 people, it was really small, and this year it was probably like 400 or 500 people. To me, it’s not that more people are into it. I think everyone’s always been into this stuff, I think they’re just finding each other.

[Damien Blenkinsopp]: Yeah it does seem like that and when you were talking about the forum on the bulletproofexec site, there is a lot. I was looking at it a couple of days ago and there are some really heavy post threads, with 10,000 posts or threads. There’s a lot of information in there now; it’s been going for a few years so like you said, there’s a lot of information and you can connect with a lot of different people there as well. But I found, like you, that conferences I can interact more with people face-to-face. It’s a great way to meet people into this stuff as well.
So you did mention your routines, I wanted to ask you if you have some kind of daily routine about tracking metrics, like first thing in the morning or in the evening? Or is there anything you do every day which you find useful in terms of tracking data or doing any of this stuff?

[Bob Troia]: I would say on a daily basis the trick is to allow as much of it to be passive as possible, so things like having some devices collecting biometric data or having something in my home that can measure my indoor environment passively, just those types of things are happening so I can always go back. Even just your smartphone is tracking my position so I can actually map out where I’ve travelled throughout the day. I’m just collecting that data, whether or not I use it.
But in terms of the morning routine, today for example, I woke up, and the first thing I’m doing is part of my thyroid program is I have to check my morning temperature every morning, so I have a thermometer right next to my bed. So as soon as I wake up I pop in the thermometer. I actually was using an old-school, non-mercury thermometer, it was like a glass one, but now I’ve moved to this Kinsa, which hooks to your smartphone and it takes it really fast so instead of having that thermometer in your mouth for five minutes, you can just do it in thirty seconds.
I do that, I get my temperature done; it’s already in my phone, I don’t have to write it down anywhere.

[Damien Blenkinsopp]: Wow, that’s a nice little hack, I didn’t know you could do that.

[Bob Troia]: It’s pretty cool. And then if I’m doing something like we talked about HRV, so while I’m lying in bed, I have a dresser next to my bed and have my Polar chest strap and my phone’s already there, I put on the chest strap and do a three-minute reading. We talked about HRV, you want to see where you are in relation to your baseline.

[Damien Blenkinsopp]: Do you do the standing or the lying down?

[Bob Troia]: Lying down. When I wake up in the morning I try not to even shift. If I’m under the blankets or over the blankets, I don’t change it, I don’t’ want to affect it. And then I’ll get out of bed and I’ll weigh myself because I have scales in the bathroom. Again, I have one of those wireless scales so automatically the data is uploaded and you don’t have to think about it.
Then if I’m doing any glucose related tracking like I’m in a window where I was like, “Okay, this is the month I’m going to track again,” I’ll take a quick reading right then. And then throughout the day, I guess depending on my schedule, in terms of what I would track, if I had blocked out time on a given day to work on any kind of mind-training, so it could be things like space repetition or dual n-back, there are pieces of software that help improve short-term memory or recall, I’ll use tools and do that for maybe 30 minutes. The trick is just finding the time to do that.

[Damien Blenkinsopp]: So me personally, I’ve gone through phases of n-back and also the luminosity; right now for instance, I don’t do either. Have you done these in phases like you’ll do for them for a while and then other times you’re not doing them? Or is it just a constant ongoing thing that you’re doing?

[Bob Troia]: I would say more with the dual n-back. Space repitition it comes down to what I’m studying with it. One of the things I’m actually working on right now, it’s more of a long-term experiment, [and] I’m trying to get better at playing poker. I’m trying to come up with ways of memorization techniques and try to become better at it. I’ve been going through a lot of exercises and reading these books and doing these tests. Take away any of the actual active playing cards, you have to build your working memory up.

[Damien Blenkinsopp]: That’s pretty cool. I’ve actually been looking at that stuff recently myself and starting to work on it. Like minds.

[Bob Troia]: For example, if you go to the gym or you’re working out, you might just be tracking your heart rate. My workout itself, it’s still for me either a notebook and a pen just writing down what am I doing today, or I type it into my phone.

[Damien Blenkinsopp]: So are you still doing the Body By Science? We had Doug McGuff on a while back and I saw you were doing that as well. Are you still doing that or are you doing something a bit different now?

[Bob Troia]: So I started off doing the Body By Science type of workouts, and then through that and through meeting folks in the biohacking space, I got connected with these folks that are doing a different type of training that’s built off what’s called isoextremes, which is essentially mostly body weight-type exercises where you’re pulling into a position. So the idea would be you have to do a wall sit where you basically go against a wall and you get down to a squat and you’ve got to hold yourself there for five minutes. But what you’re really doing though is you’re trying to pull yourself down not hold yourself up, and so there are a whole bunch of workouts around that. It’s more neurological training.

[Damien Blenkinsopp]: It sounds like you’re really intensely holding the muscles. It’s really intense effort.

[Bob Troia]: We could have a whole other conversation about that stuff because it also involves an electronic modality that you basically hook up these electrodes that are in very specific positions in certain polarities that allow your muscles to lengthen while you’re doing these exercises. Basically what you’re doing is you’re training your muscles but you’re also training your nervous system. Over time, it has a lot of impacts, everything from reaction time and speed, not just the physical benefits.

[Damien Blenkinsopp]: I find all of that stuff awesome.

[Bob Troia]: To me, that’s more like the bleeding edge stuff because I actually go to the gym with this stuff and people look at me. I always have someone coming up to me like, “What is that?” I have to explain it and eventually you start seeing the same people there so then they leave you alone, but you always get these funny looks.

[Damien Blenkinsopp]: One time I was in Bangkok and I was doing this specific exercise, and I actually came from the Body By Science guys, which was a very slow pull-up of one minute—I don’t know if you saw that before. Anyway, I was doing this one minute pull-up and this guy came up to me at the start and he starts asking me, “What are you doing?” I was in the middle of my exercise and it takes a lot of effort because it’s really intense, and he wouldn’t leave me alone, he was like, “Tell me what you’re doing,” literally for the whole minute. Afterwards I was like, “Man, seriously I’m exercising. I know it looks kind of different but…” So it does look different, and it does get people asking what the hell are you doing, you’re looking a bit strange in the gym.

[Bob Troia]: Yeah, I was doing an exercise where I was doing, imagine doing a curl, like you have a curl bar, and let’s assume you’re at the top position, you have to slowly lower it from the top position down all the way to the bottom but you have to do it over the course of five minutes. So people are looking at you like, “What the heck?”

[Damien Blenkinsopp]: Yeah, exactly, and it’s so hard. That’s very similar to what I was talking about. It’s really, really hard in terms of mental. That’s what I love about those things, like you were talking about the neuromuscular part, it’s really charging your mental capacity and you learn to push yourself way beyond where you start from and it’s just a mental game at first I find, and so they’ve looked into benefits of concentration and things like that once you learn to push yourself further than you thought you could go.
This has been such a great practical chat. I think this is the most practical chat we’ve ever had in terms of real life stuff and people doing it every day, so it’s great to hear about your routine. Also, just because that’s really useful to people like how could I implement this in my daily life.
If you were to give someone one recommendation that you think would be useful to them in their use of data to make better decisions about their bodies, health, performance, longevity; what would that one thing be?

[Bob Troia]: The biggest recommendation, I would say, don’t let it become a hindrance, meaning I think it’s ultimately how you feel. Its one thing to say I have a goal and I’m trying to achieve something, how do I get there. But if you’re going the opposite way and trying to understand your current state and what got you to that current state, I think as we talked about, figure out is there a way to do it without it becoming a burden. It’s like say even exercise; there’s no such thing as bad exercise, technically, as long as you don’t hurt yourself. So I think people can over think it, instead of just starting to do it.
I think if you’re just looking to improve your health or longevity, those are very different things, so I could give you a tip that’s diet-based where I would say, “Cut out sugar,” or something, but I think, for me, it’s more like the mental state you’re in to do it. These are people that have already made the decision they want to do this so start off and don’t let it become a hindrance; don’t try to do 20 things at once.
That’s a big answer but I was talking more like I think there’s a lot of information out there; I think you have to assess where you’re at and what your goal is. I think health is a very general thing, everybody wants that longevity, but there might be some people who are looking for a performance-based performance versus other people who are more focused on longevity.

[Damien Blenkinsopp]: So I guess what you’re saying is try and focus on what’s really important to you to start with to keep it simpler.

[Bob Troia]: Yeah I think people might even be coming at this not from the standpoint of “Something’s wrong with me and I need to fix it.” There might be people who are just “I like where I’m at and I want to be better.” And I think that mental state, I think you’re still striving to become better but I think you’re just coming at it from a different angle.

[Damien Blenkinsopp]: And the beauty of this is I think it’s really like this long slope. When you think of it as black and white, unhealthy healthy, but it’s really not; it’s this long slope and I think all of us can do better. You can push yourself up further to be better and you can be quite good like you’re saying.

[Bob Troia]: And I think people they’ll see something that doesn’t look quite in line, and instead of freaking out or stressing themselves out, if they feel okay I think ultimately that’s the gut check you always have to take: How do you feel? It could be physical, it could be mental, maybe your stress is due to things like your job or relationships or friendships, so the things that are outside of that, and so actually your biohack itself might be “Improve your relationships.”

[Damien Blenkinsopp]: Yeah, exactly. Great point. Okay Bob, so where would we find you? Where’s your blog? And is there anywhere else you’re hanging out online where we can find you and learn what you’re up to?

[Bob Troia]: Yeah, I detail all these happenings on my blog, at quantifiedbob.com. I have a Facebook page, a Twitter account, all under Quantified Bob, Google + as well, if you’re into that.

[Damien Blenkinsopp]: Where are you most active? Would it be the Twitter?

[Bob Troia]: Yeah, Twitter is the most active. And if you ever want to connect to my real life persona, myself, it’s just bobtroia.com. I tend to keep more of this stuff on the other account just to separate. That way, there are people who care about this that don’t care about my business stuff. But it’s very clear that I’m the same person but I just split my conversations up.

[Damien Blenkinsopp]: That’s cool. It seems like you’re a pretty diverse person—fitness, music, entrepreneur, tech—all this stuff going on.
Bob, it’s been great to have you on the show with all this practical information. It’s great for the audience at home. Thank you so much for making the time for it.

[Bob Troia]: Great, thanks so much for having me.

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Recently, transcranial direct current stimulation (tDCS) or the non-invasive targeting of weak direct current (DC) to specific brain regions has received media attention. Among the scientific research community, tDCS has been a subject of great interest owing to its usage ease, relative inexpensiveness, and encouraging research results on a range of functions. Studies have seen tDCS accelerate learning, reduce symptoms of dementia, and improve attention in those with Attention Deficit Disorder (ADD). Understandably, a coinciding rise in the DIY community has also prompted an increase in consumer devices available for home use in hopes of mimicking tDCS’s potential neuroenhancement abilities.

This episode’s tracking will look at how to use different types of brain scans to understand the impact tDCS is having on the brain. In circumstances such as these, where the long term consequences are not known or understood, the tracking becomes even more important.

“What tDCS appears to do is to essentially turn the amplifier up, or the volume up, just a little bit on the brain areas that are receiving stimulation from the outside world. [Thus] you get a slightly larger reaction in the brain to stimuli that are coming in through endogenous pathways as a result of this exogenous tDCS stimulation.”

– Dr. Michael Weisend

Dr. Michael Weisend is a neuroscience pioneer in the research and broad range application of tDCS. He is an expert in the neurophysiological mechanisms of learning, cognition, and memory and has developed and advanced non-invasive brain stimulation strategies under neuroimaging guidance to enhance memory and other aspects of human performance. He has worked with the U.S. Air Force, Defense Advanced Research Projects Agency (DARPA), and the National Institute for Health (NIH).

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • In order to stimulate the brain to enhance performance, areas of the brain being stimulated should be matched to the places in the brain that are active (4:11).
  • Through image subtraction, the essential difference between two brain states (tired vs. rested, inattentive vs. attentive, novice vs. expert) can be identified. Once identified, the goal is to target stimulation in order to aid in the transition from an undesirable brain state to a desirable state (5:54).
  • Dr. Michael Weisend’s lab has mainly focused on learning. It will shortly start work with subjects with lingering symptoms from traumatic brain injuries (6:28).
  • In the near future, tDCS will have an impact in depression (7:10).
  • tDCS is inexpensive and could be a wearable for many (8:40).
  • Because of advances in neuroimaging, current is able to be placed into critical brain structures for specific tasks (9:50).
  • tDCS employs direct current (DC), which turns on and stays on at a steady rate; while machines found in physical therapy use alternating current (AC), which alternates current up and down (13:42).
  • DC current, instead of directly causing an activity, is thought to “turn the amplifier up, or the volume up” on the areas in the brain that receive stimulation from the outside world (15:32).
  • Using DC in tDCS allows for less variables to be involved (18:35).
  • There are various theories on what different brain wave frequencies mean, and different frequencies are thought to do different things. For instance, sleep and waking have different wave activities at various cyclic points across a spectrum (19:55).
  • Research has looked at a subject’s ability to find a target. Similar to the game Where’s Waldo, a subject looking for a specific individual would have to go through hours of imagery in order to complete the search, while simultaneously balancing essential components critical to the search. By studying multiple variables in conjunction with tDCS, Dr. Michael Weisend is able to see if, for a variable amount of time, subjects would make fewer errors (22:00).
  • In the case of traumatic brain injury, the damage is subtle and hard to find via conventional scanning. A more specialized test, the diffusion tensor imaging MRI, can often reveal damage to the network (24:15).
  • There are three places where to target stimulation: (1)where you sense (2)where you process and (3)where you act (27:45).
  • When the brain is stimulated, it is more reactive to natural environmental stimuli. In theory, when the brain is in a more reactive state, there will be a greater number of active cells. This allows for additional opportunities for neuroplasticity to take place. In other words, because more cells are firing and more cells are wiring, a more rapid acquisition of information, able to be measured by changes in behavior, take place (29:30).
  • MEG measures the magnetic energy produced by the brain, while EEG measures the electrical energy (33:00).
  • Carefully using tDCS, Dr. Michael Weisend has doubled the rate of learning in a Where’s Waldo type task (39:00).
  • Dr. Michael Weisend is biased for two reasons against the consumer devices: (1) devices currently out there do not take care of the electrode-skin interface; and (2) devices for home use have not been tested for safety or effectiveness (43:10).
  • There is an active debate in the neuroscience community as to whether electrical brain stimulation is more like caffeine or more like a cigarette. There currently are no imaging studies looking at the effects of long term stimulation with tDCS (45:07).
  • Could tDCS enhance performance? It could reduce the perceived effort. With the current level of understanding, however one might decrease performance instead (46:20).
  • In the future, Dr. Michael Weisend sees combined therapies, or closed loop therapies, leading the field (52:39).
  • White matter changes have been seen with tDCS; however, no grey matter changes have been observed (54:20).
  • Dr. Michael Weisend uses the original Polar Loop to track steps on a routine basis to monitor and improve his health, longevity and performance. He also looks at the actigraphy for information about sleep, and downloads the information to analyze if he is reaching his goals.
  • Dr. Michael Weisend’s biggest recommendation on using body data to improve your health, longevity and performance is to meditate a few minutes every morning. He recommends to think through your body, and mindfully self-check.

Dr. Michael Weisend

The Tracking

Biomarkers

  • Magnetic Fields: are assessed by magnetoencephalography (MEG). Neural activity in the brain results in measurable currents and magnetic fields. Magnetic fields produced by the brain are measured in the unit Telsa (T).
  • Electrical Activity: is assessed by electroencephalogram (EEG). When enough concurrent electrical activity is generated by neurons firing, simple periodic waveforms are distinguishable. Rhythms generated by electrical activity are measured by their frequency and amplitude. Frequency is expressed in the unit Hertz (Hz) while amplitude is recorded in microvolts (μV).

Brain Imaging Devices

  • Diffusion Tensor Imaging: a magnetic resonance imaging technique that captures how water travels along neurons in the brain. This test reveals damage to the neuronal network in traumatic brain injuries, which other scans may miss.
  • Electroencephalography (EEG): a method to record the electrical activity of the brain resulting from current flows within the neurons of the brain.
  • Functional MRI (fMRI): is a functional neuroimaging technique using magnetic resonance imaging (MRI) to measure spatial localization of brain activity through detection in associated changes in blood flow. Dr. Michael Weisend only sometimes uses fMRI, because it is an indirect measurement of brain activity.
  • Magnetoencephalography (MEG): is a functional neuroimaging technique to map brain activity using magnetic signals. Dr. Michael Weisend prefers to use MEG compared to other techniques because magnetic fields are less distorted by tissue or bone and the MEG allows measurement of neurons turning on and off hundreds of times a second, thus allows ongoing measurement of activity.
  • Functional MRI (fMRI): is a functional neuroimaging technique using magnetic resonance imaging (MRI) to measure spatial localization of brain activity through detection in associated changes in blood flow. Dr. Michael Weisend only sometimes uses fMRI, because it is an indirect measurement of brain activity.
  • Structural MRI (MRI): provides a picture of the brain. The MRI signal generated is dependent on characteristics of different tissue types within the brain. For instance, gray matter has certain cellular properties different from white matter and these differences are visualized by contrasts expressed in a MRI image.

Consumer Devices

  • Muse Headband: a consumer EEG device, used by Damien, to track different frequencies of brain waves.
  • Thync: Dr. Michael Weisend looks forward to this company’s consumer electrical brain stimulation device. He hopes their “safety record is as stellar as they hope it will be”.

Terms

  • Alpha Wave: the alpha rhythm is the most prominent EEG wave pattern of a brain that is awake but relaxed. When moving from lighter to deeper stages of sleep (prior to REM sleep) the pattern of alpha waves diminishes.
  • Alternating Current (AC): current that alternates with time in voltage.
  • Beta Wave: occurs at the highest frequency (Hz). These patterns are found when the brain is alert. Paradoxically, these rhythms also occur during REM (Rapid Eye Movement) sleep.
  • Closed-loop system: a system capable of diagnosing electrophysiological abnormalities and treating them promptly.
  • Delta Wave: are low-frequency (only 1-4 Hz) that increase during sleep. When moving from lighter to deeper stages of sleep (prior to REM sleep) the pattern of delta waves increases.
  • Direct Current (DC): flow of electric charge (current) in a constant direction.
  • Gamma Wave: a wave pattern with activities in sensory processing.
  • Grey Matter: areas of the brain containing unmyelinated neurons and other cells.
  • Neuroplasticity: the ability of the brain’s neuron network and synapses to change.
  • Sine wave: associated with an AC current. Dr. Michael Weisend describes it as “just a fancy word for something that goes up and down equally around zero amps, or zero volts”.
  • White Matter: areas of the brain containing myelin coated axons.

The Tools & Tactics

  • Transcranial Direct Current Stimulation (tDCS): is a non-invasive targeting of weak direct current (DC) to specific brain regions. This low-intensity electrical current is passed at a constant rate from electrodes applied to the head. This type of brain stimulation induces currents able to regulate neuronal activity. The effects of tDCS can be modified by the size and polarity of electrodes used, intensity of current, and the period of stimulation.
  • Transcranial Alternating Current Stimulation (tACS): is non-invasive targeting of alternating current (AC). Dr. Weisend explains, this is different from DC, because waves or rhythms are entrained into the brain. For example, if stimulated with 10 Hz, the stimulation will have a frequency of going up and down 10 times per second. Once to the brain, this frequency will produce a sympathetic rhythm at 10 hertz, but may also enhanced in amplitude. Thus, with tACS, determining the appropriate frequency of AC for the task is an additional variable.

Other People, Books & Resources

People

  • Luigi Galvani: is credited for the discovery of bioelectricity.
  • Roi Cohen Kadosh Ph.D.: has studied tDCS to enhance mathematical ability and found data indicating that brain stimulation may enhance one type of math, while decreasing an individual’s ability to perform another type of math.
  • Andrew McKinley Ph.D.: is a colleague of Dr. Michael Weisend, who has demonstrated that giving sleep-deprived individuals brain stimulation can have the same benefit as a cup of coffee.

Books

  • The Organization of Behavior: originally published in 1949, Donald Hebb first wrote the old (but still true) adage “cells that fire together, wire together” in this book.

Resources

  • DIYtDCS website: a blog, described by Dr. Michael Weinstein, that stays up-to-date on literature and has conducted interviews with the top scientists in the tDCS field.

Other

  • ElectRX Program: a DARPA program aimed at identifying and studying biomarkers to monitor body and organ function. It will also look at what equipment is needed to monitor, and then interact with the system electrically to change its function.
  • Nootropics: are a wide variety of both pharmaceutical and non-pharmaceutical enhancers to improve one’s cognitive abilities. There is little known about their long term effects.
  • Pavlov’s dogs: initially, a bell and food were presented together. After a few times, the bell alone would cause salivation. Thus, Pavlov’s dogs learned to salivate to the sound of a bell in anticipation of food.

Full Interview Transcript

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[Damien Blenkinsopp]: Michael, thank you so much for making time for the show.

[Dr. Michael Weisend]: Oh, you’re welcome. No problem. How can I help?

[Damien Blenkinsopp]: You can help with clarifying a lot of crazy stuff.

So, to define what you’ve been doing, it sounds like you’ve worked with a lot of different neuroimaging technologies in order to find out how to apply tDCS technologies to accelerate learning. Is that a fair summary of what you’ve been up to?

[Dr. Michael Weisend]: Yeah. When I do work on the brain stimulation stuff, I always assume at the outset that I’m dumb, not that I’m smart. And so the way that you need to approach stimulating the brain in order to enhance performance is to match the places in the brain that are active with the places in the brain that are being stimulated in order to maximize the effect.

So we have used magnetoencephalography, that measures the magnetic fields that your brain generates when it becomes active. We have used EEG, which measures the electrical part of brain activity. And then we’ve also used structural and functional MRI. Structural MRI gives us a picture of the brain, and functional MRI gives us a picture of the brain that includes the places where you are using oxygen in order to support brain activity.

[Damien Blenkinsopp]: Great. Your goal is to see which parts of the brain are active, and trying to stimulate the same parts to kind of emphasize activity in those areas. Is that correct?

[Dr. Michael Weisend]: That’s correct. So what we do is we examine the brain in two conditions. So, in the first condition, you want something that is not optimal. So it could be tired, it could be inattentive, it could be a novice.

And then we measure the brain in second conditions. So you could measure it when somebody is performing at expert level after a bunch of training, or you could perform the neuroimaging after a good night’s sleep, or you could image when somebody’s paying very good attention.

Then you take those two images and you subtract them. Once you subtract them, you have the essential difference between the two brain states. And for us, that is where we have targeted our brain stimulation. Is to find the difference between brain states, and try to target stimulation in order to aid in the transition from an undesirable brain state, to one that is more desirable.

[Damien Blenkinsopp]: Great. To give the audience a broad idea of what this could be applied to, I saw a TEDx presentation where you outlined, I think it was five different applications you saw as viable. I understand that not all of them have been attempted yet, potentially. But what were those, and which ones have you actually already attempted to, or done some work on, and it’s been effective?

[Dr. Michael Weisend]: So, we have mainly focused on learning in my lab. We’ve also done some work with vigilance, and we’re about to start work with subjects who have traumatic brain injuries and lingering symptoms from those.

In the TEDx talk, I was trying to make things very understandable to the general population because, as a neuro nerd, we kind of talk in code sometimes, stuff that’s not understandable to everybody. Not because they’re less smart, it’s just that we have different vocabularies because we walk in different shoes every day.

One of the places where I think that tDCS will have an impact in the very near future is in depression. So there’s some very good work out of the National Institute of Health in Washington D.C., and out of several labs in Sao Paulo, Brazil, who say that you can alleviate the effects of depression by stimulating the cortex between your ear and your eye, kind of on the top of your head. We call it dorsal lateral pre-frontal cortex.

[Damien Blenkinsopp]: And it’s been pretty effective. So, some of the other areas you noted down, just for example, which you already kind of mentioned, was being tired, being stressed. Which of course is a huge thing these days, because who isn’t stressed, and we hear a lot about the health impacts of that.

So that’s an interesting thing. Slow; being slow, being forgetful, and you’ve mentioned sad and depression. And then even treatment of certain brain disorders, or diseases potentially.

[Dr. Michael Weisend]: Yes.

[Damien Blenkinsopp]: So this is kind of looking at the future, and you’re TEDX presentation was aimed at the layman. I thought you did a great job, it was very understandable, even by me. So, yeah. I think you achieved that objective, and I encourage the listeners to go and check that out, before, potentially, you listen to this. It might be a good intro to get started with .

I thought what we’d now is take a little step back and talk about tDCS. What is tDCS? Where did it come from, how long has it been around? What’s kind of the basis for using this versus some other potentially similar technologies? Why are you focused on this one?

[Dr. Michael Weisend]: I can tell you why we’re mainly focused on it, and that’s because it’s inexpensive and it’s very light, and it could be put into a wearable for just about anybody.

So, where did it come from? Well, Luigi Galvani, back in the 1700s, used to shuffle around on the carpet and generate static electricity, and then touch the nerves that were attached to frog muscle in order to demonstrate that electricity caused the muscles to move. And there’s even some stories, some anecdotes, from the ancient Greeks and Romans, where electrical fish, electric eels, were touched to people’s heads in order to get rid of headaches.

So, we’re not talking about something new here. This has been around, it was used in the 1800s to try to cure paralysis. Some very good work was done on this in the 1960s that we rely on still today.

But there’s been a dramatic increase in the number of locations. I think primarily due to the fact that we have now abilities, based on neuroimaging, to look into the brain and actually do a really good job of trying to place current into critical brain structures for specific tasks, instead of kind of taking a guess at where those critical pieces of brain might be and placing electrodes in locations on the head that are based on lesions in literature.

So, the lesions in literature approach will get you so far, right? So, the lesions in literature approach more or less is the idea that if you take a piece of brain out, and a function stops so, for example, speech stops, or being able to move your hand stops then there’s this kind of fallacious idea that that function resides in that spot. And so people have turned that on its head and said, well if function resides in that spot, and we put electricity into that spot, we should change the function of moment, or speech, or what have you.

But there’s a problem with that, and if you want to think about this in a kind of a colloquial way, let’s talk about where right turn is in a car. Right? Is it in the driver’s brain? Is it in the driver’s hands? Is it in the steering wheel, is it in the steering linkage, is it in the front wheels? Right, where exactly is it?

And so, in that case, that’s a lot like the brain. Because in order for you to speak, there has to be a whole bunch of ares working together. And in order for you to move your hand, there’s a whole bunch of areas that are working together. Function does not reside in one single spot in the brain. Behavior is supported by a network of areas that work together.

[Damien Blenkinsopp]: That’s very interesting. So are you talking there about the connections between, say, the hand and the brain. And these days we also hear about the gut brain access, and the relationship between the gut and the brain.

Of course, you’re focused on specific areas of the brain, but do you think one day that we would be looking at stimulating other parts in tandem? I understand that you’re not stimulating the hand and the brain at the same time in your work, you’re focusing on the brain. So, could you sort of extrapolate a little, that idea?

[Dr. Michael Weisend]: Exactly what you are talking about now, where you stimulate in the periphery in order to influence the central nervous system or influence the connection between the brain and the central nervous system is right now the topic of a DARP request for grant proposals.

So it’s of the Electrx, E-L-E-C-T-R-X, program, or electrixs program, and they’re looking for a couple of things. One, what are the biomarkers that you might monitor in order to know that something’s amiss in a system. And two, what are the pieces of equipment or the gizmos that you might use to monitor, and then interact with the system electrically in order to change function.

[Damien Blenkinsopp]: I just thought of an analogy for people at home, because they’ve probably seen some of the info commercials on TV. You know the old electricity stimulated ab belts people would wear to get abs, Six Pack Abs machines. I’m not sure if they every worked, but is that exactly the same technology?

[Dr. Michael Weisend]: It’s not the same exact technology. So tDCS is something that turns on and stays on at a steady rate. So if we say two milliamps, it comes on slowly, comes up to two milliamps, stays at two milliamps for a period of time, and then ramps back down to zero. The ab machines or, if you go to PT they can do this too, it is physical therapy they can stimulate your muscles in order to make them move, to break up spams and stuff like this.

And those machines work on an AC current. Or, an AC current is one that alternates up and down. It’s like the electricity that comes out of your wall socket, but at a very low, low, low level. Right? You wouldn’t want to try this by sticking wires into a wall socket, you’d kill yourself. And that AC current can ramp up quickly and ramp down quickly, and it’s that ramp up quickly and ramp down quickly that causes the contraction of the muscles.

[Damien Blenkinsopp]: So do muscles work rather than an on off basis, they work on an AC because it goes negative, positive.

[Dr. Michael Weisend]: Yeah. What you’re essentially doing there is you’re causing, the AC current causes the release of neurotransmitters at the neuromuscular junction. So at the place where the nerves come into the muscle, there’s a gap between the end of the nerve and the beginning of the muscle, and there’s a substance that travels across that gap to cause the muscle to contract.

It’s called acetylcholine. It’s what’s called a neurotransmitter. And so the electricity, the AC current simply causes that acetylcholine to be released, and the muscle to contract based on the same mechanism that it would if impulses came down the nerve.

[Damien Blenkinsopp]: Great, great. Thank you for the clarification. Now coming back to the brain.

So we’re using tDCS, which is a direct current. And roughly how much time do you typically apply it for, or does it really vary according to what you’re doing? And what is the reasoning for a direct versus an AC? It’s a constant stimulation versus intermittent stimulation of the brain. What’s the reasoning behind that?

[Dr. Michael Weisend]: There are people who use AC currents on the brain. Those also cause changes in behavior. We use DC current in this case, because the way we think tDCS works is that instead of directly causing activity in the brain, what tDCS appears to do is to essentially turn the amplifier up, or the volume up, just a little bit on the brain areas that are receiving stimulation from the outside world.

So, when I think about this, I think about two terms, right. One is endogenous stimulation, which means from a natural pathway inside, and exogenous stimulation, which is from outside and maybe not through a natural pathway. So, if you take tDCS, it is an exogenous type of stimulation where you put it on the head. A whole bunch of electricity goes through the scalp, and a little tiny bit of it gets through the skull, and into the brain.

And that little tiny bit causes the neurons, we think, to be slightly more reactive when there are stimuli coming in through endogenous pathways, like the eyes and the ears, and smell, and etc, etc. Touch, right. So, in that case, you get a slightly larger reaction in the brain to stimuli that are coming in through endogenous pathways as a result of this exogenous tDCS stimulation.

With an AC current, you’re doing something different. So the AC current, essentially, if you put in a sine wave a sine wave is just a fancy word for something that goes up and down equally around zero amps, or zero volts then what you do is you’ve entrained rhythms in the brain.

So if the stimulation is at 10 hertz, it means the stimulation is going up and down 10 times per second, then you will, in the brain, get a sympathetic rhythm at 10 hertz, which is either enhanced in amplitude or generated de novo from whole [unclear, caw 17:33]. And so in that way, you have to with TACS, which is the alternating current, you have to know first that you’re getting electricity into the right areas, but then you also have to know that 10 hertz is important for your task. Or 12 hertz, or 40 hertz, or whatever you’re going to put in.

So, again, we go back to this place where I assume I’m dumb, and what I do is I put in the simplest thing I can think of and in this case it was DC current that would enhance a reaction to naturally incurring stimuli in the environment, without the baggage of having to know now not only where to put it, but also what frequency is important for the task. So it just starts getting more and more complicated as you start adding in things like, oscillations, random noise. There’s a variety of things you can add in.

[Damien Blenkinsopp]: Basically, it makes more sense to focus on tDCS because there’s less variables involved at this stage. And it sounds like we’re still on the cutting edge, and to introduce more variables is just going to make the task that much more difficult to actually use effectively, or to make research start paying off, in terms of coming up with answers. Is that the theory?

[Dr. Michael Weisend]: Yeah, that’s it exactly. I prefer to keep it as simple as possible, and try to work out the simple stuff before we, walk before you can run.

[Damien Blenkinsopp]: Exactly. Great, great. I think people have also heard of different frequencies of waves in the brain. I own a Muse, this device EEG consumer device you’ve probably heard of. And that tracks some of the different frequencies, alpha, beta, delta. Delta waves in the brain. So we’re just talking about some frequencies.

Are they related, because it sounds like when you wear these EEG devices that it’s tracking the whole brain, right? It’s like we’re having the same frequency of waves for our whole brain. But it sounded like, when you were just talking about this, that we can have different waves and different areas on the brain, and it’s actually a bit more complex. So what is the kind of model that exists today?

[Dr. Michael Weisend]: Different frequencies are thought to do different things, and it’s most clearly seen in sleep. So, in waking, you have beta activity, alpha activity, gamma activity, all across the spectrum. But when you go into sleep, you go through periods where you drop out lots and lots of the other frequencies, and you get delta, which is one to four hertz. And then when you dream, when most people dream, you come back up and your brain almost looks awake again. And then you drop into this delta.

So, what do the difference frequencies mean? Well there’s all kinds of theories out there, but I would say one that I think has really kind of held water for a while is that the oscillations are the way that different pieces of brain talk to one another.

Okay, so if you are engaging this network that we talked about before, like left turn in a car, you have to have oscillations that are complimentary in pieces of that network that are talking to one another. And it might not be that they’re the exact same frequency, but it’s important that they happen together.

So you might see alpha, or beta activity in the occipital lobe when you’re looking through an image, and that might elicit gamma activity in the frontal lobe, or one of the temporal lobes. But they are temporally related, and they are related by what’s called phase, where when the cycle of one is going up the cycles of the others are in a specific relationship to that. They can also be going up, or it could be driving that phase down.

[Damien Blenkinsopp]: Okay. It sounds pretty complex.

[Dr. Michael Weisend]: Oh, it’s the most sophisticated math in neuroscience right now, is trying to figure this out.

[Damien Blenkinsopp]: Okay, right. So, again, focusing on just stimulation versus non-stimulation, versus all of the different frequencies. You used a variety of neuroimaging technologies to try and target which areas were effective for which tasks. Which tasks have you been looking at? Like which kind of case studies, where have you worked on, to give people an idea of what kind of applications in learning you’ve been looking at?

[Dr. Michael Weisend]: We have done a lot of work for the US Air Force, and the US Air Force has images to look through for targets of interest that you might want to track, you might want to forget about. Whatever that’s going on on that day.

So, in order to think about, what is that game really about, it’s really like Where’s Waldo. Right? So let’s say that you are looking for a specific individual. If you’re looking for a specific individual, you’ve got to go through hours, and hours, and hours of imagery in order to complete that search. So, the things that are critical to completing that search are vigilance, knowing what the target looks like, knowing what the target looks like when it might be disguised.

So, we’ve looked at all that kinds of stuff to see if we can get people to, essentially, play the Where’s Waldo game for a variable period of time, and in that period of time make fewer errors, in terms of either losing the target or mis-identifying a target, or kind of falling off the wagon in terms of attention. All of those things are what we’ve looked at primarily.

We’re working now with people who have traumatic brain injury, and in this case we’re looking at veterans who have traumatic brain injury. In those veterans with traumatic brain injury they report lingering symptoms in terms of memory, attention. And that’s why we think we can have an effect, is because we can, in a healthy person, we can have the effect on memory and attention.

And so we’re now going to try to push that stuff out to people who really need it. To get back to a space where they can function in society as a healthy person, instead of trying to enhance the abilities of already healthy people.

[Damien Blenkinsopp]: So when you’re talking about injuries, is it structural damage, or is this post-traumatic stress disorder, or is it a kind of variety of different symptoms reports of which aren’t necessarily structural? So there’s not like bits of the brain actually missing or atrophied, or is there a range of different conditions?

[Dr. Michael Weisend]: So it’s a range of different conditions. It’s almost always the case that somebody who has lingering symptoms after traumatic brain injury has at least damage that is subtle. It might not be visible on conventional CT scanning, CAT scanning, or conventional MRI, but if you do some highly detailed and highly specialized scans, it is often noticeable. And one of those techniques in MRI is called diffusion tensor imaging.

The brain is connected, one end to the other and side to side, by fluid filled tubes called axons. And those axons carry electricity from one piece of the brain to the other in this network, like we talked about for right turning a car. So, you can imagine that your car wouldn’t turn very well if you pulled part of the linkage apart that moves the front wheel. So you can turn the wheel all you want, but the front wheels might not respond.

So in people with traumatic brain injury who have lingering symptoms, a specialized test called diffusion tensor imaging can often reveal that damage to the network, which is not obvious in more conventional, easily done, turn-key or canned scans that you would get at your local hospital.

[Damien Blenkinsopp]: Let’s talk about the different ways you’re quantifying changes here. Just to give people [an idea].

Are we talking about functional versus structural? Is the important thing you see as the functional aspect? Because the structural technologies I think most people are used to are the CT scan, the MRI, magnetic resonance imaging, which basically gives you a map of the structure of the brain.

If you add a bit of contrast, it will come up with some of the white matter, which is still basically the structure of the brain. It doesn’t necessarily say which bits are active versus which bits are non active. And in technological language, they say functional in terms of trying to understand how the brain’s actually working, whether it’s active or non-active.

So is most of the work you’re doing looking at understanding whether it’s active or non-active, or are you also looking at the structural changes? Because another thing that comes into this is plasticity, and neuroplasticity, which has over the last ten years has become something. There’s a few books about this, and it’s been quite hopeful in terms of saying, if we do get structural damage then we have this ability to regrow, redevelop, and overtime we can develop our brains. And so it kind of gives us this optimistic look of the brain that we can kind of adapt and grow it the way we want to.

I guess the other question behind this is also when you’re stimulating it, are you actually affecting neuroplasticity, and trying to emphasize an area of the brain to actually grow structurally? So that’s a lot of questions all wrapped up into one. I don’t know if you can remember all of them.

[Dr. Michael Weisend]: There were some tricky questions in there. But let’s start by the difference between structure and function.

So, structure is looking at your TV, or computer monitor. There’s a nice space there, and the reason that light appears in the specific places it does is because of the way it’s wired internally. But without function, the picture is black. Right? You don’t have a picture.

When we look at function what we’re doing is we’re looking at the places. Not only locations, which are defined anatomically, but by when those little pixels in the brain, the areas in the brain that are analogous to the pixels, turn on and off as a result of either being stimulated, or sensing information in the environment, processing that information, and then acting upon that information.

So, those are the three places where we can actually target stimulation. Where you sense, where you process, and where you act. You might think, and it is the case, that if we were going to try to influence behavior, we could pick one of those things to look at.

So you might try to say, let’s make people more sensitive to differences in light and dark. Maybe that will help them play Where’s Waldo. Or what’s more critical is pressing a button fast. So, then you might look at the place where people act. Or you might say, what’s most important is how you interpret the information. And so then you might target stimulation to look at where it is being processed in the brain.

So now if we move on to one of the next questions, which, I’m sorry, I forgot. So we were talking about…

[Damien Blenkinsopp]: I threw in plasticity in there as well.

[Dr. Michael Weisend]: Neuroplasticity is a fancy term for something that is very simple. And that is a change in the brain that sticks. No more complicated than that. And we call changes in the brain that stick, we call that learning. So neuroplasticity is a way that the brain captures information and holds it to change behavior.

[Damien Blenkinsopp]: Okay.

[Dr. Michael Weisend]: With neuroplasticity, how does that work? So let’s think about how that works first. So there’s an old adage, and as far as we know it’s still true, but it was first written about in 1949 in a book by Donald Hebb. He said this in very fancy terms, but what it boils down to is cells that fire together, wire together. Okay?

So if you think about Pavlov’s dog. Pavlov’s dog learned to salivate to the sound of a bell in anticipation of food being given to it. So how does that work? Well it only works, actually, if the bell and the food are presented together.

So once you have the bell and the food presented together a few times, then what you have is the bell starts to cause salivation just like the food caused salivation. And it’s when those two things are presented together the brain changes its wiring to connect them, so that you can now change behavior.

So what the heck does tDCS have to do with any of this, right? So now think about what we talked about before, where we said when you stimulate the brain you make it more reactive to the natural environmental stimuli. So, when it’s more reactive you have a greater number, at least in theory, a greater number of cells that are active. And you have additional opportunities for this plasticity to take place, because more cells firing, more cells wiring, and a more rapid acquisition of information that you can measure by changing behavior.

[Damien Blenkinsopp]: So it’s basically when the brain’s operating, you’re encouraging one area to take the lead versus another.

[Dr. Michael Weisend]: Yeah, I think that’s a good way to summarize it.

[Damien Blenkinsopp]: Alright.

[Dr. Michael Weisend]: All that fancy crap, why is it there.

[Damien Blenkinsopp]: We made it. Okay. Well thanks for all these clarifications, it’s great. So what technologies have you played around with, and which do you think are the best for what you’re trying to achieve here?

The one that I saw mentioned one time was the functional MRI. Another one was the MEG, which is something I hadn’t heard of before, actually. EEG, I saw as well, which I feel like was an older technology and not as accurate, but I don’t know. That could be just like branding and marketing, and it’s got into my head, and it’s firing the neurons in that kind of area, so I feel that way.

So when you’re looking at these technologies, which do you feel are the most useful for your work at the moment, and is that going to develop soon into different ways? Are you going to be using different, more accurate technologies which is going to be able to further this kind of work?

[Dr. Michael Weisend]: So I prefer magnetoencephalography to the other techniques for a couple of reasons. So, magnetoencephalography measures the magnetic energy that your brain generates. When you think about electrical activity, electrical activity is always accompanied by magnetism.

You can use your right hand to visualize this. If you point with your thumb at something, and imagine there’s an electric current running along your thumb on your right hand, then there’s always a magnetic field that wraps around any current that would travel in the direction if your thumb. There’s always a magnetic field that wraps around it in the direction that your fingers naturally curl on your right hand.

So, with EEG, what we’re measuring is that electrical current that’s running along your thumb. With MEG, what we’re measuring is that magnetic field that is wrapping around your thumb. So, why would we do that the technology’s way more expensive and way more difficult to maintain?

The reason we do that is because your scalp and skull are transparent to magnetic fields, but your scalp and skull are opaque, or mostly opaque, to electrical energy. Okay? So anything you see with EEG, is kind of blurry and smeared out. But the things you see with MEG are a very clear reflection of what’s going on in the brain.

But it comes with a cost. Everything, there’s no free lunch, everything comes with a cost. So, MEG has a lot more information, and as long as you take the time to figure that out then you can learn additional things about the brain.

But, in some cases it’s too much information. It’s one piece of brain talking on top of another piece of brain, on top of another piece of brain. And it’s very difficult to sort out.

So EEG gives you kind of an oversimplified picture, MEG gives you an overly detailed picture, and there’s no Goldilocks area there, where this one’s just right. You lay down your bets and you go with one of the other.

I err on the side, again, that I’m dumb. And so I want the maximum information I can get to try to learn the most. And so that’s why I prefer MEG.

[Damien Blenkinsopp]: Great. And, as you said, it’s a lot more expensive. And it’s newer.

[Dr. Michael Weisend]: Yeah.

[Damien Blenkinsopp]: You haven’t mentioned fMRI. I’m guessing that you’re not using that so much. And fMRI is very different, right? It’s about blood flow, and blood oxygenation levels. That obviously is a very different approach to tracking function.

So do you say that is relevant, because obviously in the press these days functional MRIs are the big thing in terms of behaviors, and pretty much all the brain studies that are reported these days contain these fMRIs. So how do you look at that, and why don’t you use those? It seems like you don’t use those.

[Dr. Michael Weisend]: Yeah, functional MRI I use a little bit, not a lot. But I’ll tell you, I have a couple of issues with MEG, oh, no sorry, with fMRI. One is it’s not a direct measure of neural activity, it’s an indirect measure of neural activity.

Having said that, it also has very good spatial localization of an activity. Now superior to MEG or EEG. If what you’re about is all spatial, then you can’t get better than fMRI.

What I argue is that not only is the spatial location of stuff important, we also get the on. and the off, and the frequency, and all that stuff with MEG and EEG. So I just feel there’s more information there, and I prefer them for that reason.

[Damien Blenkinsopp]: So basically, blood flow moves slower than electricity activation. So you’re looking at the thing that’s moving the fastest, and as you’re saying, it’s the first measure, rather than a secondary proxy.

[Dr. Michael Weisend]: Yeah.

[Damien Blenkinsopp]: Great.

[Dr. Michael Weisend]: Neurons can turn on and off hundreds of times a second. And so, MEG and EEG can both measure that, but [with] fMRI the maximum time resolution is on the order of seconds.

So, if you use the analogy of the ocean, if you take a picture and you see the waves coming in, that’s MEG, EEG. If you took a film and then averaged it all together so that there were no waves, right, all you got was the general level of the water. That’s fMRI.

[Damien Blenkinsopp]: So all of these technologies we’re talking about, EEG is used in the consumer world today, but the fMRI and MEG aren’t because they’re just damn expensive. So they’re not used for diagnostics as yet.

In terms of that, how applicable are they? Because we do this research with them. Is the research you find directly applicable to everyone? So if you analyze someone in the military, you analyze his brain. And we were just talking about plasticity, and when they talk about plasticity they often talk about how sometimes different areas of the brain can be doing the same thing.

So I was wondering, do you feel like everyone’s brain is this kind of a standard you can rely on? If you establish a pattern by analyzing 10 people in the military, can you now say that if you want to work on that same activity, that same task, and improve the learning, could you now apply that pattern you’ve established to anyone in the world? Or are there limitations to how broad this can be applied?

[Dr. Michael Weisend]: Well this can depend on your task, right? So if you’re interested in where is the piece of brain that moves the finger? That’s pretty standard across different people. If you are interested in languages, like reading languages, well that’s pretty uniform in the Western hemisphere, but in the Eastern hemisphere, where characters are more prevalent, then it’s a little less like Western hemisphere style.

If you are now interested in what makes this person more reactive to, more anxious than the next person, now we’re talking about each individual person learning about each individual person. So, it really kind of depends on your question what level of detail you need to go into, and the analysis.

For us, we’ve tried to focus on things that are on the level of language, where we can get good generalization across people of similar cultural background.

[Damien Blenkinsopp]: Great. Well, let’s talk about some of the specific results you’ve seen, because we’ve talked a lot about all the modalities.

Now what’s the kind of rewards you’ve seen for this activity? What kind of improvements have you seen compared to controls? What benefits do you basically see in this technology that you’ve actually kind of proven and carried out case studies and research, and you got the data behind them?

[Dr. Michael Weisend]: So we’ve replicated several times that we can, by careful placement of tDCS and implementation in a specific task, we can double the rate of learning in a Where’s Waldo type task.

Another thing; a very good colleague of mine, who works at the Air Force Base, Andrew McKinley, has recently demonstrated that you can give people who are sleep deprived the exact same benefit as a cup of coffee by doing brain stimulation. One of the interesting things about that is that and I alluded to this in my TEDx talk you don’t have all the effects on the liver and the kidneys and the lungs and the brain, with brain stimulation that you might have by taking a drug to influence being tired.

So, when you drink a cup of coffee and you are benefiting from the wakefulness as provided by the caffeine, there’s as much caffeine in your elbow as there is in your brain. And what we do with tDCS, really, is take the elbow out of the equation, and direct the stimulation at the organ that is most responsible for behavior.

[Damien Blenkinsopp]: That’s great, because I mean, caffeine is a great example there. I myself am a bit tired I’m jet-lagged from travel so I’ve had a couple of coffees today. And I also have documented adrenal fatigue, so it’s not the best idea for me.

But for me, if it was proven that I could use a tDCS unit at the moment while I’m fixing my adrenals, it probably would be a pretty wise idea, because then I could quit coffee and use tDCS when I had to get some work done.

[Dr. Michael Weisend]: Right.

[Damien Blenkinsopp]: And so, if used, is it applicable for people at home? Can they have a look at the research and use a home tDCS unit and actually apply that today? Or have we got still a little way to go in terms of, let’s just take that specific application right there.

[Dr. Michael Weisend]: Well I would say tDCS at present is a very nice, kind of cute, kind of interesting, laboratory trick that under specific controlled conditions, we can demonstrate it has an effect. If we select out lots of variants in the studies.

So, for example, if somebody hasn’t eaten normally, we reschedule them. Or if somebody had a big night out last night, and they’re a little hungover, we reschedule them. If somebody says they have some either brain disease or are taking some drug that might influence the brain, we don’t allow them into the study. So when we do our studies, we try to operate in as pure a space as possible.

And I don’t think there is a single example yet of the application of tDCS or any other brain stimulation technology in a population that takes all comers, regardless of the issues that they bring through the door, whether it be, you know, addiction, or ADHD, or tiredness, or a hangover. I don’t think there’s a single study that takes all comers and still demonstrates a good effect.

That’s important for the DIY market and consumer market because it has to have its effect when anybody comes through the door. If you buy one and it doesn’t have an effect, you’re going to be upset. That’s a hurdle that has to be jumped before we’re ready for the consumer market, I think.

[Damien Blenkinsopp]: There’s a DIY tDCS movement that started up just recently, right? I actually heard you talk on one of their podcasts. Versus, before that, there’s basically a few companies selling units.

What is the difference between those? Is DIY more about constructing your own units and kind of figuring out the positioning, versus in the units that were bought before that were basically set up for the consumer market, and so they’ve been pre-established by some companies and with a better research backing?

[Dr. Michael Weisend]: Yeah, there are a couple of companies through which you can buy tDCS units now. There’s not a single company who has a validated device for their technology, that doesn’t exist. I mean, these are literally people I’m biased here, so you take into account that I’m biased.

And I’m biased for two reasons. First reason; the devices that are out there don’t take care of the electrode-skin interface. I have the scars on my arm to prove that you can do this in a dumb way and hurt yourself.

So, I look at my forearm now and I can count, as we were trying to generate good technique with electrodes, I can count six scars on my wrist where I burned myself very badly. The electrode-skin interface is critical to take care of, or you’re going to scar yourself up. And that’s not good.

The second reason I’m biased against DIY home use is that the devices that are available have not been run through any studies, for safety or effectiveness. And so I really worry that because we don’t have documented safety, effectiveness, and feasibility that what is really going to happen is there’s going to be a bunch of people who fail to get their desired effect, burn themselves, and it affects the ability of other people who are being careful to move forward to get this technology into the hands of consumers, patients, and other interested parties that might be able to benefit from this.

[Damien Blenkinsopp]: Great. So to kind of go with that, what kind of advice would you give to someone who’s interested in playing around with this? Is there any safe way to do this now? Because we’re talking about safety here. So safety concerns. And I guess most people are going to be a little bit wary of applying electricity to their brains.

Beyond skin burns we’ve talked about skin burns could there be potential other damage? Say you stimulated the wrong areas? Or, maybe some of these units enable you to turn the charge up higher, and is that something that could cause some kind of brain interruption? I’m not going to say damage here, it’s a big word, but could it cause some kind of issue for you?

[Dr. Michael Weisend]: I believe that’s possible. So I just came from a conference in New York last week, and there’s an active debate in the community whether electrical brain stimulation is more like caffeine, where, “Nah, let it go, let’s see what happens.” Or, more like a cigarette, where, you let it go, you see what happens, and you discover down the road that you might not have done something correctly, or you might have hurt some people.

What is it? Is it more like caffeine, is it more like a cigarette? There’s not a single study right now, not one, that has done imaging long term stimulation with tDCS, and then brain imaging again to find out if the technique ultimately does cause changes in the brain that might be deleterious. We just don’t know. So, we’ve got to be careful about that.

What I would say to the DIY community is that long term study doesn’t exist. The other thing I would say to the DIY community is the exact same thing I said to people I met in Los Angeles a while back, with people for the Olympic Team. Pole Vaulting team, in particular.

And they were asking if we could use tDCS to enhance performance, because, little did I know, but I guess pole vaulting is one of the most cognitively demanding sports in track and field. Where you have to put a giant sequence of things that are done perfectly together in order to get a good pole vault.

[Damien Blenkinsopp]: Well I’m guessing also, in terms of neuromuscular activation, tDCS could be helping increase your strength, basically, by enhancing neuromuscular activation. Is that part of that too?

[Dr. Michael Weisend]: Well it reduces your perceived effort. That helps with things like fatigue. But what I said to them was, what do you want to ingrain in your brain? Is it the case that if you have a bad pole vault, you want that to stick? My guess is no. But if you have a good pole vault, you want that to stick.

So, I worry that right now, given our level of understanding, if you just put it on somebody’s head and they go pole vaulting, what if you make bad technique stick? And be hard to get over? You might actually hurt your Olympics team, or your Olympic athletes. You might decrease their performance instead of increase it. And so, I was pretty dubious about that, and I said I don’t think we’re ready to do this with you guys. I’m sorry.

[Damien Blenkinsopp]: That’s a great example, and it sounds like it connects with the argument that’s currently going on in neurofeedback at the same time.

[Dr. Michael Weisend]: Yes.

[Damien Blenkinsopp]: Because they’re asking, okay so we’re not sure of where we’re going. So there’s different neurofeedback technologies. There’s some that just try to enhance what you have, kind of like help your brain to know what it’s doing, and then there are others which are kind of pointing in a direction. And people are a bit nervous about the one’s pointing in a direction.

Which I guess what you’re saying is I don’t know which direction in most of these applications we should be pointing the brain. You know, should we be activating this more? We’re making an educated guess with the MEG and the other technologies right now.

How confident do you feel in those applications, or are you feeling this is going to be a research, and potentially a medical use, where people are actually going to get big benefits? It’s not just going to go from healthy to a performance increase, but it’s, you know, “I’ve got some health issue, I’ve got some brain issue, and maybe I can get back to normal.”

So that’s generally where technologies start, because it’s in a more extreme, desperate situation, and there’s a bigger upside to using technology. It’s like, am I going to be a little bit non-functional for the rest of my life, or am I potentially going to get back to normal functioning? So could you highlight what your opinion on that is?

[Dr. Michael Weisend]: However you decide to alter your brain, there’s no free lunch. Right?

So there’s very good data out of Roi Cohen Kadosh’s lab at Oxford that if you apply tDCS to enhance mathematical ability in one field, or in one type of math, you decrease your ability to do a different kind of math. And that is potentially an issue, in the case that how would you best apply this for your specific application?

Well in the DIY market, you don’t even have this choice. What you’ve got is one electrode configuration, one type of electrode, one recommended spot on your head. You don’t even have the freedom to apply this to your specific situation that you would like to change. So I’m worried that what’s out there now, especially for the DIY market, is gimmicky and quirky, and maybe dangerous.

I mean, there’s very little in the way of harm. The side effects are very low with tDCS, but I worry that there’s always somebody that’s going to pushing that limit, and pushing that limit, and having limited options. Maybe turning the current twice as high, using it twice as often. Soon you’re going to have somebody who hurts themselves, and then we all feel bad about that. Nobody feels good about that.

[Damien Blenkinsopp]: Right. Great, thanks. Alright, so tips for someone who is going to do this at home anyway, [despite] listening to this interview, which I’m sure there’s people out there, because I see a lot of talk about tDCS, and one of my buddies has been playing around with it.

So, if they were going to track something that might help them to know it’s actually improving, versus worsening what they’re up to, are there any biomarkers or anything like that you would advise they watch so that they can tell if it’s probably a positive versus a negative? Or is it kind of very difficult because it’s quite task specific, so you kind of need to look at whatever the task is, and try to measure somehow that you’re getting better or worse at it?

[Dr. Michael Weisend]: So, I would say there’s two things that we know we’re fairly close to clinical application on. One is depression. So you might want to have somebody monitor their mood, and do mood ratings every day to find out if when they use tDCS does it alter their mood. And I would say the other thing that you might have somebody do is to monitor their perceived effort.

So let’s say that you go to the gym, and you get home and you feel awful, and you get old and fat like I am. You go to the gym, and you’re tired and sore, and don’t feel so good the next day. So, does your willingness to return to the gym, does that change when you use tDCS? Or your willingness to engage in a task that’s difficult for you? Does that change?

Pay attention to that kind of stuff. I hope that if you are going to go ahead and use this against my recommendations I do not recommend this at all you do it very carefully. Take care of your electrode-skin interface, and monitor something that we know for a fact has, well we know that in a carefully selected population we can have a meaningful effect.

[Damien Blenkinsopp]: Thank you. That struck me as very meaningful measures, which could hopefully avoid them going backwards for a long time if it actually does turn out negative, and hopefully give them some positive feedback.

In terms of this whole area, where do you see it going in the next five or ten years? Or where would you hope it goes?

[Dr. Michael Weisend]: I hope a couple of things. So, first I hope that companies like, there’s a company called Thync that is going to come out with a consumer device for electrical brain stimulation here within the next couple of months. And so, I hope that Think’s safety record is as stellar as they hope it will be.

I also think that you’re going to have combined therapies, or closed loop therapies, that are going to lead the field. So, let’s say that somebody is sitting there at their computer, and when we monitor their eye movement what we notice is that their eyes are not paying attention to [the] task. And so we could turn on tDCS in order to help them stay engaged with tasks when we notice that they’re deviating from a task.

I think those are applications that might come. So especially I hope that the safety’s good, because I know people are going to push it out there whether we like it or not, and I hope that people start thinking about ways to put the stimulation in a closed loop to help people when they need help, and turn it off when people are doing fine.

[Damien Blenkinsopp]: Great, thanks. What’s the most exciting thing you think, in terms of opportunities? So you looked at the downsides there, and hoping that the downsides I can see, you’re like, “Oh, I hope this doesn’t cause a mess.”

So, what would be the upsides over the next five or ten years for you? If you were to get involved in research, or if some of your projects were to work well and maybe develop over the next ten years, what would be the exciting opportunities for you?

[Dr. Michael Weisend]: I would say that the traumatic brain injury work really has me quite excited. So in traumatic brain injury, there really is no good therapy. There is a whole lot of, try it a different way, take this drug to deal with problem A, take a different drug to deal with problem B, take a third drug to deal with problem C. And hope that those drugs interact in a way that’s friendly and works.

Something else like multiple sclerosis. I mean, [there’s] really no good treatment. I keep hoping that one of these brain stimulation technologies is really going to enter that space and make a difference for people right now that really have no, no good treatment available.

[Damien Blenkinsopp]: Have you seen structural change influenced by tDCS? So, like if you stimulated an area for a while if it had atrophied at all, would you potentially see some de-atrophying, or growing back, or anything like that?

[Dr. Michael Weisend]: We’ve seen white matter changes with tDCS. So, white mater changes are the wires that connect different pieces of the brain, and it looks to strengthen them.

[Damien Blenkinsopp]: So white matter is myelin?

[Dr. Michael Weisend]: White matter is axons that are coated with myelin. So it’s the part of the neuron that’s coated with myelin. And so, it looks like the myelin coating is getting stronger.

Now, this is not yet verified by a lot of studies, but I had a conversation with a researcher from Harvard last Sunday night. They have seen similar things to what’s going on in our lab in Dayton, Ohio. So we’re actively working together to see if we can understand better how we might be affecting myelin and white matter using tDCS.

[Damien Blenkinsopp]: Right. But there’s no grey matter changes?

[Dr. Michael Weisend]: Not that we’ve seen.

[Damien Blenkinsopp]: Okay, great.

[Dr. Michael Weisend]: Not that we’ve seen.

[Damien Blenkinsopp]: So, in terms of someone at home learning more about the types of tDCS, and potentially some of the other things you’ve been talking about today, where would you direct them to? Or what would be good sources of information where they could learn more, and get more into depth? Especially if they’re going to potentially use this, [or are] thinking about using this. Is there anywhere you would direct them to learn more?

[Dr. Michael Weisend]: Well, if it’s a DIY person, there’s a website called DIYtDCS, and it has a whole bunch of audio interviews and blogs by a guy who really does keep up, pretty amazingly, with the literature. I can’t keep up with the literature, but this guy does a great job.

So, there’s a great deal of information there, there are some good interviews by a lot of real top flight scientists. So that’s a good reference, and I would pay attention to the idea that every single person who is on there who’s a top flight scientist worries that this is going to hurt somebody at this point, and that we need to be very careful.

[Damien Blenkinsopp]: I mean, it sounds a little bit comparable to nootropics. There’s a wide variety of nootropics out there today, and we don’t know the long term effects of them. For many of them, sometimes it’s even anecdotal. Some people say they work, and some people say they don’t.

Would you compare it to nootropics? I don’t know how much you know about nootropics, but it’s another approach to stimulating and changing. Another approach [through] chemistry rather than stimulation. But would you say it’s as risky, or potentially the same?

[Dr. Michael Weisend]: Well I would say nootropics is not a new idea, right? I would say caffeine is nootropic. So, is it the same, is it difference? I would say people are often pushing the limits of their capability, and would like to be able to go that one more step.

And so, in that sense, I think, the nootropics and the brain stimulation stuff are really partially the same desire of individuals to better themselves, and to be able to push that one more step. And so, I’m all about that. I just think that we need to approach it in a reasoned and careful way.

[Damien Blenkinsopp]: Great, great, thanks. Rounding off into, I’d love to get to know a little bit more about. You know, you’ve obviously taken a very vigorous approach to this area. How about yourself? Are there any data metrics that you track for your own body on a routine basis, to gain insights or improve health, longevity, performance, or any other concerns?

[Dr. Michael Weisend]: Yeah I wear a band on my wrist all the time that tells me about my steps, and it also does actigraphy that gives you some insight into sleep. And I look at it every day, and I download the information. It looks like I’m reaching about half my goal all the time instead of the goal I should be shooting for.

[Damien Blenkinsopp]: I see you smiling there, so it sounds like you’re happy that your meeting those goals.

[Dr. Michael Weisend]: Yeah, well I mean, it’s better than zero. And it also, it kind of helps you think about being more healthy. It kind of prompts you.

So my wife and I are very much, the little town we live in has restaurants that are about a mile and a half away, a grocery store that’s about a mile and a half away. And we often walk to the restaurant or walk to the grocery store. And I’m not sure we would have done that if I didn’t have this little thing on my wrist bugging me all the time saying, hey, get out of your chair and go do something.

So, I use that kind of thing. I mean, we all use devices that help us regulate our activity. I mean one very simple example is an alarm clock. It aids in your sleep-wake cycle. Another thing that people often use is a meal at a scheduled time. It helps them to set the tempo of their day, or to set the day up so they are meeting expectations. So, there’s all kinds of these little things that we use, that we monitor, that we impose upon ourselves in order to help us get to where we want to be.

[Damien Blenkinsopp]: Great. Can I ask which tracker are you using on your wrist there?

[Dr. Michael Weisend]: Yeah, I use the original Polar Loop. That’s what I typically use. And I use it just because I thought it had the best cosmetic appearance. That was the whole… It was the least obtrusive, least clunky looking…

[Damien Blenkinsopp]: That’s true. A lot of them do look a bit clunky. I guess that’s where Apple’s trying to come into the market, to de-clunkatize it.

[Dr. Michael Weisend]: Well, Apple’s had a history of doing that well when they lead. I’m not sure they have a great history of doing that when they follow. So, we’ll see how that all works out.

[Damien Blenkinsopp]: In terms of tDCS, actually, have you used tDCS yourself? Is it something you have applied to yourself, or are you basically, ìI’m not going to use this technology, it’s far too dangerous.

[Dr. Michael Weisend]: I’ve put it on my head for demos, and I’ve put it on my head to test paradigms. I will not do anything to a subject that I wouldn’t do myself.

[Damien Blenkinsopp]: It sounds like you’ve done a lot then.

[Dr. Michael Weisend]: I’ve probably had it on my head 50, 60 times, for sure.

I do not use it if I need to focus to get something done. And I do not use it if I wake up in the morning and I’m super tired, and I think I need a boost. I don’t think we’re quite there yet, but I’m not afraid of it at all. I put it on my head, stimulated in multiple different ways, to try to basically reassure myself that I wasn’t going to do something stupid to some other human being.

[Damien Blenkinsopp]: That’s a great attitude. Now I’m guessing you’ve got the unit that has good electrodes that aren’t going to burn you now.

[Dr. Michael Weisend]: We’ve developed some electrodes that have never caused a burn.

As a matter of fact, electrodes cause such a little bit of skin reaction that not too long ago we did a demonstration on a film crew that came from New York, from a place called Vocative. And when we took the electrodes off, the skin was a little bit red. And I said to one of my graduate students, take this gel and test it, I think the gel is going bad. And in fact it was.

[Damien Blenkinsopp]: Is that something you could license? Is that a technology that you need to license to other companies?

[Dr. Michael Weisend]: Well we’ve applied for a patent for that stuff, and I am actually in active discussions to do some of that kind of stuff.

[Damien Blenkinsopp]: Okay, last question here. What would be your number one recommendation to someone trying to use some form of data to make better decisions about their body’s health, performance, and longevity?

[Dr. Michael Weisend]: I would say I think about this all the time and I actually regularly do this is when I get up in the morning, have a standard routine, and just kind of meditate for a minutes. Or think through your body, top to bottom, how am I feeling today? What are the things that I could do better if I wanted to feel a little differently?

So it’s almost like a self-check, right? Like you’re doing a system test. Don’t get up at the last minute, run out the door, find out ten minutes into your drive that you have a headache, or your guts don’t feel right today. But get up, have a nice standard breakfast, and just kind of think through from the top of your head to the tip of your toes about how you’re feeling today, and what would be the thing that you might do today to make yourself feel better tomorrow.

[Damien Blenkinsopp]: That’s great. So is that actually a semi-meditative practice, or are you just being quiet, and just trying to be internally focused and trying to see what’s up. Being self-aware kind of thing? Or is it focusing on your breathing, using one of the techniques. Or is it just kind of your own mindfulness, trying to be aware of your body?

[Dr. Michael Weisend]: I think it’s very much mindfulness. So, just yesterday I went out and chopped wood for three hours. So this morning I get up and I’m a little sore. And I think to myself, where am I sore, why am I sore. And it turns out, for god knows what reason, my hands are the things that are really the sorest, from gripping the stupid ax handle while it was wet.

And so, when I think about this, what I think about is now, well, I should stretch my hands, I should be careful to make sure that I’m not repeating that same kind of motion today, if I can avoid it. Just, making sure that you think it through what’s the step you are going to take to make it better, and then actually carry it out.

[Damien Blenkinsopp]: Great. Thank you Michael. I actually start my day with something similar, or at least I try to. I don’t succeed every day, I don’t know if you’re better at that than me. But some phases when I’m more stable. When I’m traveling a lot, it really tends to suffer. Now I’m just kind of getting back into it, and it really makes a difference for me too, just a similar practice to yours.

[Dr. Michael Weisend]: Yeah.

[Damien Blenkinsopp]: So, I can vouch for that from personal experience also. Thank you for the wealth of information. Also, all the tips on safety, being practical about this, and just you’re depth of information today. It’ been super insightful. Thank you very much.

[Dr. Michael Weisend]: Oh, no problem. Glad to help.

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Is Heart Rate Variability the best biomarker of the time to track our longevity? In this episode we look at why HRV may be the best way to track how well you are aging and the bets being placed on it in Silicon Valley to drive innovation in anti-aging and longevity research.

Previously we’ve looked at using HRV for training and recovery, stress management, and tracking hormesis. If you are new to biohacking, HRV is an easy economical way to start tracking. All one needs is a heart rate strap and phone app.

The activity around HRV in Silicon Valley originates from The Palo Alto Longevity Prize – a one million dollar life science competition to “hack the code” that regulates our health and lifespan. The prize is using HRV as a proxy measurement for longevity, so teams will compete against each other to find tools and tactics to increase the HRV metric – and thereby potential longevity.

“Whenever you want to nurture innovation, you need to have metrics… The reason HRV was chosen was… one, we have decades worth of heart rate variability data…. there is good cohort data, population level data, that suggests that declining HRV is also due to a chronologic age…. [and] unlike most biomarkers in health, HRV can be measured continuously, contextually. You can measure it for 24 hours.”

– Dr. Joon Yun

Today’s interview is with the man behind the Palo Alto Longevity Prize, Dr. Joon Yun. Dr. Yun is managing partner and president of Palo Alto Investors,LLC, which oversees 1.8 billion dollars in assets invested in healthcare. Dr. Joon Yun is board certified in Radiology, was clinically trained at Stanford and received his M. D. from Duke Medical School. He has published numerous scientific articles, and has a column in Forbes magazine. Recently, he agreed to sponsor the Palo Alto Longevity Prize by donating 1 million dollars to this life-science competition.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • By the mid 40’s there are both subjective (able to be felt) examples and objective (not felt) examples of homeostatic capacity loss. (3:46).
  • Prior to middle life, the body’s homeostatic capacity is able to return to baseline (5:00).
  • Aging can be thought of as a decline in the body’s ability to get back to homeostasis due to an erosion of homeostatic capacity (5:27).
  • The healthcare system is centered on returning homeostasis and not homeostatic capacity (5:41).
  • The goal of the Palo Alto Prize is target and nurture ways to improve and restore homeostatic capacity, instead of restoring homeostasis (6:10).
  • There is some overlap in hormesis and homeostatic capacity (9:20).
  • Challenges to the body can increase homeostatic capacity (9:53).
  • The final perimeters of the Palo Alto Prize were announced at the end of 2014 (10:29).
  • Millions of people succumb to aging or aging-related issues. Thus, the sooner we start, the more people can benefit (11:19).
  • This is the first prize Dr. Joon Yun has sponsored (12:09).
  • Despite the innumerable traits of homeostatic capacity happening on the physiological level, there are existing biomarkers that represent proxies of homeostatic capacity (12:51).
  • Practical reason for why HRV was chosen as a biomarker include: (1) ability to be measured continuously (this is a unique feature compared to other health biomarkers); (2) ability to be measured contextually; and (3) ability to be measured non-invasively. Globally, there are numerous devices available to help measure HRV, thus providing an opportunity for a range of teams to apply for the prize (15:34).
  • Orthostatic hypotension was another biomarker considered (16:50).
  • Too rapid heart rate response or insufficient heart rate response during cardiac stress testing may indicate dysfunction in certain areas (18:05).
  • The data from orthostatic hypotension, cardiac stress testing, and heart rate decline after exercise are strong relative to other areas of homeostatic capacity assessment (19:05).
  • The goal of the project is to gather more data and develop more biomarkers of homeostatic capacity (19:14).
  • The definition (or standard) of HRV to be used in awarding the Palo Alto Prize will be determined by a team of experts (19:45).
  • Dr. Joon Yun does not track biomarkers on a routine basis (20:51).
  • Dr. Joon Yun’s single most important recommendation is exercise to improve your health, longevity and performance (23:37).

Thank Dr. Joon Yun on Twitter for this interview.
Click Here to let him know you enjoyed the show!

Dr. Joon Yun

The Tracking

Biomarkers

  • Heart Rate Variability (HRV): measurement of how one’s heart rate varies over time. Dr. Joon Yun describes HRV as a proxy for autonomic capacity, which itself is a surrogate of overall homeostatic capacity. Additionally, HRV can be taken continuously and non-invasively. Please check out other episodes for details on how to track HRV and optimum ranges.
  • Orthostatic Hypotension: measures the ability of the body to recalibrate blood pressure when moving from a lying to sitting position or a sitting to standing position. In aging, it has been associatively observed that the body’s ability to adapt to rapid changes in blood pressure deteriorates. Therefore, this is one way to infer homeostatic capacity and is another biomarker considered for the prize.
  • Heart Rate Recovery: measures autonomic capacity by looking at heart rate behavior after exercise. Looking at this decline over a certain time period gives insight into the function of the heart when compared with a normal curve.
  • RMSSD (Root Mean Square of the Successive Differences): the industry standard for measuring and calculating HRV. Discussed in more details in Episode 1 & Episode 6.
  • lnRMSSDx20 (RMSSD with natural log and multiple of 20 applied): applications have begun using this measure. This is RMSSD scaled to an index of 100 for easier use. Discussed in more details in Episode 1 & Episode 6.

Terms

  • Homeostatic capacity: a network of traits in our bodies to achieve homeostasis. It is the body’s ability to “self-tune” or, in response to stressors, its capability to self-stabilize. This capacity or trait is inborn: when we are young, the feeling of health feels like “nothing”. Once it begins to decline in midlife, we become aware of it. For instance, we notice an inability to tolerate hot or cold weather or that the recovery from a late night takes longer that it use to. There are also changes not necessarily felt, such as homeostatic capacity returning elevated blood pressure to base levels.

Lab Tests, Devices and Apps

  • Cardiac Stress Test: this test is an assessment of the body’s response to an exercise heart rate challenge. Dr. Joon Yun describes this as a test, common in standard practice, that can be viewed as a “homeostatic capacity test”.

Other People, Books & Resources

People

  • Edward J. Calabrese Ph.D.: Dr. Joon Yun first heard about the idea of hormesis from him.
  • Aubrey de Grey: a link to Aubrey de Grey’s published work. He was also mentioned in this episode by Dr. Joon Yun in reference to the Methuselah prize. We talked to Aubrey de Grey about his framework to increase longevity in Episode 14.

Organizations

  • Methuselah Mouse Prize (MPrize): started in 2003, this prize was designed to accelerate the development of life extension therapies. In 2009, the MPrize for both longevity and rejuvenation were awarded. Currently, $1.4 million is available for awarding to researchers who can top previous winners’ performances.

Full Interview Transcript

Transcript - Click Here to Read
[Damien Blenkinsopp]: Yeah, it’s great to have you here.

So, you’re involved in this big project called the Palo Alto Longevity Prize. Could you give us a run down. What is the vision behind that, and why have you put this together now?

[Dr. Joon Yun]: The vision of the Palo Alto Prize is to nurture innovation that improves the homeostatic capacity as a gateway into promoting healthy longevity, and health span.

[Damien Blenkinsopp]: Right, so, I think a lot of people aren’t exactly sure what homeostatic capacity is. So how would you describe that, and why is it particularly this homeostatic capacity that you’re linking to longevity?

[Dr. Joon Yun]: Most people are familiar with the word homeostasis. So think of homeostatic capacity as a network of traits in our body that enable us to achieve homeostasis.

Now homeostatic capacity is something that’s endowed by nature. It’s been shaped by evolution. And you can think about it as robustness, resilience, coping mechanism, dynamic range, anti-fragility. These are all kind of similar concepts. But the basic notion is that we have an incredible set of traits that enables our bodies to self tune.

One of the ironic things about homeostatic capacity is that we don’t really realize we have it until we start losing it, typically in mid-life, where all the sudden you start to feel things that you didn’t feel before. At nighttime, it’s a little too dark, the sun shines a little too bright during the day. [When] riding a roller coaster, you may come out of it nauseous, because your body doesn’t re-calibrate. Altitude sickness starts emerging around then. The bouncing back from injury or jet lag, or a late night.

All these things are suggestive ways that we start to experience the loss of something that we didn’t have. That we didn’t used to feel. The loss of something that we didn’t feel when we were younger.

In fact, when we’re 12 years old, another way to define health is the feeling of nothing. When we’re young and we’re healthy, what we feel is nothing. It’s when we start feeling something that we realize something’s going on.

[Damien Blenkinsopp]: Right, right. So in a sense, this is balance, and you’re just feeling well without any negative symptoms, or negative feelings, I guess.

[Dr. Joon Yun]: Yes. So you can think about homeostatic capacity as your body’s ability to self tune, and get back into balance or homeostasis. But think about all the things that happen…well.

So we’ve described the things that are subjective that you can experience. There’s also a lot of objective things that you can’t feel, but start to emerge by the middle of life, again that’s defined by the mid-forties.

When we’re young and our blood pressure’s high, or our blood sugar is high, the body has the homeostatic capacity to return those numbers to a normal baseline. But as we age, a lot of those numbers no longer return to baseline. They remain high.

And we call those situations diseases like hyper-tension and diabetes. The thing about a lot of the diseases of aging as reflections of the body’s declining intrinsic ability to get back to homeostasis because of potential underlying and inevitable erosion of homeostatic capacity.

Now what we do in the health care system today, we provide an external mechanism called the health care system, we trying now here in the US to help the body get back to homeostasis. But because we’re trying to restore homeostasis, and not necessarily focused on restoring homeostatic capacity, the inevitable loss of homeostatic capacity continues manifesting in increasing features of aging. And in the long run the health care system can no longer help the person make the homeostasis, and then death ensues.

So the gambit of the prize is to target and nurture innovations that improve homeostatic capacity. That we restore homeostatic capacity instead of restoring homeostasis, to see if this could be a gateway into improving health, and sustain health, and longevity could be an outcome of that.

[Damien Blenkinsopp]: Great. So this is an area you feel is undervalued, under-utilized, and currently when it comes to health and health care, and it’s something you want to promote.

What is the kind of vision behind the prize? For instance, we had an interview with Aubrey de Grey recently, and he’s talking about extending lifespan considerably. Would you put it along those kind of lines, or is it more kind of making sure that we live to our prime years 80 years old, 90 years old, 100 years and we live really well, versus having the current diseases which plague a lot of people these days?

[Dr. Joon Yun]: Well it’s really about promoting health. Longevity might be an outcome, but there’s a difference between something being an outcome and a goal.

Our goal is to improve health, and helping longevity may be a consequence of that. So I do think that the target is a little it different. And I also think that the target, the homeostatic capacity, is different than homeostasis.

To give you the example of high blood pressure. Think about high blood pressure or hyper-tension as it’s called medically as the lab error reported by the body of the blood pressure being too high. And the way we fix this is in the modern medical system is we give patients drugs that normalize that blood pressure. Meaning, return it back to a number associated with homeostasis.

But because we are externally providing that capacity, when you miss your dose of drug, or when you come off a drug, in many cases your baseline has progressed, and may be even worse. Because the one thing your body knows how to do is to homeostasis against all the external challenges. The more it sees blood pressure lowering drugs, in many ways the body rebounds. It’s called toxic phalasis.

And this is a challenge with most pharmaceuticals that the body remodels against the drug. So when you come off the drug, your lag error can even be worse. You can have rebound hyper-tension, something called addiction decompensation.

The way nature addresses high blood pressure is by exercising. Meaning the natural way to treat hyper-tension is to leverage your homeostatic capacity as a way to lower your blood pressure. Meaning, when we exercise, we’re actually increasing our blood pressure by challenging it. And in this sense, the homeostatic capacity can be stronger. And so the baseline blood pressure actually gets lower the more times you raise it. So it’s almost a mirror image of what we’re doing with the medical system today.

And when we think about the diffuse benefits of aging in, really, all those views of aging, including longevity itself, it’s generally suggested that using homeostatic capacity as a treatment for aging, rather than tools of homeostasis, may actually work in terms of expanding health for society and expanding longevity.

[Damien Blenkinsopp]: Great, great. Thanks. We’ve spoken about hormesis quite a few times on the podcast before. Would you say it’s related to hormesis? When you were talking about exercise, it sounded very similar to the kind of hormetic discussions we’ve spoken about. So are homeostasis and hormesis linked?

[Dr. Joon Yun]: Some people may find some overlapping ideas. Hormesis I first learned of it through some some great body by Ed Calabrese, out in the East Coast. My understanding of it is that it’s the notion that at different ends of the curve your going to have differences in response.

I guess there’s some relation to it, although I think the mechanism attributed to hormesis has been debated out there. But the notion that challenges to the body that, many challenges to the body can actually paradoxically induce competitory strength, or induction of homeostatic capacity. But I do think that there’s some overlap in the ideas.

[Damien Blenkinsopp]: Great, great. Thanks for that. Helps to situate our audience better.

Okay, so coming back to the Palo Alto Longevity Prize. Is there a specific reason why you decided to do it this year, and could you explain a bit more about the background? So you already have many teams participating in this challenge. Have they got any rules around defining the participation? So, have you said that there’s any restrictions to what they can do in order to compete? Or is it kind of very, very broad?

[Dr. Joon Yun]: The Palo Alto Longevity Prize is run by a team, including some of the scientific experts and industry experts in health care, and they’re the ones who convened to determine both the criteria, and they’ll represent the independent judging panel as well. And those final parameters will be announced to the public sometime this year. And there they’re accepting public comments.

Remember this is a new area, homeostatic capacity. It’s kind of a new word, although I think it is a phrase the scientific community understands, and it can embrace, and can develop innovations around. So we’re in the early stages of all that.

As to why do it this year? Well, we know that every year we wait, there’s enormous amounts of suffering that goes on around the planet associated with age and loss of life. And so we know that every week we wait, a million people have succumbed to aging or aging associated conditions. So, we think this is a very significant time, and the sooner we start, the better.

We do think that this is going to take some time, and maybe a series of prizes, with a lot of different starts. And we think it will be a long journey, but the earlier we start, the more people can benefit from improved health.

[Damien Blenkinsopp]: Great, thank you very much. I understand that you’ve put your money, or is it Palo Alto Investors that have put the money in for the prize to stimulate? We’re seeing a lot more prizes now, as a method for stimulating innovation in other industries. I think this is the first one that’s tried to do it in health care, and certainly longevity. Or have you seen other ones before?

[Dr. Joon Yun]: I think there have been other prizes before. The [inaudible 11:56] Prize, Aubrey de Grey, the Methuselah Prize. I’m new to prizes. I’m the sponsor of the prize, and I learned about prizes with some of the experts in the prize community.

And one of the things I like about it is that it mirrors how evolution works, Darwinian evolution works. There’s a niche, there’s a diversity of options that compete for the niche, and there’s a winner.

[Damien Blenkinsopp]: Great. Coming back to the rules of the prize, you’ve decided to focus the prize on using heart rate variability, HRV, which we’ve covered quite often in this podcast before. Why did you decide that this was the biomarker you were going to use for the focus of the prize?

[Dr. Joon Yun]: Exactly. So whenever you want to nurture innovation, you need to have metrics. And homeostatic capacity is a new phrase, and there are some existing biomarkers or diagnostic tests that could represent proxies of homeostatic capacity.

But homeostatic capacity is a diffuse network of many, many innumerable traits. Such as physiological level, tissue level, systems level, molecular level, cellular level. It’s a composition and the inter-relationship between all of them. It’s a composite that reflects an overall organismic homeostatic capacity. So the challenge is how do you take and define biomarkers that represent copies that affect the surrogates for homeostatic capacity?

The reason HRV was chosen was, first of all, it represent a… Well, so HRV is heart rate variability. It is a biomarker of autonomic capacity, which itself is a surrogate of overall homeostatic capacity. So it’s just one variable that happens to have a number of features that make it interesting.

Number one, we have decades worth of heart rate variability data. It’s been in clinical use since 1963 to monitor fetal stress. And when HRV goes low, it’s one of the criteria for determining fetal stress and associated infant-fetal mortality. So it’s notable that it’s not used in the post-natal life, adulthood. I mean there are very few labs around the world that actually monitor HRV in patients as they get older.

And there is good cohort data, population level data, that suggests that declining HRV is also due to a chronologic age. And many of the diseases of aging are also associated with aberration in heart rate variability. None of this is established in a causal way, but the degree of association of HRV decline with some features of aging suggest that it might be an interesting biomarker.

But there’s some additional practical reasons why HRV was chosen. Unlike most biomarkers in health, HRV can be measured continuously, contextually. You can measure it for 24 hours. Most biomarkers, as you know, are done through blood tests, body fluid samples. You only get a snap shot in time. And given the dynamism of the system, most biomarkers have a tremendous amount of variation, even in a 24 hour cycle.

So the fact that [with] most biomarkers, it’s impractical to get continuous monitoring, and you can’t detect changing patterns, and changing dynamism over 24 hour life cycle, as well as in a very different context, make it less useful than HRV, which can be measured non-invasively, continuously.

There’s also a global footprint of devices, including consumer devices, that help measure HRV. What that does is opens up the aperture in terms of the breadth of teams that can apply for the prize. If we make the biomarkers too narrow, it limits the number of labs and groups around the world who might have an innovative idea on the intervention side to be able to process their innovation.

So there is a tradeoff between specificity of a biomarker for homeostatic capacity versus this practically of the diversity of options that we may be able to solicit. So, HRV, again, there’s been empirical association with aging. Mechanistically because it’s associated with autonomic capacity it is a feature of homeostatic capacity. It’s global footprint, non-invasive, continuous monitoring, and relatively inexpensive to obtain, unlike some biomarkers that are proprietary, it’s pretty costless.

[Damien Blenkinsopp]: Great, thank you for that. Are there any other biomarkers that you looked at, and you considered for measuring homeostatic capacity?

[Dr. Joon Yun]: Absolutely. There’s only a small subset of modern diagnostic tests that actually assess homeostatic capacity. And you can think of a lot, well, actually get an annual checkup, but indirect proxies. But more direct proxies, more direct surrogates, really require tests themselves be dynamic.

So, an example of another potential surrogate is orthostatic hypo-tension. So it’s your ability of the cardiovascular system to recalibrate blood pressure from a sitting to a standing position, or lying to a sitting position. When we’re young, we have tremendous real time system dynamism that allows us to adjust to quite the rapid demand. And you really don’t have much else raising your blood pressure.

But as we get older, it’s observed that the body’s ability to adapt to those change in conditions deteriorates. So it’s associated with aging, and that’s one way to infer that there’s declining homeostatic capacity. And this may help explain why as you get older there’s one of the contributors to syncope, one of the contributors to declining ability to perform a lot of more strenuous physical tasks.

You can also start to think about the cardiac stress test as an example of a homeostatic capacity test. This is one of the ones that is more standard practice out there for the medicine of today. Essentially, one of the things we’re measuring is the body’s heart rate response to an exercise challenge.

And in some cases the heart rate response is too rapid. So that could reflect some dysfunction in the Diego Connor Response. And in some cases the heart rate increase is insufficient. So, BP is reflective of a system that is less dynamic than it used to be. And these things are associated in a lot of, on toward clinical outcomes in the long haul.

Anything where the heart rate declines after exercise. And one of the things we look for is does the heart rate return to normal, does it look like a normal heart? Does it happen in a normal amount of time? Because as we age and our intrinsically homeostatic capacity declines in which case this is a non-capacity there is abnormal return to normal as well.

So these are small subsets of the overall diagnosis landscape used in clinical medicines today, that we think already reflect homeostatic capacity. But those things require, there’s a higher burden in terms of throughput to asses innovation, and the tests themselves require more involvement.

And furthermore, the data in those areas are strong, although there are many others, but we certainly need more data across the spectrum. So one of the hopes for the competition is that we help promote the idea, that we gather more, and develop more biomarkers for homeostatic capacity.

[Damien Blenkinsopp]: Alright, great. Great, I didn’t realize that was part of the project. Have you defined the exact standard? Because there’s a few different standards of HRV out there.

One of the ones we’ve discussed quite a lot is is the natural log, RMSSD, which is multiplied by 20 and used by a lot of consumer devices at the moment. Have you defined that as yet, or are you going to be defining that at one stage as a criteria for use in the project?

[Dr. Joon Yun]: Yeah, we’re deferring that to a team of experts that have, they did the exact same topic. So, I’ll leave it up to them

[Damien Blenkinsopp]: Great, great. How can people get involved in the Palo Alto Longevity Prize? I understand there’s already 15 teams which have signed up? Maybe there’s a few more already. What’s the timeline before, for instance, you stop accepting new teams, and then for the other steps of the project?

[Dr. Joon Yun]: Yeah, you know, I don’t have that information at my fingertips. Again, all of that, the process is being managed by the production team. And I’m a sponsor of the prize. So for those details I’ll have to refer you to the team.

[Damien Blenkinsopp]: In terms of your own personal use of biomarkers, are there things that you use, or you track on a routine basis for your own health, longevity, or performance?

[Dr. Joon Yun]: You know, I actually haven’t. I haven’t thought about this project relative to my own health yet. It’s something that I probably will consider. But no, I’m not doing any personal tracking right now.

[Damien Blenkinsopp]: Maybe that’s because you’re really healthy and your homeostasis is pretty good, so you know you don’t feel out of sync, and the need to do it.

[Dr. Joon Yun]: Oh no, I definitely feel it. But yeah, these are early days, and I think a lot more science has to happen. And I think, I think we will learn about it, if nothing else, from this process.

[Damien Blenkinsopp]: Great, great. If someone is interested in getting involved in this, perhaps putting together a team, should they just go to the website for the Palo Alto Longevity Prize, or I understand it’s still available for signing up, as a project team. So would that be the best place to go?

[Dr. Joon Yun]: Yeah, I think the best way to engage is to read through the website. And I believe all the details are there, at the paloaltoprize.org. I believe all the teams have signed up through the website process.

[Damien Blenkinsopp]: Do you know if there’s other ways people can participate beyond just putting together a team?

[Dr. Joon Yun]: I don’t know, I don’t know. Again, I will defer that to the team, the way the public can engage.

[Damien Blenkinsopp]: Great, great. What do you think will happen in the next five or ten years in this area? Have you got some kind of vision or hopes, or are there any things that you’re excited about? The opportunities that are going to occur in this area, biomarkers or longevity, in the next five or ten years?

[Dr. Joon Yun]: I do hold out some hope that there’s a small chance that there are some major breakthroughs coming. And you can sense that even in talking with teams. Scientists tend to be pretty conservative, and also for reasons of competitiveness they tend to under-share hypotheses and preliminary data. And after you hear enough of these really intriguing, unique ideas, you realize that the scientific field is more advanced than the public realizes.

And one of those things that prizes are trying to accomplish prizes such as ours and the initiative such as ours is to accelerate those ideas and actions. So it’s possible that there’s some major breakthroughs that are possible in the five year time frame.

The thing that we know for sure, is that we’ll learn a ton, and the idea to create new paths and new avenues of research that give us more shots on goal in terms of improving people’s health.

[Damien Blenkinsopp]: Great, great. Thanks for that. Do you have one biggest recommendation or insight that you’ve used some kind of data, or you’ve learned about your biology when it comes to health, longevity, and performance, that would be a recommendation for other people when they’re using data?

You’ve mentioned a few things as we’ve gone through this talk about why you selected HRV, for instance. And what would be your one biggest recommendation for using data effectively to improve health, longevity, or performance?

[Dr. Joon Yun]: Well, for now I like HRV because it’s affordable, and it’s also accessible from a technology perspective. And I think the access is growing throughout the world. I like the convenience factor. It’s more practical.

Most other biomarkers, I think the distribution isn’t as broad, and the effect is not at real time. And in terms of in lifestyle habits that, in a way that also match to improving someone’s health…. exercise is still my favorite. And there’s good data suggesting exercise improves the measures of HRV.

We also know that our improvement of HRV as well as exercise itself is also with the amelioration of the stages of aging. So, based on what is known today, I think that’s probably the most practical thing that a person can do to enhance their health.

[Damien Blenkinsopp]: Great Joon, yeah. Exercise is very important. Thank you so much for your time today. I really appreciate it, I know you’re a very busy man. We’ll put together some information on the project, some of those references, in the show notes so everyone can get access to that. Is there anything else that you’d like to share about the project that we haven’t covered already?

[Dr. Joon Yun]: No, that’s great Damien. I appreciate your time, and thank you for having me on your show.

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Today our bodies, particularly our bones, are burdened with one to two thousands times the level of lead that our ancestors carried. As recently as seven hundred years ago (prior to the industrialized age) human skeletal remains contained very low levels of lead. Once the earth’s crust was disturbed through mining, much higher levels of lead were released into our food and air.

In a previous episode, Episode 13, we looked at the burden imposed by the heavy metal mercury on the body. Today we will discuss Heavy Metals Part II: Lowering Your Lead Burden. Problems associated with a heavy lead burden in adults include cancer and heart related problems, while children are more vulnerable to brain-related damage.

In this episode we address a different issue of the multi-faceted detoxification theme. Overall, by using the detoxification process to lower our toxic burdens, we can increase our performance. Future episodes will address other metals and chemicals that can affect us.

We now can relate to its adverse effects on every tissue in our body, we know that it’s causing stress on the heart, stress on the kidney. And across the board, there is no tissue in your body that is exempt from the adverse effects of lead.

– Dr. Garry Gordon

Today’s expert has over 55 years of experience as a practicing physician, and possesses an infectious energy and vitality that sets him apart. He is an internationally recognized expert on chelation therapy. Dr. Garry Gordon has received both a DO degree and a honorary MD degree. He was the Medical Director of Mineral Lab, is Co-Founder of the American College for Advancement in Medicine (ACAM) and Board Member of International Oxidative Medicine Association (IOMA).

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • The body may be fooled into mistaking lead for zinc. Zinc supports key metabolic steps, while lead does not (3:15).
  • All tissues in the body are susceptible to lead (5:40).
  • Lead’s toxic properties play a role in: increased free radical damage; preventing the body’s ability to use oxygen; chronic fatigue; depression; and impaired judgement (7:09).
  • In published data, higher levels of lead found in the bone are related to an increased rate of heart attacks. (11:00).
  • Genetics play a role in one’s capacity to clear heavy metals. Diet also has a tremendous influence on the ability to clear heavy metals (12:20).
  • Bones take 15 years to remodel. As bones remodel, lead contained in the bone is released into the blood. If chelations are being given, then the lead levels being treated are low because lead is being chelated out. Dr. Garry Gordon, however, cautions that the problem is not solved, despite the apparent low level of lead (18:29).
  • Discussion of EDTA begins (20:20).
  • Dr. Garry Gordon wishes people would look at EDTA as being no different than taking Vitamin C (21:37).
  • In over 30 years, Dr. Garry Gordon has not gone a day without oral chelation (22:02).
  • EDTA is an anti-oxidant able, perhaps, to prevent cross-linkages related to free radicals (22:43).
  • The Trial to Assess Chelation Therapy (TACT) was based on Dr. Garry Gordon’s protocols. He states these protocols have been followed safely by over 10 million people (24:50).
  • Benefits discovered looking at TACT data included: 51% reduction in death among diabetics; lowered hypertension; and improved blood flow (25:20).
  • Dr. Garry Gordon strives to teach people about oxidative therapies as there is a current over-emphasis in anti-oxidants; he believes more of a balance is needed (29:42).
  • ASEA water is not illegal or considered doping by the Olympic Committee. Dr. Garry Gordon points out that the Committee had to meet because so many athletes were consuming it and beating their own records (31:05).
  • Safe redox signaling molecules enable the body to turn on SOD and catalase (33:40).
  • The human population is loaded with polybrominated diphenyl ether (PBDE) (38:19).
  • Dr. Garry Gordon discusses his FIGHT for health principle: Food and positive focus, Infection, Genetics, Heavy metals and hormones, Toxins (45:10).
  • Through ozone, vitamin C, silver, and other methods, Dr. Garry Gordon believes he can reduce the inflammation associated with common infections, such as CMV, to a “dull roar” (46:50).
  • Discussion of the reactive protein hs-CRP and inflammation (50:30).
  • Everyone needs both an anti-oxidant and oxidant.For instance, Dr. Garry Gordon discusses using a very strong stable reductant (Zeolite Enhanced) and following with a stable oxidant (ASEA water) (52:55).
  • Dr. Garry Gordon routinely tracks biomarkers to monitor and improve his health, longevity and performance. He says that, at one point or another, he has tried them all in the process of formalizing the entire anti-aging process. Dr. Garry Gordon believes the cost of biomarker tests and the use of better biomarkers will change very quickly and soon.
  • Dr. Garry Gordon’s biggest recommendation is to exercise: “it’s the poor man’s oxidative therapy”.

Damien’s Heavy Metal Testing

  • In 2014, using DSMA in a Doctor’s Data’s post-provocation urine test, results indicated Damien was high in lead, arsenic, and thallium. Damien’s post-provocation urine results (10/12/14)
  • Damien attributes high arsenic levels from consumption of chicken and rice while living in China and Asia.
  • Damien attributes high thallium levels from contaminated food consumed while living in Chengdu, West China, where high thallium has been documented in pollution.
  • The Quicksilver Scientific’s Mercury Speciation test was also performed. This test demonstrates the body’s natural excretion abilities for Mercury. Damien’s results (50% to 75%) were higher then normal levels. The test also indicated his ability to detoxify mercury was slightly depressed. Damien’s Mercury results (01/31/15). For a complete discussion of this Mercury test see Episode 13 with Chris Shade of Quicksilver.
  • To detoxify and for detoxification support Damien uses: PectaClear, Quicksilver Scientific’s IMD intestinal cleanse, Clear Way Cofactors, alpha lipoic acid, SE-methyl L-selenocysteine, and an FDA regulated drug, Radiogardase.
  • Damien will retest once every six months to confirm effectiveness of chelators.

Dr. Garry Gordon

  • The Gordon Research Institute: Dr. Garry Gordon’s main website.
  • Doctor’s Data: Dr. Garry Gordon was a co-developer of Mineral Lab, a laboratory for trace mineral analysis, and eventually bought by Doctor’s Data.
  • American College for Advancement in Medicine: Originally to teach chelation, Dr. Garry Gordon co-founded the American College for Advancement in Medicine (ACAM).
  • Detox with Oral Chelation: Co-authored by Dr. Garry Gordon detailing EDTA chelation therapy.
  • 507 published papers: A list of 507 published references compiled by Dr. Garry Gordon on EDTA and lead levels.
  • Trial to Assess Chelation Therapy (TACT): The NIH study for which Dr. Garry Gordon wrote the test protocol. In this study, chelation with EDTA was compared to a placebo in patients who had experienced a myocardial infarction. There were certain high-risk cohorts (such as patients with diabetes mellitus) where the evidence for the use of clinical EDTA was substantiated.

Tools & Tactics

Supplements

  • Alpha Lipoic Acid: A chelator taken by Damien.
  • Asea: a non-toxic way to increase glutathione production. Glutathione is able to deal with the heavy metals. Dr. Garry Gordon would use this very stable oxidant, following using a reductant.
  • Clear Way Cofactors: Damien uses this to provide detoxification support. This product contains Selenomethionine.
  • EDTA: EDTA: stands for ethylenediaminetetraacetic acid. This molecule is a synthetic man-made amino acid that is a non-specific chelator with a high affinity to lead.
  • Garlic: A natural chelator.
  • IMD – Intestinal Cleanse: Damien uses this to specifically target mercury for detoxification.
  • Modified Citrus Pectin: Made from modified citrus pectin with alginate, this target specific chelator is used by Damien. This chelator avoids creating mineral deficiencies by not interfering with other non-targeted minerals (e.g. calcium, zinc, or copper).
  • Radiogardase: Regulated by the FDA, is used to target radioactive cesium and thallium with prussian blue.
  • SE methyl L selenocysteine: A selenium form able to bind well to mercury and offer a protective effect.
  • Zeolite Enhanced: Dr. Garry Gordon would use this very strong stable reductant and follow with a stable oxidant.

Therapies

  • Far Infrared Sauna: A type of sauna that uses light to create heat. Different from a traditional sauna, which uses heat to warm the air, which then warms the body. An infrared sauna heats the body directly without warming the surrounding air. Infrared saunas still result in the sweating and elevated heart rate associated with traditional saunas; however, an infrared sauna is able to produce these effects at lower temperatures.
  • Pulsed Electro Magnetic Field: Works by restoring the body’s natural electro-magnetic energy resulting in boosted cell metabolism, regeneration of blood cells, and improvement of circulation and oxygen carrying capacity.

Tracking

Biomarkers

  • Blood Lead: Measured in micrograms of lead per deciliter of blood (μg/dL). Blood lead has a half-life of 30 days, thus is typically used to asses more acute lead exposures.
  • Bone Lead: Measured in parts per million (ppm). The amount of lead in the bone is an established biomarker for cumulative lead exposures and has been correlated with adverse health effects on various body systems.
  • hs-CRP (high sensitivity C-Reactive Protein): A marker of inflammation. In this episode, Dr. Garry Gordon notes hs-CRP may or may not be a sensitive enough marker of inflammation as it depends on the location and type of inflammation. Damien typically has a very low number, despite high inflammation in other areas. C-reactive protein is discussed previously in, Episode 7, for tracking cardiovascular risk.
  • Oxidative Reduction Potential (ORP): A negative value indicates a reductant, while a positive value indicates an oxidant. Currently ORP is able to be measured by meters available online. Ideally, Dr. Garry Gordon would like to find a meter that can be placed in the urine to measure the level of oxidants.
  • Urine Lead: Measure in micrograms of lead present in urine per gram of creatinine present (mcg/g). A comparison of these both before and after chelation therapy is used as a lead exposure indicator. Less than 2mcg/g is optimal.
  • Vitamin C: When the body has excess vitamin C, the body will urinate vitamin C out. In high doses vitamin C is a chelator, thus if vitamin C is being urinated out, vitamin C will be chelating heavy metals and other toxins along with it.

Terms

  • Catalase: Intracellular enzyme that coverts hydrogen peroxide into water.
  • Polybrominated diphenyl ether (PBDE): Originally used in a wide variety of products as flame retardants. Now nearly all tested individuals have at least trace levels of this and other flame retardants in their bodies.
  • Redox signaling molecules: Molecules such as ozone and hydrogen peroxide.
  • SOD (superoxide dismutase): An antioxidant enzyme found within cells that converts a super oxide radical into hydrogen peroxide and molecular oxygen.
  • Zeolites: Are both naturally occurring and synthetically produced. This aluminosilicate structure has large empty spaces within its structure able to attract positively-charged ions and is a chelator.

Lab Tests, Devices and Apps

  • 23andMe genetic testing: Mentioned in this episode. This test has also been mentioned in Episode 5, Episode 9, Episode 14, and Episode 16.
  • CA profile: A test used by Dr. Gordon to detect cancer years prior to the presentation of “lumps or bumps”. The Cancer Profile is a composite of 8 tests looking at detectable biochemical changes occurring within the body when undergoing a cancerous state transformation.
  • Coronary Calcium Scan (Heart scan): A noninvasive test mentioned by Dr. Garry Gordon, able to measure the amount of calcium present in the plaques deposits of artery walls. The amount of calcium in plaques can be used to calculate a score.
  • K-shell X-ray fluorescence (KXRF): This approach is very accurate and the standard way to access lead amounts in bone. This approach, however, has limited widespread use, and is only found in research labs.
  • Mercury Quicksilver Scientific: involves mercury speciation testing to separate methyl mercury from inorganic mercury, and measure each directly. Damien’s test results may be found under the show notes.
  • Mineral Hair Elements Test: Provides information regarding recent and ongoing exposure to potentially toxins. Dr Garry Gordon cautions this is not an indicator of lead present within the bone.
  • Urinary Toxic Metal Test: A test from Doctor’s Data looking at numerous metals present in the urine. To evaluate retention, the level of metals in urine comparing pre and post administration of a metal detoxification agent are used. Examples of agents are DMSA (meso 2,3-dimercaptosuccinic acid) and DMPS (2,3-dimercapto-1-propane sulfonic acid). Dr. Garry Gordon mentions, this type of test serves to provoke mobilizable lead in the body. Damien’s test results may be found under the show notes.
  • VitaChek-C: A test mentioned by Dr. Garry Gordon to test the vitamin C levels in urine.

Other People, Books & Resources

People

  • Johan Bjorksten Ph.D.: World famous work on cross-linking as an underlying mechanism of aging. He has done work indicating that EDTA is able to reverse cross-linkages in tissue.
  • L. Ron Hubbard: The founder of the Church of Scientology, is credited by Dr. Garry Gordon for his initial protocols on infrared sauna therapies.
  • Barney Kolata: An employee in the smelting case, uncovered by Dr. Garry Gordon in Sacramento, who, despite doing the most work with molten lead, had one of the lowest levels of lead among the employees. Dr. Garry Gordon attributes this to Mr. Kolata’s Japanese diet.
  • Gervasio Lamas M.D.: Dr. Garry Gordon mentions Dr. Lamas is raising 30 to 40 million dollar to do another study (similar to the TACT). Dr. Lamas is the Chairman of Medicine at Mount Sinai Medical Center.
  • Philip Landrigan M.D.: Head of the Department of Preventative Medicine at the Mount Sinai School of Medicine. His research focuses on toxic chemicals in the environment and their effects on children’s health and development.
  • Christiane Northrup M.D.: Friend of Dr. Garry Gordon, and has studied the impact of pueraria mirifica in menopause.
  • Linus Pauling: A close friend of Dr. Garry Gordon and the reason he takes 12 to 16 grams of vitamin C.
  • David Perlmutter M.D.: Dr. Gordon discusses a youtube video of Dr. Perlmutter administering glutathione to a patient with Parkinson’s disease.
  • Robert Rowen M.D.: Along with Dr. Garry Gordon, brought International Oxidative Medicine Association (IOMA) to the world.
  • Garry Samuelson Ph.D.: Works to stabilize nanoparticle structures. He discovered that components, now in ASEA, are stable redox signaling complexes.
  • David Servan-Schreiber M.D./Ph.D.: Diagnosed with brain cancer at the age of 31, underwent chemotherapy and radiotherapy only to have it return. He then used his medical and scientific background to find a solution through diet.
  • James Watson: Co-discoverer of the double-helix.

Books

  • Biological Aging Measurements: Written 20 years ago by Dr. Garry Gordon’s good friend, Dr. Ward Dean, on how one can gain insight, through physical examination, into their individual rate of deterioration.

Other

  • Cytomegalovirus (CMV): Detectable through a simple blood test according to Dr. Garry Gordon, yet many doctors ignore active CMV and its contribution to inflammation.
  • Pueraria Mirifica: An herb found in Thailand that Dr. Garry Gordon, in conjugation with Chulalongkorn University, has shown to have positive indications in prevention of broken bones.
  • Toxic Hot Seat: The HBO documentary based on the Chicago Tribune’s investigation of fraudulent flame retardants.

Full Interview Transcript

Click Here to Read Transcript
[Damien Blenkinsopp]: Welcome to the Quantified Body, Dr. Gordon.

[Dr. Garry Gordon]: Thank you.

[Damien Blenkinsopp]: It’s a real pleasure to have you here. I’ve been following your work for a long time indeed. Can we start off with, is lead a toxin, and if it is, why, and how does it damage us?

[Dr. Garry Gordon]: Well the answer is, yes. If you look at the periodic table, lead is able to fool the body into thinking it is supplying good things, like zinc, and the net result is lead does not support the key metabolic steps that things like zinc do support.
With the end result that lead, even in extremely minute quantities, is absolutely a negative effect on our health, and we are all loaded with a minimum of one to two thousand times the level of lead in our bone, that was present just 700 year ago.

[Damien Blenkinsopp]: Wow. Have there been biopsies or things like studies that have quantified the amount of lead in tissues, or in bone?

[Dr. Garry Gordon]: We have studies telling you every tissue, from the back of your eye to your toenails to your hair, there’s a part, everything has been tested, and the level is known. And it’s different from tissue to tissue, and of course it will be different in people who have impaired ability to push toxins out, or people who have increased exposure because of a life where they work with lead paint, or they’re a welder, or many other occupations that give people lead as part of their job.

[Damien Blenkinsopp]: Great, great. So you just described a mechanism for how lead is a toxin. You were describing how the body believes that lead is zinc, or one of the other metabolites, one of the other minerals that it uses in its functions and its cells. And when it does so, it’s putting it into enzymes, and different areas of the body, and those parts of our body stop functioning. Is that a correct way of looking at it?

[Dr. Garry Gordon]: That’s a very clear and succinct way, yes.

[Damien Blenkinsopp]: Oh, great, great. Are there other ways in which it does that? So besides basically stopping at parts of our bodies from working which I think we can all understand that we don’t want parts of our body to stop working, or to start working in the wrong way does it create oxidative stress, or does it do anything else while it’s in the body?

[Dr. Garry Gordon]: It has many mechanisms by which it is doing the poisoning of our ability to use oxygen. It increases free radical related damage. It’s a toxin on many levels.

[Damien Blenkinsopp]: Great, thank you very much. So, what are the typical health conditions that you have linked through your work, or you’ve seen in your experience, that particular lead toxicity tends to lead to?

[Dr. Garry Gordon]: Well, initially we always thought of it as it related to damaging nerve function, with neuropathy and numbness, tingling, impaired judgment, depression. But as time has gone on, we now can relate to its adverse effects on every tissue in our body, so that we know that it’s causing stress on the heart, stress on the kidney. And across the board, there is no tissue in your body that is exempt from the adverse effects of lead.
And it’s hard for people to understand that you, in your body, store lead primarily in bones. So therefore, if I do on you a blood test, a urine test, or a hair mineral test, and I come back and say, “Gee, it doesn’t look any worse than anybody else.” Because we all have some lead. You cannot find a human being that is free of lead.

But if I say you don’t look like you’re particularly lead poisoned, I am giving you very misleading advice. Because only Harvard has done these studies, because it takes a very special instrument to non-invasively, instead of doing calcium in your bones, which is bone density, instead to do lead density, using specialized equipment that I think we only have about six setters in the United States, who can do this test.

But, when they do it, they are able to confirm that what you see in the lead in the bone is not accurately reflected in urine, hair, or blood, with a net result that people are being erroneously mislead into thinking that lead toxicity is not one of the reasons for their chronic fatigue, their impaired judgment, their depression, their weakened heart. And across the board, it’s really sad that the average doctor still thinks that lead in the hair, or blood, or urine is enough of a test. And it’s not.

[Damien Blenkinsopp]: Right. So there you’re referring to, in functional medicine we often use the urinary metals test. So what we’re looking at, the metals that are coming out your urine. And sometimes then we’ll do the post chelation test.

[Dr. Garry Gordon]: Yes.

[Damien Blenkinsopp]: So using something like DMSA, or DMPS, and then taking urine sample to see that. So, do you see any purpose in that test? Do you think it’s relevant, in terms of just lead? If we’re talking about right now, is this something that you use with your patients? Is there any way that you approach quantifying? Is it with that test, or do you use something else?

[Dr. Garry Gordon]: I was the co-developer of the laboratory called Mineral Lab, which we sold many years ago to Doctor’s Data, and I had offices in Europe and Asia and across America, from the east to the west coast. So, I loved tests, because without tests, the patient has no way of knowing what’s going on, nor does the doctor. My only problem is that there’s always a limitation into how accurate tests are.

So, a provoked urine test by chelation has served in a fantastic way to help millions of people, because a provoked specimen wakes you up to the mobilizable lead in the patient’s body. And that number will help motivate the patient and, when necessary, the patient’s employer, into doing the needed health care.

I’m looking now at a different dimension, since I will be 80 years of age very shortly. I’m looking more at the effect on longevity, and the subtle effects that are not readily appreciable unless you take the time to read the published data, which is published in journals like the Journal of the AMA, but that doesn’t mean anybody reads it.

[Damien Blenkinsopp]: Right, right. So, in terms of, I mean we’re very interested in longevity on the Quantified Body, so I’d be interested in your own, I don’t know if you do this, if you do your own post chelation urine, is yours very low levels of lead, for example? Or do you still have some of that? And I understand that, obviously, you’re looking at body reserves as well, when you’re talking about in the bone, for instance, for your longevity.

[Dr. Garry Gordon]: So, an answer to that, first of all on my own tests, because I was born sick. I just happened to have reviewed my medical records from many years ago from the Mayo Clinic, because I have spent many years being extremely ill. And so, in medical school, I, because I could not go up a flight of steps without going into early heart failure, in my earlier training in school I was forbidden from being in active sports because my heart was quite obviously not up to any and significant activity.

So my level of lead, mercury, and cadmium has been a life-time challenge, because I understand that it takes 15 years for bones to remodel. And therefore, I tell everybody that since you can do the data, before the industrialized age, which roughly starts 700 years ago, the level of lead widely published in skeletal remains is extremely low, until we start doing the mining and disturbing the earth’s crust. And that’s when we bring the lead into our food and air.

Now, in terms of what’s optimal treatment for a patient, if you look at the published data that shows that, right out of Harvard, that the level of lead in your bone accurately predicts when you’ll go blind with your cataracts. And that the higher the level of lead in your bone leads to six times increased heart attack rate.

So, the problem is, we can’t suddenly have a large number of these expensive instruments available, and it wouldn’t change things very much, because there aren’t any people that aren’t born with lead, mercury, etc. because it’s widely documented that your body, as a baby, is rapidly growing, and, in a sense, serves as a waste basket for the mother’s body. So it’s now widely known.

If you look at the 10 American Study, where they took 10 Americans at random and looked at DDT, and PCB, and dioxane, polybrominated diphenyl ethers. When you look at published data, in general you can be certain that whatever level you found of a heavy metal in the mother will be at least twice that in the child. And so therefore, it becomes interesting to know what was the mother’s occupation?

And when we realize how much lead paint we were using at one point, the causes of where we get all these heavy metals are sometimes obscure. And in addition to that you have quite different capabilities on a genetic level for some people to clear the heavy metals they may be born with, or work with, much more effectively. Their diet, of course, has tremendous influence.

I, as a researcher in the field of heavy metals, I’ve uncovered many amazing stories with patients whose life has been virtually wasted because nobody ever thought to look for heavy metals.

And I can take an example of a young girl, about 15 years of age that happened to be in a study that I was doing on behalf of the University in Canada. They wanted to determine to what extent Shell Oil was poisoning people downwind when they were taking the sour gas and turning it into sweet gas with tremendous levels of the toxic metals being released into the air.

As a result of our laboratory being given the contract to do that study, this young lady had a cadmium level in her hair that was off the scale. She was not my patient, but it became my ethical obligation to chase her down. She turned out to be in McGill, and they were about ready to treat her for some rare form of malignancy that they couldn’t identify, and they were sure they were going to start chemo. And I told them if they start chemo she would be dead instantly, and that her death would be on their head. And so they backed off.
And I was able to, in her case, find the buried nickel-cadmium batteries that some bad people had deposited near the water intake to the facility that she was living in. And I have stories, like a whole household of people poisoned with mercury because the grandmother was storing mercury in an open container in the kitchen where all the kitchen towels were.

But the stories go on, and on.

We find what you look for, and since my interest at age 80 is how long should we be physically still active and healthy, and I really like the idea that that should be 100 years. And I would therefore like to help people understand that since you cannot suck all the lead out of your bone, the bone is going to take 15 years to remodel.

And so during that 15 years as your bones are remodeling, should you be lucky enough to meet a doctor who tells you that oral chelation works extremely well. I have published the book, and it’s in all the bookstores, Detox with Oral Chelation. And yet, doctors hardly tell people about it.

Just a high dose of vitamin C alone is a chelator. And if you’re taking 4, 8, or 10, or 12 grams, Linus Pauling was my close friend, so I liked 12 to 16 grams. But whatever you’re taking, if you’re urinating C out in good quantities in your urine, which is a 20 cent test on a piece of paper called VitaChek, if you’re urinating a lot of C out, that C will be chelating heavy metals and other toxins with it. So my obligation, if I’m going to help mankind enjoy a higher level of health when we get older, is to make us aware that this is a ubiquitous problem.

And obviously in some people it is the main problem. The man comes to me, he’s been welding for 30, 40 years, and his lead levels are off the scale. Those are pretty open and shut, but it’s really amazing how in one case I uncovered a smelting function in Sacramento.

They had about 30 or 40 employees, many had been in the hospital repeatedly, many times, at Kaiser and other hospitals in Sacramento. And they would be sick for two, three weeks. They’d be treated and sent home. No one ever made the diagnosis.
And when I did, by coincidence, my nurse, her husband was one of those employees and I said, well bring his hair in. And then I got it, and it was off the scale. I did a few other people, but what was interesting is that Barney Kolata, who was the guy doing the most work with the molten lead, was Japanese, and he never gave up his early Japanese diet. And he had one of the lowest levels of lead out of the entire employees. Whereas one of the secretaries working at the computer in the distant office living on sugar and Sweet’N Lows and coffee had one of the highest levels.

So it’s really interesting the influence of diet and genetics on how well you handle these heavy metals. But it’s an important part of, I think, of anti-aging, or any kind of medicine, to make people aware that yes, it may be the main problem that you’ve come to me with.

And when we look at the amount of mercury in many people’s mouths, when you just open their mouth, it’s pretty clear that they have a toxic time bomb in their mouth. And yet at the same time, some people handle it better than other people. But across the board, no one is escaping without a negative effect on their body.

But we have to settle for the fact that all tests have their limitations, and it makes it easy because people have to spend their own money doing this detoxification. And therefore, they’re entitled to have the best data we can give them. How full was your tank when you came to me, and how effective was I at getting your tank empty of lead, or mercury, or something.

And what’s so sad about all of that is that, very simply put, we can show you that if I take that welder, and I have him get 100 chelations, and at the end of 100 IV chelations he’s excreting almost no lead. What is amazing is, I knew that I didn’t want to put him back to welding, and so he was with a big company so we put him in an air-conditioned office to do paper-shuffling.

But at the end of six months, I brought him back and did another provoked chelation test. And this time after receiving over 100 chelations and telling me how fantastically good he felt, he was a brand new man. But at the end of six months with that provoked specimen, it was 90% as bad as it was before I gave him 100 chelations.

And this is what’s so sad. I am having trouble getting people to understand that just because you’ve chelated somebody, and they feel fantastic and the lead levels being treated are low, you have not solved the problem.

[Damien Blenkinsopp]: So, this is because, as I understand it, as the bones remodel, the lead is coming out into the blood again, and then you see the visible levels and it comes out of the urine as it’s getting chelated again. So, as you were saying, it takes 15 years for that to happen so, basically as I understand it, you’re saying that we have to be chelating every day or like with IV once a week, or whatever the regime is constantly because it’s going to constantly be refilling your blood stream as time goes on.

[Dr. Garry Gordon]: Exactly. And the thing that we have to make clear is that I took the time to put 507 published references from doctors in industrial medicine, who work with lead workers, who had actually published the data that all EDTA will bring lead levels down, even if you’re working with lead daily, to safe levels for most workers. Again, my website, 507 published papers.

Oral works, and yet 99% of doctors tell patients that it will not work. And it’s misleading. If you tell people there’s something they can do orally, and if technically vitamin C and EDTA are almost the same price range.

So why make a big deal out of it if EDTA was shown by Johan Bjorksten, back in Madison, Wisconsin, where I am born and raised and he’s a world expert on cross-linkages. He showed that multicultural organisms, called rotifers, dipped in EDTA every day lived a minimum of 50% longer than any rotifers not so treated.

So the message is loud and clear. In my mind, no one today is achieving the health span they might have achieved because we are ignoring this obvious problem.

[Damien Blenkinsopp]: So, for listeners at home, what is EDTA, and what does it do?
[Dr. Garry Gordon]: Ethylenediaminetetraacetic acid. I kind of make a joke out of it, because acetic acid is another way of saying vinegar, so I tell people I’m you’re handy dandy grocer. But the facts are that EDTA has been used by companies like Chick-fil-A to keep the coleslaw fresh. It’s part of our diet; they buy it by the railroad carload.
And so people are hearing that it’s a synthetic molecule. You could call it a synthetic man-made amino acid. Some people are going to run away from it, and that’s their prerogative. We can do good chelation with garlic, and vitamin C, and there are many natural chelators out there.

It’s only that EDTA happens to have a really high affinity and is so specific in lead it is not that specific with mercury but at the same time, it has these documented studies, because I have pulled every published paper that involved EDTA with a professional researcher for over 20 years, and I pulled over 7,000 papers. So I know a great deal about EDTA, and I really wish that we could have people look at is as being not any different than taking vitamin C.

Ascorbic acid, acetic acid, the point is that EDTA is doing things that can help forgive what we have done to our planet when, out of necessity, we started mining. And when we started mining, we put things in the air, and it winds up in our bodies. And it is not allowing us to live to, what I think, is my intended useful lifespan, which is why, for over 30 years I haven’t gone a day without oral chelation.

[Damien Blenkinsopp]: Wow. So, when you’re talking about EDTA, is this something you’re taking like twice a day? What kind of dose of EDTA are you taking daily, and can you explain what it’s actually doing? Is it binding specifically to lead, or is it binding to other things? And is there any safety concerns in terms of it binding to other things, say minerals that we do need?

[Dr. Garry Gordon]: Thank you for a great question. Because I took on this obligation, I have researched that EDTA is a non-specific chelator. It’s not going to deal with just lead. When it is bored and there’s not much lead around to work with, it will grab mercury too.

And across the board, when we look at what it is doing in the body, it seems to be a wonderful anti-oxidant. So it seems to prevent cross-linkages that may be free radical related. And on children, babies particularly, I love putting EDTA into the bathtub.

We’ve had some people like to put it in rectal suppositories, which I have nothing against other than I want that to be done on a factual basis. I see nothing to support that it’s better absorbed at the rectum than it is at the mouth. And if you’re going to be doing it every day for 15 years, I think it gets tiresome to put it in the rectum every day.

But bottom line, we can use zeolite as a chelator. We use vitamin C. There are many things that we use. But EDTA, because there’s so many published papers about it, and it’s what we wound up using in the study, which was called the Trial to Assess Chelation Therapy, where we did spend 31 million dollars of NIH funds.

And it’s really important to understand that most people who read NJAMA, the TACT trial, the Trial to Assess Chelation was supposed to put all the chelation doctors out of business for once and for all. And it was a pretty shocking thing when it came back that it was in fact safe, and effective. But, they have done everything they can to keep how safe it was from the general public.

And we have now taken the time to get the raw data, and find that in fact there’s a 51% reduction in death, in diabetics. And the data is so persuasive that we have had another visit. Gervasio Lamas, the head of the Miami Heart Institute, is taking on the burden of raising another 30 or 40 million to do another study, because the data is that substantial that even the FDA says if you do one more study, we will approve this as a treatment for diabetics.

[Damien Blenkinsopp]: Wow. This study was specifically done on EDTA, or is it on other chelators?

[Dr. Garry Gordon]: That was, and let’s make it very clear. The Trial to Assess Chelation Therapy was based on the protocol that I wrote. It was I, Garry Gordon that took it on myself to write the protocol that over 10 million people have followed safely without a single reported fatality ever, using my protocol.

[Damien Blenkinsopp]: And, besides the diabetes benefit you just remarked, were there other benefits that were discovered?

[Dr. Garry Gordon]: Every possible benefit from lowering hypertension to getting feet warmer, to stopping intermittent claudication to improving blood flow to the brain, memory. I mean, anything that’s tied to blood flow, because think of it, the cheapest test you might do would be a calicium measurement of the patient’s coronary arteries.

And if we can just realize that age 60 we have 140 times more calcium in our vascular tissues than we did at age 20. And so we gradually turn to stone, so there’s good reason to tie the entire aging process. In fact, I tell people that as an anti-aging doctor, I focus first on a simple motto. I want you to have strong bones and soft arteries when you’re 80.

[Damien Blenkinsopp]: That makes a lot of sense. And you certainly sound very energetic. You say you’re 80 years old right now. Are you 80 years old?

[Dr. Garry Gordon]: Not until January 3rd. I have another two weeks reprieve there.

[Damien Blenkinsopp]: Okay, that’s pretty much the same thing. I would just like to ask you, personally, how do you feel these days, how active are you? You mentioned that at one time it was difficult to walk up stairs. How does that compare to the situation today?

[Dr. Garry Gordon]: Well, I just yesterday was jogging on the golf course with my two dogs at 5:30 at night, trying to find out how can I tell the rest of the world how great it is at age 80 to be healthier than I have been in my entire life. And so just coincidentally I was looking for some papers today, and there it was, my old medical files. And there fell out because I’ve had so much heart problems, so much bone, I have had advanced osteopenia. The list of problems I had is so long, that I got bored reading my medical history.
But, the point is, that I was a basket case, and it was interesting that I would up seeing all these doctors at Mayo Clinic. Which, it’s always good to see the best mainstream doctors you can, because although they didn’t help me one iota, it at least documents where you were. And it’s really interesting because I really wound up seeing them because of a minor accident. Riding my horse I got bucked off, got a fracture of the ankle. Turns out, I had osteopenia.

And I have very advanced, an underdeveloped testicle, and other problems. I have a lot of health issues. But it was amazing that age 80, I feel today better than I have in my lifetime. I just want to share with others that it’s more important in my mind because I still drive the same car after 10 or 11 years I’d rather drive the same car and spend whatever I save on my body.

Because it’s not free to take care of yourself. I spend a lot of money taking care of me. And a lot of people would rather think that it’s nonsense. And so all that’s going to change as the tests for how old we are become much more widely available and increasing sensitive. We’ve been dealing with rather insensitive monitors to tell you exactly how old you are.
But I can motivate people today to take care of themselves because many people are either worried about losing their memory, or dying of a heart attack, or dying of cancer. So it’s not that hard to go online and do some pretty good memory tests today.

It’s very easy today to do calcium scoring and other tests of your heart to know what’s going on. And in terms of cancer, I’ve been lucky enough to find a Caprofile.net that has been, fortunately, finding cancer three or four years before the lump or bumps, so I can motivate people to keep their tests in really a good safe range.

But the ideal test is going to come very soon. Because we are getting into the day and age that the price of tests continues to drop, and the number of potential tests you do on people continues to expand, and pretty well. I’m confident within two years we’ll have tests that will tell you, within a month of introducing a new modality into your diet change and exercise.

I’m now having fun teaching people about exercising while breathing oxygen. I mean, there’s many different things we can do. We now have people drinking a water product that has in it all, what we call, redox signaling molecules. That includes molecules like ozone, hydrogen peroxide, etc. And so, an amazing thing is going on with me.

I am today sitting remarkably sad that we all bought into the wrong theory and we thought anti-oxidants was the best way to help people. And now it turns out that I’m devoting much of my daily effort to teaching people the power of oxidative therapies.

And ozone, of course, is kind of expensive at the high end, but drinking ASEA water and taking things like silver that is catalyst to oxidation, and breathing oxygen while exercising would all obviously be oxidative. And if I happen to add some time in the far infrared sauna, you begin to get the feeling that I’m really teaching people today that although anti-oxidants have their definite place, we must have balance in what we teach.

So I’m really on a vendetta to change the over-emphasis today that everybody thinks the whole answer is anti-oxidants, because without oxidation you will not get the signal for your intracellular switch to turn on the production of glutathione. Let’s make that simple.
ASEA water is available, proven safe the FDA says it’s totally non-toxic yet it increases intracellular glutathione production by 500%. Which is a cheap way of my helping people have something, because glutathione is another nice way to help deal with the heavy metals and other challenges that our body’s doing.

And it’s so documented that the Olympic Committee had to meet to decide that it’s not illegal doping, because this water so enhances oxygen utilization that athletes are beating their own record. But it’s all, totally legal.

It’s nothing but salt water that’s gone through a process so that what we call redox signaling molecules like ozone, which most people aren’t very familiar with. But they’re going to have to become familiar with, because it’s only with things like silver, and ozone, and using high dose C that I can deal with Ebola, and hepatitis C, and other threats that people are beginning to recognize.

[Damien Blenkinsopp]: Wow. Could you, that reference was Sea-o water?

[Dr. Garry Gordon]: A-S-E-A. It’s really astonishing. I thought that this was nonsense, and I was a hard one to convert over, but when I finally met Garry Samuelson, who’s a medical nuclear physicist from BYU, and understood what he did with the salt water. Because I’ve been with Robert Rowen, he and I brought International Oxidative Medicine Association to the world.

After I formed ACAM some 40 years ago the American College for Advancement in Medicine to teach chelation. Now I’m teaching oxidative medicine, but we have this problem that people don’t know anything about ozone.

Yet, if you take anybody that’s got hep C or terminal cancer we’re getting dramatic results on these patients because we help the body overcome challenges by having available safe redox signaling molecules, like ozone, that cause the body to turn on amazing switches, so all of the sudden you’re making 500% more intracellular glutathione.

So, glutathione is [something] everybody appreciates. We’ve seen Dr. David Perlmutter if you go on the internet he has an advanced patient with Parkinson’s who’s been with a walker for six, seven years. He cannot say anything understandable and he can’t walk. He puts the glutathione in the patient’s vein, 10 minutes later he walks perfectly up and down without the walker, and he speaks perfectly clear. So glutathione is a pretty good thing.

So I’m just teaching people that we have it all wrong. That only when the body sees a safe signal, like a controlled stable ozone, or a stable peroxide, is the body able to say, oh, I think I better turn on my own intracellular production of things like SOD, catalase, and glutathione. So it’s pretty exciting.

With the field of medicine, I’m quite confident that we will be doing a lot of [in] my life adding things like pulse electromagnetic field, and the use of far infrared saunas. And the whole idea of breathing in oxygen while you’re exercising. I mean, I am having so much fun.

[Damien Blenkinsopp]: I can hear that, I was just about to say it sounds like you’re having a lot of fun with all these new therapies.

[Dr. Garry Gordon]: If you told me 10 years ago that when I reached 80 I was going to be in the peak of my health, I would have said that you must really have been nuts.

[Damien Blenkinsopp]: So, you mentioned so many different things, I want to clarify a few things. First of all, you mentioned infrared sauna. And this is one modality people use to detoxify by sweating the toxins out through their skin. Is this the reason you’re using it for? Are you using it for a specific toxins? Why are you using infrared specifically?

[Dr. Garry Gordon]: The answer to that is that your skin is a great, huge organ. Perhaps the largest organ, unless you want to argue the endothelium is slightly larger. The skin is the major way your body handles certain toxins.

We have documented that we’ve had people that were disabled by chemical exposures, to the point that their brain had been fried; they didn’t know their family’s name. They were on total lifetime disability. We brought them back totally, taking sometimes 8 to 10 hours a day for one, two, or three months of sweating in a far infrared sauna with them coming in and going out and using certain nutritional things.

I can do it far faster today when I had the rest of my knowledge about oxidative medicine. But the principle is there. The Attorney General state of Utah had so many officers that were poisoned when they raided angel dust operations and lost their memory were on permanent disability. So that he’s so happy because he doesn’t have to pay disability the rest of their lifetime because they’re back to full functioning.

But in one case, it took 90 days of supervised far infrared sauna and a total treatment program. I, of course, with a homeopathic background and nutritional background, with a pulse electromagnetic field and the other things I’m telling you about, could get that same result in certainly less than 30 days.

[Damien Blenkinsopp]: Okay, okay. So, will infrared sauna chelate, or, it’s not chelation, but detoxify across the board of toxins, or is it specific?

[Dr. Garry Gordon]: Yes. The guy who really wrote the book about it is the founder of the Church of Scientology, L. Ron Hubbard. And so some people call it the Hubbard Tank therapy. And we used it after the 9/11 disaster. And we were able to get some of those workers that had not protected themselves, that were so filled with chemicals they were facing death.

We have a lot of experience with this, but I reluctantly give the knowledge to him. But since he was the founder of a sudo-religion, there’s a lot of people who have not thought to improve his initial protocol. But it was involving constant use of some niacins so your skin as always getting a lot of extra circulation, so you had more blood getting to the skin and other nutrient ideas.

And there’s a lot of refinements in this whole concept available today. I have 4,300 doctors I talk to daily in my forum on anti-aging and chelation therapy. And I’ve spelled out a lot more detail in that, which is free of charge to any health professional, and we’re in 68 countries.

[Damien Blenkinsopp]: Great, and I certainly want to put links to a lot of the things you’ve mentioned. Like, the chelation study you mentioned, your protocol, this email list, would be interesting to many people.

Now just to go through some of the other things you mentioned. I think going back, first of all, to the lead, and you mentioned that there’s only one way to establish if you have a high level of lead in your bones. Is that through some x-ray mechanism? I’m guessing this is only used in studies, and it’s not really available for the general population or patients.

[Dr. Garry Gordon]: That’s the unfortunate fact, it’s only available at research level, but, the papers are so solid. You just go to any computer and you put in bone, lead, and health. John Hopkins also has one of these devices.

And so there’s nothing to argue about. It is so clearly well established, and there is the simple fact. You have to understand that National Geographic first did the first issue on Chemicals Within Us. They said open and shut, the way the mother gets rid of lead is just have more babies. Because that’s where the lead is leaving her body and going into the babies.

And so, when we realized that the babies they’re talking about, when you go to Mount Sinai School of Medicine, Dr. Philip Landrigan, he’s the head of the department of pediatrics, he runs the research laboratory for measuring all the toxins in your blood. They charge, when you send him 20 tubes of blood, $4,900.

But he says, why keep sending me blood? No one has ever been able to pass the test. The human population is loaded with polybrominated diphenyl ether. That’s the flame retardant that HBO pointed out in this past year, was complete fraud. It actually makes the house burn faster, it does not protect.

But we’ve sprayed it on every mattress, on every pajama, and on every airplane seat cover. So every human is filled with PBDE. And there is an interesting correlate. Since we’ve been doing the PBDE, I got out of medical school only some 56 years ago, and at that time the average sperm count was 140 million. Today the average sperm count is around if you’re lucky 40 million.

We’ve lost 100 million sperm because everyone is walking around loaded with toxins. That’s one of the reasons we have so many fathers now have twins, because they can’t have babies the old fashioned way, they have to have a fertility specialist.

[Damien Blenkinsopp]: So, for the people listening at home, this is going to sound really frightening, all of this, if they haven’t come across the area of toxins before. So, in what ways could they quantify any of these?

What would you suggest for someone who’s maybe concerned with a few symptoms, maybe not serious symptoms, but a few symptoms here and there perhaps you could outline symptoms that should be more of concern? They should think more about these types of things? Lead and these other toxins. Or, the types of tests.

Would you recommend they go, for example, for the urine, the post urine chelation test to establish these kind of markers? Or how would you suggest that they kind of gather some evidence to convince themselves that this is something that they should be working on continuously, as you recommend. So like a daily chelation, or an approach to detoxifying.

[Dr. Garry Gordon]: I think the answer is this: everybody, if they get a really careful health history given to them we’re going to have more and more of these questionnaires available online. When people are honest and admit how many days they have trouble getting running, how often this isn’t working, their memory isn’t up, they have abnormal appetites.

If we look at everything from depression to fingers that have lost feeling, the list is very long, and the cheapest test, of course, was the mineral test on your hair. Because hair didn’t require a doctor, it could be sent to a laboratory. But some laboratories got in that weren’t really up to our speed. So I’m a proponent that they use a laboratory that other doctors use.

Doctor’s Data is the one that purchased Mineral Lab. When I had Mineral Lab we had offices, as I said, in Asia and Europe. So this has been my life’s passion. But any test.

[Damien Blenkinsopp]: So at the lowest cost end, you would recommend the hair metals test from Doctor’s Data?

[Dr. Garry Gordon]: The hair test. And here’s the rest of the story. If the hair test shows no mercury, no cadmium, no lead, then that means, essentially, that you cannot get rid of them. Because you can’t be living in this planet without being loaded with these metals. So if there’s none in your hair at all, then it means that you have a block in your ability to get rid of them.

And that is really very common in autistic children. It’s so sad, because we have tremendous success in dealing with autistic children, but if the poor doctor doesn’t know that the hair test will not reveal the lead and mercury if there’s a blockage in the body’s ability to excrete heavy metals because hair is nothing other than excretion, just like urine is an excretion. And so if they don’t see it, then they think that they said, Oh, well it must be something else in the way you feed your child.

It’s got to be something else, because always, you cannot escape the heavy metals. And I repeat, if you’re the director of the most advanced toxicology lab available to doctors, at Mount Sinai School of Medicine, Dr. Philip Landrigan, his question is, why would you keep sending me anybody’s blood specimen, because it’s not paid for by your insurance, it’s going to cost you $4,900 for us to do it.

And there’s never been anybody he’s ever tested that doesn’t come out with at least 160 chemicals that will induce cancer, or neurotoxin, or endocrine disruption when he measures them. And there is no safe levels, because when you have a little of the polybrominated diphenyl ether and a little DDT, and a little dioxane, all of this is on top of having the lead.

So nobody should think, oh well it’s just a small level. A small level is on top of a small level of something else, on top of a small level of something else. So if the goal is to realize that in our complex society today, I think that it’s terribly important to keep you as sharp as a tack after 65, because I think many people, their first job may not be their ultimate career that they’re meant to be on Earth to do, and many of us don’t know enough until we’re 65 to be a tremendous service to our fellow men.

So I’m a real proponent of course, I have a vested interest in this, as I’m 80. I’m a proponent of life extension.

[Damien Blenkinsopp]: That’s great. So one of the other topics you have spoken about during this is taking EDTA via oral chelation versus IV chelation. For many people, when, if they go to local doctors who are specialized in detoxification, often IV chelation is the method they’re probably first going to come across.

I think you recommend more strongly oral chelation with EDTA. Could you talk a little bit about that, and what your thinking is there?

[Dr. Garry Gordon]: Well, it is a little complicated. As the founder of this chelation movement, I came up with a name, the American Academy of Medical Preventics, and I wrote the first protocol. And I told every doctor, you can tell me how you’re doing it, but I’m going to take input in. So I wrote the first protocol.

And when I was doing that, I was just thinking today because I had a 16 year old young lady in a hospital in Sacramento out of control, facing death, with juvenile diabetes. And her family had seen the dramatic things that I was doing with IV chelation. And we took her out of the hospital for a few hours each day for me to do IV chelation. And we completely saved her life, and her diabetes went under control.

But we’re not allowed to talk about things like that, because there’s not enough research. Although I just told you that I didn’t know that, some 40 years ago, that that was going to be that effective. Now that we have a 31 million dollar study, we have a lot more knowledge.
So, the sad thing is this. We don’t know until we test the question. Will chelation stop, in this case, the person’s schizophrenia? Will chelation stop this person’s depression? Will chelation stop this person’s cancer?

Obviously, it’s not that simple, because everything that I teach is built around my FIGHT for your health program, where the FIGHT, F-I-G-H-T. F stands for food and positive focus, I stands for infection, G for genetics, H for heavy metals and hormones, and T for toxins. So, with my FIGHT program, the more of the modalities I add to my program, the greater the chance that I’m going to have somebody very happily restored to full health that they’ve never enjoyed.

So most people can’t deal with that multifactorial. They want to assume that if I get all the lead out, that’s all I need to know. But unfortunately they now report that well over 5% of us have some kind of a lesion in our pituitary that is making our endocrine picture more complex.

And so the more you study medicine, the more you’ll find that you can become a super specialist at any aspects of the FIGHT program. You can do like Dr. Servan did as an MD after his brain cancer. He came back shortly after they gave him the chemo, surgery, and radiation that didn’t do him any good. He decided to become knowledgeable about which foods will help cancer not come back. And he was able to make it stay away for 10 years.

So some people do all their thinking about food, but they never ever realize that Harvard publishes the paper that proves that 96% of people, with a simple blood test, actively have cytomegalovirus in your body right now. And all doctors say, gee we think inflammation is bad for you. But not one doctor out of 50 is aware that they, and their patients, are walking around with active CMV.

Why am I making a big deal? Well, because we don’t have a drug for it, the doctor chooses to ignore it. Whereas I live in the world of ozone, and silver, and high dose vitamin C, and other tricks for infection. So I can bring that infection down to a dull roar so that the inflammation is lowered, so that nobody is aging as rapidly in their disease.

So, the more you look, the more you find. And now that we have the ability to do with 23andMe you can do a genetic test for less than 200 dollars. And you can now find out that yes, our genetic pool has changed because some of these toxins have changed the way our body handles methylation. So now you can see the big word epigenetic, which means above genetic.
So, as you get into the medicine that I study, it is fascinating to realize how many doctors go through life and all they learn is hormones. They never learn the heavy metals. They’ve never tested for toxins.

If you told them PBDE is in every one of your patients at astronomical levels, they would ask you, what is PBDE? Polybrominated diphenyl ether is the flame retardant that is in every human being, every mammal, from the Antarctic to the Arctic, in frighteningly high levels.

[Damien Blenkinsopp]: So it really comes across that you see today health is a multifactorial battle. Basically a battle ground on many levels, where it’s us versus infections, heavy metals, toxins. And it’s through a protocol like yours, which tries to address each of those, which we’re going to be able to protect our health, improve it, resolve chronic conditions, and promote longevity. Is that a good summation?

[Dr. Garry Gordon]: That’s an extremely good summation, yes. Bottom line, everything is multifactorial and if you just attack any one of my FIGHT issues, you’re going to help every patient. But that doesn’t mean you’ve done all you could do, because some of us need to go from the infection control on over to the hormone support.

We have an ability now to stop menopause in all women safely, with the pueraria mirifica plant that grows in Northern Thailand. We have 14 years of research. And a dear friend of my, Christiane Northrup who wrote the book Women’s Wisdom, Women’s Body, is coming out with a new book in February.

And I have been working diligently with the Chulalongkorn University in Bangkok, and we actually have proof that you will not get broken bones if you take this herb. You will never see dementia in your patient if you give them this herb.

And the reason Dr. Christiane Northrup, who’s head of OBGYN at University of Vermont, the reason she’s so enthusiastic is because during her OBGYN she looks at the vaginal tissues on 74 and 80 year old women, and find they become 15 years younger in less than six months.

So we have so much exciting good things to do for people. That’s why I wanted to get the basics out of the way, and have everybody realize that we are in for some exciting times, where you’re going to live longer and be more productive than you ever dreamed possible. But its part of my job is to start with the basics. And today we’ve really focused more on the kindergarten and first grade level.

[Damien Blenkinsopp]: We’re screwed, we have to get in somewhere. So, you’ve spoken a little bit about inflammation there. I’m wondering if there are any markers you look at? There’s the HS-CRP, that’s the reactive protein that people often look at. But do you look at that?

Because for some people like me, mine is very low but I know I in fact have every high inflammation in other areas. So I don’t know how you look at the whole inflammation area, and if you look at that as a kind of marker of general health, or how progress is being made.

[Dr. Garry Gordon]: It is extremely useful. It is only one of many markers. My friend Dr Vishdani is an MDPHD in molecular medicine, and we have at least 10 other tests that often will show inflammation that’s not reveled with C-reactive. So C-reactive is never a waste of time, but if it comes back and it doesn’t look like a big problem, it may have missed a lot of other forms of inflammation that it’s not sensitive enough to reveal.

[Damien Blenkinsopp]: Okay, okay. So the other thing you have promoted, you feel very strongly about, is oxidative therapies here. On a previous episode we talked to Christine Burdette of Dunwoody Labs I don’t know if you know her, or of her work.
[Dr. Garry Gordon]: Yes, I have heard, yes indeed.

[Damien Blenkinsopp]: Okay, great. Well so she has a certain set of stress markers [51:21 – 51:59 inaudible due to theme song] markers across our body.

Is adding an oxidative therapy, like ozone therapy or some of the others you mentioned earlier, potentially going to push them over the edge? And so is there potentially a balance that has to be made between oxidative versus anti-oxidative?

[Dr. Garry Gordon]: Great question. Well the bottom line is this. If you learn fungal bacteria and viral infections are epidemic in men, and only with my oxidative therapies will you keep them at a dull roar because nobody’s immune system is working as effectively as it could or would if you got the lead out. So let’s look at the big picture.

Everybody needs an anti-oxidant and an oxidant, and one doesn’t preclude the other. We have stabilized our ability to offer a product we call one Zeolite Enhanced. And in that product I have a -450 ORP, which means it is a stronger reductant than any anti-oxidant you could buy, but it is stable. And I can give it to you five minutes after I give you the oxidant, which is ASEA water, which is a +850, because it too is stabilized.

So we’re going into an exciting time when you could look at those two things, as we used to say oil and water won’t mix. Now, that turns out, we’re in a sophisticated age that these are merely ammunition, these are energies that your body needs, and they’re fuels. And so my biggest sad thing is that most people are going to take a long time to really get enough oxidative therapies.

I felt so fantastic yesterday because I was using my pulse electromagnetic field, and I was using my silver, and I was drinking a lot of ASEA water, and I was breathing the oxygen while I was exercising on a bicycle. I was doing everything oxidative. And everybody else would sit there and say, well you’ve embellished, you’ve gone too far. No, that was the best day of my life.

So, we have to kind of move it over to say oxidation is good, because we all have been using anti-oxidants, because we get them from many sources.

[Damien Blenkinsopp]: Okay, great. You mentioned ORP. What does that stand for?

[Dr. Garry Gordon]: Oxidative Reduction Potential. And so the ORP meters that you can buy online for $110. The day will come that I hope to have it, we haven’t worked it out yet, but wouldn’t it be nice if one day I find that I can have a meter and everybody can measure their urine and find out, ooh, boy do I need an oxidant. I mean, I haven’t gotten there yet, but that’s where I’m hoping all this goes.

[Damien Blenkinsopp]: Right. So it’s about balance, it sounds like. And so there you were talking about taking two things one oxidative, one non-oxidative and getting that balance by combining Zeolite and the other one.

Then it also seems like you put a lot of emphasis on how you feel, and how people feel in general. Do you believe if someone feels good, or if they’re taking some kind of treatment, or they introduce something new into their life and they’re feeling better, do you think that’s always a good thing?

[Dr. Garry Gordon]: I would say it’s just a pretty good guide, but I am, of course, in energy medicine, so I have used Voll, V-O-L-L, electroacupuncture diagnosis by Voll, and they have many companies that sell that kind of equipment. They have simplified it, they call it Zito, and they have different tests.

But bottom line, I have changed lives for 40 years because I knew how to read the energy in your kidney, and I could tell you instantly if the medicine you bought that you’re taking is going to kill you or not. When I first got into this, I didn’t believe that testing could work. I was very skeptical. But my friend was Harvard trained MD in San Francisco was helping my patient and brought the device.

So I finally went ahead and got the device. They brought a child to me that age 18 month was having at least three to four seizures per hour, and had been to UCLA, Stanford, and had been to UCSF. Seen every top pediatric neurologist; nobody could stop the seizures. I stopped the seizures 90% in the first visit.

How did I do that? I took a simple history. Having heard me today, I said to the mom, well you’ve seen all these super specialists, did anybody ask you where did you live when you were pregnant? And nobody ever asked her. She said I lived at home with my folks. I said well what do they do? They’re almond farmers.

I said go home and get the spray they use on the almonds. She bought the spray in, in just a small tiny container. I checked it energetically on the child’s nerve point. It immediately made the nerve point go crazy.

When I balanced it out by thinning it out to one to a million, which we do homeopathically, instantly, the brain was able to start. Just like you can take a person after they get stung by bee, you can give them a very weak bee sting and they find they aren’t sensitive. But I had a home run in the first visit.

[Damien Blenkinsopp]: Wow. That’s an incredible story. Well, Dr. Garry Gordon, thank you so much for all this information. It’s pretty overwhelming, I have to say. Because you’ve obviously had a long career, and you’ve added a lot of different practices over time.
I would love to hear a little bit about you, just in terms of how you manage. Since you are nearly 80 and have been doing this for a long time. Are there any biomarkers that you track on a routine basis to monitor health, or longevity, or performance?

[Dr. Garry Gordon]: I have tried all of them, because I have tried to formulize the entire process of anti-aging. And so a good friend of mine wrote a book called Biological Aging Measurements 20 years ago, Ward Dean, and the game is going to change dramatically.

So I don’t want to burden your listeners because the costs of tests is dropping rapidly, and we’re getting better biomarkers. The ones we’ve been using have all been useful. But it’s going to change overnight. And so, I’m not going to go down so that they… It’s been a kind of expensive labor of love to do the tests we’ve been doing.

[Damien Blenkinsopp]: Right, right. And what do you think is going to change it? I mean, I know there’s new companies coming in with things like blood spot test. And is there anything specifically you see that’s going to change the future of testing, like are there specific companies coming to market? What do you see that’s going to change all of this so rapidly?

[Dr. Garry Gordon]: One woman alone says she will be able to devise a machine that with one drop of blood will give you 1,000 tests. So, I’m pretty confident this lady is telling the truth. And then doctors won’t be able to look at 1,000 tests, but computers will weed through it, and help doctors see the pattern that is there.

[Damien Blenkinsopp]: Great, thank you very much for that. Just one last question or you. What would be your one biggest recommendation for listeners? If they were to do one thing to improve their health, longevity, and performance, what would it be?

[Dr. Garry Gordon]: I have to go along with James Watson. He was the co-discoverer of the double helix. And he’s telling people, exercise. And of course exercise is the poor man’s oxidative therapy.

[Damien Blenkinsopp]: Yeah, I knew you were going to say that. That’s a great answer. Thank you very much. And, thank you so much for your time today.

[Dr. Garry Gordon]: My pleasure.

[Damien Blenkinsopp]: I hope you enjoyed today’s interview. If you’re concerned about lead and other heavy metals, here’s my experience so far as an example. To make this a little bit more practical. You can download my latest heavy metal test from the show notes for today’s episode.

There are two reports. The first is that I did a six hour post-provocation urine test with Doctor’s Data in November of 2014. I used DMSA, dimercaptosuccinic acid, as the chelating provoker agent for that. Lead was one of the three metals to come up higher on my test.
My levels were at 4 micrograms per gram of creatine, with their reference range being to target less than two micrograms per gram of creatine. So, for the more visual of you guys, it’s in the yellow zone. There’s a red zone, a green zone. Do you kind of get the picture?
My other two metals in the yellow zone are arsenic and thallium. Now arsenic most likely came primarily from my high consumption of chicken and rice for many years while living in China and Asia in general.

The thallium, based on the studies I’ve read, it’s a bit more unusual. But it very likely came from food contamination I was exposed to while living in Chengdu, West China, where the pollution has been documented. So, specifically thallium problems have been documented there.

The second test I did was Quicksilver Scientific’s Mercury Speciation test, which requires whole blood, hair, and urine samples. We looked at that test in Episode 13 with Chris Shade, so you can go check that out, if you want more details on it. He’s the guy behind Quicksilver Scientific.

My mercury came back slightly elevated compared to the Quicksilver Average. So, I was between the 50% and 75 percentile. It also shows my natural excretion ability, so my body’s ability to detoxify from the mercury, was slightly depressed. It wasn’t a big deal. It wasn’t really bad, but it was just slightly more depressed than usual, so it’s something I can work on.

The test did come back pretty much as I expected though, as I’ve been working on mercury for a while. And so I didn’t expect it to be super high. As you heard in Episode 13, I’ve been doing biological dentistry and other things to lower my mercury levels.

The Quicksilver test provides a lot more detail than the Doctor’s Data test. A couple of other things I learned about these tests along the road is I’ve run the Doctor’s Data urine toxic metal tests while living in different places around the world over the years, as far off as Thailand. So it’s a test that is easily accessible if you’re outside the US. Which can’t be said for all tests; you know, some tests are really complicated to get done if you’re not in the US or maybe Canada.

Due to the blood, Quicksilver is a little more tricky, but most of the time you can just fine a phlebotomy service, or a local lab, that will help you with that part of it. And then you just ship it off to the States.

If you plan to do your own tests, avoid obvious heavy metal contamination the week or so before it so you don’t bias your results. You don’t want to think that you have more metals than you actually do because you’ve just taken in some. So, cutting out things like rice and chicken, for that period, because these generally have some level of arsenic contamination. And then of course, for mercury fish, in particular big fish like tuna and swordfish, which have high mercury levels.

So what have I been doing to lower these heavy metals? Well I’ve been working off and on on detoxifying these for about, just over two years now, with different chelators. Currently I’m taking modified citrus pectin with alginate, in a product called PectaClear. So this is the main chelator.

The reason I’m taking this one is because it doesn’t interfere with other minerals as much as some of the other chelators. So, the idea is that it provokes less detoxification symptoms because it’s a more specific binder, or chelator, to the target heavy metals; in this case, lead, for example. So it avoids creating mineral deficiencies by binding to, say, calcium, zinc or copper.

A comment I want to make on this particular product, PectaClear, and modified citrus pectin in general is that there aren’t a lot of studies on it. And the studies that have been done are mostly from the owner of the PectaClear products. There’s a little bit of conflict there.

However, the functional medicine physician I’m working with recommended this to minimize my symptoms. So I’m trying it out as an experiment. I have gone through some symptoms, such as fatigue and headaches in the past, so I wanted to avoid those.

I’m also using some of Chris Shades products, which we discussed in Episode 13. So I am using Quicksilver Scientific’s IMD intestinal cleanse, which binds specifically to mercury, and the Clear Way Cofactors. They provide detoxification support, basically. To help your natural detoxification system. That also includes his glutathione and vitamin C and alpha Lipioc acid supports, discussed with him in the episode.

I’m looking at this as long and slow process, and not pushing it aggressively to avoid the side effect as much as possible. So, personally, from my experience, if I push it harder and take in larger doses, I get fatigue and headaches, generally. So, I want to avoid those because I like being productive during the day.

Previously, I’ve done runs of EDTA, which is the chelator Dr. Garry Gordon was talking about today in today’s interview. For which there’s a lot of past research support its use, right. So that’s got a lot of studies behind it, if you want to go with the more standard option.

On an on-going basis over the last few years, I’ve also been taking standard alpha lipoic acid. Not the liposomal form from Chris Shade. And selenium in the form of SE-methyl L-selenocysteine. Selenium binds quite well to mercury, so that’s the reason for that. Alpha lipoic acid is a chelator, and selenium has a protective effect, because it binds to the mercury. In fact, selenium is an ingredient of Quicksilver’s Clear Way Cofactors I just mentioned, in the form of selenomethionine.

The forms of selenium do make a difference, so you kind of have to watch out for those. Make sure you’re taking the right ones; some of them can be a bit toxic, especially if you’re taking the higher doses. And you don’t want to take in too high a dose. 200 micrograms per day is the standard.

I’ve also done a run of Prussian Blue recently, which specifically chelates thallium, which is my bit usual metal which I’m carrying there. And the drug name for that, because it’s FDA regulated, is Radiogardase. And it’s often used for radioactive cesium, and radioactive thallium also. Just so that’s why it has that name.

That’s where I’m at. At this point, I’ll probably get retested once every six months to confirm that the chelators I’m using are effective, and everything is going smoothly, and steadily detoxifying myself.

I’d love to hear about your efforts to lower your burden, if you’ve been working on it also. Whether it be mercury, lead, or any of the others, arsenic and so on. Especially if you’ve tracked your progress, or you have some test results already. Let me know on the show comments, or just hit me up an email. I reply to everything.

Detoxification’s going to be something we come back to quite often, because it’s one of the ways we can increase our performance by lowering our burden of these toxins. Some of the ones we haven’t looked at all are like some other metals, but also there’s a wide variety of chemicals and other types of toxins like that, like pesticides and so on, that can affect us. So we’ll be looking at those in some future interviews that I’ve already pre-recorded, and are coming up soon.

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According to a 2015 consumer wearables report, 1 in 10 Americans has a fitness tracker. Yet there have been various media reports questioning the accuracy of these devices. Today we talk about whether the accuracy of fitness trackers matters; upcoming research trends; and, the most important question, even if they are accurate, are fitness trackers serving their purpose? Are they getting us moving by holding us accountable?

With the help of our expert, Dr. Greg Welk, we discuss the complexities involved in making a device to quantify movement. We will also explore the findings of Dr. Welk’s 2014 paper from Medicine & Science in Sports & Exercise that captured media attention by examining the accuracy of what are now earlier versions of eight mainstream monitors available on the market.

We live in a very challenging environment to be active today…monitors provide a way to keep people accountable…[People] have to build physical activity into their day; it doesn’t just happen. It has to be actively planned and prompted during the day.

– Dr. Greg Welk

Dr. Greg Welk is a Professor in the Department of Kinesiology at Iowa State University, where he oversees the Physical Activity and Health Promotion lab. With more than 50 peer-reviewed, data-based research publications to his credit, he is a national leader in developing and assessing the accuracy of physical activity measurements while promoting physical activity.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

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Show Notes

  • Expensive accelerometers, previously used for research, were introduced to the consumer market through development of the Wii (4:58).
  • University researchers have performed calibration measurements on consumer devices; the degree of accuracy they have found reflects the level of calibration research occurring at the consumer device companies (7:38).
  • The integration of several types of sensors enables better inferences of activity (9:46).
  • An overall error of 10% to 15% was found in the 2014 study of consumer devices; this is a reasonable level of error given that the goal of consumer monitors is behavioral change, not precision (12:39).
  • Companies must balance accuracy with fashion and functionality (15:32).
  • In the forthcoming study, device accuracy was measured while the subject engaged in twenty-minute time periods of sedentary activity (office work); locomotive activity (aerobic workout) and circuit training. Analyzed in this manner, monitors would overestimate activity for certain types of work and underestimate activity for other types of work, contrary to a previous study showing a reasonable overall error (17:09).
  • Consumer companies develop their own equations and algorithms and work to improve them, while researchers publish, share, and exchange calibrations used (19:21).
  • Currently in research there is a movement to use accelerometers that report in the same unit, g-forces. This unit allows inferences across monitors (20:15).
  • Different data storage and software processing capabilities are required between consumer and research devices (21:15).
  • There is a ongoing movement to use monitoring devices to integrate patient activity and other parameters into an electronic medical report for healthcare purposes (23:15).
  • In the coming years, minimizing inactive behavior, while promoting active behavior, will be a desirable combination for the market. Researchers are currently pursing ways to better monitor sedentary time (28:15).
  • Upcoming studies will be looking at the new Jawbone Up3 and FitBit Charge. Other studies will be looking to expand the health coaching model (36:09).
  • The biomarkers Dr. Greg Welk tracks on a routine basis to monitor and improve his health, longevity and performance is to minimize sedentary time. He previously tracked heart rate variability.
  • Dr. Greg Welk’s one biggest recommendation on using body data to improve your health, longevity and performance is to use devices as needed to hold oneself accountable for actively planning and prompting physical activity throughout the day.

Dr.Greg Welk & The Physical Activity Lab

The Tracking

Terms & Technology Used in Activity Trackers

  • Accelerometer: a device measuring body movements in terms of acceleration.
  • Altimeter: measures altitude.
  • Counts: a unit that lacked consistency across initial devices due to how devices were scaled or internally processed. Researchers would then take this unit and link it to an area of interest, for example a certain number of counts would equate to a number of calories.
  • G-force:: the force of gravity.
  • Gyroscope: a device used to measure orientation within 3D space.
  • Piezoelectric: an early accelerometer type, able to be scaled and calibrated, that converted a physical force into an electrical current and produced units referred to as counts.

Devices

The list of activity and fitness tracking devices discussed in this episode:

  • ActiGraph: Demonstrated a 12.6% error in the 2014 paper.
  • Amiigo: Mentioned by Damien, Dr. Welk did not have plans of it in future studies.
  • Apple Watch: Performance to be evaluated in upcoming spring study, with results projected for January 2016.
  • Basis B1 Band: Highest error on 2014 study (23.5%) and has been discontinued.
  • Body Media Fit : Top performer in the 2014 paper with a 9.3 % error.
  • Directlife: Demonstrated a 12.8% error in the 2014 paper.
  • Fit Bit Charge: Performance to be evaluated in upcoming studies.
  • Fit Bit Flex: Performance to be evaluated in upcoming studies.
  • Fit Bit One: Top second performer in the 2014 paper with 10.1% error.
  • Fit Bit Zip: Top third performer in the 2014 paper with 10.4% error.
  • JawBone Up: Demonstrated a 12.2% error in the 2014 paper.
  • Jawbone Up 24: Performance to be evaluated in upcoming studies.
  • Metria Patch: The wearable patch with monitoring technology of a device.
  • Nike Fuelband: Demonstrated a 13% error in the 2014 paper.

Biomarkers

  • Heart Rate: Dr. Welk previously used heart rate monitors to track intensity of workouts in high level training.
  • Heart Rate Variability (HRV): An athlete can track HRV as an indicator of whether the athlete’s body has fully recovered from previous workouts and whether the athlete’s body is ready for the next workout. Athletes can use HRV to identify symptoms of overtraining. Please check out other episodes and guests of The Quantified Body focusing on HRV: Episode 1: Andrew Flatt (resistance training), Episode 6: Ronda Collier (managing stress), and Episode 8: Todd Becker (hormesis and stress).
  • Calories: Devices may overestimate or underestimate the number of calories burned by ten to fifteen percent. On the level of individual assessment, the exact number of calories burned is less important; what is important is that using the device may cause the individual to make a behavioral change.
  • Steps: Individuals may use monitoring devices to track steps taken. As is the case with devices used to track calories, the use of devices measuring steps may cause positive behavioral changes.

Other

People

Full Interview Transcript

Transcript - Click Here to Read
[Damien Blenkinsopp]: Hi Gregory.

[Dr. Greg Welk ]: Hi.

[Damien Blenkinsopp]: Greg, thank you so much for being on the show.

[Dr. Greg Welk ]: Yup, my pleasure.

[Damien Blenkinsopp]: So, first of all, I wanted to dive into what the interest is in tracking exercise, or activity in general. What kind of benefits do you think this can have for us?

[Dr. Greg Welk ]: Well as researcher I’ve been using monitors for many years. We use them to study how active people are so we can quantify associations with health benefits, and evaluate whether interventions work to change behaviors.

So the recent movement to consumer monitors has been a really interesting development. So I think the research community is at least still tying to learn how best to use these devices, and whether they do work to change behavior or not.

[Damien Blenkinsopp]: Right, so it’s mostly about, is it going to change our behaviors, and thus provide benefits in terms of, say increased activity, or more focused activity, on things that are tending to work. Obviously, there’s still a lot of exercise science debates going out there. Like, is cardio better, is weight lifting better, resistance training better. There’s a lot of these kind of discussions still going on.

Maybe over time, if we’re tracking exercise on a larger level, and we have big data. Do you think it can help some of these questions?

[Dr. Greg Welk ]: Sure. I think the devices give consumers the power to monitor their own behavior. I guess the key is whether they pay attention to the cues, and tune into them. Because tracking data by itself won’t necessarily change behavior unless it becomes something that’s use in your daily life.

So what we would refer to the data as, would be helping people with self-monitoring. Learning to monitor their own behavior, and using that as cues to change their behavior. But when you talk about the broader level of the data being stored in the cloud, and being able to infer what people are doing and not doing, it opens up all kinds of new opportunities to understand human behaviors. So that’s very exciting as well.

[Damien Blenkinsopp]: Great. And so perhaps you could talk about, what were you doing before this exercise tracking market started developing? What kind of things were you doing in order to estimate and assess activity?

[Dr. Greg Welk ]: Well again, accelerometers have been around for 20 or 30 years for active research in the research community, so there’s been probably second or third or fourth generation monitors being used by researchers since the early 1990s, I’d say. Even a little bit, there were some preliminary models in the 1980s. So we’ve been using accelerometers for many years.

I guess the key that turned it into a consumer marketplace was when the Wii was developed, actually. Because when the Wii was released, the accelerometer that was used in the Wii device all of the sudden became in demand, and the price came down.

And that’s what allowed some of the monitors to develop a consumer versions that were more price competitive at sort of the price point. Because we were previously using very expensive accelerometers, and then the price dropped tremendously and allowed all the consumer development.

[Damien Blenkinsopp]: Great. For people at home, could you describe briefly how does an accelerometer work?

[Dr. Greg Welk ]: Right. Well there’s different technologies. Actually, many people aren’t aware, but Leonardo Da Vinci is credited with coming up with the early idea of a monitoring device, and Thomas Jefferson was one of the first developers of a mechanical pedometer, hundreds of years ago. So the concept of tracking steps has been around for many years.

The most early accelerometers use what’s called a piezoelectric bender moment. This type of device would allow a physical force to be converted into an electrical current, which could then be scaled and calibrated. So the way researchers use these initial devices, the devices all produce a unit that we called counts, an activity count.

And it’s a nebulous unit because a count depended on, it didn’t have a value to it, and it depended on how the device was scaled or internally processed. But researchers could take that device and then calibrate it by linking it to a certain number of calories, or oxygen consumption, to determine how many counts equates to how many calories, for example.

And now those calculations are built into most of these devices. Again, the early devices were piezoelectric, and there was some concerns about the reliability of the sensors, for example, in the early models. But then when they went to solid state devices, they became much more reliable. And now there’s the typical accelerometer that’s at least used in most research devices, it’s more of a men’s accelerometer that senses true gravitational forces, rather than bending moments.

And that opens the door for other type of sensors. So some of the accelerometers can tell, for example, by the direction of the moment whether you’re standing or sitting. So there’s interest in posture as well as movement.

[Damien Blenkinsopp]: So it sounds like there’s quite a wide variety of accelerometers that are available today, and some of them are still more expensive, and less expensive. So it sounds like it’s a technology in evolution. The ones you’re using in research currently are basically ahead of the game compared to the ones we have in consumer devices. Is that correct?

[Dr. Greg Welk ]: Well, somewhat. But actually the studies that we’ve done recently, we’ve compared some of the consumer monitors directly head-to-head with some of the established research monitors. And they’re in the ballpark. So the consumer monitors are not far behind. Which leads you to conclude that there is some calibration work going on behind the scenes at these companies.

So the various companies don’t really talk much about the research. I guess they figure the consumers don’t really care or want to know the details of how accurate it is, and that’s why researchers like myself study it. So we did compare some of the leading consumer monitors against standard research grade monitors.

And several were better than others, but in general it shows that some of the technologies are probably using pretty advanced calibration methods, or multiple sensors, to get the type of precision that they’re getting.

[Damien Blenkinsopp]: So when you say multiple sensors, is that so they have maybe more than one accelerometer inside the device, and they’re using algorithms to calibrate?

[Dr. Greg Welk ]: Right. In addition to a standard accelerometer, a lot of devices include a gyroscope, for example. That’s built into almost all of our cell phones. So, a lot of the way the field’s moving is that a lot of the technology that already exists in your cell phone can actually be an activity monitor. So instead of wearing something on your wrist, we’re actually wearing a very powerful sensing tool in our pockets.

The challenge is calibrating it to having people wear it in different body positions, and things like that. So a standard position, if it’s worn on the wrist, for example, gives you a better way to calibrate it, because everyone’s wearing it in the same spot. But the other sensors would be gyroscopes, or altimeters.

So the one limitation of accelerometers, for example, is that it can’t really tell if you’re walking up a hill , or carrying a backpack. They’re based on gait, for example. So the accelerometers get pretty good at detecting that locomotion is taking place. And then if you’re running, you’re moving faster, and there’s more counts, so your count rate goes up. And they can tell that that’s running.

And more advanced sensors are now using pattern recognition technologies that can determine what type of activity it is. The real challenge is you’re limited if you’re using just an accelerometer, because we know, again, it can’t detect if you’re carrying a backpack, or walking up a hill. So, including an altimeter or some of the devices, including heat sensors, or heart rate monitors. So the integration of several sensors allows you to make better inferences about what people are doing.

[Damien Blenkinsopp]: Great, great. So, let’s talk a little bit about some of the accuracies. Which devices did you actually look actually look at in your studies?

[Dr. Greg Welk ]: Well, that’s the challenge and some of the fun. The paper we had published even just this past year in Medicine and Science and Sports and Exercise compared a number of the leading consumer monitors, but by the time the paper goes live and is published, there’s already new monitors in use.

So, for example, FitBit is a very popular device, and in that original study we compared the FitBit One and the FitBit Zip, which were worn on the hip. Those were the early FitBit devices. And we also compared the BodyMedia Fit, which was an armband monitor, and a host of other monitors. The Groove, DirectLife, the Nike FuelBand. But then, by the time the paper is even out, the consumer models are already very dynamically changing.

So we actually just finished another study that’s submitted and in review now, that compared most of the recent wrist worn monitors. So the movement in the field was away from the waist worn monitors, which is where researchers have typically used them and where pedometers are worn, to the more wrist position, because people are used to wearing things on their wrist, and it’s more fashionable.

Our new study we used the FitBit Flex, which is the wrist worn monitor, and also the Jawbone Up24. And those two tend to be the leading performers, at least in our tests so far.

[Damien Blenkinsopp]: So it’s the Jawbone and the…?

[Dr. Greg Welk ]: The FitBit worked out reasonably well. I’ve seen better results in almost all of our work with the BodyMedia Technology. BodyMedia was the original developer of the most powerful research grade monitor, and most of their technology and development went into the JawBone. So I don’t know if consumers are aware, but JawBone is a very powerful technology company, BodyMedia, that is behind a lot of the infrastructure and the pattern recognition work that they do.

[Damien Blenkinsopp]: Yeah, I mean, because it’s interesting, because some of these companies are now even if they were start-ups are getting bought out by some of the bigger companies. Because Intel bought the Basis watch?

[Dr. Greg Welk ]: Right.

[Damien Blenkinsopp]: Well, of course Intel’s a huge company.

[Dr. Greg Welk ]: Sure.

[Damien Blenkinsopp]: I mean, you’ve got Apple moving in with the watch. Which I guess you haven’t had access to, with their watch.

[Dr. Greg Welk ]: We’re actually just starting that. We have plans to do another study in the spring with the Apple watch. But it’s not going to be out for another couple months, or maybe January or so. For us, anyway.

[Damien Blenkinsopp]: Great, great. So in general, if you’re using a JawBone or the latest FitBit, you think it’s good enough for people to be using, and not be concerned with any accuracy differences between the reality the research grade ones you’re using?

[Dr. Greg Welk ]: Right. I’m pretty comfortable with the results. Actually, our paper showed an error of 10 to 15% for overall estimates, and I have a caveat to that to add, but that’s considered an individual level assessment. So if a person is wearing it and it says that you burned 200 calories, a 10% error would mean its 220, or 180.

So there’s a buffer around that point. But that’s a reasonable amount of error for a consumer level device. Especially when the goal is behavior change. So if you’re using it for research, then precision is more important. But if your real goal is to use it to monitor your activity and to prompt you to be more active, then I think the accuracy is pretty good.

[Damien Blenkinsopp]: Yeah. And I guess the idea behind that, also, is if you’re just wearing something, it’s kind of relative. If I took 10,000 steps one day, and I take 8,000 the next day, is it safe to say that the monitor’s reporting the same kind of bias if it does have a bias and so…

[Dr. Greg Welk ]: Right. That would be constant error, and you’re right. If you have more on one day than another, that would say that you’re more active. And that’s the real goal from a behavior change standpoint, is to have it cue your behavior and prompt you to be accountable to move.

[Damien Blenkinsopp]: Right. And I guess for the moment, that’s probably one of the best uses, in terms of, let’s say, because exercise science is still trying to define what’s, say the ideal movements and the things like this.

I don’t know if you’ve looked at the Amiigo. I don’t think it’s commercially available yet, but that was looking at trying to track more different aspects of the exercises. The movements, and so on.

[Dr. Greg Welk ]: No I haven’t heard of that one. We keep pretty close on this. My students keep me tapped into all the latest and greatest out there, but we hadn’t heard of that one. But I think you’re right, that eventually the movement needs to be to integrate these sensors with other technologies, where they can provide more information.

So it’s not just the amount of movement that you’re getting, and how does that relate to your health, and does it change your behavior and change your health outcome.

[Damien Blenkinsopp]: Right. Right. I guess it’s going to be evolving for quite a while, until we get to any kind of ideas of what’s optimum. Because it’s probably going to be different for each person, as well, depending on where they’re coming from. It’s quite complex.

For the Basis watch which I used for about a year what I found, first of all, it didn’t really reflect very well changes like in the steps reporting, trail running, walking. Sometimes it would think I was doing one thing versus the other. So I think that was for sure something that needs ongoing work to… I don’t know how the Basis turned up in your work. Did you look at the Basis compared to the others?

[Dr. Greg Welk ]: Yeah, we did in our early study. And it didn’t perform too well, but we got contacted by the company after that, and they said, ‘Oh, I think we can do better than that.’ And they were surprised by the results, but we reported what we got. The Basis was one of the poorer performing monitors in our initial study, but they indicated it might have been that we had an earlier version than their latest, or something along those lines.

But you’re right, it’s a challenge for the companies to balance the need for accuracy with consumer forces. So right now, most of the emphasis in the development is on fashion, or size, and making them smaller. But accuracy is not a high priority among most of the companies. And that’s the balance that they’ll have to play, is how to keep the quality good and add new sensors, but without making them bulkier, or not as functional or fashionable anymore. So there’s this balance that they have to play.

[Damien Blenkinsopp]: Yeah, it seems like the people who are most concerned about accuracy are, potentially, some of the athletes, the people who have more going on, or quantified selfers. But for the mass market, it seems like they just kind of assume that it works. Kind of thing.

[Dr. Greg Welk ]: Yeah.

[Damien Blenkinsopp]: And that they don’t have to worry about it too much. I mean, it’s not something that they really question a lot. Because I guess it’s kind of beyond them. We’re talking about accelerometers, and the technologies are relatively advanced and complicated for just the average person to start trying to dig into.

[Dr. Greg Welk ]: Exactly. And so the consumer, like when our study came out, actually the media picked it up, and a lot of the media buzz was, ìThe monitor isn’t as accurate as you think.î And so, again, I pointed out that 10 to 15% error was decent in the paper, but when the media spun it then it became known that your monitor may not be as accurate as you think.

But I think the media and the general public, for example, don’t fully realize how difficult it is to quantify movement. So when we walk around, the accelerometers are basing most of the estimates only on this ability to detect gait: walking and running. If you’re standing, lifting weights, the monitor can’t tell what you’re doing. And if you’re walking up a hill, for example, it can’t note that and really capture the true energy cost. If you’re digging a ditch, with these monitors, you could be burning tons of calories, but you’re not moving in space. And so the monitor’s not picking up that detail.

And that’s the caveat I mentioned earlier, that I was going to get back to. Our recent study, we broke up the time periods and we looked at the accuracy of the devices for sedentary time, like typical office work. And then we looked at locomotor activity, like an aerobic workout on a treadmill. And then we looked at 20 minutes of circuit training.

So we had people for about an hour come in, and we had them first do 20 minutes of sitting around, standing around, just doing office work. 20 minutes on a treadmill, and then 20 minutes in a free weight circuit training environment. And then we looked at the accuracy for all three settings.

So, when I was pointing out earlier that the accuracy was 10 to 15% that was in a more controlled study, and also for an overall period. Like for a full hour. But then when you break out the accuracy for individual segments, the monitors were all over the place. So they overestimated for one activity and underestimated for another.

[Damien Blenkinsopp]: So I guess they’re mostly, are they standardized on jogging or walking primarily?

[Dr. Greg Welk ]: Pretty much, yeah. That’s where the JawBone BodyMedia Fit tended to be better performers, because they have other sensors that are detecting the patterns. Whereas the FitBit and the DirectLife and the Nike FuelBand had more variability in their estimates for each individual activity. So they have more error, even though the overall estimates looked comparable.

[Damien Blenkinsopp]: So what are they combining with the accelerometer in order to determine the type of activity so that they can run a different algorithm, I guess, on the count.

[Dr. Greg Welk ]: Right. A lot of the work actually looks at the patterns within, how the counts are accumulated. So if the counts are in a repeatable pattern, like in a rhythm of frequency, then we know it’s walking. If they see a chaotic pattern, then we can know it’s not walking, or running, and then other patterns can be detected. For example, the BodyMedia can detect a pattern in cycling that most other companies have not been able to do. And we’ve done studies that show it gets better at predicting the energy cost of cycling than other monitors.

So they use other sensors, again, these heat sensors, or just the pattern within the minute. And so even though the devices are producing an estimate of a single minute they’re actually sampling at 30 hertz or more to capture all this rich data.

[Damien Blenkinsopp]: And so, I guess an important thing to understand here is that they’re using proxies, right? They’re taking data which isn’t directly counting steps, calories, and then they’re using research is it standardized research, or is it their own personal estimates?

[Dr. Greg Welk ]: For the most part, all the consumer devices are doing in on their own, and that’s what researchers are now starting to test. Again, when the original calibration work that came out that most of the people in our field use; we developed the calibrations, they get published, and they get used by other researchers. But the companies are on their own to kind of develop their own calibration equations, or pattern recognition algorithms. And then they work over time to improve them.

[Damien Blenkinsopp]: So there’s no activity going towards a standardization of any of this as yet? Whether it’s the hardware, or the software?

[Dr. Greg Welk ]: Not within the consumer market. In the research world, we’re sort of converging back around the use of raw G-forces, I’ll say. So the original accelerometers were producing an output that was called counts. Again, that was you couldn’t compare one count to another count, because they were scaled differently. But if all the accelerometers could report in the same unit, which is gravity, G-forces, then we can make inferences across monitors. And that’s becoming the unit that we should have been using all along, but it wasn’t possible before. But there’s sort of a move towards using raw data, and using raw G-Forces as the unit of comparison.

[Damien Blenkinsopp]: That sounds great. So, I guess, would you envision that consumer companies will eventually be doing this, or is this a very different cost? Has it got a very different cost structure as yet? Could you give us an idea of what the difference is? Is it 10x, or…

[Dr. Greg Welk ]: No, I’d say maybe 2x or less, in terms of the sophistication of a research monitor. It’s more the processing capabilities that they built in the data storage that differentiates a consumer monitor from a research one. So, what researchers want to know is we want to be able to see the raw data in minute by minute form, or second by second. And that requires a lot larger data storage, which then makes the device bigger.

And also we need better processing software. A lot of the consumer monitors export only data every hour, for example, because it doesn’t require as much storage in the unit and keeps the data piece smaller. So it’s a factor of what’s important. So a researcher needs different things than the consumer needs, and it’s kind of that trade off.

But I’d envision, again, the consumer monitors evolving more in the direction of combining multiple sensors, and linking, eventually, to other health related indicators. There’s a big movement now towards how they could be used by physicians, or behavior change applications. So I think the real key is going to be how these devices can interface with the health care system.

Right now they’re just kind of a fun thing that people are using. But the real question is whether health care providers will start using them, and whether insurance companies will start paying for it. Because getting people more active would go a long way to preventing chronic disease and reducing obesity in the population.

[Damien Blenkinsopp]: And for something like that, that’s going to encourage the device manufacturers to move, potentially, towards some standards like the one you were just talking about, which, when it comes to government and stuff, they want something more standardized. And we can’t have just all these monitors.

Just if all the medical doctors arenít going to be able to work with all of them, obviously, that’s not the way it works. And I can imagine there would be some kind of approval process eventually. I don’t know if you’ve seen anything going on like that. I know that Apple was apparently talking with the government, and some of the health bodies I don’t know if you were looking at that about some of the markers and some of the structure that they were putting behind the watch.

[Dr. Greg Welk ]: Yeah, I’ve seen a little bit, but probably not enough to comment. I think stymieing competition would go against what America’s about, and what the companies are about. And so all companies should have a chance to compete for that marketplace, and not force health care providers to use the same device.

But the key is whether the devices can be successfully integrated into an electronic medical record, for example. So I work with a couple of companies that have already been working on the medical interface. And there’s a patch the product’s called the Metria Patch and it’s basically a piece of, version of an accelerometer that a doctor could slap on a person’s arm, tell them to wear it for a week. And then they tear it off and mail it back in, or bring it back in.

And it has all the sophistication of the best available research device, but in a form that a physicianís group could use. And they’ve started working into how that data can be incorporated directly into an electronic medical record, where it can be acted on.

[Damien Blenkinsopp]: And that’s big enough to store the type of minute by minute data you were talking about?

[Dr. Greg Welk ]: Oh sure. Yeah, it is. Yeah. And it has the adhesive capabilities, so when you put it on, it becomes like a patch that sticks to your arm for a week at a time, or even a month at a time. You could swim with it, shower with it, and eventually when it’s taken off and they’ve even figured out the breathability, like how to make sure that if you’re wearing it, that it doesn’t affect your skin underneath. So there’s a lot of work in that particular interface.

But even with that device, I think the missing piece is the health coaching that goes along with it. So for it to ever get traction in the health care community, they need to know that they can see the data, and then use the data to inform behavior change. We’ve done a lot of work lately with health coaching applications of some of these monitors.

We have a virtual health coach, for example, that can see the participant’s data, and we can comment about whether they’ve been active that week, or whether we see patterns that they could act on to improve their physical activity or weight loss behaviors. And so we’ve got a number of studies in process with this kind of health coach model.

[Damien Blenkinsopp]: That sounds very interesting. How long before you think this kind of thing becomes more available to consumers? I know there’s some health patches already out. We’ve spoken with one provider, Ronda Collier, and she’s been working with the health patch for a heart rate monitor. So there are some of these starting to creep into the market.

But they’re still a bit cost prohibitive, based on the fact that it’s a usable one, consumable. So you have to buy one every week, or every month.

[Dr. Greg Welk ]: Right, but that at least gives a cost structure that a physician’s group can budget for. It’s more challenging to use like a physical device that gets lost, or that they have to buy and upgrade. It’s sort of like disposability is an advantage, in a lot of way, because it can be built into the fee structure.

[Damien Blenkinsopp]: That’s right, and it can be updated easily, rather than having to pay a higher price and have someone have to have that for one or two years before they can upgrade.

[Dr. Greg Welk ]: Right.

[Damien Blenkinsopp]: Especially at this time when the technology’s moving very fast. So do you foresee the technology changing rapidly for the next five years, or do you think it’s going to settle down soon?

[Dr. Greg Welk ]: Oh I think it’s just getting started in dynamic phases. I think all these are new and very exciting. We saw them all out at Christmas, I’m sure a lot of people got them in their Christmas presents this year. You saw them highly advertised at the Christmas sales and things.

I think the movement will be towards these smart watches, and the integration with your cell phone. And again, in a few years, the technology already exists in cell phones to do this, so the watch really becomes the cue, or the device, that prompts you about how active you are. Whether the accelerometer is in your watch or in your pocket doesn’t really matter, they’ll basically start interacting with other aspects of your life and provide prompts about your blood pressure, and your heart rate, and other features that can inform your health.

[Damien Blenkinsopp]: Great, thank you very much. Do you have any practical tips for use, which could help to get better feedback, more accurate feedback, over time? For instance, a lot of these watches are, as you say, worn on the wrist. Does it make any difference which wrist you put it on?

[Dr. Greg Welk ]: No, I don’t think that matters. The companies may tell you it’s best if worn on the left, because that’s where they calibrated it. The right or left doesn’t really matter, but I think the key, as you pointed out earlier, is that people should use them on a relative basis, as a reminder to be active. If they want to take a day off and remove the monitor, that’s okay. The world’s not going to end if they have a gap in their data, because the real goal is to be using it to cue your behaviors.

I, for example, don’t use one every day, or I use them when I feel the need to monitor, or things like that. Other people, however, really do benefit from the daily accountability, and want to have that as a daily reminder. So it’s kind of an individual preference there.

[Damien Blenkinsopp]: Yeah, one of the main things I was using it for was just judging how much I was walking, and how far, or how many steps. Just trying to keep that at a reasonable level, and increasing it. Actually, at the time I was suffering from chronic health issues, and it was difficult for me to walk.

So it was great for me to see the progress. Like, I made 10,000 steps today, that’s awesome.

[Dr. Greg Welk ]: Right.

[Damien Blenkinsopp]: Unfortunately, it didn’t take into account the hills which we’re talking about which was a huge factor in whether I made that 10,000 or if I went up this hill. So I’m sure that’s going to come relatively soon.

In terms of the next things you see happening in the market, which you’re kind of excited about, you talked about the patch. Is there anything else you see in the consumer market which you think will be coming soon? Or in the next five years?

[Dr. Greg Welk ]: I think one of the convergences is going to be with the balance between not just promoting activity, but minimizing inactivity, or sedentary behavior. So the researcher community is really intrigued with the dual effects of both inactive lifestyle, and basically being more active and less inactive. That’s one of the things I’m personally much more interested in is minimizing my sedentary time. So I’m like a number of people that have a standing desk, and try to be on my feet more than I’m sitting. So I think the monitors that can start proving information about sedentary time and activity time, that’s going to be a desirable combination.

[Damien Blenkinsopp]: And position, as you said earlier. Because right now most of them don’t tell if you’re standing or sitting. And there’s a fair amount of research, as I understand it now, that sitting’s a really bad idea. For our backs and other aspects. Whereas, at least it sounds like you and I are trying to stand, and do the standing desk thing, more because of that, but it’s not getting tracked?

[Dr. Greg Welk ]: Right. But most devices don’t really have a good sense of how to track sedentary time. The research community is actively pursuing that, but we haven’t really seen good output from most of the consumer monitors on sedentary time yet. I mean, I think they’re working on it. So I think eventually there will be these separate indicators.

And even on the smart watch, the prototype for Apple, they have a really cool interface I don’t know if you’ve seen that, that shows these loops. There would be a circle, and when you meet the day’s activity goal, your circle would complete, or you would get a full circle. And if you also minimize the time you spend sitting, you would also get a full circle. And the way they track that is you can’t have any hours where youíre sedentary for more than an hour. So basically it forces you, every hour, to remember to stand up and move, which is a good cue.

And so they have built that into the planned smart watch. Again, I haven’t gotten to try one myself yet, but that’s what I’ve seen in the prototypes.

[Damien Blenkinsopp]: Yeah, and if you have alerts. We have calendar alerts on our IPhone, if we have alerts on our watches that say hey, you’ve been sitting for an hour, it’s time to get up. The Basis watch actually has it, so every day it would say I was sitting for too long a period. That’s one of the other things it used to say was I was asleep whenever I was watching TV, or something like that.

Which is difficult to assess, when you are asleep versus watching TV or something very low key.

[Dr. Greg Welk ]: I think yeah, that’s a movement where the research community is actively interested in both the effects of promoting activity and minimizing sedentary time. I guess you brought up before that there’s not a consensus about the right type of activity, but I think among researchers and the public health community, we’re in agreement that more physical activity is better, but a moderate amount is sufficient for health. So if we can get the population to do 30 minutes of physical activity on most days of the week, that’s what we’re after. Unfortunately a large percentage still doesnít do that.

And then the addition of resistance training is a really important piece that isn’t really captured with these monitors, unfortunately. So that’s where we need people to be adding some resistance exercise to their routine, because that adds independent benefits also.

[Damien Blenkinsopp]: And the Amiigo I brought up, which is trying to do that. I’ve actually been watching for a year. I don’t think they’ve actually delivered any of the devices yet, it was an Indiegogo project. I could be wrong, I haven’t look at it for a while. But they’ve run into some manufacturing issues, and I’m not sure what the technology was there. But someone is trying to incorporate this resistance training aspect into it.

[Dr. Greg Welk ]: Yeah, I had seen a couple. And we were planning to incorporate them into that study I mentioned, about resistance training, but we couldn’t get them in time. I forgot the names of those, but they weren’t ready. So we just decided to go forward with the study with the monitors we had.

[Damien Blenkinsopp]: Great. So this is an ongoing work project, right? You’re going to be continuously looking at the new devices coming out, and tracking. Is this something that you’re going to continue working in your assessment center?

[Dr. Greg Welk ]: Oh, definitely. My students are very interested in that, so I have a whole fleet of grad students that help me do this work. They’re very interested in keeping up on the latest technologies. Our lab is called the Physical Activity Lab. So if you went to physicalactivitylab.org, we have, that’s where we post information on our past studies, and things like that.

But when we finished testing this one consumer study, we then completed another one in the fall that will be presented at a conference this spring. And that’s, again, in review now for publication, and we’re already planning another study this spring to compare the new smart watches, like you said, and also the new JawBone Up3, and the FitBit Charge. Those are the latest devices that, again, are released. Even before we can finish testing them, there’s new monitors that come out. So we’re very interested in testing the new JawBone Up3 that has a number of new features in it.

[Damien Blenkinsopp]: Yeah, that’s great to hear you’re going to be keeping up with it, so we can follow you and keep up-to-date on all of this. Because I haven’t seen anyone else covering this in so much detail.

I’d like to ask you a couple of personal questions about your use of data. In terms of biomarkers or personal data, do you track anything on a routine basis for yourself to either monitor or improve your health, longevity, or performance?

[Dr. Greg Welk ]: Yeah, I’m kind of a dabbler, probably, more than a regular user. So I dabble in them maybe because I’m more thinking about them from a research perspective. But as I think about it, the indicator that I’m probably most intrigued with is the sedentary time. So it operates in my mind all the time about how long I’m sitting, and trying to minimize sedentary time.

So, I’ve started becoming more interested in devices and assessments that can do that; either simple cell phone apps or logs that I can track my behavior with. So I used to do a lot with high level training and using heart rate monitors to track the intensity of my workouts and things like that, but I kind of know by now my own ranges, and if I’m working hard enough. So as an exercise physiologist, I kind of know what I need to know about my own training. But this whole sedentary world is a new frontier.

[Damien Blenkinsopp]: Great, great. Did you ever look at HRV? We’ve talked about this quite a bit on this show.

[Dr. Greg Welk ]: Yeah, early on I used to use a heart rate monitor and using HRV to track. It’s a good indicator of, over training, for example, if your body’s not rested from a previous night, a lot of athletes would use the advanced heart rate variability indicators to determine if their body’s fully rested and ready for the next workout. So at one point in my life I was very focused on triathlon training and did a lot of that monitoring. But recently it’s not been as high of a priority for me.

[Damien Blenkinsopp]: Great, thank you. What would be your biggest recommendation or insight on how people could use data effectively? Because there’s more and more data coming about, and especially with these devices. How would you suggest that they use this data effectively to improve any aspect of their life?

[Dr. Greg Welk ]: Good point, and I think that’s where the goal would be for using the device to help you change your behavior, and to use it to inform decisions, not just to collect data for the sake of collecting data. So, I think as the devices become more sophisticated they’ll provide actionable insights that give you prompt, that says last week you were active in the mornings, or you weren’t active in the mornings. And it would cue you to maybe be more active at different periods of the day.

So I think that’s where it’s got to get, where the devices are basically helping people to make changes. I mean, we live in a very challenging environment to be active today, with people using cars, and the busyness of our lifestyles. And so I think the monitors provide a way to keep people accountable to their goals, and realize that they have to build physical activity into their day; it doesn’t just happen. It has to be actively planned and promoted during the day.

[Damien Blenkinsopp]: Great, thank you so much for that. I’d really love to have you back on in say a year or something. Would you mind if we reached out and, obviously, you’re going to be seeing the trends as they develop, and I’m sure you’ll have a completely different idea and research on where things have got to in a year’s time.

[Dr. Greg Welk ]: Yeah, I’d be happy to. I’m actually, we’re working on our health coaching models, we’re testing some of the new devices in the spring, and we’re also including expanding our health coaching model, where we’ll be testing this new patch device from a physical physician referral system. I think that’s where the key is. And we’ll be able to learn from these studies what type of information consumers need to change their behavior, and what level of involvement do they need.

So a lot of our goals in our health coaching studies is to figure out a very cost effective solution. For example, can we give people a monitor and a few tips every week, and even text messages. Is that enough? Or do we need to give them a one on one counseling session, three weeks in a row, and then put them on their own?

And so we’re trying to figure out that optimal dose and scope of what a behavior change component needs to be. And, you know, we’ll have a lot more to know by next year.

[Damien Blenkinsopp]: Great. Yeah, and so you bring up a lot of the challenge of using these is understanding the psychology and the behavioral implications of it. So this is the more complex area to look into, really. Analyzing, as you say, how to report the data of people on frequency, the format, and what actually influences behavior and gets us to the end goal.

Well great Greg, thank you so much for your time today, and looking forward to talk to you again as your research expands and continues to look at this area.

[Dr. Greg Welk ]: Yeah, I’d be happy to join, and I’ve been enjoying following the blogs, and I look forward to continuing the discussion.

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Micro-nutrient deficiencies are prevalent today, and prevent our biology from functioning optimally by limiting its activity. The most common and most severe micro-nutrient deficiency for most of us is Magnesium.

A hundred years ago we were able to get five hundred milligrams per day of Magnesium. Today we get closer to two hundred milligrams per day because of changes in food nutrient composition and diet that we’ll discuss today. The impacts can be subtle and long term, to severe and immediate.

As Magnesium has an important role in over 300 enzymes throughout the body, it can effect performance and health in everything from cognitive to muscle performance, and as with many other micro-nutrient deficiencies, increases our risk of cancer by causing DNA strand breaks. For the more severe, but not so uncommon deficiencies in this nutrient, symptoms can include headaches, fatigue (lower cellular energy output) and muscle cramps.

Today, we dive into the bioavailability of magnesium sources, the different types of tests available and their accuracy, and figure out the significant biomarkers.

“[Magnesium] really is the one supplement
that everybody should take.”

– Dr. Carolyn Dean

Dr. Carolyn Dean is both a medical doctor and naturopathic doctor with thirty plus years of medical experience. She is the author/coauthor of over 30 health books (print and eBooks) and 106 Kindle books. Currently in its third edition, the Magnesium Miracle has been Amazon’s #1 best selling book in both the Alternative Medicine and Vitamins & Supplements categories. She is on the Medical Advisory Board for Nutritional Magnesium Association, President of Hallmark-Dean Laboratory, and contributing editor to Natural Health magazine.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • Magnesium is involved in 700-800 different enzyme systems within our bodies (05:09).
  • Diverse roles of magnesium (05:33).
  • Magnesium has a “push-pull relationship” with calcium.  Calcium causes muscles to contract, while magnesium relaxes muscles (05:41).
  • 80% of the population is not getting the recommended daily allowance of magnesium (07:25).
  • There are two reasons for this common micro-nutrient deficiency: (1) The soil doesn’t have magnesium. (2) There is more stress/higher demands of magnesium going on (07:37).
  • Medications, diet choices, and water sources can “bump” away, deplete storages, and bind to magnesium (08:47).
  • Amount of magnesium required to metabolize table sugar and high fructose corn syrup (08:54).
  • Common electrolyte products do not replenish magnesium (09:54).
  • Neither farmers nor organic farmers replenish the soil with minerals. Farmers would need to use rock dust on the soil to do this(11:09).
  • The soil is much lower in magnesium currently compared to ancient times due to: (1) overuse of the top soil and (2) the recycled water we use today has not undergone micronutrient accumulation (11:54).
  • When fluoride (a molecule found throughout our environment) and magnesium bind – a compound of magnesium fluoride called sellaite is created (13:15).
  • Sellaite is able to replace the magnesium found in bone and cartilage, overall making bones more prone to fracturing (13:30).
  • 20% of prescription drugs have added fluoride molecules to assist in drug delivery to the cell (13:49).
  • The highest amount of magnesium can be found in the heart (14:36).
  • Explanation of the magnesium depletion cycle (16:01).
  • Dr. Carolyn Dean defines terminology: skipped beat, arrhythmia, and palpitations (18:35).
  • Additional symptoms of magnesium deficiencies (20:45).
  • There are many seemingly unique symptoms or symptom combinations that can appear in a magnesium deficiency. The appearance of these symptoms is based on the individual and that individual’s vulnerable areas (23:45).
  • Doctors and specialists often see and treat the various symptoms individually, and may be unable to put it all together as a magnesium deficiency (24:14).
  • Magnesium deficiencies have contributed to ending the careers of professional athletes due to severe muscle cramps (26:20).
  • Advice Dr. Carolyn Dean gives to parents of teen athletes on muscle cramps (26:44).
  • The typical test administered by doctors is the blood serum magnesium test.(27:57).
  • The red blood cell magnesium test (28:09).
  • The gold standard test is the ionized magnesium test (28:24).
  • Like many lab tests, the blood range of the tests represents the average of the population and the not the optimum (30:15).
  • What to use and how to track your own magnesium (35:30).
  • Reasons why some people feel better taking magnesium and then feel it is no longer helping (38:00).
  • How to slowly introduce magnesium, tracking symptoms and/or RBC measurements as they increase slowly and steadily (38:24).
  • The dynamic between treating the symptoms of magnesium deficiency and other medications (39:24).
  • Table salt compared to sea salt (41:40).
  • Magnesium sources through the skin (42:48).
  • If one is taking a magnesium supplement able to be properly absorbed, then it should not produce the laxative effect (44:58).
  • Foods high in magnesium (46:48).
  • How many milligrams of calcium Dr. Carolyn Dean recommends (47:22).
  • Once treated, feeling symptomatically better can occur overnight, within a week or after several months depending on various factors (51:29).
  • Herbicides and pesticide can also bind up minerals found in the soil (55:17).
  • Discussion of German New Medicine and Total Biology (57:16).
  • Dr. Carolyn Dean does not track biomarkers on a routine basis (57:30).
  • Dr. Carolyn Dean’s one biggest recommendation on using body data to improve your health, longevity and performance is to track magnesium (58:50).

Thank Dr. Carolyn Dean on Twitter for this interview.
Click Here to let her know you enjoyed the show!

Dr. Carolyn Dean

The Tracking

Biomarkers

  • Red Blood Cell (RBC) Magnesium Level: This biomarker indicates the amount of magnesium located within the RBC. This can give a more accurate result then serum magnesium levels. Dr. Carolyn Dean advises an optimal range of 6.0-6.5 mg/dL.
  • Serum Magnesium Levels (or Serum Total Magnesium): This is the most common biomarker tested for when clinically evaluating of magnesium levels currently. It is expressed in Milligrams per Deciliter (mg/dL) and is very limited in its ability to reflect total body magnesium levels. Less then 1% of total body magnesium is found in serum.
  • Serum Ionized Magnesium Levels: This is the measure Carolyn recommends for the most accurate assessment, for which unfortunately tests are not accessible outside of research currently. There are many studies over the last decades using this marker – see pubmed reference.

Lab Tests, Devices and Apps

  • RBC Magnesium Test: Able to be ordered online without a prescription and used to evaluate magnesium levels in red blood cells.
  • Exatest: This test is the most accurate and most expensive test. Magnesium levels present within the tissue cell are determined through a cheek swab.

The Tools

Supplements

  • Transdermal Magnesium Chloride: This is Damien’s described method and is an oil to be placed on the skin and is comprised from super saturated magnesium chloride and distilled water.
  • Magnesium Citrate: Often in powder form, may be dissolved in water and sipped throughout the day.
  • Sea Salt and Himalayan Salt: Carolyn recommended using sea salts because of their high mineral content. Options include Sea Salt and Pink Himalayan Salt.
  • Epsom Salts: Traditionally used to replenish magnesium levels, this is a magnesium sulphate source. Dr. Carolyn Dean recommends placing one to two cups in a medium hot bath and soak for 20-30 minutes. (Note from Damien: Some people, particularly chronically ill with methylation issues may be sensitive to sulphur and get some negative symptoms from magnesium sulphate. So monitor for symptoms if this is your situation.)
  • Magnesium Oxide: One of the cheapest and poorly absorbed sources of magnesium. In this form only 4% is absorbed, while contributing to the laxative reputation of magnesium.

Other People, Books & Resources

Organizations

  • Remineralize the Earth: Dr. Carolyn Dean praises this organization’s focus of soil amendment with minerals.
  • The Heart Rhythm Society (HRS): The Heart Rhythm Congress organized by the HRS awarded, “The Arrhythmia Alliance Outstanding Medical Contribution to Cardiac Rhythm Management Services Award 2012” to Dr. Carolyn Dean.
  • Nutritional Magnesium Association: A non-profit educational site Dr.Carolyn Dean is a part of the Medical Advisory Board.

Other

  • German New Medicine: Dr. Carolyn Dean has studied a version of this, Total Biology. This describes the connection between brain and physical symptoms in the body.

Full Interview Transcript

Transcript - Click Here to Read
[Damien Blenkinsopp]: Carolyn, thank you so much for joining us today.

[Carolyn Dean]: Oh, you’re welcome Damien. Good to be here. Always love to educate people about magnesium.

[Damien Blenkinsopp]: Yeah, and the first time I came across magnesium as being something important for our health was your books. So thank you very much for putting that out there, because it really was something that was a bit different. I’m not sure how you first came upon all of this, because you were the first person to start talking about magnesium.

It’d be interesting just to see, where did this all start? And when did you decide to start focusing on magnesium, and see it as something so important?

[Carolyn Dean]: How I became interested in magnesium is, it actually came to me. Random House, the publisher, wanted me to write a book on magnesium. At the time, I didn’t think that you could find 300 pages to write on one mineral, but I was completely amazed. This was in the late 1990’s.

And I realized that I had magnesium deficiency symptoms of heart palpitations and leg cramps. So for me, it was very serendipitous, and really helped my health. And, as it turns out, has helped hundreds of thousands of people who’ve read the book.

[Damien Blenkinsopp]: Yeah, that’s great, that’s very interesting. Why did Random House decide that magnesium was something worth talking about?

[Carolyn Dean]: Well one of their editors, I was told, had migraine headaches, and found when she took some magnesium, they helped her migraines. And she was so amazed she wanted more information. And as it turns out, it can help literally hundreds of symptoms, and many dozens of conditions. So, it’s quite an amazing mineral. As you said, not many people know about it.

[Damien Blenkinsopp]: Yeah, yeah. So, what is the role of magnesium in the body? Why is it important? Basically, if a deficiency in a mineral – or micro-nutrient, as we sometimes call them – is able to cause a lot of symptoms, it’s because it’s taking on some important roles in the body. And then when it’s lacking, it’s obviously us all these symptoms.

So what is the magnesium doing in our body? Why is it so important?

[Carolyn Dean]: Right, we’ll you’ve laid it out quite well. Magnesium is necessary for the activation and function of between 700 and 800 different enzyme systems in the body. So, it’s catalyzing most chemical reactions in the body.

It synthesized protein, transmits nerve signals, relaxes muscles. And I should throw in here that calcium contracts muscles. And so they have a push-pull relationship, magnesium and calcium. And magnesium also produces and transports energy called ATP.

And yet in medical school we’re just told that magnesium is a laxative. So, that’s why I write the book, and do a lot of interviews, and a lot of papers to describe the importance of magnesium, and to show people how they can improve their magnesium intake.

[Damien Blenkinsopp]: Excellent. Interestingly enough, I’ve had magnesium deficiency myself. I’ve had all the tests you recommend and everything. Also, some additional tests relating to mitochondrial functions. So you just mentioned ATP, and magnesium. And I had issues of my mitochondria and energy production, which caused all sorts of symptoms.

So my own personal story, I’ve come across this directly. And it was coming across in those tests as well, that I needed to build up my magnesium. So we can talk a little bit later about how you get people’s magnesium status to be raised under these things. But certainly for me, it was, and still is, very important to maintain my health.

So, why is it that they, there are many people… Because it’s counted as the second most common deficiency, in terms of micro-nutrients, in the Western world. Why is it today that we have this issue, where it is so deficient? Are there reasons that, either our intake of magnesium has changed, is it lower than historically, or, somehow is maybe the demands for magnesium higher?

[Carolyn Dean]: I think both contribute to the extreme magnesium deficiency to the point where 80% of the population is not getting even close to the recommended daily allowance of magnesium. Number 1, there’s very magnesium in the soil anymore. So, when a plant grows and it’s supposed to pull up minerals into it’s tiny, tiny plant rootlets, if the minerals aren’t there, the plant is not going to have minerals.

I’ve had cases of people on these crazy 140 ounces of green drink a day. And they come to me with heart palpitations and leg cramps – two of the major symptoms of magnesium deficiency – and they can’t believe it when I tell them they’re magnesium deficient, because they’re eating all these plants, all this greenery. And they go and get a blood test, and well and behold, they’re low in magnesium. And it’s because even if they’re eating organic plants, if the soil doesn’t have magnesium, the plants aren’t going to have magnesium.

And number 2, the demands from magnesium are much higher. I suppose there was always stress, of course, but now you see magnesium can be bumped away by medications that contain fluoride. The fluoride binds magnesium. Fluoridated and chlorinated water can bind up magnesium and make it unavailable. The diet, for example with sugars, it takes 26 molecules of magnesium to metabolize one molecule of table sugar.

The quarreling there with fructose, it takes twice as much. So it’s 52 molecules of magnesium required to metabolize one molecule of fructose. So people who turn to these high-fructose corn syrup sweeteners and say, well it’s fruit sugar; they’re actually in worse shape. They’re using up more magnesium.

So, we’re not getting it in our diets, and we continue to dissolve it with our behavior, and with the food. With alcohol you drain it, coffee drains it. Even in the athletics, the sweating where we lose sodium we think, we’re also losing magnesium. And when we just replace with certain electrolyte products that are high in sugar, and maybe high in sodium, we’re not replacing magnesium. And we’re causing people, actually, to have blood sugar imbalances.

You take an elite athlete and their intake of one of the major electrolyte products. They could be taking about 60 teaspoons of sugar a day, which they’re not able to metabolize, which ruins their magnesium balances, and they’re sweating out their magnesium and not replacing it.

[Damien Blenkinsopp]: Wow, that’s a whole host of conditions. I guess one of the most interesting ones is the soil, this input. Why is the soil so much lower in magnesium today? Is it because of overuse? We all hear about how we’ve been overusing the same amount of soil, and the top soil is disappearing steadily. Is that one of the main reasons?

[Carolyn Dean]: Yes, exactly. In ancient times, or even just a hundred years ago, they tell us that we could get about 500 milligrams of magnesium in our daily diet. Now we’re lucky to get 200. And it’s because the soil has been completely depleted of certain minerals, like magnesium, and the farmers don’t replace minerals. Even organic farmers, they don’t necessarily put what we need, which is rock dust, on the soil.

Hundreds of years ago when the spring thaw would bring water down from the mountains, the water and the tumbling of the rocks would create a high mineral content water that would end up in the deltas before it landed in the ocean. And the plains around the mouth of the rivers would flood, and in those plains with high mineral content water, they would grow the crops.

Now, that’s where everybody lives. And the farms have been relegated to places where they have to irrigate. But they just haven’t put the minerals back in the soil.

[Damien Blenkinsopp]: Right. Of course, and we’re using recycled water, which hasn’t gone through that whole natural process of micro-nutrient accumulation. It’s very interesting. I think there’s a business out there for someone, agricultural organic crops with micro-nutrients added. I don’t know if it’s possible. Have you seen that today? Does that exist somewhere?

[Carolyn Dean]: Yes, there’s a great website called Remineralize.org. And they do a lot about reaching education, about amending the soil with minerals. Remineralize.org.

People definitely know there’s a problem. In my Magnesium Miracle book, right at the beginning I talk about a 1934 Congressional Committee that reported on the enormous deficiency of minerals in the soil that just lead people to eat more and more food to try to get the nutrients they needed, which just ended up making people fat and mineral deficient.

[Damien Blenkinsopp]: Yeah, yeah. Exactly. And another interesting aspect that you mentioned was the fact that some molecules aren’t natural to our body. You brought up fluoride actually bind to magnesium. And of course, there’s a lot of fluoride around us in the water, the toothpaste, and so on today. Is that a very tight binding? Are they strongly attracted, those two molecules?

[Carolyn Dean]: Yes, very strongly. They form a complex called sellaite, and it’s brittle. And sellaite, this magnesium fluoride, it’s insoluble. It replaced magnesium in bone and cartilage. And it can make bones prone to fracture.

And what I found when I was doing the recent research for this third edition of Magnesium Miracle, 20% of our prescription drugs have added fluoride molecules, but those drugs are the majority of the commonly used drugs. They added the fluoride molecules to drugs because it increases the drugs ability to dissolve in fats, and therefore go across the fatty cell membranes. Which means it can be built up in stronger levels in the cells.

So anyway, what we’ve ended up doing is what 70% of Americans taking prescription drugs, we’re giving them all this extra fluoride. It’s binding up the magnesium. And when you look at the side effects of the commonly used drugs, a lot of them are cardiovascular side effects. The highest amount of magnesium in the whole body is in the heart. So, when you start to experience magnesium deficiency, you can start to get heart symptoms. Mine were the heart palpitations. That’s very common. I won an award actually in 2012 from the Heart Rhythms Society for my work with magnesium on heart arrhythmias.

But most doctors don’t understand the magnesium picture because we did not learn about it in medical school. You were mentioning – and I know I’m jumping around here, but there’s just so much to say – you were mentioning about the Krebs cycle, the energy cycle, in the mitochondria. Six out of eight of the steps in the Krebs cycle require magnesium. So, when anyone ever talks to me about mitochondrial problems, and they take about all these esoteric supplements they’re being told to take, and that, of it’s so dangerous. You need a lot of magnesium, mainly, to get your Krebs cycle going.

And so what happens with the vicious cycle of fatigue in terms of magnesium deficiency occurring. People go to doctors, and they’re fatigued, their heart may be palpitating, they’re under stress, their magnesium is deficient so they may get high blood pressure. So what happens is they start on this round of medications. They’re given a diuretic that drains out fluids, including magnesium.

They’re not even tested for magnesium – and we can get into that later – but there’s a cycle of blood pressure medications, and then they come back and all the sudden their blood sugar’s elevated. Well one of the signs of diabetes is low magnesium. And then their cholesterol is elevated. Well, the enzyme that helps balance cholesterol in the body requires magnesium. And if it’s deficient, then your cholesterol level will go up.

So, we’ve got people on things like Prozac because they’re fatigued, and they’re not sleeping, so they appear depressed. Well Prozac has three fluoride molecules. They’re put on cholesterol drugs; Lipitor has one fluoride molecule. They’re put on anti-arrhythmia drugs; one of them called Flecainide has six fluoride molecules.

And they irony of putting someone on an anti-arrhythmia drug that actually binds incredible amounts of magnesium is incredible. Because even when you look at the side effects of Flecainide, it’s fast, irregular pounding or racing heartbeat, shortness of breath, and tightness in the chest. The nerves, you have burning, crawling, itching, numbness, prickling pins and needles, or tingling feeling and chest pains. All of those are magnesium deficiency side effects.

Even the shortness of breath. When the smooth muscles in the bronchial tubes tighten up, because without magnesium your muscles get tight because you have relatively more calcium. Calcium tightens muscles, magnesium relaxes them. So that’s where you get all the tightening in the heart muscles, tightening in the calf muscles. And then people think you have a heart problem, whereas you have a magnesium problem.

[Damien Blenkinsopp]: Great, great review there. Just for some people at home, you mentioned palpitations and arrhythmias a couple of times. In kind of layman’s terms, how would you explain that to someone at home?

[Carolyn Dean]: Well, it would be… You don’t even notice your heart beating, number one. That’s normal. But when you start feeling your heart pounding, or going fast, to me that’s magnesium deficiency, until proven otherwise. Unless you’re running down the track or something. But if your heart’s starting to pound out of the blue, it can make people feel anxious for that to happen. They can actually go into an anxiety attack.

Anxiety itself can be a magnesium deficiency. And then your heart can sort of pound along, and then stop for an instant. And then resume again.Well that’s a skipped beat, and when that happens more frequently then it’s called an arrhythmia, or a heart palpitation.

When I used to get my little run of abnormal beats, it would make me have a little cough. I’d just cough as my body tried to re-adjust the rhythm. And it’s mainly that the heart has several pacemakers. The natural pacemakers of the heart keeps the steady beat. If and when the heart muscle is in tension from magnesium deficiency, or it’s damaged by a heart attack, then the accessory pacemakers of the heart can be pulled on or tweaked, and they can start firing out beats inappropriately, and that is an irregular rhythm that’s created.

[Damien Blenkinsopp]: Great, thank you very much for that. That helps clarify it.

So, have we covered all of the symptoms? For people at home, if they were asking themselves a question right now, do I have a magnesium deficiency, and how serious is it, potentially.

[Carolyn Dean]: Right. I can quickly run through a list Damien, because even when I say, well anything that can tighten a muscle can be a symptom. And you see that can be: acid reflux; if your stomach is in a spasm you can push stomach contents up and give yourself some heart burn; the angina I talked about, that’s the heart muscle going into spasm; anxiety; high blood pressure; cholesterol elevation, we mentioned; constipation, where the muscles of the intestines are kind of tighten and spasm, and they won’t push along your intestinal contents; depression; diabetes; fibromyalgia, that’s a huge magnesium deficiency problem. There are other things involved, but that’s where we start.

Headaches and migraines, I’ve mentioned. Even irritable bowl syndrome, where you have these incredible abdominal pains and either constipation or diarrhea. Any sort of inflammation, insomnia. I tell people if you have insomnia then you should take magnesium. If you don’t think it’s working, take more magnesium. Kidney stones, any sort of nerve twitching, PMS, seizures. A lot of some birth problems like eclampsia in women, that ‘s a magnesium deficiency symptom.

I have in my blogs, and in my books, I’ve put down 100 factors where you can gauge your magnesium deficiency. And we’ve gone over a couple, like alcohol intake. If you’re angry, you could be magnesium deficient. If you have any brain trauma, the first thing a person needs to do is have a magnesium intravenous, but not a lot of doctors understand that, or realize it.

If you’re eating a junk food diet, you’re making yourself magnesium deficient. Even infertility. If the fallopian tubes are in spasm, then they won’t allow the sperm to go along the fallopian tubes up to the ovary.

[Damien Blenkinsopp]: Right. So a lot of, it comes across that really there’s a lot of bits of your body that can malfunction if they don’t get the magnesium. And that’s basically what’s going on, they’re not functioning optimally, and it’s causing spasms and different things like this.

Just out of interest, I know my friends and I growing up – because we grow up in the coffee-stimulated management consulting area – we used to get a lot of pains in our chest. I was just wondering, as you said earlier, could it have been coffee induced magnesium pain, or was that just something completely different?

[Carolyn Dean]: It’s quite possible, because if the chest muscle – it doesn’t have to be heart, but the lungs, even the muscles around the ribs can go into spasm, some magnesium deficiency. In my case it was leg cramps. I have big calf muscles from dancing when I was younger, so it would hit me in my calves.

And everybody’s different. Some people who are typing a lot, they’ll say they’re getting carpel tunnel. And often that can be a magnesium deficiency.

[Damien Blenkinsopp]: Right. So it can depend where you’re basically using your body the most, because then, obviously, the magnesium’s getting exhausted to a worse extent in that part of the body, in that area.

So, are there severities, like if you continue to be magnesium deficient you’ll get more and more symptoms. Is that something you’ve seen in your practice?

[Carolyn Dean]: Right, yes. When you were saying that, I thought, you see different people will experience it in different areas. Why would one person get migraine headaches, and another person get chest pain, another person asthma, another person leg cramps? So it can be your vulnerable area.

And then what happens, it just seems to escalate where you start having different body parts effected. By the time people get to me, they have insomnia, they have anxiety attacks, they have irregular heart beat, they’ll get migraine headaches. So when you go to a doctor and you have that whole list, and you’re off to see a half dozen different specialists, and nobody puts it together that it’s all one thing: magnesium deficiency.

[Damien Blenkinsopp]: Great. So, do you understand the mechanism behind the headaches? Is it because there’s too much calcium versus magnesium in the brain, and that’s causing damage? Or how does that work?

[Carolyn Dean]: When I go into that in the book I have a whole chapter on headaches, and it can be muscle tension and spasm in the neck and head muscles. That’s sort of a common one. But it can also be, with migraines, a serotonin imbalance, because serotonin, the feel good neurotransmitter, is magnesium dependent. So if you have a deficiency, it can result in migraines and depression.

So there’s lots of reasons for a person to get headaches. And it can be injury; I remember a patient of mine, she was hit with a baseball bat in the head when she was young, and she began to get headaches. Well, 20 years later the doctors wouldn’t believe that a baseball bat to the head could still be bothering her. But, what had happened is the muscles in the scalp will just clamp down, and create this chronic tension and pain.

[Damien Blenkinsopp]: Okay, so we’ve talked a little about negative health. Right, chronic health conditions. So, being normal, like less than normal. Now, in terms of performance, have you looked at all into the impact of, or have you come across people who their performance has been impacted with various cognitive performance, athletic performance?

[Carolyn Dean]: Absolutely. I’ve had a couple of former NFL players who’ve had to quit the sport because of extremely severe muscle cramping, and then come to find out many years later that it was magnesium deficiency.

[Damien Blenkinsopp]: Wow. So their career’s finished because of magnesium deficiency. And it could have been fixed.

[Carolyn Dean]: You look at Kobe Bryant in the first game of the NBA finals. He was taken off with muscle spasms. So I wrote a big article about Kobe Bryant Has Magnesium Deficiency. And that’s where I was quoting earlier about when you take these electrolytes, you’re just getting sugar and sodium back. But anyway, yes players can be very much effected in any sort of team sport where you’re sweating a lot.

I’ve had a lot of teen athletes whose parents have come to me for guidance in how to get over their spasms. And it’s increasing their hydration, putting sea salt in the water, getting liquid magnesium, and liquid multiple minerals into water. And that is all that it takes to turn them around and keep them in the game.

[Damien Blenkinsopp]: That’s great to hear that. That’s really bad news for the guys who quit the game just for magnesium deficiency. It’s unfortunate that things weren’t known back then.

So, we talked a lot about the symptoms now, so people can have an idea if it’s a possibility. But, if you really want to know, I guess the first thing people do is they go to a doctor and they get their magnesium tested. And what is the standard way of testing that if you go to your doctor he’s going to test you, in terms of labs?

[Carolyn Dean]: Right. Unfortunately, it’s a blood serum magnesium. And the serum, it only has about 1% of the total body magnesium. So it’s the wrong measurement. It’s the wrong dipstick to put your needle into, because you’re not getting any accuracy in that test.

I’ve been recommending people get the red blood cell magnesium test. You can even go online and get it yourself, if your doctor doesn’t know about it. And I tell people to go to their doctor and keep asking and asking for the red blood cell magnesium test. I would love to see the ionized magnesium test, because that is the gold standard. And it’s still in the research stages.

But one of my articles online about kidney disease and magnesium. A magnesium researcher worked with a kidney researcher, and they found that people with chronic kidney disease of all varieties have the highest levels of serum magnesium. But in that same sample, the lowest level of ionized magnesium. So, in the serum it’s looking high because you see the serum has to perfuse the heart. So the serum magnesium is always going to be in this very narrow range, and it’s always going to look pretty normal, unless you’re really far gone, because it has to keep the heart perfused.

So, it will take extra magnesium out of your bones and muscles as needed. So every time you measure the serum magnesium it’s going to look normal. And doctors have gotten to the point of saying, well we don’t bother testing magnesium because it always looks normal. And you will notice in any electrolyte panel you’ve ever gotten, there’s never a magnesium level. It’s calcium and sodium and fluoride, but never magnesium.

So, I’m pushing for the ionized magnesium. In the meantime, I do the magnesium RBC blood test. But, Damien, it’s so crazy out there. The range for the magnesium red blood cell test, it used to be 4.2 to 6.8. And one year later, it’s 3.8 to 6.0 because the population is getting more and more deficient in magnesium. And what a blood range is is just the average population that the lab serves. They don’t look at the optimums, they just look at what’s out there.

So, I have to educate people, “Okay, right. The range may say 3.8 to 6.0, but we want you to be 6.0 or even higher.” I used to tell people with the old range – it would go up to 6.8 – I said, I want you to be 6.0 to 6.5. But it’s a huge educational leap to say to people, well you want to be higher than the range; It’s all marked with red flags that it’s too high. So it’s a huge educational challenge to make doctors, and the public, understand that they really are very deficient in magnesium, and need to take it.

[Damien Blenkinsopp]: This is a big problem with many labs. I mean, it’s the fault of the labs as well, but their normalizing based on the population instead of studies saying that optimum levels, healthy levels, are what they tend to do. Just a normal curve of what they receive in the door. And then they say you’re in the middle.

Even if – as we’re saying – 80% of the population is deficient, so clearly the average is going to be far, far from optimum, in this case. As many tests were in this case. So it’s just, even if you’re getting tests back from labs, you should check what is the reality of benchmarks. And that’s why I wanted you to talk about that a bit.

So what units of measurement are the RBC magnesium?

[Carolyn Dean]: The measurements of the RBC magnesium, how do you mean? The average range, I just mentioned it.

[Damien Blenkinsopp]: But how are they measuring it? Just in case different labs use different units.

[Carolyn Dean]: Ah, yeah. Milligrams per deciliter.

[Damien Blenkinsopp]: Okay. Great. And so you’re saying six or above is what you should be aiming for.

[Carolyn Dean]: Is optimum. I use the word optimum.

[Damien Blenkinsopp]: Yeah. Is there any case where you could have too high magnesium?

[Carolyn Dean]: Well, when I’ve seen – I think it’s twice out of the hundreds I’ve seen – it’s been a bit over the range, and then when I asked the person, they’ve taken magnesium the morning of the test. And in terms of having too much magnesium, the body does have a fail safe for magnesium, where it will give you the laxative effect if it’s got too much – either at that point in time or just too much in general. But no other mineral has that fail safe in the same way, so I consider magnesium an extremely safe mineral.

[Damien Blenkinsopp]: Great, great. And you’ve just dropped another little gold tip there, which is don’t take magnesium before your magnesium test. If you want to get a realistic value there – which goes for most things we’re testing – make sure you’re not interfering with the test results.

So the other test you mentioned was ionized magnesium, and you say that’s better. What are the issues with RBC magnesium first?

[Carolyn Dean]: Well, the RBC magnesium tests what’s in the red blood cells, and that is a different entity than a tissue cell, or a muscle cell. So it may give – and I don’t know, I’m just making this assumption – that maybe it’s 40 or 50% accurate. Whereas the serum magnesium test, it’s only measuring 1% of your total body magnesium.

You see there has not even been enough research comparing them all. This anecdotal study I’m talking about, with the magnesium researcher and the kidney researcher, and finding that kidney patients have high levels of serum magnesium. You see, they’d be warned to not take magnesium. “Oh, it’s going to be too high.” Whereas that same sample had a low level of ionized magnesium. So they had magnesium in their blood, but not in their cells.

And then the study went on to give people liquid magnesium that was ionized. It went into their cells, and their health improved. These kidney patients actually got better. So, when the magnesium researcher asked if the kidney specialist would write about these amazing findings, he said he couldn’t because it was so well known that magnesium can’t be taken in kidney disease.

So we’ve got another instance where people aren’t being given information because it goes against the grain of what doctors have learned all these decades.

[Damien Blenkinsopp]: Right, right. So is this ionized magnesium test available with many labs?

[Carolyn Dean]: No, it’s only about, at the last count, 125 labs out of the 5,000 in the US. And they’re all in research institutions, as I understand it.

[Damien Blenkinsopp]: So that’s like LabCorp, CorQuest, which are the typical ones people go to.

[Carolyn Dean]: No, they wouldn’t have it. I mean, you’re lucky to educate them about magnesium RBC test. I tell people to go to an online site called Requestatest.com. And without a doctor’s prescription you can order your own blood test, which I think is fabulous. And then people can follow their magnesium. The price of it is often less than the copay you’d have to pay your doctor to go in and get a prescription.

[Damien Blenkinsopp]: Right. Because when we order directly, we can’t get insurance to cover it?

[Carolyn Dean]: I don’t know about that. I just talk about the copay in the sense, well insurance doesn’t cover your copay. So, people make up their own minds. But I do ask people to talk to their doctors about it, just to educate the doctors, because doctors don’t even know about it.

[Damien Blenkinsopp]: So it sounds like the ionized magnesium test is pretty hard to get at. Maybe if you are a typical citizen, we can’t actually get access to it right now? Or is there one lab that we can get it from, perhaps with a prescription? There isn’t right now?

[Carolyn Dean]: No.

[Damien Blenkinsopp]: Okay, great. Well, not great, but it’s good to have the clarity on that. Hope it’s coming soon.

The other test I heard you mention in the past, maybe you’ve kind of dropped it now, is exit test? Where you have the scraping of the inner cheek to see what is in the bio-sample. Is that something you don’t recommend though?

[Carolyn Dean]: Well, it is a very good test, you can measure more than the magnesium. It’s getting right into the tissue cells, so I think it is more accurate than the magnesium RBC, but it’s very expensive; it’s hundreds of dollars. However, insurance does cover it. And then there’s another however, you have to get a practitioner to do the scraping. So you have to pay for an office visit to get it.

[Damien Blenkinsopp]: Right. So it’s inconvenient.

[Carolyn Dean]: Inconvenient, that’s the word. Right.

[Damien Blenkinsopp]: Right. So you’re just saying people should get RBC magnesium. I got my RBC magnesium done, I haven’t done the exit test.

[Carolyn Dean]: Oh good!

[Damien Blenkinsopp]: Probably for those reasons, because it was the easiest one to get set up, and the exit test is quite a lot of money considering. If you’ve already decided to supplement with magnesium, because, say you’ve got a few symptoms, then thinking about it, what’s the cost benefit of me doing the exit test versus the RBC.

Because the nice thing is, you can trend the RBC, and if it’s going upwards then you should be making improvements. Is that an assumption you could make?

[Carolyn Dean]: Oh yes. I see that all the time, people improving. And when they don’t, then I just have a conversation about, are you taking medications? Yes, usually. Are you under more stress? Yes. Are you taking your sea salt in water? No.

I have a blog called When Magnesium Makes Me Worse. And I go through this sort of thing where people will start taking magnesium and they’ll feel better, and then they say, well it’s not helping anymore. And it’s often because they’re not taking enough.

When you’re starting to wake up 700 to 800 different enzyme systems in the body, you’re body is crying out for more and more and more. And it doesn’t go on forever. You certainly come to a point where you have a daily requirement. And in fact, as you build up your stores you need less magnesium as time goes on.

So, in the beginning you really, in my opinion, you have to go slowly into magnesium, because it can actually help detoxify the cells, detoxify the liver. So I tell people to go slowly and steadily, and increase as they either watch their symptoms, or watch the magnesium RBC test.

I only started really pushing the magnesium RBC test because I put it in my book. I don’t know the people who are taking magnesium, they’re not my patients. So I’m just trying to be very cautious, and be scientific about it. Especially with people on a half a dozen medications, and then they’re saying, “Well, is magnesium going to be dangerous?” I’d like to say to them, well did you ask that question about your six medications?

Because if you’re on medication and you start taking magnesium for magnesium deficiency symptoms, you’re not going to need as much medication. The medication might start to appear toxic. And then you’re going to say, “Oh, the magnesium is making me sick.” Whereas it’s your body is trying to get rid of the drugs.

So, it’s an education. That’s why I’ve written so much about it. Because we’re in the situation now, as I mentioned, where you have a little bit of high blood pressure, and all the sudden you’re on six medications, and that’s going to start really depleting your magnesium.

[Damien Blenkinsopp]: There’s some very good points on how you’ve taken a personal approach to this, to consider all the factors in your life. So it’s difficult for someone like you, who’s written a book trying to address the general population to just say, everyone do this. It’s not bad.

But I guess having an RBC magnesium test, and judging by your symptoms, you can make a start of understanding where you’re at, and what could be necessary. So what kind of things do you recommend to increase our magnesium? You’ve mentioned sea salt. Is that Himalayan salt, or is that just natural sea salt? (40:19)

[Carolyn Dean]: Himalayan is good, Celtic salt. Yes with the stress that people are under, the stress that makes them lose magnesium, you’re also losing sodium. And I tell people that sea salt, it has the sodium, it has some magnesium, a bit of calcium, but not that much. But it does have 72 minerals. So, there are tiny amounts of minerals that we may not even know we’re lacking.

I have people on sea salt, and overnight they’ll say they’re not getting up to go to the bathroom. They’re retaining their fluid in their cells more than it just running through them, and claim all kinds of benefits. So it’s a great start in terms of water intake. I tell people to take half their body weight measured in pounds, take half that weight in ounces of water a day.

With all the filtering and reverse osmosis, even distilled water out there, people are not getting minerals from their liquids anymore. So I add the sea salt, and of course people say, “Oh my doctor told me not to take salt because of my blood pressure.” Well, table salt is just sodium chloride, and that is almost like a drug. We’re not talking about sodium chloride, we’re talking about sea salt, which has 72 minerals. (41:40)

[Damien Blenkinsopp]: Right, right. And then, the rock salts as well. They’re balanced, basically, instead of being concentrated, many-made synthetic. That’s why you’re saying it’s a drug, because it’s refined compound. Which I guess you could compare to refined food, which often doesn’t have positive impacts on the side because it’s unbalanced, at the end of the day.

So, in terms of athletes, you also mentioned that they have issues with electrolyte drinks. Are there any electrolyte drinks out there which have a more balanced profile?

[Carolyn Dean]: I have not found one yet. I’m more keen on an electrolyte liquid myself, but we don’t have to go there. Because I just couldn’t find anything out in the commercial world that wasn’t loaded with sugar and sodium.

[Damien Blenkinsopp]: Right. So, in terms, are there foods we should be eating? Personally, I use transdermal magnesium oil, magnesium chloride oil from some of the seas, so it’s supposedly pure. Could you talk a little bit about that? Is that one of the better methods to raise your levels?

[Carolyn Dean]: It is a good method. When you put magnesium on your skin, you’re actually stimulating the DHEA receptors in your body, so it helps your hormone balance. Myself, before I got into my liquid magnesium, I had to use so much magnesium oil on my skin it became irritating. So, some people have to dilute it with distilled water.

All of magnesium oil is super saturated magnesium chloride in distilled water. And, the transdermal approach, that was started centuries ago, probably, with Epsom salts baths, where the midwives would use it for all their pregnant patients. And what you do is put one or two cups in a medium hot bath, and soak for about 20 or 30 minutes. And you can begin to see the effects of magnesium immediately just by doing these baths.

It’s a way for people to sort of get introduced to magnesium, because I just said, they may be on half a dozen drugs and afraid to do anything that their doctor doesn’t recommend. So, you do the Epsom salts, you feel better, and then you may feel like going to a transdermal magnesium oil, or some of the oral magnesiums.

In terms of the most common and the cheapest magnesium, it’s actually the least well absorbed. And this is where magnesium will get the reputation for just being a laxative. Because the magnesium oxide is only 4% absorbed, and that means the other 96% will find its way into the intestine and cause diarrhea. Now, that’s okay for a certain percentage of the population that’s constipated, but you do have to be careful to not create too much of a laxative effect.

[Damien Blenkinsopp]: That’s interesting. So if you are magnesium deficient, and you’re taking a supplement – I don’t know which ones you’d recommend – but, I don’t know, magnesium glycinate. There’s many different varieties, there might be a more available one you’d recommend.

But if it’s getting absorbed into your body then it won’t produce the laxative effect. So, is that really based on the economic ones right?

[Carolyn Dean]: Correct.

[Damien Blenkinsopp]: That’s interesting, because I actually had that problem where I was trying to induce… And obviously I had the wrong type, because I had to buy an available type, and wasn’t aware of this connection. Because it never induced the laxative effect I was looking for.

[Carolyn Dean]: And the way around the laxative effect too, there are forums. People can check on my website under resources for the different forums written about them. But you can take, for example, a magnesium citrate powder and put it in a liter of water, and shake it up and just sip it through the day. If you take small amounts of magnesium through the day, then it will gradually get into the cells, and will build up.

But if you take two or three teaspoons of a magnesium citrate powder all at once, then you could overwhelm the cell’s ability to absorb, and then it runs out the other end. So. And that’s a waste of money, and also you could be pulling out other nutrients when you have diarrhea.

[Damien Blenkinsopp]: Yeah, that’s key. In terms of foods, are there higher magnesium foods which you recommend people start to incorporate into their diets?

[Carolyn Dean]: Right, there are, but I’ve already had the caveat about if they’re grown on mineral depleted soil it’s hard to say, but seaweeds are high in magnesium. In the ocean there’s three times the magnesium compared to calcium. So there’s a lot in seaweeds, in chocolate. 100% cacao is high in magnesium, that’s why some women, especially, have chocolate cravings before their period, because they’re craving magnesium.

There’s different herbs. I have it in my book, purslane, for example, is very high magnesium, again, if the soil is high. Cilantro is high in magnesium. Nuts and seeds, deep green leafy vegetables. Some grains. But again, I always have to hesitate and say, but if the soil is depleted, I can’t confirm.

But I do know food has a big impact. For example, I’m telling people not to take calcium supplements, but get your calcium in your diet, but get your magnesium in a supplement. And calcium, for example, we’re told that we need 1,200, 1,500 milligrams. Whereas in the UK and the World Health Organization, they’re only saying 500 to 700 milligrams of calcium.

Well if you look at a cup of yogurt, that’s about 300 milligrams of calcium right there. I’ve done experiments with myself, and I find if I have two or three cups of yogurt in a day, I actually start getting a bit of heart palpitations and leg cramps, because it’s really pushed on my magnesium. It’s kind of bound up my magnesium.

So I know that you can get your calcium from your diet, just by looking at some food list – I have a couple of free e-books that people can get on my website – and you can figure out if you’re getting enough calcium in your diet. Usually from dairy, or bone broth, or fish with bones. But with magnesium, you have to be very, very wary that you’re probably only going to get about 200, maximum 300 milligrams. And I’m recommending people get about 700 milligrams, equal amounts of calcium and magnesium.

[Damien Blenkinsopp]: Great. We’ll put links to all of these things you mentioned in the show notes so that people can find them; the free e-books, and you mentioned something else earlier, about some of the tests. Make it easy for people to find.

Thank you for all of those clarifications. It really sounds like we shouldn’t really trust the food, and go the supplementation route. And you brought up magnesium citrate. Is that you’re preferred supplement?

[Carolyn Dean]: It’s one of them. I have my own product, but again, this is not a commercial broadcast, so people can search sites.

[Damien Blenkinsopp]: But do feel free to point out any… Is there something specific you’ve done with your product that you feel is better?

[Carolyn Dean]: Well what happened with me Damien is I couldn’t get enough magnesium therapeutically, without stimulating my intestines and getting the laxative effect. What I did was work with a chemist to create a magnesium that is absorbed 100% at cellular level, and does not cause the laxative effect.

So that people even, I’ve had people who’ve been forced to live on an IV magnesium drips, where three or four times a week they have to take an IV drip, or their levels become so low they develop heart symptoms and cramping. And they can switch from IV onto a good magnesium that’s absorbed fully. And that’s what we’ve been lacking; all the research in medicine is in drugs, and we haven’t had enough research in the supplementation that people absolutely require.

I mean, the other thing I’m working on is the balance of the other minerals. I’ve found that the thyroid requires nine minerals to make the hormones properly. And instead of using mineral supplementation of the type of mineral that can be absorbed fully into the cells, doctors wait until the thyroid is barely functioning, and then give thyroid hormone replacement, either a synthetic or natural. And the natural doesn’t make that much difference, if you consider that what the thyroid really needs is it’s nine minerals to create it’s own hormones.

[Damien Blenkinsopp]: Yeah. I mean, this is a really recurring theme on this podcast, is micro-nutrient deficiencies across the board are causing many symptoms. So I think it’s really something people need to think about, in terms of their diet and supplementation, trying to maximize how many of these micro-nutrients they’re getting into them. And testing, where possible.

So, if someone has a deficiency, how long does it take to resolve that? If they’re implementing the types of recommendations you’ve just announced? And how often do you think they should get tested? If they’re doing RBC magnesium testing, trying to figure out how close they’re getting to six.

[Carolyn Dean]: Right, I mean. There’s such a range that I get a lot of emails – I have a radio show too, so people call in – in people who have, what I would consider, minor symptoms. They can lose those symptoms overnight. They can be sleeping the first night. But then the people I get in my consulting practice – I do telephone consultations – they’ll be the ones on a half dozen medications, and sick for 40 years. And they’ll start feeling symptomatically better within a week, but then it’s going to be probably several months before they’re completely symptom free.

The way nutrients are approached in our society is as if they’re drugs. And some people will say, “Well I’ve been taking magnesium for two weeks, and I have another heart palpitation. Why is that?” And it’s because magnesium is not suppressing your palpitations, it’s actually trying to heal your muscles, and you’re building up your magnesium stores. And when I get the story of, “Well yes, I forgot to take a couple of doses.” And, “Yes, I had a lot of sugar,” or, “I had some alcohol.”

There’s a balance; when you’re taking nutrients you want your nutrients to be absorbed, so you want really high quality nutrients. And you want the basic nutrients. I have people come in to me who are on dozens and dozens of different supplements, where they read about, “Oh, this is important. If you don’t get it, you’ll surely die.” The advertising for supplements has gotten people so scared that they think they have to take everything. And they end up actually coming to me with stomach distress, because they’re swallowing all these pills.

[Damien Blenkinsopp]: Right. And as you mentioned, there’s ratios involved with many of these. Calcium to magnesium ratios, zinc to copper ratios, and in some cases it’s actually the ratio that’s really, really significant as well. One of the first episodes we had on here was talking about zinc and copper imbalances, and how they can actually create anxieties. and also some conditions in the brain.

So you’ve covered that from a different aspect, but the ratios can be very important too. So, supplementing just one single nutrient can be a problem also. Have you ever come across anyone supplementing magnesium who get problems with calcium balance?

[Carolyn Dean]: In the past number of years, I think I’ve had two people where they’ve just thought that the magnesium was all they needed, and took higher, and higher, and higher amounts. And I don’t know if we proved that there was a calcium problem, certainly, when they did their blood tests. Their calcium levels were not low on their blood test, but that’s where, in my writing, I make sure people are getting their 700 milligrams of calcium every day in their diet. And if not, to take a well absorbed calcium supplement.

I think I’m going to have to work on… They’re called picometer minerals. Picometer is like a trillionth of a meter, so that’s the size of the minerals I work with. And that is actually the mineral ion channels size in the cells. And it’s actually the diameter of the plant rootlets, picometer.

So, what’s supposed to happen is the soil is supposed to be flush with worms and organisms that break down the minerals to a picometer size so that plan rootlets absorbs them into the plants. And then we eat the plants, and we get our minerals. And it’s all supposed to go brilliantly like that. And, we’ve stopped that from happening. Its not occurring anymore, because the soils are so dead.

I mean, we didn’t even talk of the different herbicides and pesticides that actually bind up minerals. The Roundup Ready by Monsanto, it binds up 50% of magnesium, even in the soil, and it has a half life of 23 years.

[Damien Blenkinsopp]: Yeah. What we are doing these days is pretty crazy, to look back on it.

Thank you very much for your time today, and I’d really like to wind down the interview with a few slightly different questions about you, and your ideas about the world of health.

First of all, are there other people, besides yourself, that you recommend to go to for advise and insights on areas around health, or testing, or any of these types of areas we’ve discussed today?

[Carolyn Dean]: Well, when people come to me, for example, with cancer, I don’t treat cancer. I’ve studied something called Total Biology. Have you heard of German New Medicine, or Total Biology Damien?

[Damien Blenkinsopp]: No, I haven’t.

[Carolyn Dean]: It’s the conflict that basis of disease, where a conflict in somebody’s brain, a worry, an unsolvable problem, can actually be downloaded in the body as a physical symptom. Like, if you’ve got a boss who makes you sick to your stomach, then you can develop a stomach ulcer. Or, if somebody’s a pain in the neck, then you can get neck pain. So, there’s simple comparisons like that. And then solvable conflict can also put itself into the body, and unless we deal with the conflict, then physical medicine really won’t be able to completely solve the problem.

So, beyond what I do in my books and my products and my website, I have a two year online wellness program. I really don’t know that anybody is covering the water front in the way I do, but, you know, I’ll refer out to people for the Total Biology, and that aspect of the psychology and physiology of the body that was never addressed in either allopathic or even my naturopathic training so far.

[Damien Blenkinsopp]: Great, great. Thank you very much. Are there biomarkers or labs that you track on a routine basis to monitor, or improve, your health, longevity, or these kinds of concerns?

[Carolyn Dean]: No.

[Damien Blenkinsopp]: Nope? Nothing you look at. Okay. Great.

What would be your one biggest recommendation to people for health, longevity, and performance?

[Carolyn Dean]: It would have to be magnesium, really, seriously. When you look at the products that some of the doctors have these days – and I’m not saying… I’ve been active for over 40 years, and it’s only in the past year or so, I’ve decided that I had to get into products because the ones I needed for myself weren’t available. And people were getting so desperate.

I spent two years creating a two year online wellness program for people, because I wanted to educate, and give them all the information I knew. People don’t have time to do a two year course. They’re desperate, they want something now. And so what I realized when I look at a lot of the supplements that, even the medical doctors are selling, you can’t even find magnesium in their products.

And so that’s where I really come back to start with magnesium. It works on nearly 700 to 800 enzyme systems, it supports the energy of your body, it helps you sleep, it gives you energy during the day, it relaxes you enough to help you sleep at night. So it really is the one supplement that everybody should take.

[Damien Blenkinsopp]: Thank you very much for that. So, in terms of people connecting with you, you just mentioned that you have a radio show. I think it’s also a podcast, correct?

[Carolyn Dean]: Yes! You’re right, we did podcast it. People can just go to drcarolyndean.com, and I have a little radio on the side where people can click on to get my radio show. I do blogs periodically. I used to do them more frequently, but everything really slows down in December when we’re of course doing this taping. So, drcarolyndean.com, you’ll see my wellness program, I have a free online news letter, a couple of my products are listed there that takes you to a website.

And actually, under the wellness program, people can pick up two free e-books on minerals with their pdf format. Under my wellness program.

[Damien Blenkinsopp]: Great. And of course, your book is called the Magnesium Miracle, and it’s in its third edition, I believe?

[Carolyn Dean]: That’s right. The 2014 edition, and it’s on Amazon. And actually, Amazon is doing a great job now, I heard they’re doing same day delivery in some major centers. It’s amazing.

[Damien Blenkinsopp]: Yeah, they are. I mean, I use Amazon every single day, it’s crazy. If you’ve got the iPhone app for Amazon, it’s dangerous.

And if you use the Amazon lockers, you can get stuff literally shipped next to a 7/11 next to you.

[Carolyn Dean]: But then even worse is having a Kindle, where you can order the next book in the series while you’re lying in the bathtub. They’re making a mint on Kindle, because you can’t lend them. So everybody has to buy a new Kindle, where as with books you can lend them all over the place.

[Damien Blenkinsopp]: Yeah, that’s true. I’m not complaining, I love Amazon. It makes everything very convenient.

So Carolyn, thank you so much. Of course we’ll put those references you just spoke about in the show notes, so people will be able to find you easily. But thank you so much for your time today. It’s been a pleasure talking with you, especially after having read your books so long ago. And using magnesium as a result for these many years. So thank you very much for your time, and great to connect with you.

[Carolyn Dean]: Thank you Damien, good interview. Great questions. I enjoyed it. There’s a lot of information out there, and I appreciate being able to do that, so thank you.

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Is some aspect of mitochondrial damage behind cancer? If so, can this theory help us take control of cancer via tactics such as yearly or more frequent “7 day water fasts”.

When we think about death, cancer is often what we think of first. If you’re like me, most, if not all, of the deaths affecting you personally in your life may have been due to cancer.

Part of what makes a cancer diagnosis so devastating is that it’s mechanisms – how it works, where it comes from, how we can treat it effectively, how we can track it’s development, assess our risk and avoid it – continue to allude us. That makes us feel powerless against it.

Today’s episode is about the theory that mitochondrial damage is behind cancer, and how this theory may let us take control of cancer. We also hear our guest discuss the power of “water fasts” as a potential tactic to beat cancer.

If that’s true then tools that we have today such as ketogenic diets, fasting, lipid replacement therapy and other approaches to mitochondrial repair may help reduce or eliminate the risk of cancer, and even treat it when we have it.

We’ve already seen how important our mitochondria, and keeping them healthy, is in previous episodes, looking at longevity and aging with Aubrey de Grey, and autoimmune diseases with Terry Wahls. Today we add to that list the role they may be playing in the cancer diseases process.

“All cancers can be linked to impaired mitochondrial function and energy metabolism. It’s not a nuclear genetic disease. It’s a mitochondrial metabolic disease… therapeutic ketosis can enhance mitochondrial function for some conditions, and can kill tumor cells.”
– Dr. Thomas Seyfried

Today’s guest, Dr. Thomas Seyfried, is Professor of Biology at Boston College, where he leads a research program focused on the mechanisms by which metabolic therapies such as ketogenic diets and fasting can manage chronic disease and cancer. He sits on the editorial boards of four research journals, and has over 60 published papers on cancer and metabolism.

He is the author of the review paper Cancer as a Metabolic Disease, appearing in the Journal of Nutrition and Metabolism in 2010, and of the textbook in 2012 entitled Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer.

He’s a frequent lecturer and speaker at conferences on the topic of cancer, impaired mitochondrial function, and using ketogenic diets and fasting tactics as therapy to treat and avoid cancer.

This was personally an important episode for me. I hope you feel more in control of your cancer risk after listening to it, as I do having followed Dr. Seyfried’s work.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • How the idea that a change in mitochondrial function is behind cancer started in the 1920s (4:10).
  • The ancient energy mechanism through which cancer cells can bypass the mitochondria through fermentation instead of normal mitochondrial respiration (7:20).
  • The part of mitochondrial function that seems to be compromised in cancer – oxidative phosphorylation (8:15).
  • Different types of cancer cells and tumors have varying damage to their mitochondria. The worst and most aggressive cancers have the least mitochondrial function (9:00).
  • The oncogenic paradox (9:00).
  • Lipids such as Cardiolipins in the inner membrane of mitochondria are the part responsible for respiration (15:10).
  • How Dr. Seyfried pooled research from over 50 years together to develop his conclusions on cancer and the mitochondria (18:00).
  • Therapeutic ketosis and fasting can enhance mitochondria (23:00).
  • Ketone bodies produce cleaner energy, with less oxidative stress (ROS) than glucose molecules, when used for fuel in the mitochondria (27:00).
  • Nuclear genetic mutations prevent cancer cells from adapting to use ketone bodies as their energy source (29:30).
  • Which biomarkers could be indicative of cancer risk? (33:10).
  • Using therapeutic fasting of several days to improve your metabolism (36:00).
  • Using combined blood glucose – ketone meters to take readings and using Dr. Seyfried’s calculator to calculate Glucose – Ketone Indices (38:00).
  • It requires 3 to 4 days of fasting to get into the therapeutic glucose – ketone index zone (42:00).
  • “Autolytic cannibalism” to improve overall mitochondrial function – the mitochondria can either be rescued, enhanced or consumed (47:30).
  • The difficulties with directly measuring mitochondrial respiration vs. anaerobic fermentation and lactic acid to assess cancer status (49:50).
  • Weight loss can come in two types, pathological and therapeutic. The weight loss via fasting is therapeutic and healthy (52:00).
  • Cancer patients do better with chemotherapy, with less symptoms, when they are in a fasted state (52:00).
  • Cancer centers currently do not offer mitochondrial based therapies, only chemo or immuno therapies (57:40).
  • The biomarkers Dr. Thomas Seyfried tracks on a routine basis and his use of the ‘fasting’ tool (101:40).
  • What Dr. Seyfried would do if he had cancer (102:30)
  • Should you remove organs if you discover you have a high genetic risk for cancer? (E.g. BRCA1 as with Angelina Jolie) (103:30)

Dr. Thomas Seyfried

The Tracking

Biomarkers

  • Blood Glucose: A measure of the level of glucose in the blood at one point in time. Dr. Seyfried’s therapies target reduction of blood glucose levels to limit cancer cell growth, and according to his theories high blood glucose is a biomarker of increased cancer risk.
  • Glucose – Ketone Index (GKI): The ratio between the concentration of glucose in the blood to ketone bodies in the blood. The calculation is Glucose (mmol)/ Ketone (mmol). Dr. Seyfried created the index as a better way to assess metabolic status. Therapeutic efficacy is considered best with index values approaching 1.0 or below. Patients with chronic disease like cancer have index values of 50 or more. Thomas’ paper on the use of GKI for cancer patients has just been accepted for publishing: The Glucose Ketone Index Calculator: A Simple Tool to Monitor Therapeutic Efficacy for Metabolic Management of Brain Cancer. It is on Nutrition & Metabolism journal here and you can download an excel sheet to calculate the Glucose Ketone index here.
    Glucose Ketone Index - Thomas Seyfried

    Glucose Ketone Index Tracking of a Water Fast as Therapy for Brain Tumors Trial – Thomas Seyfried

Lab Tests, Devices and Apps

The Tactics

Treatments

  • 3 – 5 Day Water Only Fasts: A water-only fast of at least 3 days and preferably 5 days is recommended by Dr. Seyfried as a tool to reduce cancer risk and to lower your glucose – ketone index to 1.0. He recommends doing this twice yearly. For cancer patients he recommends much more intensive use of the water fast.
  • Ketogenic Diets: The ketogenic diet is a low carb diet which also raises the level of ketone bodies in the blood. We discussed this in depth, as well as the Ketone biomarkers and devices in episode 7 with Jimmy Moore on Ketosis.
  • Intermittent Fasting: An approach to fasting where you fast for part of the day or certain days per week. There are many approaches to this, however in Dr. Seyfried’s research he has found this doesn’t have a significant enough impact on raising ketone bodies to be therapeutic. He has only seen this via the water-fast.
  • Hyperbaric Oxygen Therapy (HBOT): Another therapy Dr. Seyfried believes may be beneficial to fight cancer but is relatively non-toxic in comparison to current treatment modalities (chemo and immunotherapies), and would like to trial in conjunction with fasting protocols.

Supplements

  • Oxaloacetate: A support for the mitochondria, also dubbed as an anti-aging supplement as it has caloric restriction mimicking effects. It is sold by Dave Asprey in his “Upgraded Aging” formula.
  • 3-Bromopyruvate (3BP): Dr. Seyfried would like to incorporate this non-toxic molecule in combination with fasting therapies to treat cancer patients.
  • PQQ (Pyrroloquinoline Quinone): Mentioned by Damien as a potential tool for mitochondrial biogenesis.

Other People, Resources and Books

People

  • Otto Warburg: A well known scientist who worked on cancer in the 1920s and 30s and discovered that cancer cells have different metabolism to normal cells.
  • Albert Szent-Györgyi: The oncogenic paradox was first coined by this nobel prize winner for his work with vitamin C and energy metabolism.
  • Valter Longo PhD.: Dr. Seyfried referred to Valter Longo’s work at the University of Southern California on the impacts of fasting on patients undergoing chemotherapy.
  • Angelina Jolie: The actress recently had her breast’s removed when she discovered she has the BRCA1 genetic mutation, that predisposes women to breast cancer.

Organizations

Books

Full Interview Transcript

Transcript - Click Here to Read

[Damien Blenkinsopp]: Thomas, thank you so much for joining us today.

[Dr. Thomas Seyfried]: Thank you.

[Damien Blenkinsopp]: I’d like to start off with basically kind of an overview, because you are putting for a different theory of cancer compared to that that’s been the reigning theory for a very, very long time now. Could you describe the differences between the two theories, and what is the basis for your new theory?

[Dr. Thomas Seyfried]: Well, it’s not that my theory is new. The theory was initiated in the early part of the last century, in the 1920’s through the 30s and 40s, by Otto Warburg, the distinguished German scientists and biochemist. It was Warburg who found that all tumor cells continue to ferment glucose in the presence of oxygen. Put it this way, lactic acid fermentation.

This is a very unusual condition that usually happens only when oxygen is not present. But to ferment in the presence of oxygen is a very, very unusual biochemical condition. Warburg said, with his extensive amounts of data, that the reason why tumor cells do this is because their respiration is defective. So, in our normal bodies, most of our cells generate energy through respiration, which is oxidative phosphorylation. And we generate ATP this way.

But cancer cells, of all types of tumors and all cells within tumors, generally have a much higher level of fermentation than the normal cells. And this then became the signature biochemical defect in tumor cells. And Warburg wrote extensively on this phenomenon, and presented massive amounts of data – he and a number of other investigators.

But what happened after Watson and Crick’s discovery of the structure of DNA, and the findings that genetic mutations and DNA damage were in tumor cells, and the enormous implications of understanding DNA as the genetic material, this just sent the whole field off into a quest to understand the genetic damage in tumor cells. And it gradually became clear to many people that cancer was a genetic disease, rather than a mitochondrial metabolic disease as Warburg had originally showed.

[Damien Blenkinsopp]: Right, so when you were talking about the energy and respiration of the cells, just a minute ago, that was actually in fact the mitochondrial respiration, and energy generation from mitochondria within cells.

[Dr. Thomas Seyfried]: That’s correct. That’s correct, it’s mitochondrial. It’s an organelle within all of our cells, the majority of our cells – erythrocytes have no mitochondria, so they ferment. But the mitochondria are the organelle that dictates cellular homeostasis and functionality, and provides health and vitality to cells in our organisms, and ultimately our entire body.

And when these organelles become damaged, defective, or insufficient in some way, cells will normally die. But if the damage or insufficiency is a gradual chronic problem, the cells will resort to a primitive form of energy metabolism, which is fermentation. Which is the type of energy that all cells had, all organisms had before oxygen came onto the planet, which was like a billion years ago.

So what these cells are doing then is essentially going back to a very primitive state of energy metabolism, which was linked to rapid proliferation. Cells would divide rapidly and grow widely before oxygen came onto the planet. So what these cancer cells are doing is just falling back on the type of energy metabolism that existed for all organisms before oxygen came on the planet.

[Damien Blenkinsopp]: Does that type of fermentation type of respiration, metabolic activity, is that originating from the mitochondria, or from the cell itself?

[Dr. Thomas Seyfried]: No, there was no mitochondria before oxygen came on the planet. So this was purely a reductive activity within cells. It doesn’t require mitochondria, it’s a purely cytoplasmic form of energy. Glucose is taken in, and rapidly metabolized to pyruvate through cytoplasmic in the cytoplasm, and then the pyruvate is reduced to lactic acid or lactide, which is called lactic acid fermentation.

And this then could drive energy metabolism, and the processes that can emerge from this type of energy metabolism. But it’s a very inefficient form of energy generation, and it’s often associated with rapid proliferation.

[Damien Blenkinsopp]: Right, thank you very much. So, in very simple terms it seems like, basically what you’re saying is, as the mitochondria get damaged they stop functioning, and then the cell goes back to the original form of energy generation, and it’s as if the mitochondria weren’t there any more.

[Dr. Thomas Seyfried]: Well it’s not that they’re not there. They are there, and they can also participate in certain kinds of amino acid fermentations. They still play a role in generating energy and nutrients for the cell, but it’s not through the sophisticated aspect of energy generation through oxidative phosphoryation. That part of their function seems to be compromised, but other parts of their function can take place. But they’re not generating energy through what most cells would generate energy through, which is respiration or oxidative phosphorylation.

And I also want to point out, it’s not a complete shut down of oxidative phosphorylation. Tumor cells, depending on the grade, and how fast they grow, and how aggressive the tumor is. It is true that some very, very aggressive tumors have very few, if any, mitochondria. So these cells are primarily massive fermenters.

But some tumor cells still have some residual function of their respiration, and they grow much more slowly than those tumor cells that have no function, or very little function, of their respiration. So it’s a graded effect, but the bottom line is the cells continue to grow, but they’re dysregulated. Because the mitochondria do more than just provide efficient energy. They are the regulators of the differentiated state of the cell. They control the entire fiber network in the cell. They control the homeostatic state of that cell.

So these organelles play such an important role in maintaining energy efficiency. And when they become defective, the nuclear genome turns on these oncogenes, that are basically transcription factors that drive fermentation pathways. So the cells are able to survive, but they’re dysregulated.

[Damien Blenkinsopp]: Right, which becomes cancer.

So, in what ways are the mitochondria getting damaged. What is the context for this kind of damage that takes place today? Is this a modern phenomenon, because, obviously cancer has become a bigger and bigger target of medicine over the years, and, potentially, it’s been growing. I’d like to hear your view on that.

Is cancer something that’s always been around, or is it something that affects us more today, and how is it that the mitochondria are getting damaged?

[Dr. Thomas Seyfried]: Yeah, what you said there is referred to as the Oncogenic Paradox, which has been discussed by Albert Szent-Gyorgyi, who received a Novel Prize for his work on Vitamin C and energy metabolism and these things, and John Cohn from England. These people had referred to this phenomenon as the called the Onogenic Paradox. How is it possible that so many disparate events in the environment could cause cancer through a common mechanism?

And when we think of what causes cancer, we think of carcinogens. And these are chemical compounds in the environment that are known to be linked to the formation of cancer. So there’s a whole array of these kinds of chemicals that we call carcinogens. Then there’s radiation can cause cancer. Hypoxia, the blocking of oxygen into cells, can be linked to the formation of cancer.

A common phenomenon and finding is inflammation. Chronic inflammation that leads to wounds that don’t heal. This is another provocative agent for the initiation of cancer. Rare germline mutations, such as the mutations in the BRCA1 gene that a lot of people hear about because of Angelina Jolie bringing attention to that area. Viruses, Hepatitis virus, papillomaviruses. And there’s a variety of viruses that can be linked to cancer. Age. The older people get, the greater the risk of cancer.

All these provocative agents all damage respiration. Their common link to the origin of cancer is damage to the mitochondria, and damage to the respiratory capacity of the cell. So the paradox is solved once people realize that these disparate, provocative agents work all through a common mechanism, which is basically damage to the cellular respiration.

Now, but people say, “Well what about all the genome mutations? What about all these mutations?” Which is a major focus in the field right now, is that cancer is a nuclear genetic disease. Now what happens is the integrity of the nucleus and the genetic stability of the nucleus becomes unstable once energy from respiration becomes defective.

Now it’s very interesting. All of the so-called provocative agents that are known to cause cancer through damage to respiration release these toxic reactive oxygen species, which then cause nuclear genetic mutations. And this is what most people are focusing on. The nuclear genetic mutations in the tumor cells are the targets and focal point of the majority of the cancer industry. Now, when you look at the disease as a mitochondrial metabolic disease, the nuclear genetic mutations arise as secondary downstream epiphenomena of damage to the respiration. So what most people are focusing on is the downstream effect, rather than the cause of the disease.

[Damien Blenkinsopp]: You’re saying that because mitochondria are damaged and energy output is damaged, that causes the cell to lose it’s integrity?

[Dr. Thomas Seyfried]: Lose the genomic integrity.

[Damien Blenkinsopp]: Ah, genomic integrity.

[Dr. Thomas Seyfried]: Yeah. Most people you talk to about this, they say “Oh, cancer’s a genetic disease. We’re trying to talk all these genetic mutations. Every kind of tumor has all kinds of mutations. We need personalized therapies because the mutations are different in all the different cells, and the different types of cancer.” And that’s true, but all of that is a downstream effect of the damage to the respiration.

So, people are focusing on red-herrings. They’re not focusing on the core issue of the problem, which is stabilized energy metabolism. And this underlies the reason for why we’re making so little progress in managing the disease.

[Damien Blenkinsopp]: So, I don’t know if you can break it down into a bit more detail. The mitochondria are made up of several parts: the outer membrane, the inner membrane, and so on. Is it certain parts, or is it any part of the mitochondria that’s getting damaged?

[Dr. Thomas Seyfried]: Yeah, it’s very interesting. It seems to be we’ve defined the lipid abnormalities, the lipid components of the inner membrane of the mitochondria. So there’s certain types of lipids that are enriched primarily in the inner membrane of the mitochondria. This lipid called cardiolipin. It’s an ancient lipid that’s present in bacteria and in mitochondria, but it plays a very important role in maintaining the integrity of the inner membrane, which is ultimately the origin of our respiratory energy, which is that inner membrane.

And many of the proteins that participate in the electron transport chain depend, or are dependent under interaction in the lipid environment in which they sit. So, lipids can be changed dramatically from the environment, which then alter the function of the proteins of the electron transport chain, effecting the ability of that organelle now to generate energy.

This is a real issue, and that inner membrane can be effected by all these carcinogens, radiation, hypoxia, viruses. The viruses themselves, or the products of the virus, will enter into the mitochondria and take up residence, thereby altering the energy efficiency of the infected cell.

And most of the cells die. When you interfere with respiration, most cells die. But in some cells of our body that have the capacity to up-regulate fermentation, these primitive energy pathways, they survive, and they go on to become the cells of the tumor.

[Damien Blenkinsopp]: Great, thank you for that. So, this is a very different theory to that which most people have come across, which, of course, you just outlined with the DNA mutations. Which bits of research have you pulled together in your book, and in your presentations, that you feel like present this view of the world the most strongly. Are there key research elements, researchers that have gone on, and maybe it comes down to four pieces that you feel strongly support this versus the other argument?

[Dr. Thomas Seyfried]: I think that’s an extremely important point. What is the strongest evidence to support what I’ve just said? And what I did in my book in evaluating the therapeutic benefits that we’ve seen in managing cancer by targeting fermentation energy. How is it possible that we overlooked this information? It’s very interesting.

Over the last 50 years, various sporadic reports had been published in the literature showing that if the nucleus of the tumor cell is placed in a new cytoplasm, a cytoplasm that has normal mitochondria – and this is cytoplasm either from a newly fertilized egg, or an embryonic stem cell. Because now we have this technology where we can do these kinds of nuclear transplantations. And this ultimately was what lead to the cloning of Dolly the sheep, and these kinds of experiments. These had been done many, many years earlier in frogs, and in mice, before we moved on to the larger mammals and things like this.

But it became clear that when the nucleus of the tumor cell was placed into the normal cytoplasm, sometimes normal cells would form, and sometimes you could clone a frog, or a mouse, from the nucleus of the tumor cell. Now this was quite astonishing. Because people were thinking you would get cancer cells, because the mutations in the nucleus, if the hypothesis is correct that this is a nuclear genetic disease and the gene drivers are in the nucleus, then how is it possible that you could generate normal tissues without abnormal proliferation. In other words, normal, differentiated tissues from the nucleus of a tumor cell.

I was able to pull together a variety of these reports that had been sporadic in the literature over 50 years. And when these reports came out, it was considered kind of an oddball report that didn’t support the gene theory, but most people discounted it, because it was one singular report. But every four or five years, another report. Eight years would go by, another kind of report. And some of these studies were done by the leaders of the field, the key developmental biologists, the best there were. These people were heavy-weights in the field.

And they were coming to the same conclusions. That we were not getting tumors from transplanting the cancer nucleus into a normal cytoplasm. We were cloning mice, we were cloning frogs. We were seeing normal regulated cell grow. Now how can this happen, if the nucleus is supposed to be driving the disease?

So what I did was, I put all these reports together in a singular group. And I distilled it down to what the ultimate results showed. And then when you look at the whole group of papers, together for the first time, and the conclusions are consistent from one study to the other, using totally different organisms, totally different experimental systems, the results are all the same. The nuclear mutations are not driving the cancer disease.

And then if you take the normal nucleus and put it into a tumor cytoplasm, you either get tumor cells or dead cells. You never get normal cells. So this was clear. It became very clear to me, and when people look at these kinds of observations in their group and their totality, it’s a devastating statement on the nature of the disease. It’s not a nuclear genetic disease, it’s a mitochondrial metabolic disease. And the field has not yet come to grips with this new reality.

[Damien Blenkinsopp]: Just on that point, quickly, if you were to predict the future, do you think that this view of cancer metabolism is going to get traction in the near future? Say the next five years, next ten years, and what will it take to make that happen?

[Dr. Thomas Seyfried]: Well, it’s already gaining a lot of traction. People are now coming to realize that metabolism is a major aspect of cancer. But, unfortunately, what the field has done, there’s still links to the gene theory. So, the top papers come out and they say, “Oh, the abnormal metabolism in cancer cells is due to the nuclear gene mutations. Therefore, we still must be on the quest to find out what these mutations do.”

They have not evaluated in the depth of the information that I’ve presented. It becomes clear that this is not a nuclear genetic disease. So the mutations are not driving the disease, they’re the effects of the abnormal metabolism.

Now, there’s a groundswell of new interests in this. Now this opens up a totally different way to approach cancer. Once you realize it’s not a nuclear genetic disease, but it’s a mitochondrial metabolic disease, you have to then target those fuels that the tumor cell is using to stay alive. These amino acids and glucose, which can be fermented. Those molecules that can be fermented through these primitive pathways now become the focal point of stopping the disease.

So it becomes a much, much more manageable and approachable disease once you realize that if you take the fuel away from these tumor cells, they don’t survive. They become very indolent, they stop growing, they die. And now this gives you an opportunity to come in and target and destroy these cells, using more natural, non-toxic approaches.

[Damien Blenkinsopp]: Right. If you could reinforce that a little bit, because as I understand it, the current approach, which is pushed the most, is to target all of the different nuclear genetic mutations – and there’s many, many thousands of them, you can’t really count how many there are, because it’s constantly developing – versus, with mitochondria, as I understand it, mitochondria are all the same. So it’s a completely different problem when you look at it from that respective. Am I summarizing it correctly?

[Dr. Thomas Seyfried]: Yes, I think you’re absolutely right. I mean, it’s a completely different problem. It now becomes a problem of energy metabolism. And the nucleus becomes a secondary peripheral issue.

[Damien Blenkinsopp]: Right. And the fact becomes much simpler, because you’re targeting the same problem versus thousands of different problems.

[Dr. Thomas Seyfried]: Absolutely.

[Damien Blenkinsopp]: And then therapy is… Today we’re developing thousands of hundreds of different drugs to target different types of cancer.

[Dr. Thomas Seyfried]: Yeah, it makes no sense. And the issue is every single cell in the tumor suffers from the same metabolic problem. But every single cell in the tumor has a totally different genetic entity. And we’re focusing on the very different aspects of every cell, rather than the common aspects of every cell.

The problem becomes a much more solvable problem once you target the commonality. The common defect expressed in all cells, rather than the defects that are expressed in only a few of the cells. You would not do that until you came to the realization, and saw the data, that this is a disease of energy metabolism, not nuclear genetic defects. It’s a totally different way of viewing the disease.

[Damien Blenkinsopp]: Right. Thank you.

This may be kind of off subject for you, let me know if it is. But, I understand it, there’s also, more and more people are starting to link other types of diseases – say multiple sclerosis, Parkinson’s, and some of the other chronic diseases that we have and are not very solvable today – to mitochondrial disease. So I’m wondering if in any way you link that to the same origin of cancer, here. That we’re discussing.

[Dr. Thomas Seyfried]: Well, those diseases, that’s true. There are mitochondrial abnormalities in Parkinson’s disease, Alzheimer’s disease, epilepsy, and Type 2 diabetes. I mean, you can go right down the list and find a mitochondrial connection to a lot of these different diseases. But the mitochondria can be damaged, and insufficient, and influenced in many different kinds of ways. So, only cells that can up-regulate, significantly up-regulate fermentation, can go on to form tumor cells.

But many of our cells are not killed outright, and they struggle. For example, the brain. We rarely get tumors of the neurons in the brain, because if you damage the respiration of the neuron, the neuron will die.

Many of the tumors in the brain come from the glial cells. These are supportive cells of the brain, they play an extremely important role in the homeostasis of brain function. But those cells have a greater capacity to ferment than do the neurons. So when mitochondria are damaged in neurons, the neurons usually die. You can never get a tumor cell from a dead cell.

Now Parkinson’s disease and Alzheimer’s disease, these are situations where populations of neurons die from reactive oxygen species. So these reactive oxygen species, which are produced by inefficient mitochondria, kill the cell. And the cells never form tumors, they just die. So you have populations of cells in the Substantia nigra in Parkinson’s disease, or in the hippocampus in Alzheimer’s disease, where the neurons are dying. And they’re dying from mitochondrial energy inefficiencies.

And the idea then, is can we enhance neuronal function by using therapies that will strengthen mitochondrial function. And the answer is, yes. And this is why these ketogenic diets are showing therapeutic benefit for a variety of different ailments, a very broad range of ailments. But the diets and these approaches – what we can therapeutic ketosis – can enhance mitochondrial function for some conditions, and can kill tumor cells in other conditions.

So one now has to appreciate a new approach to managing a variety of diseases that may have a linkage through inefficient mitochondrial metabolism.

[Damien Blenkinsopp]: Could you talk about – we’re coming into treatment here a little bit now, based on your theory. There’s the difference between ketone, or like, fat versus glucose metabolism in the mitochondria. And you were just talking about efficiencies. Could you go over that? What is the difference there? Why is it that glucose metabolism is different that of fats and the production of ketones?

[Dr. Thomas Seyfried]: Yeah, well the body is very flexible. It can burn energy from carbohydrates, which is glucose, or it can burn energy from fatty acids. Or it can burn energy from ketones. And we evolved as a species to survive for considerable periods of time without food. It’s amazing how people don’t understand this. They think if they don’t eat food in a week or less, they’re going to drop dead. This is nonsense.

We evolved as a species to function for long periods of time. As long as we have adequate fluids, water, the human body can sustain functionality for extended periods of time without eating. Now, you say to yourself, well where are we getting our energy. We evolved to store energy in the form of triglycerides, which are fat. And many of our organs store fats to various degree, and we have fat cells that store fat.

Now, when we stop eating, the fats are mobilized out of these storage vacuoles in the cells. And the fats go to the liver, and our liver breaks these fats down, like a wood chipper, to these small little ketone bodies, which now circulate through the bloodstream, and they can serve as an alternative fuel to glucose. So we can sustain, because the brain has a huge demand for glucose, but the human brain can transition to these fat breakdown products called ketone bodies.

So this all comes from storage fat, and our brains can get tremendous energy from these ketones. The energy in food comes from hydrogen carbon bonds that were produced during the production of the food. Ultimately from planets and the sunlight. But the energy in the bonds is ultimately derived from the energy of the sun. Now, our bodies break down these bonds, and recapture that energy. What we’re doing then is just recapturing this energy.

Now ketone bodies, when they’re burned in cells, they have a higher number of carbon oxygen bonds. They produce more intrinsic energy than does a glucose molecule, which is broken down to pyruvate, which is a glucose breakdown product. And when ketones are metabolized, they produce fewer of these reactive oxygen species. They work on the coenzyme Q couple within the mitochondria to produce clean energy, energy without breakdown products. It’s a very efficient form of energy.

[Damien Blenkinsopp]: I like that analogy there, because people could relate to how we had lead gas before, and we cleaned it up a bit, and now we’ve got less waste products in the environment.

[Dr. Thomas Seyfried]: Yeah!

[Damien Blenkinsopp]: It’s a little bit similar.

[Dr. Thomas Seyfried]: It’s the same thing. I mean, our bodies are so super energy efficient when we begin to force them into a situation. In the past, this was done all the time, because in the past the humans almost were extinct a number of geological epochs, for the ice ages, lacks of food and all. And I mean, we have a very energy efficient machine in our bodies that can generate this energy from within. Clean, powerful, efficient energy that allows us to sustain our mental and physiological functions for extended periods of time.

And this comes from the genome. Our genome has a remembrance and a knowledge to do this. It evolved over millions of years to do this. The problem today is that this capability is suppressed by the large amounts of high energy foods that are in our environment. And what happens, this then creates inflammation and the kinds of conditions that allow inefficiencies, and eventually inflammation and the onset of cancer.

So, returning to the more primitive states allows our bodies to reheal themselves. And, as I said, here’s the issue. The nuclear genetic mutations that collect in these cancer cells prevent those cells from making the adaptations to these food restrictive conditions. So, because the mutations are there, the cells are no longer flexible. They can’t move from one energy state to the other, like the normal cells can, which have integrated genomes.

So, the mutations can be used to kill these tumor cells, but by forcing the body into these different energy states in a non-toxic way. It’s not necessary to have to poison people, nuke people, surgically mutilate people to make them healthy. There’s natural ways we can do this, if we understand the differences in metabolism between normal cells and cancer cells.

[Damien Blenkinsopp]: So, from your perspective, anything that would help to repair mitochondria, would that be helpful against cancer?

[Dr. Thomas Seyfried]: Oh, absolutely. Absolutely. You’re not going to get cancer in cells that have very healthy mitochondria. If mitochondrial damage is the origin of cancer, and the cells have very high efficient mitochondria, it’s very unlikely. The risk of developing cancer in those situations is remarkably low.

There are groups of people that we have in the United States, the Calorie Restriction Society of America. It exists in other areas throughout the world. These people have a very low incidence of cancer. They’re in a constant state of ketosis, and the incidence of cancer in these people is very, very low.

Now, I have to admit. This is not an easy lifestyle. People don’t want to be restricting themselves all the time, and doing this stuff. This is the issue. We live in an industrialized society that has come a long way to create an environment that is free of the massive kinds of starvations, and these things that existed in the past. So it’s hard to take your body and go back into these primitive states to do this kind of thing.

[Damien Blenkinsopp]: Right. So, there’s [unclear 31:58] a really big focus on what you’ve been saying on reactive oxygen species, which is kind of like the mini explosion that takes place inside a car when it’s running. And I think people can relate to the fact that all engines are causing damage while they’re running, because they’re producing heat, and so on.

So, with the mitochondria, it’s basically the same. And you’re saying that when we’re on a ketogenic diet, or where we’re fasting and we’re producing this more efficient type of fuel, it reduces our assets [unclear 32:23] causing less damage. And it’s an important type of the damage that is caused to mitochondria.

And this is why eventually it helps with the status of the mitochondria, to heal them and repair them, or to limit the additional damage that goes on which would help to promote the cancer. Is that a good summary, or have I got some things wrong?

[Dr. Thomas Seyfried]: It’s a very close analogy. I would say this is exactly what it is. We damage our body by the kinds of foods we eat, the kinds of environments we’re exposed to. And the mitochondria in certain cells just get damaged, and these cells then revert back to a more primitive form of energy, which is fermentation, which then leads to a total dysregulation of the growth of the cell. Collects these mutations that come as a secondary downstream epiphenomena of this.

And the thing of it is is, how do you target and eliminate those kinds of cells. And cancer, people must realize, this is systemic disease, rather than a focal disease. People say, “Oh, what does he study? He’s a liver cancer, breast cancer.”

These cancers are all the same. They’re metabolically all the same. You need to treat cancer in a singular global systemic way, and this then will marginalize and reduce the growth of these cells. And you have to be able to do it non-toxically.

And these ketogenic diets, or therapeutic ketosis, is just one way to enhance the overall health and well-being of the body while targeting and eliminating these inefficient cells. And this can be done if people do it the right away.

[Damien Blenkinsopp]: Great, great. Thank you very much.

So, based on this theory, what kind of biomarkers would give us insights into someone’s potential to develop cancer? Because today we look at 23andMe data, for example, genetics to kind of asses our risks of future cancer. For instance, on mine it says my highest potential cancer is lung cancer. And that’s pretty much the only markers that we’re given. Are there markers related to mitochondrial function, or damage, that you would feel that would be relevant to estimating a future potential risk of cancer?

[Dr. Thomas Seyfried]: Yeah, well I think one of the risks of cancer is high blood sugar, blood glucose levels. I mean this creates systemic inflammation, which underlies a lot of the so-called chronic diseases that we have, including heart disease, and Type 2 diabetes, and Alzheimer’s disease, and cancer. These are just the predominant number of chronic diseases that we’re confronted with.

So, if we know that high blood sugar is a provocative agent that increases the risk for cancer, then making sure your blood sugar levels are low. And the other thing too is elevation of ketones. So we developed what they call a glucose-keton index that can be used for people to prevent cancer, as well as managing the disease.

So if the glucose-ketone index, which we have defined as the ratio between the concentration of glucose in the blood to the concentration of ketone bodies in the blood. If this index can be maintained as close to 1.0 or below, the body is in a very high state of therapeutic energy efficiency. Which is then going to reduce the risk for all of these different kinds of chronic diseases. So, and if you look at most people with chronic disease, their index is about 50 or 100, rather than 1 or below 1.

We’ve just developed this, and we’re working on a paper. It’s called the Glucose-Ketone Index. It was designed basically for managing cancer, because patients who have cancer, if they want to know what these therapies are doing, how they’re working, you look at your index.

Now, people who don’t have cancer, who would like to do something to reduce their risk, they would do the same thing. And people would say, “What’s your index today?” “My index is 1.2.” You’re in a very good state of health.

And if most people – I can guarantee – people who eat regular foods, their indexes are about 60 or 70, not 1.2 below. Because what you do is when you have a lot of carbohydrate in your bloodstream, the ketones are very, very low. They’re like 0.2, 0.1. And you’re blood sugar is like 4 or 5 millimolar, and your blood ketones are 0.1 millimolar. Well what do you think your index is going to be? It’s going to be huge.

But then if you increase your ketones, if you can bring the ketones bodies up to the same level as glucose, then I have a 1.0.

[Damien Blenkinsopp]: Is this sensitive enough to manage potential? You made a very clear scenario of 60, where that’s a very dangerous situation to be in.

[Dr. Thomas Seyfried]: Oh no, no. I don’t want to say it’s dangerous. I want to say it’s the norm.

[Damien Blenkinsopp]: Oh, okay. Great.

[Dr. Thomas Seyfried]: It’s not dangerous. When you take somebody who has Type 2 diabetes, and his blood sugar is like 300 milligrams per deciliter – and you have to divide that by the number 18 to bring it down to millimolar – and his ketones, you can’t even measure them. I mean, these guys are inflamed. Their bodies are in an inflamed state. And inflammation will cause all kinds of effects.

So, you want to bring people down. How do you get these low numbers? Well, you can either go on these calorie restrictive ketogenic diets, or you can do therapeutic fasting, which is water only fasting, for several days. You’ll bring those numbers right down. You’ll get into an extremely healthy state. Because the ketones go up naturally when you don’t eat, and blood sugar goes down naturally when you don’t eat.

So then you enter into these states, it’s called therapeutic ketosis. The problem is it’s very, very difficult for most people in our society to do this, because our brains are addicted to glucose. If you take somebody who stopped eating for 24, 36 hours, this guy thinks he’s going to go crazy. It’s almost like trying to break the addictions to cigarettes, alcohol, drugs. It’s not easy. It’s very, very difficult to break the glucose addiction.

[Damien Blenkinsopp]: Absolutely. It takes a little bit of time to change your metabolism.

[Dr. Thomas Seyfried]: Yeah.

[Damien Blenkinsopp]: So we spoke to Jimmy Moore before. I don’t know if you connected with him before, and his book…

[Dr. Thomas Seyfried]: Yeah, I know Jimmy.

[Damien Blenkinsopp]: Right, right. So we spoke about some of the different ways to measure ketones. We had the blood test, the blood-prick test with the precision, which is a little bit expensive today. And you have the breath test, the Ketonics, which has just come out. With that index, are you using the blood-prick test, or are you using maybe blood labs, or something a bit more complicated?

[Dr. Thomas Seyfried]: There’s a couple of companies that use the blood test, the most accurate. It’s more accurate than the breath, blowing into a ketosis meter. Or you do urine sticks. So the most important measure, of course, is blood. So you have to take a blood stick. There’s only a few meters that can do both ketones and glucose, using the same meter.

You have to use different sticks. There’s a ketone stick, and a glucose stick. So from the same drop of blood, you can get your blood sugar, and then you can put a new stick into the machine, which is a ketone stick, and then you can take the same drop of blood and get your ketones.

Now what we did was we developed a calculator so that all the person would have to do is to push the button on the meter, and it would calculate already your glucose-ketone index. This would give you a singular number from a drop of blood.

[Damien Blenkinsopp]: So you’ve developed your own device, you’re saying, which does that calculation?

[Dr. Thomas Seyfried]: We developed the calculation. It’s called the Ketone Index Calculator. And because you have to convert everything back to millimolar. Because many of the ketone meters give you blood sugar in milligrams per deciliter, and ketones in millimolar. So we have to convert. You can do all this by hand, you just have to do the divisions and all of this stuff.

[Damien Blenkinsopp]: So you’ve got an online calculator where people can put their values in and it will give them the index?

[Dr. Thomas Seyfried]: Well, we don’t have that yet. What we did was develop the calculator that could be incorporated into these meters.

[Damien Blenkinsopp]: I see.

[Dr. Thomas Seyfried]: This is the thing. So people, regardless of whether you’re a cancer patient and you want to manage your disease, or you’re a person who wants to prevent cancer, or you’re an athlete who wants to know what his physiological status is, or you’re someone who wants to lose weight. All of these issues, you can get a sense, a good solid biomarker sense, by looking at your glucose-ketone index.

And everybody can do that from these meters that are capable. But the meters right now are not designed to give you glucose-ketone indexes. And this is what we’re saying; it’s the index that will tell you your overall status, your health status.

[Damien Blenkinsopp]: Right. So I imagine, right now, you’re approaching the providers of these tools to see if they can incorporate this calculation into their devices?

[Dr. Thomas Seyfried]: Yes. Exactly. They don’t have it yet. They’re not even aware yet of the potential market, or interests, among the general population. Not only for people that are afflicted with various diseases, but people who are healthy and don’t want to get those diseases.

So this is a very simple tool. The only drawback from it is you have to stick your finger with a little prick to get a little bit of a drop of blood. The people with Type 1 diabetes do this regularly. This is not an issue. But for those people who are into this, and they want to do it the right way, and they want to get accurate biomarker measurements, then they would do this. For those people who are interested in this.

This is invasive in the sense that you have to prick your finger to get a drop of blood, but it’s not invasive in the sense that you have to take tissue samples, or any of this kind of thing.

[Damien Blenkinsopp]: And so this is something that people could do on an on-going basis? So I’m guessing for someone with cancer – I don’t know if this would be something you would say – they’d probably want to look at daily, or every few days, or something like that. And someone else, maybe it’s just something they need to do a lot less intensive routine, in terms to just monitor the levels of their general ketogenesis.

[Dr. Thomas Seyfried]: Yes. You’re absolutely right about this. People who are trying to manage their diseases thoroughly might want to do this maybe once or twice a day. Just like someone who might have Type 1 diabetes. They measure their blood sugar several times a day.

The issue right now is the glucose strips are relatively cheap – they’re like 50 cents a piece – but the ketone strips are much more expensive. They can range from anywhere from $2 to $5 a stick.

[Damien Blenkinsopp]: Do you know if that’s due to economies of scale? Or if it’s simply because not enough people are using them yet?

[Dr. Thomas Seyfried]: Yes, it’s an economy of scale, absolutely. Because very few people measure their ketone levels. But now, linking those ketones to your overall general health, a lot of people would be interested in this.

And people in general like numbers. They want to know, and especially a singular number that would dictate your state of health. If you can say to somebody, “Listen. My index is between 1.1 and 0.9,” people would automatically know this guy is in a tremendous state of health.

People like to know that. You say, “Where is your number?” And people like to keep log books. They like to record these numbers. And they also link this to a greater sense of well-being. People who have their numbers down in these ranges, they tell me – and I’ve done it. Some people get into a state of euphoria. It’s like unbelievable.

When your body starts burning these ketones, it’s like you enter a new physiological state. And athletes are doing this sometimes. So it’s a whole new realm of how to monitor your own health with accurate biomarkers that give you an indication of your health status.

[Damien Blenkinsopp]: So do you follow a similar prescription to Jimmy Moore? I believe you understand his approach, where he’s eating a high fat diet, or sometimes he’s fasting. Kind of like intermittent fasting, which has become pretty popular these days.

[Dr. Thomas Seyfried]: Well intermittent fasting is, from what we’ve seen in our work, you don’t get the health benefits, the power of the health benefit, until you’ve gone three to four days without any food. Just drinking water. And then those who can go a week, like a seven day period, this is really when you start to see your blood sugars going down and your ketones going up.

But once you can get into this zone – we call it the zone of therapeutic management – where now you know your in the zone, this is where the health really comes in. And when you say periodic fasting, now there’s a lot of people that I know – numbers of people – who have a rather restrictive diet for the week, and then one day a week they’ll not eat anything. So, it’s one day off on food, like a 24 hour period where they’ll just have maybe a green tea, no calories, or just pure water.

[Damien Blenkinsopp]: Some of the intermittent fasting regimes propose that approach, a 24 hour fast every two days.

[Dr. Thomas Seyfried]: Yeah, but then you’ve got to know, okay what did that do to my index? How effective was the 24 hour fast on my index? And you look down, you say, “Well, I didn’t get my ketones up very far. They went from 0.1 to say, 0.5.” Okay, but if I go four or five days, it goes from 0.1 to 3.0. Oh wow, this is the magnitude difference.

[Damien Blenkinsopp]: Yeah. So have you looked at different people, because when we were talking to Jimmy, he was saying that different people have different responses. It’s based on their current state of metabolism. They’ll have to be more extreme in their approach to get the same level of ketones, and the same impact on an index, depending on, potentially, how damaged their mitochondria are. I don’t know how you look at it.

[Dr. Thomas Seyfried]: Yeah, no, that’s a really important point. It’s certain people. It’s also certain sexes. Women can get into these ketone states much easier than men. And young people can get into these zones much, much easier than can older people.

So it’s an age issue, it’s a gender issue. We’ve seen some of our students get down their blood sugars down into the low 30s, which people would say would be a crisis situation, you’d have to go to the hospital. But their ketones are elevated, and when the ketones are elevated, you have no crisis situation. It’s only when you lower blood sugar and don’t elevate ketones that you have this situation.

Males have a lot more muscle, they tend to burn protein, which can be converted to glucose. So their blood glucose doesn’t go down as sharply as women, the blood glucose of females goes down. Females can get their blood sugars down and their ketones elevated – from all the data that we’ve seen for several years on different gender – and this is what we see.

And older people are simply locked into a much longer lifestyle of high glucose. And for them to get their blood sugar down, it’s a real struggle. And also their muscle mass over the age. They have a lot of other issues that play into this whole thing.

And you’re absolutely right, it’s an individual thing. Some people can’t tolerate this. They get really sick, they get light-headed. Where other people make the adaptations much more quickly. So again, people have to know their own physiology.

But they have to have the biomarkers that let them know. They need to see these numbers, and once they see these numbers they’ll know that they’re on the right path, and they probably can do this if they persist a little bit longer. Rather than throwing their hands up, not knowing what’s going on, being very frustrated. And as I said, once you have this information and knowledge, that these kinds of things become much easier.

[Damien Blenkinsopp]: Yeah. It definitely helps with your confidence in something if you can see that, maybe you don’t feel better, or you don’t feel a difference yet, but if you see the numbers starting to move then it gives you that sense of accountability, and motivation also. I think that’s one of the very helpful aspects of these kind of indexes that you’re talking about.

[Dr. Thomas Seyfried]: Absolutely. This is a very important point, you’re absolutely right about this. Because when you see that you’re killing yourself, and nothing’s happening, or you don’t feel anything, but when you see numbers starting to change in the direction you know your hard work is starting to pay off. And then you get motivated, and you want to see then how far you can push these numbers.

Now this is not going to hurt anybody. You’re just lowering blood sugar and elevating ketones, and your body gets into a new state of health. And people feel it, believe me. You can feel this stuff happening. But there’s a rocky road going from the high glucose state to the high ketone state. And that rocky road can be more rocky for some than others.

[Damien Blenkinsopp]: Absolutely. So there are other aspects to mitochondrial health that certain people are looking at at the moment. I don’t know if you’ve come across any of these, but I thought I’d just throw them out in case you had some comments on them.

Some people are talking about mitochondrial repair, in terms of repairing the membranes with specific lipids, by providing those lipids to help reinforce the mitochondria. Other people talk about things like PQQ to help stimulate biogenesis of new mitochondria. I don’t know if you’ve heard about these things, or have any ideas or opinions on them.

[Dr. Thomas Seyfried]: Well, in my book I called it autolytic cannibalism. And this is basically, the mitochondria can either be rescued, enhanced, or consumed through an autophagy mechanism. And when you stop eating, now every cell in the body must operate at its maximal energy efficiency. That means that the mitochondria in those cells must be operational at their highest level of energetic efficiency. Otherwise the cell will die, and the molecules of that cell will be consumed, and redistributed to the rest of the body.

Now, in cells that have some mitochondria effective, or more efficient than other mitochondria within the same cell, the inefficient mitochondria can be incorporated into the lysosome. The parts of that mitochondria can then be redistributed to the healthy mitochondria within the cell. And this way you eliminate internal energy inefficiencies, but without having to kill the cell, because the cell is able to repair itself.

Whereas those cells that can’t repair themselves die, and their molecules are then consumed by macrophages, excreted back into the blood stream, and the nutrients now are used to support the health and vitality of those cells in the body that have this higher energy efficiency. It’s a remarkable state of efficiency. So it works both with individual cells, and throughout the whole entire physiological system.

[Damien Blenkinsopp]: Great, great. Thank you. I’m just thinking, you’ve spoken about fermentation versus respiration. Is there any way to measure that, that you know of? Is that being done in studies? So are the studies coming out are comparing the state of fermentation versus respiration taking place in people’s bodies, and correlating that to cancers, or anything like that?

[Dr. Thomas Seyfried]: Yeah, that’s kind of hard to do, because we all have lactate in our bloodstream, and the lactate comes from erythrocytes, our blood cells. The blood cells have a shorter half-life than many of the other cells in our body, and those cells have no mitochondria. They have no nucleus. So they’re little cytoplasms that primarily ferment.

But they don’t use a lot of energy, because the role of that cell is simply to exchange gases. So it floats around in our tissues, it deposits it’s oxygen and picks up CO2, as more or less a little mailman running around, picking up this and dropping that off. And they have a shorter half-life. But they have lactate.

Now if you have a tumor, or if you’re under hypoxic stress, lactic acid will go up in your bloodstream. But it’s hard to know if a tumor will do that. Sometimes what tumors will do, they have a phenomena called cachexia. This is where the tumor cells will send out molecules that will digest proteins, or dissolve proteins in our muscles and other proteins. And these proteins then go to the liver, and are broken down into amino acids, and the amino acids are conjugated into glucose.

So the glucose goes now into the tumor cell, and some of the proteins and the amino acids go to the tumor cell after being broken down. So the tumor is essentially causing our body to starve to death. We might be eating, but it looks like we’re not gaining any weight, and we’re becoming moribund and looking like we’re starving to death. This is an effect of the tumor,.

Sometimes you don’t see that. Sometimes lactic acid will go up, and sometimes it won’t. So there’s a lot of ambiguity of looking at a good biomarker to assess the state of what level of tumor growth you might have, other than the fact that you’re losing weight even though you’re eating. Which is the cachexic state; you’re kind of wasting from within. This is the whole thing.

And this is one of the fears that the medical profession has with cancer patients, because they say these poor people are losing weight through this cachexic mechanism, and then you come along with a metabolic therapy, and they say, “Oh, this can’t work.” But the issue, of course, is that there’s two types of weight loss. One is a pathological weight loss, and the other is therapeutic weight loss.

Pathological weight loss is cachexia, and of course if you treat it with toxic chemicals and radiation, you get so sick with fatigue, nausea, diarrhea, vomiting. I mean, this is pathological weight loss. Therapeutic weight loss is you’re losing weight, but your body is getting extremely healthy, and killing cancer cells at the same time.

So weight loss can come in two different varieties: pathological and therapeutic. And people have a tremendous difficulty in understanding the differences between these kinds of weight loss.

[Damien Blenkinsopp]: I think we’ve mentioned on a podcast before that when people are fasting in this state, they actually feel better, even if they have, for instance, chemotherapy. They tend to do better in chemotherapy when they have been fasting.

[Dr. Thomas Seyfried]: Yes, because it reduces inflammation. We published a number of papers showing how therapeutic fasting reduces systemic inflammation. Systemic inflammation contributes to a pathological state, and facilitates tumor growth.

So therapeutic fasting, while at the same time you’re taking a toxic drug, it’s like what are you doing here. But it does take the sting out of that toxic drug. People feel better when they’re therapeutically fasting. I think Longo’s group down at University of Southern California has clearly shown that some of these cancer patients can do a lot better, and feel better, when they’re fasting while they’re taking chemotherapy.

But you’re absolutely right about that.

[Damien Blenkinsopp]: Thank you so much for this interview[unclear 53:08] Thomas. I want to ask you just a few more questions to round off now.

What do you think will happen in the next five or 10 years, or hope? What are your visions for this area, in terms of biomarkers, like testing devices, or change in the way we approach this? Do you think there’s specific opportunities ahead, are there specific questions you’re looking at at the moment to resolve, in research, or so on?

[Dr. Thomas Seyfried]: Yeah, well I think the people themselves are demanding a change. The issue is that they haven’t been shown other alternatives, other than the standards of care, which are conducted by the major medical schools: Dana Farber Cancer Center, MD Anderson, John Hopkins, Yale Cancer Centers, Sloan Kettering, UCSF. The major industries of cancer and academics are closely aligned in how to do this.

And it’s not working. We’re having about 1,600 people a day are dying from cancer in this country. And the statistics in other countries in Europe, and China, and Japan, are not far off of this. And if we had Ebola outbreak in this country, where 1,600 people were dying a day, this would be of the greatest catastrophe that people can imagine.

But for cancer, it seems to be okay. This is the norm. Well it doesn’t have to be this way. It doesn’t have to be this way. And the issue here is that the people see that we have more, and more survivors, and people doing pretty well on these metabolic therapies. Why are we not doing this as more of a general treatment as opposed to these toxic approaches to manage the disease?

So I think the change will come from the grassroots. I don’t see it coming from the top medical schools, because these people are not trained. They’re medical education doesn’t give them the training to identify these approaches to therapy. It’s not part of the medical training.

There are a number of physicians that are recognizing this now, and they want to become part of this new approach to cancer management. Now, you have to realize that we’re just beginning. This is just a new field, it’s a beginning field. Even though the science is well, well established, the implementation of this science for patient health is just at the beginning. It can be refined, it can be modified.

A lot of this now we’re talking about, the potential for managing cancer in a non-toxic way with greater therapeutic efficacy, is just beginning. So, I think that we need more trained people. We have to have people that understand this. Eventually, these kinds of approaches will be more and more recognized, and more and more implemented in the overall society.

The problem is people have not yet found a way to make a large profit on this kind of an approach as you can with certain drugs, and immunotherapies, and these kinds of things. But that will probably come in time, once people understand what the best approaches and techniques are.

[Damien Blenkinsopp]: Another aspect I wanted is there’s more research being undertaken on mitochondria over time. Do you think that will help, in any way?

[Dr. Thomas Seyfried]: Yeah, I think it will help a lot, like you said, with the lipids. And we’re looking into this ourselves. I think there’s ways that we can enhance mitochondrial energy efficiency through various diets and supplements, and things like this.

And there will be a real quantitative measures that can assess this, for people to recognize what works and what doesn’t. So I think it’s just that it’s an area that has been not well appreciated, and not well recognized.

And as long as people think that cancer is a nuclear genetic disease, the focus on the mitochondria hasn’t been there. People have known the importance of mitochondria, and it’s been a very major area of scientific research. But it’s not recognized as the solution to the problem. It’s kind of a side effect.

What we’re looking at is understanding mitochondrial functions, and it’s interaction with the nucleus and other parts of the cell to maintain a healthy cell – a healthy society of cells – and a healthy overall physiology. All linked to the mitochondrial energy metabolism. This is going to be a very exciting new development.

[Damien Blenkinsopp]: Yeah, I agree. There’s not a day that goes past that I don’t think about mitochondria these days. And hear someone talk about it. It happens a lot on this show, also.

If someone wants to learn more about your work, and this theory of cancer, and the index you were talking about, where should they go?

[Dr. Thomas Seyfried]: Well, I wrote the book On Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of the Disease. That’s published by John Wiley Press. Unfortunately, it’s a science book and it’s not cheap, like you’d find most of the Amazon books, but it gives you the literature, it gives you the science. It gives you the hard evidence to support everything that I’ve said.

Another book that’s just appeared is Tripping Over the Truth: The Metabolic Theory of Cancer, by Travis Christofferson, who’s written a book for the layperson, where he actually read my book and went back to test all the things that I was saying, and actually talking and visiting and interviewing those scientists who work in the gene theory, and work in the metabolic theory, and get the word directly from them. It reads like a novel, and it’s much less scientifically intimidating than what I wrote.

I wrote this book to convince my peers, and people in the cancer and scientific field, the evidence that supports what I’m saying. This sometimes can be intimidating to the layperson. Whereas Travis went out and actually interviewed those scientists, and asked them the specific questions. And now it becomes a very intriguing story; I mean, how did this cancer thing get so far out of whack with what we know about it. People like to see this, and read it.

So that is another book that’s generating… If you go on Amazon, you’ll see the reviews. They’re all quite outstanding for Travis’ book. And I’ve been privy to a number of other books that will be coming out over the next year, which are harping on the same general theme, that cancer is a metabolic disease, and it can be beaten by metabolic solutions. Totally different than what’s been going on in the main focus.

And this is kind of shocking, because you go to the top cancer centers, and they don’t speak anything about this. They’re still talking about the standards of care as they have been done, or they’re talking about immunotherapies, which is the new buzzword for the cancer field, where you’re going to identify all the mutations, and then make anti-bodies to the defective proteins, and then treat people. And they show a few survivors on the cover of the Wall Street Journal saying how wonderful this works. But they don’t show you the other evidence showing how many people are dying from this.

All this will change, because the people in this society, the public, is going to be fed up with the lack of progress, and what we have is a new way to approach this problem based on solid scientific fact. It’s just that these facts are not well understood or recognized at this point.

[Damien Blenkinsopp]: Great. Thank you very much, and we’ll put all of this in the show notes, so people will find these links easy. Also the index you spoke about, I’m guessing there’s nothing really published about that. If people go to your website in the future, will you have something on there which will talk about that in more detail?

[Dr. Thomas Seyfried]: Yeah. We have a paper that’s under review right now, where we’ve submitted a paper for the index, and we’re in the process of making some revisions on the index. And the index was, in this paper, was mostly focused on managing brain cancer, but we also noted that this index could have a broad applicability to a whole range of different diseases.

And in the Journal of Lipid Research, which is the top journal in the field of lipid biochemistry, I edited one of the issues that was entitled Ketone Strong: Emerging Evidence for the Role of Ketones and Calorie Restriction for the Management of a Broad Range of Diseases. So, more and more scientists are getting involved in this, and more and more information will be coming out. Both in the professional scientific journals as well as in the public interests articles in journals, and magazines, and radio shows.

More and more people will be coming to know this, and I think the field is going to have to deal with it. And I think in the long run, we’ll emerge into a new way to manage these chronic diseases with a lot less toxicity, and greater efficacy.

[Damien Blenkinsopp]: Great, great. Thank you. Now, just two more questions, personal questions for you.

What data metrics do you track for your own body on a routine basis, if any?

[Dr. Thomas Seyfried]: Well, basically I try to get on a scale and see how much I weigh. Obviously, if you can keep your body weight at a stable level for a period of time, this is certainly one way to maintain homeostasis.

I’ve done the three day fast, but as I said, when you’re older like myself, it’s very uncomfortable, but it’s certainly doable. It’s like training exercise. You’d have to do it probably a couple of times a year to get into the state. I think every time you do this, you become more confident in your ability to do it again.

There is a state of uncertainty and discomfort, like, “Oh my god, I’m not eating any food. How can I go, and I feel uncomfortable, and a little light-headed.” And you try to drink water to say, “Maybe I can fill my stomach up with water and I won’t feel as hungry.” And then you start getting water intoxication. And eventually you realize that you really don’t need to drink a lot of water, and you just have to bite the bullet.

But as I said, as we begin to do this, we realize that it’s not so life-threatening as everybody would think it would be. So I think I try to do that. But as I said to a lot of people, they said, “Oh, you must do this all the time.” No, I don’t do it all the time. But if I had cancer, I’d know exactly what I would do.

[Damien Blenkinsopp]: What would you do? Just to speak it out clearly.

[Dr. Thomas Seyfried]: I would stop eating.

[Damien Blenkinsopp]: Completely?

[Dr. Thomas Seyfried]: I’d get my index down below 1, that’s for sure. And then I would transition off to these high-fat, nutritious kinds of diets, ketogenic diets, and maintain my index. And then of course, we’re investigating – it’s very hard to get funds to do this kind of stuff too, because it’s not considered sexy science – what is the best combinatorial therapy that would work with therapeutic fasting and ketogenic diets, that would put the greatest amount of pressure.

And most of it has to do with what kind of non-toxic drugs would you dovetail in with therapeutic fasting and ketogenic diets? And like hypobaric oxygen therapy, 2-deoxyglucose, 3-bromopyruvate, oxaloacetate. I mean, we can go down these lists. Most of these are non-patentable drugs, but they have tremendous power when used together with these other therapies. And most of this stuff is just trying to figure out the dosages, the timing.

These kinds of issues, it’s just like perfecting the engine. How did the car engine become so efficient today from the way it was in 1900?

[Damien Blenkinsopp]: Right. So the things you just mentioned either stress the cancer cells specifically, like hypobaric oxygen, or they support the mitochondria, oxaloacetate, right?

[Dr. Thomas Seyfried]: Yes! Exactly. What you’re doing is you’re enhancing mitochondrial function in normal cells, and you’re putting maximal metabolic stress on the tumor cells. For the first time, we’re using our normal cells to directly combat and battle the cancer cells, while enhancing their health and efficiency.

[Damien Blenkinsopp]: So for someone who has, say we do a 23andMe test – like a lot of people on this podcast do their 23andMe test – and it comes out with some DNA, and it says, maybe you have a pretty high chance of cancer in your lifetime – and it could be lung cancer or whatever. Lung cancer’s not a good one, because often it’s smoking. So, one of the other more general ones, like breast cancer.

What would you basically say that they should be fasting once per month for three days, or twice per year for seven days, and maybe looking at those therapies you just outlined.

[Dr. Thomas Seyfried]: Yeah. People who have Li-Fraumeni syndrome, which is an inherited germline mutation in the gene for P53 which encodes a protein in the electron transport train, or BRCA1. Product of the BRCA1 gene has been found in mitochondria. We look at a number of these so-called inherited genes that increase your risk for cancer. But as I told you, everything passes through the mitochondria The mitochondria are the origin of the disease.

So, the inherited mutations simply make that organelle slightly less efficient in certain cells of our body. Not all cells, but only certain cells, like the breast, the uterine, or these kinds of things. And we know that there are people, like if you inherit the BRCA1 mutation, your risk of cancer goes up significantly. But not everybody who has BRCA1 mutation develops cancer.

So clearly the environment can play a huge role in determining whether that gene will be expressed or not. You can do prophylactic removal of organs, and things like this, to reduce your risk. But it would be just as effective in my mind to transition the body to a metabolic state that would minimize the problem of that gene influencing the mitochondrial function. It seems a lot less draconian than doing these massive surgical mutilations.

Or you can do both. The idea is some of these inherited mutations, they might have a preferred organ – like a breast, or a uterus, or ovary – but you’re not going to remove all your organs. You’re not going to remove brain. You’re at a higher risk, so what can you do to lower your risk? As I said, if you keep your mitochondria healthy, the risk is going to be significantly reduced.

People need to know this so they can make choices that would be best suitable for them.

[Damien Blenkinsopp]: Thank you so much for the information today. This is really an information packed episode. It’s got this great new take on cancer, which I think is very positive, because it’s talking about something which people can have more control about. So it’s not just that this is a new approach, and the older approach has been struggling for quite a while, it’s become very expensive, and so on, with not so much success, but also that this is an approach which is within people’s own manners, sphere of management.

A lot easier to start having an impact on their own lives. So it’s very positive from that perspective also.

[Dr. Thomas Seyfried]: Yeah, I agree. Absolutely.

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This week’s podcast is about the rising movement for quantifying our lives beyond just health and body. The Quantified Self  is about self-knowledge through self-tracking and extends our awareness about what’s happening in our lives, how we’re spending our time, and pretty much anything related to our daily living.

In 2007 Ernesto Ramirez joined with Wired Magazine’s Kevin Kelly and Gary Wolf to create this organization, made up predominantly of individuals with a passion for managing their lives. The society has grown from its San Francisco roots to about 90 groups meeting regularly worldwide. Many of the devices we talk about on this show have been supported by this movement, and some of the trendsetters in our community are themselves “Quantified Selfers”.

“…that gentleman just opened up his computer and said, ‘I’ve been tracking every day of my life for, like, the past three years in 15 minute increments.’ And that just… blew everyone away.”
– Ernesto Ramirez

Ernesto is the program director for The Quantified Self, as well as a research associate at the Center for Wireless and Population Health Systems at the University of California, San Diego where he’s done his PhD work. Today we speak with Ernesto in his role as program director and talk about The Quantified Self, where it’s going, and about the best practices for quantifying aspects of our biology and daily lives.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • The roots of The Quantified Self (2:55)
  • The first meetings (4:50)
  • What are meetings about and what types of information are shared? (5:59)
  • “Show and tell” (8:12)
  • Personal “N = 1” experiments and personal self-tracking (9:10)
  • Gaining value from personal tracking (15:10)
  • Where is the movement now, and where is it going? (18:50)
  • The challenges of engaging with your personal data and the role of data visualization (19:15)
  • Data privacy in a quantified world (21:37)
  • Medical self-testing, value and drawbacks (24:40)
  • Accuracy and action-ability when using personal tracking devices (29:30)
  • What is the role of personal data collection in research and healthcare (35:21)
  • Best practices for Quantifying the Self (41:58)
  • What is the future of self quantification? (44:12)
  • How to get started in self quantification (46:00)
  • Useful resources in self quantifying (49:42)
  • Your most important recommendations for people (51:18)
  • What data metrics do you personally track? (53:30)
  • What have been your biggest insights from Self Quantifying? (54:20)

Thank Ernesto Ramirez on Twitter for this interview.
Click Here to let him know you enjoyed the show!

The Quantified Self & Ernesto Ramirez

Biomarkers/Tracked Data Points

  • Running schedule and physical activity: Ernesto finds the most important aspect to his daily life quality is how much he moves. He uses a number of tools such as a FitBit and his phone to monitor his running schedule and other activity. His phone keeps track of his heart rate and Geolocation, to give him a better idea of the effectiveness of his workouts and how they affect his life.
  • Weight: Monitoring his weight allows Ernesto to keep an eye on his health and determine when he’s not getting enough time on his feet. He doesn’t check it daily, but keeps a running idea of its fluctuations.

Lab Tests, Devices and Apps

  • FitBit: Ernesto uses his FitBit to track his running schedule and activity. FitBit have a range of activity tracking devices, and are one of the larger and more popular manufacturers of activity tracking devices in 2015.
  • SuperMemo: A website and software devoted to improving memory, self-growth, creativity, time-management, and speed-learning. It’s based on the concept of spaced repetition – which improves retention by repeating new ideas at an ever-increasing interval based on the average time to forget learned material.

Other People, Resources and Books

    People

  • Kevin Kelly: Wired magazine’s founding editor and The Quantified Self co-founder. His official web page can be found here.
  • Gary Wolf is a contributing editor at Wired and co-founder of The Quantified Self. He’s the author of “The Curse of Xanadu” about Ted Nelson and Project Xanadu, and “The World According to Woz” about Steve Wozniak. His TED talk about The Quantified Self can be found here.
  • Organizations

  • The National Health and Nutrition Examination Survey: The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States.
  • Databetes was founded by Doug Kanter, a patient with type-1 diabetes. Doug is a graduate of NYU’s ITP where he studied data visualization and interaction design. Previously Doug worked as a photographer in New York City and Beijing, China. He’s run a few marathons and is pretty intrigued by Quantified Self.
  • Asian Efficiency: Damien mentioned that a friend Aaron who runs this site, tracked every minute of his day for a year to optimize his schedule and how much time he put into each activity from work to social to sleep and everything else.

Full Interview Transcript

Transcript - Click Here to Read

[Damien Blenkinsopp]: Ernesto, thank you so much for joining us today.

[Ernesto Ramirez]: No problem, glad to be here.

[Damien Blenkinsopp]: Great. Well, I wanted to jump straight into it. You’re from the Quantified Self. Welcome Quantified Self to the Quantified Body. You guys have pretty much started this. When did you start the Quantified Movement? When did QS come about?

[Ernesto Ramirez]: Sure. So Quantified Self came about out of a collaboration between Gary Wolf and Kevin Kelly. Both had been working at Wired magazine for quite a long time, and late 2007, early 2008, they were looking at what was – what were kind of the new things.

Obviously, personal computing had come about. Like the reason Wired was started was – had been here. Now, at that point, people are walking around with iPhones, and they realized that computing was getting a lot closer to individuals’ bodies. People were able to now use computing in ways to ask very personal questions about themselves. So they started to meet up, and people came in and started talking about how they were tracking different things about their lives, and we’ve kind of just been rolling ever since.

[Damien Blenkinsopp]: That’s great, right. I think a lot of people have heard of Gary and Kevin, but could you give a quick background on why these two people came together at that time? What were their backgrounds to kind of start all of this?

[Ernesto Ramirez]: Yeah, so Kevin Kelly was one of the founding editors of Wired magazine, but he’s been involved in lots of different projects around how people use different tools, objects and technologies. I mean, he’s been a thinker on technology for quite a long time. You know, he was around Stewart Brand and the whole Earth Catalogue, and then transitioned into Wired magazine.

Gary is a journalist focusing primarily on technology, and so they were – they both kind of just used their mutual interests to brainstorm on what was next, you know, and that’s what they came up with was Quantified Self, QS.

[Damien Blenkinsopp]: Yeah, that’s great. And, of course, QS is pretty much all over the world now, and we can talk a little bit about that as we go on and how people can participate. But back there in the first meeting, I think you had, like, eight people. It was a very small meeting. I think Tim Ferriss was one of the guys who turned up to the first meetings. Do you know how many people turned up to that first meeting?

[Ernesto Ramirez]: I think they said somewhere around 25 or 30. That was before my time.

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: I only got involved in about 2010, but it was a really interesting meeting because they didn’t really have an agenda. It didn’t look at all like what it looks like now, and then they really didn’t know what was going to happen. They thought, okay, people that are interested in this stuff will kind of just come and talk to us, and we’ll just have like a chat.

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: And then someone came in late, and because they came in late, Kevin Kelly just said, you know, ‘You have to talk first. You have to tell us about what you’re doing, why you’re here, what you’re interested in.’ And that gentleman just opened up his computer and said, ‘I’ve been tracking every day of my life for like the past three years in 15 minute increments.’

[Damien Blenkinsopp]: Wow.

[Ernesto Ramirez]: And that just, like, blew everyone away. And from there, we’ve kind of built on top of that mentality where people come and actually show the things that they’re doing in their own lives. You know, the tools they’re using, what they’re learning from self-tracking, and how they’re experiencing this new idea of Quantified Self.

[Damien Blenkinsopp]: Yeah, yeah. Well, let’s get people an idea of what’s going on at the moment. So basically there are groups all around the world meeting in different cities all around the world. How is a meeting structured? What goes on in a meeting?

[Ernesto Ramirez]: Yeah, so right now we have about 110 groups in a little over 30 countries around the world, and all of them have a little bit different structure. We don’t kind of force anything on them. They’re all volunteer groups that are meeting.

But what we try to do is have people come together to share their own personal stories. So rather than people standing up and talking about, oh, you should do this thing, or you should use this tool, it’s very much a first-person narrative where an individual will come in and say, ‘This is a thing that I’ve done, I’ve used this tool or this system or this application in this new and interesting way, and these are the things I’m learning about myself.’

That spans, like, all different types of self-tracking technologies and experimentations and projects, all the way from – we’ve had a lot of individuals with chronic diseases, people with type 1 diabetes saying, ‘This is what I’m learning from tracking my blood glucose and my diet in this really interesting way,’ or, ‘This is what I’m learning from tracking the dates I go on,’ to my pets, to all sorts of different stuff.

[Damien Blenkinsopp]: I think that’s one of the things that strikes you when you go to a Quantified meeting. Here at the Quantified Body, we tend to focus on health, longevity, things about the body, which can be related a bit to medical or performance or longevity, these kind of things. But Quantified Self is a lot broader. You can go to a meeting and you can hear, like you said, about someone’s dating life and how they’ve managed to track that over time and quantify it in whatever way.

So, I think the big difference people should get the idea of here is that it’s absolutely quantifying any aspect of your life that is interesting to you. And for that reason, when you go to a meeting, you really don’t know what is going to come up. I think the conference really displays that quite well, because you have many, many what we call show-and-tells. So if you could explain to people a little bit about what a show-and-tell is?

[Ernesto Ramirez]: Sure. It’s where we have those individuals come and actually talk about what they’re doing. We call it the show-and-tell because it’s very much like kindergarten. You get up in front of the room and you say, ‘This is what I’ve done. This is what I’m bringing to everyone.’

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: And we ask presenters to really answer three simple questions, which is: What did you do? How did you do it? What did you learn? And all the time, keeping that kind of first-person narrative perspective, where it’s really about their experiences, the visualizations they made, the data analysis they’ve done, the process they’ve done to gather data, and what conclusions they’ve come up with through that entire data gathering experience.

And if you think about it, one of the fun things is that those three questions – ‘What did you do?’, ‘How did you do it?’, and ‘What did you learn?’ are really a simple, simple way to think about the scientific method. The scientific method is a little bit broader, but if you bring it really – if you kind of just simplify that and bring it down to the individual level, that’s what we’re trying to do.

[Damien Blenkinsopp]: Yeah. Another term we often come across today is ‘N=1 experiments.’ Would you say there are a lot of people also doing kind of N=1 experiments? Because it’s basically – there’s tracking, just recording – and then there’s, like, I’m going to change something and see what happens. So are both of those things covered in QS naturally, or how does that work?

[Ernesto Ramirez]: Oh, totally. So you have a lot of people engaging with self-tracking. You know, the broad spectrum of things that could be called self-tracking for a variety of different reasons. One you mentioned – a few of them you did mention.

One is just kind of data gathering, just for the purpose of data gathering. You know, a lot of people wear smart pedometers, like a Fitbit or Jawbone Up or a Nike FuelBand, without any real purpose other than they want to just understand and keep track of this data. And then there’s the individual, like you’re saying, that do these kind of N=1 experiments. And even within those experiments, there’s a huge range of kind of how meticulous and detailed people get.

Some people just say, ‘You know what? I want to see if going on a more plant-based diet is going to reduce my weight and improve my blood cholesterol levels.’ And they’ll just kind of track the things they’re eating. They’ll track their weight. They might do a blood test or something, and then there’s other people that are just super-meticulous about setting up a very programmed experimentation or experimental protocol. Those are always a lot of fun to watch, to see people get very scientific about the things that they care about.

[Damien Blenkinsopp]: Right. I’ve seen many of these things where it’s actually made a huge impact on people’s lives. Right? That’s some of the astounding things. I remember the first one I went to in London, and there was a presentation from a guy who had suffered from depression for most of his life, and he simply set up a way of quantifying and communicating that to all of his friends.

So I think there’s sometimes a social aspect – you can potentially speak a lot more about this than me – and simply by doing that, he found that his rate of depression dropped, and he was basically happier every day just through this exercise of tracking and letting all of his friends see how depressed or how not depressed he was. Obviously, that completely revolutionized his life, because he didn’t feel depressed most of the time anymore. So I’ve seen some, you know, huge changes, and weight loss is very obvious. What are some of the most exciting changes you’ve seen people get out from the Quantified Self?

[Ernesto Ramirez]: Yeah, so there’s a bunch. One of my favorites – there’s a gentleman in New York. He’s given a talk a few times, actually, in New York at their MeetUp, and I think he also gave a talk at our last conference in 2013 – our last U.S.-based conference.

His name is Doug Kantor. He’s a type 1 diabetic. He’s been on an insulin pump for quite a long time, and now is on a continuous glucose measurement system, so rather than doing, like, the finger prick, he has an implanted device that can continually measure his blood glucose.

As part of one of his graduate design projects in New York, he developed a system to gather all of that data, so he was gathering his insulin, his blood glucose, and then also his meals and his physical activity. He was primarily a runner. And he tells this really interesting story about bringing all of that data in and being able to see all this information and kind of how it all connects. Led to the healthiest year of his life when you look at it from a diabetic perspective.

So, you know, that’s A1c, which is their primary measure, so which is how well they can metabolize blood glucose. And it really tells this, like, interesting thing. Plus, his visualizations, that’s primarily what he was doing in graduate school was working on design, are just astounding. You can definitely see what happens to him over the course of a year through his wonderful visualizations, which – if your listeners want to look online – I believe his website is called Databetes.

I mean, that’s a really interesting one. And we’ve seen a bunch, like you were saying, the gentleman that was tracking his mood, that seems to be a really, really interesting one as well. One of the most interesting and fun ones that you wouldn’t think would be in Quantified Self, but is, is there’s an individual who actually does some work with us, but lives in Portland named Steven Jonas, and he’s really interested in memory and being able to remember things, and he uses a system called Space Repetition and a program called Super Memo. He’s given two talks recently about how he’s using Space Repetition to try and remember every day of his life.

[Damien Blenkinsopp]: Wow.

[Ernesto Ramirez]: So every day he creates a card, basically these are like intelligent flash cards that say these are the important things that happened today, and quizzes himself to see if he can remember what days those were.

[Damien Blenkinsopp]: That’s really interesting. I mean, that’s something very unique, as well. I think that’s the amazing thing about QS. No matter what you’re interested in, you can go there and you can get feedback from other people to potentially improve what you’re doing. Like with these show-and-tells, there’s a lot of questions, of course, that come from the audience once you’ve finished your show-and-tell.

[Ernesto Ramirez]: Yeah, I think you’re right. I mean, and that’s one of the interesting things. Like, a lot of people would say – you would think that we would focus just on health, or just on weight loss and physical activity, since those are like the primary things that people do when they engage with these self-tracking tools and applications and devices.

But what we’ve found is that when people go up and talk about their super personal experiences, whether it’s individual tracking his – we had one in San Francisco tracking his blood coagulation levels, because he is on blood thinners. Or it’s someone talking about how they track their heart rate variability, because they want to understand their stress. Even though you may not be interested in that particular topic, the process that they go through and the things that they do might inspire you to try something in your own life around the ideas that you’re interested in, like, who knows, tracking how much you drive your car.

[Damien Blenkinsopp]: Yeah, because I think there’s this whole – I mean, there’s scientific relevance in terms of how you’re tracking, is it controlled and things. And I found, because I led the Bangkok QS session, most – like the questions that come out, it’s about the quality of the data, if we can trust it. You know, these kinds of things come up. And if you’re doing an experiment, is it well controlled? Can we believe in the results? These kinds of questions often come up, and it helps us to – and, of course, this could apply to anything that you’re tracking. It’s obviously a lot of the time it’s the same kinds of questions. Okay, how useful is this data?

And also, I found that people often share their own experiences from that kind of aspect of their life, and they get new ideas. So one time we had one of my friends, he has a website called asianefficiency.com, and he tracks all of his time, all of his time he puts into categories, no matter what he’s doing. When he’s sleeping, it’s categorized as sleeping. And he’s done this experiment for, I think it was about a year.

So he brought all his data, which basically showed what he’d been doing with his life for about a year, and it was really interesting for a lot of people, because, like, oh, that’s interesting. How much time you spend preparing meals, or how much time you spend walking or commuting, and it can be quite shocking to some people when they start to think about, well, maybe I’m spending too much time commuting in my life and stuff.

So I found that a really interesting one, and obviously everyone had something to say about that. And for most of the show-and-tells, I would say, it is things that relate to anyone, and you’ll go and you’ll – and these are aspects of your life maybe you don’t look so closely at, but most of the time it’s something you can relate to and learn from yourself, also.

[Ernesto Ramirez]: Yeah, and, I mean, a lot of times, like what you’re describing here with this individual that tracks time, which is also a super, very, very popular topic. It’s really interesting to kind of see how people actually engage with their time tracking in different ways. Whether they just let their machines track their time for them, or they do it all themselves and set up really fancy Excel spreadsheets to do it.

What is interesting is that a lot of times when someone gets up and says, ‘I’m doing this thing,’ There are a lot of times that people will say, ‘You know what? I was interested in that, too,’ or, ‘I’ve always been thinking about it.’ Like you were saying, I was wondering how much time I spend commuting. This is someone who has actually done something, and now I can take this lesson. If I want to apply it to my own life, I can take their lessons that they are learning and try to do that in my own life, or reformat it into a different way that might work for me.

[Damien Blenkinsopp]: Right, right. Well, I can tell you, once I had seen my friend’s data, I was inspired to track my life for a few moments every hour, and I got a lot out of it as a consequence. So I think what we’re touching on here is QS helps motivate, inspire people. The fact that people can get together and talk about quantification.

So, for someone who perhaps – they’d like to do experiments on their life, they’d like to potentially improve upon their life which they have been having trouble with before, or maybe they are just interested in understanding something better, I think QS is a great place to go to, because they’ll be other people, and it kind of provides you this motivation, this support network following through, is that – whereas most people maybe find it harder to get started. And there’s a lot of people who know a lot about the devices, and there’s a lot of people generally in those groups who know a lot about the kinds of devices that are out there. And so it’s a great group, also, to swap ideas on things.

[Ernesto Ramirez]: Oh, yeah. I mean, the number of individuals around the world that engage with their own Quantified Self MeetUps, they organize them, or they come to our conferences, or they just engage with us on our forum on our website is astounding. And the amount of help that people get, people are asking questions all the time. ‘What device can I use to track this thing?’ Or ‘I’ve been thinking about doing this.’ ‘My physician said I should try tracking this to help me with this condition or that condition.’ It’s amazing. It’s always great to see. It’s one of the reasons we love doing this.

[Damien Blenkinsopp]: Yeah, absolutely. Another thing I wanted to really touch on is where have you seen the movement come from, and where is it today in terms of making progress? What have we learned so far about tracking data on ourselves from QS? What are the kinds of biggest achievements to date? Is there anything that you’ve changed about the way you’re going QS to help people get more out of it, get more out of tracking in general?

[Ernesto Ramirez]: Well, I think one of the things that we’re learning is that people definitely want to engage with their data, and that’s not always easy. And so one of the things that we’ve been doing and one of our core pieces of our current work and future work over the next few years is going to be really tackling this issue of data access. So if you use a device or an application that you’re contributing data to, so it’s tracking your physical activity or your location or doing something where you’re contributing pieces of information that are about you, and this happens a lot in the medical setting. You know, like that individual that has to wear a glucose meter. They are contributing their own personal data.

In many cases, getting that data out, controlling it, being able to access it – even in some cases having ownership of it is tricky, and it’s not a very clear, like, consensus across the board whether or not people should have ownership, whether they should have control, whether they should have access. All of these are like three different concepts that kind of always get talked about in each other or around each other.
And that’s one of things that we’re really focused on is improving the amount of access that people have from their data. Right now, we’re really early on, but it’s something that we’re really, really passionate about. Because one of the things that we’ve seen through a lot of these show-and-tells and through our conferences is that when people actually get access to their data, they can export their data, put it into a CSV spreadsheet, you know, use an API connection to plug it into a different tool, they can do astounding things with it. They can learn really, really important stuff, whether it’s just through a visualization or some kind of analytics tool. So that’s one of the things that we’re definitely seeing.

The other is, I think – just kind of piggybacking on that one – is the role of data visualization and storytelling in this. Visualizations don’t always have to be super scientific, and I think they can tell a really, really interesting story around people’s data. The issue is that it’s kind of hard to make them. You know, unless you’re really, really good at Excel or you’re a decent software developer that can handle JavaScript or Python, it’s hard to really make compelling visualizations that tell the stories that you want to tell or that can help you understand your data in that new and different way. So that’s something that we’re keeping an eye out for.

[Damien Blenkinsopp]: That’s interesting, because I think the first one you talked about, – access – it’s kind of like knocking its head with privacy. If we look at the world to date, information has been pretty private. If we look at medical information, for instance, it’s tucked in some doctor’s drawer, and even the patient doesn’t realize he can have access to that information a lot and even take it home.

So there’s kind of the health area, and I think also, like, financials and all of these different aspects of our lives. And it is an interesting topic, how much do we want other people to have access to it, how easy is it to get access to our own information. I think, obviously, the first one is it would be nice if everyone had ownership of their own information, to start with, and be able to decide what privacy limitations are on that, in an ideal future world. Are these some of the topics you’re struggling with and looking at?

[Ernesto Ramirez]: Definitely. So, across the board, we’re really interested. I mean, privacy, data access and data ownership, they’re all kind of like prongs in this really big conversation, which is what is the role of personal data in our lives? What should we be able to do with it? So all the way from – you see there’s a lot of work now in, like you were saying, the health records space. Like should you have access to the health records?

Like if you get a lab test at your physician’s office, should you have immediate access to that information? What does that mean? Actually, there’s some really interesting programs going on in the United States where if you go to see a physician, when you’re talking to them, you’re having a conversation, they’re writing on their laptop or their desktop computer, they’re writing notes in your file. Should you be able to read those notes? For a long time, those were just kind of in your medical record and you never got to see them unless you specifically asked for them, and then in some cases you have to pay for that access and lots of weird stuff. Now there’s projects opening those up, so people could have conversations about those notes, which are pieces of data about that interaction.

And then there’s a lot of information around data privacy, as well, so should a company – like say you are wearing a Fitbit. Should Fitbit be able to make aggregated charts and graphs about your physical activity to share with, kind of like, readers of their Fitbit blog? You know, maybe not your specific, but a group of people, and what does that mean? Is that going against data privacy or not? There’s a lot of unanswered questions.

And I don’t think there’s a lot of – there’s not going to be any definitive answer. I don’t think anyone’s going to just say, okay, we’re going to turn the key now and now everyone has complete ownership over their own data, and they have to authorize every single person in the room, whoever wants to look at something. Nothing so far has really shown that that’s going to occur, because data has some inherent value for a lot of these companies that you’re engaging with. But there are really interesting conversations around, like, what does mean and who actually should be able to work with this data, and how easy should it be for the individuals that create it to use it and have access to it so they can do whatever they’d like.

[Damien Blenkinsopp]: Yeah. These questions definitely need to be tackled. Like you said, it’s kind of up in the air. There’s a lot more self-testing in the health area being made available to us now. Increasingly over time, but of course, that’s kind of knocking heads with regulation, and physicians, how comfortable they feel with that based on the complexity of tests, if people can understand them and interpret them properly. There’s lots and lots of questions in the health area about that. I don’t think it’s going to get resolved any time soon.

But in the meantime, it seems like access to testing is steadily coming on line anyway, whether we’re ready for it or not from that perspective. So it will be interesting – I guess, like, QS is going to be tackling those issues. Because, I mean, what happens in QS is like whatever is going on tends to come up and be talked about in QS, since it’s basically the home of everything that’s being discussed in quantification in the moment, right?

[Ernesto Ramirez]: Yeah. You know, this is something interesting. Someone – we’re hosting another – what we call our global conference, the large conference in the United States, in June of next year.

[Damien Blenkinsopp]: Which city is that in?

[Ernesto Ramirez]: So, yeah, in 2015, we’re hosting the Quantified Self Global Conference, which we call QS15. It’s actually going to be a three-day conference. It’s a conference and expo. I can talk about it a little bit, if you want. We can talk about our overall program.

[Damien Blenkinsopp]: It’s in San Francisco, right?

[Ernesto Ramirez]: In San Francisco, correct.

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: So someone was talking about this idea of privacy and ownership, specifically around home testing. So, you know, in the United States we have the FDA, which has to approve medical tests. And there’s a big push from a lot of companies in the startup space saying, like, we can have people do medical testing at home. All the way from testing your blood for vitamin D levels to testing urinary fluid to see about – to track blood glucose and other different things.

And this big push, because people want to be able to do this stuff on their own, just in the same way that people wanted to measure their blood pressure at home a long time ago. They realized that just getting your blood pressure measured, you know, twice a year in the doctor’s office doesn’t really give you a good look at what blood pressure is for you. The same way, you know, that getting your blood tested once a year or once every few years if there’s only an issue, doesn’t really tell you the whole story.

And so there’s like a big push right now, and we’re closely following it, because, obviously, that’s a whole new area, a way for people to learn about their lives, being able to actually gather data that heretofore has been just kind of siloed in the medical establishment, and bringing that to the individuals.

[Damien Blenkinsopp]: But if we open that – I mean, there’s a huge potential in terms of – a big problem doctors have today is compliance with whatever protocol or treatment they’ve applied to people. But, you know, a feedback system. Feedback is incredibly valuable. If you tell someone that – well, look at glucose management, right?

So if you tell them that currently their fasting glucose in the morning is 100, and it really needs to be down in the low 90s, and they have some convenient way of doing that at home, say it’s uploaded to a system that’s shared with the doctor, if they are given that reading in their face every morning, they’re like, uh-oh, I’m not making progress here, and I’ve got my doctor’s appointment coming up next month. I think there’s incredible accountability and motivation aspect from that perspective to be, like, okay, I’ve got to get back on this treatment protocol that my doctor gave me last visit.

[Ernesto Ramirez]: Exactly. You know, there is that – there is the motivational aspect. There’s – I mean, the individual’s ability to learn about themselves, but there’s also the ability to understand – you know, if you really take the medical example as the leading example here – understanding treatment and outcomes at a very personal level.

So rather than a doctor saying, hey, go use this thing – use this blood pressure medication for 6 weeks, and then come back to me, and then we’ll measure your blood pressure again and we’ll see how it’s working. Rather than waiting that entire time, you can maybe get a faster feedback system so you can say, ‘This one is really working for me. I’ve already seen my blood pressure go down. I’ve been taking it once in the morning, once in the evening, by myself, in my home, using the protocol that you set up.’ Or, ‘This one is definitely not working. We need to use a different kind of medication.’ So rather than just saying, here’s what works, now we can start to ask what actually works for me as an individual.

[Damien Blenkinsopp]: Yeah, absolutely. There’s many, many devices, as you’ve eluded to. There are startups – there’s a lot of investment in this area right now in terms of startups, where it comes to health testing, fitness tracking, all sorts of aspects of this. And social media kind of like sharing of data and these kinds of things, and aggregating data. So in terms of the state of devices available today, are there any challenges faced with people using these and getting a value from these? Because I’ve bought many tracking devices, and I have to say, so far, I think the main complaint is people don’t find that a lot of data is very actionable when it comes down to it.

And I think sometimes it comes down to – there’s the other concern of accuracy. Many of the devices, it’s kind of nascent. If you look at, for instance, a lot of the watches, the fitness trackers and all of these kinds of things which are tracking, in a very convenient way, because you’re just wearing this piece of technology which is going to quantify different aspects of your movement and things going on each day. But when – like some of the studies I’ve seen where people have compared these devices with each other, well, they don’t really measure up to each other, right? They got different results. So there’s a concern of accuracy there which has come up.

So I think that leads into the actionability, also, of what we are doing. And also like the selection of measures and what the device companies are doing. So I’m just interested in your perspective on what’s going on out there, and what the biggest challenges are to reinforce that movement. If we are going to see an explosion of devices over the next years because they did become so valuable to our lives, what would need to change?

[Ernesto Ramirez]: Yeah. I think regardless of whether we want it or not, we are going to see an explosion of devices.

[Damien Blenkinsopp]: The investment’s there.

[Ernesto Ramirez]: Yeah. There’s a lot of – yeah, there’s a lot of money there that people are kind of pouring into the system. Sensors are becoming cheaper. Battery life is improving. The technical capacity of computing to track things and make sense of objects and behaviors and information is improving. I mean, that’s just kind of the state of technology as a whole. It’s just kind of on this upwards trend, and it’s always improving. Data science is getting better. Algorithms are getting better.

I think one of the issues around this kind of accuracy idea is in some cases the over-promising of what a device can do and what it can understand, and individuals – what they really, actually need. So I always like to have the more philosophical conversation around, like, accuracy versus truth and that that actually means for an individual. Does your Fitbit or Jawbone UP need to know down to the exact number of steps? Like, does it matter if it says 10,412 versus 10,512?

[Damien Blenkinsopp]: And also this is a relative thing. If it’s wrong the same amount every day, well, you can still use it for motivation, like a lot of things.

[Ernesto Ramirez]: Yeah. I mean, if you have systematic error, random error, it really matters. But in most cases, a lot of this stuff is just kind of systematic bias. It’s always going to be wrong at this certain level. But if your scale is always wrong 5 pounds heavy in the morning, it doesn’t really matter, as long as you use the same scale.

But in some cases – a lot of the issue, though, around this accuracy is tied to the medical system. Because a lot of people want to push the data that they’re collecting into some sort of health record, or have it coordinated with their care so that people can understand this data in relation to their health outcomes.

And so now there’s a bigger push to take the data from these devices, figure out if they are accurate, and then put them in kind of a clinical model so they can be looked at in the health records. And I think that’s something that is coming quickly. We are already seeing that happen with – Apple made a big push for this with Health Kit. So they took devices, and they took data formats, and they said, okay, these are the exact formats that we can use, and now they’re being pushed into electronic medical records, I think at, like, Duke Hospital and a few other different hospital systems.

[Damien Blenkinsopp]: Wow, wow. So could you just talk a little about that? Basically Apple has done some work to standardize a number of measures that they’re going to be –

[Ernesto Ramirez]: Yeah. Rather than saying, like, we trust you as a device maker. So let’s say there’s like seven different digital scales that are out there. Rather than saying, ‘These are the four that we think are accurate,’ they are saying, ‘If you want to integrate with our Health Kit system, you have to report this data format, this data feature.’ Which is weight in a specific way that we know is clinically understandable.

So if you’re going to say what blood glucose is, it has to be in – I think it’s in millimoles. You have to report it in the specific data format so that it can be understandable at a clinical level. The accuracy part is kind of left up to the people that take in that data, because one of the things – this is kind of a more technical conversation how Health Kit works, but basically someone who says –

Say a doctor says they want to look at my Health Kit data, and they want to look at the amount of miles I run each week, and if I connect, like, three different running apps, they can say, well, I trust RunKeeper, but not Strava. So I only will take runs that are reported with RunKeeper, for whatever reason. That’s a completely arbitrary example. Both I think are fine apps.

So that is something that is definitely coming on board, which is – it kind of relates to our conversation earlier, which is this kind of personalized medical testing, is that there’s a lot of push to get the entire breadth of someone’s life, their behaviors that they do outside of a clinical or medical setting, and bring that understanding into the medical field, so that people can create better care plans. They can understand cause and effect at a better level.

And it’s still very nascent. You know, this is still very early on. But there’s entire work on this which is people who are wanting to say let’s track from your genome to your weight to your diet to your physical activity. If we could bring all of that in, what is it that we can actually learn about humanity and how life actually works out there in reality.

[Damien Blenkinsopp]: Yeah. It sounds like the device manufacturers, the technology companies like Apple and – like Intel has been making acquisitions in this area. They’ve acquired Basis. So, you know, a lot of these companies are now looking at this area. It sounds like they’re going to be a tremendous force in where this goes, and even when it comes to the governmental typically regulated parts, like health and so on. They’re going to be a tremendous force in where this eventually goes in influence. Is that what you’re seeing at the moment? There seems to be more and more influences that are trying to push the realm out, basically.

[Ernesto Ramirez]: I think so. I think there’s a lot – it’s still a little early on to say, like, these are going – they are going to start maybe lobbying the government to do different things. But what we are seeing is that there is actually a lot of pressure within governmental organizations and governmental bodies to understand – everyone calls this stuff different things. We have mHealth, we have ConnectedHealth, and we have Quantified Self. All of them kind of relate to each other. And there’s a lot of push right now to say, like, this is happening.

We can’t just say, like, that this stuff isn’t around. What can we actually do to make sense of this? So one of the things that we actually did as an organization, in collaboration with a large funder – health research funder here in the United States, called the Robert Wood Johnson Foundation, we hosted a meeting last year – I’m sorry, earlier this year, actually, early 2014, where we brought together people in the Quantified Self that are what we call toolmakers, you know, the people that make devices and applications and systems, along with researchers in public health and computer science, to say – to understand what is the role of this personal data in research?

Because now, rather than a researcher saying, ‘I have to develop an entirely new strategy, and I have to buy a bunch of sensors to give to people so I can understand how much activity they get during the week versus the weekend,’ now those people, they’re just collecting that data on their own. What is the role of that information in the research realm? And what can we learn from that? And that’s still very, very, very early, but there’s a big push, I think, to say why should we pay a $1 million grant for you to develop new sensors or new tools or buy different things, when there are all these people actually out there doing it on their own? What can we learn from them?

[Damien Blenkinsopp]: Right. So previously, on episode 9 of the Quantified body, we spoke to Jessica Richman of uBiome, which you should know well. And she’s approaching this whole thing, calling it crowd science.

[Ernesto Ramirez]: Yeah.

[Damien Blenkinsopp]: Which is basically turning science upside down and using technology and putting the right standards in place and so on. We could completely revolutionize the approach through quantification, like, of the masses. Basically Quantified Self everywhere could start feeding science, the new ideas and so on, and completely revolutionize the way we approach all of that.

[Ernesto Ramirez]: Exactly. I mean, this idea of crowdsourced science or citizen science is super compelling. You know, at this meeting, we were talking with an individual named Margaret McKenna who is on the data science team at RunKeeper. And we were talking just about –

So in the United States, I think in 2008, they published kind of what they called a physical activity guideline, which says adults have to get 150 minutes of moderate to vigorous physical activity a week. But she was talking about when they look at their data, that’s just not true. People just don’t do that. They’re not robots. They don’t, like, every week get exactly this amount. It kind of goes in waves. People come and go. And she was talking – is there something we could do as an organization? Like, we are a large data collector – we have millions and millions of users that are tracking activity – to better understand what guidelines should actually be?

Or if you look at – say, for instance, in part of my world, I did physical activity research, so that’s where all my examples come from, I apologize. But in the United States we have what’s called the National Health and Nutrition Examination Survey. So every few years, they go out and try to measure the health of America. And they do it through clinical work, through surveys, and they also – to measure physical activity, they give a few thousand people accelerometers. That’s how we say, okay, people aren’t or are getting enough physical activity.

And that – if you were to say that’s how we measure physical activity in the United States, that data set is just completely dwarfed by the amount of data that companies like Garmin and Nike and Fitbit and Jawbone have. If – just in the United States. But then if you think about the worldwide scale, we’re now – they’re able to track millions of people. And if we could use that to understand interesting things about human behavior, it really opens up a whole new world of possibilities in the research realm.

[Damien Blenkinsopp]: Yeah. It would change completely our approach, I know, from a business decision making prospect of Internet marketing, for instance. With previous partners, I always used to have discussions, and it was opinion based. And even when I was working in consulting, we’d have opinion based discussions, and whoever argue the best would win. In this new world, the idea is that we’re actually able and go test, and that’s what’s nice about the Internet today.

People in business, instead of arguing backwards and forwards and the person who argues the most in business, now they’re saying, well, ‘let’s test that idea and see what happens’. Right? I think that’s what’s really exciting, especially with people who follow kind of the health realm, there’s been many assumptions made and killed over time. And there’s still a ton of conflict in the world of medicine and health, for sure, if not more and more so as things – as different people discover new things and so on.

I don’t think that’s going to disappear any time soon, because it’s kind of like cutting-edge, leading-edge science. But if we had this kind of feedback mechanism where we could actually do tests and see – let’s just put it to a test. Let’s see what the population tells us about that hypothesis. It would revolutionize the speed of development of things.

[Ernesto Ramirez]: Or imagine, like one of the things that we’re doing. Like what if you put the question asking in the hands of the actual individuals? So in Jessica’s case, she’s looking at microbiome data. So rather than saying, okay, what are the research questions that are in the field, that’s in the literature, what if individuals came up with those questions? What if they – what if someone said, ‘You know what, I really like my pets. I wonder if being around my dog changes my microbiome, my amount of bacteria that I’m in contact with?’ That’s probably a really interesting question. Has it been asked in the literature? Who knows? I mean, someone probably knows; not me.

[Damien Blenkinsopp]: Exactly. So it brings to surface things people actually care about instead of us assuming this is what matters to humans. What matters to everyone that we kind of resolve and put science towards. So in terms of Quantified Self, coming back to more practical, what would you say are the best tips if someone wants to quantify something about themselves? What would you say are best practice kinds of tips that you think it’s good to follow in terms of gathering or using the data or whatever you’ve seen over time?

[Ernesto Ramirez]: I think simplicity is always best. So one of the things that people – like they always – okay, well ‘I want to know about X, Y and Z about my life’. And then you start building the mechanism, how can I keep track of this data that I care about? And that can get really unwieldy really quickly. Because there’s so many different ways to do it, and we may want to get very, very super specific.

I think the easiest thing to do is whenever you find the question that you’re interested in, in other orders, ‘I’m curious about,’ or ‘I wonder if this is related to that,’ try to develop the easiest way that you can collect that information and engage with it, and then build a system around that. Whether that’s going and buying a fitness tracker or an Internet-connected weight scale, or setting up, you know, Google spreadsheets. I think one of the most underrated quantified self-tracking systems is Google Forms. It’s super easy to do. You can put it on your phone, and you can just have yourself answer surveys whenever you want.

[Damien Blenkinsopp]: Right, right. Just answer those two questions every morning. You can have an alert on your IPhone as well that says answer your form.

[Ernesto Ramirez]: Exactly, exactly. Say you wanted to know about your sleep. You could just say, every morning, just click open that little Google Form that says, how did you sleep; how long did you sleep; what did you do the night before? Simple things like that. But the other thing is, you know, it does seem a little self-promotional, but on the Quantified Self website, we have a link to the show-and-tell videos, and there are hundreds of them.

We have over 700 videos in our video archive on Vimeo. But you can search the website, and probably find something that’s related to what you’re interested in. So if you’re interested in blood glucose, you can type that in, and you’re going to get returned a bunch of different posts and videos and real people talking about their real experiences tracking that thing.

[Damien Blenkinsopp]: Exactly, and what obstacles they came across and resolved, or so on, so you can get a head start, rather than starting from zero and maybe falling into the same traps. Yep, excellent point. So, Ernesto, what do you see – what’s the future of QS? You spoke a little bit about what you guys are focusing on right now, but are the specific things you’re looking at the moment, and any kind of challenges you’ve kind of got your eye on as well of the movement?

[Ernesto Ramirez]: One of the things that we’re doing is we’re trying to open up and really bring this idea of Quantified Self to the public and really showcase that these tools and technologies are going to start coming hard and fast, and whatever kind of questions you have, you’re going to be able to engage with those questions.

And so one of the things that we’re doing alongside of our global conference is having this public expo. So we have this really amazing venue in San Francisco, right on the water at Fort Mason, where we’re inviting people just to come and experience all of the different kinds of tools and tracking systems, to understand what’s actually available out there. What are the cool things that you can do? What are the questions that you can ask? How can you engage with your own personal data through a way of engaging with your own life?

So that’s one of our – I think one of the things we’re really interested in, and one of our fun challenges for next year. Part of it is also that data access piece, something we’re very interested in. Trying to engage the research community with the quantified self-community as a whole.

[Damien Blenkinsopp]: Great, great. Thank you very much for that. Who besides QS or perhaps specific resources, what would you recommend people look at in order to learn more about quantifying themselves? Like are there any specific resources, people, or things that people could look at to learn how to do this better and so on?

[Ernesto Ramirez]: Obviously, again, self-promotional here, I’ll start with the Quantified Self website, which is just QuantifiedSelf.com.

[Damien Blenkinsopp]: Right. And to join – I mean, what’s the best approach to get involved? Let’s talk straight about it. To get involved in QS, what’s the best – I know how I do it. But let’s hear how you would go and get – how would you – what’s your first step to get involved in QS?

[Ernesto Ramirez]: So on the website, we have – there’s a sidebar. There’s a list of all of the different MeetUps that are Quantified Self MeetUps around the world. So one of the first things you can do is -I mean, obviously in person is going to be a lot more fun than just watching videos at home on your computer. So trying to find a MeetUp that’s close to you is step number one. So whether you’re in Los Angeles or New York or Boston or St. Louis or – like yourself, or in Australia, gosh, I’m trying to name all of them, now. London.

[Damien Blenkinsopp]: They’re all over the world.

[Ernesto Ramirez]: They’re all over. Singapore. You can find a MeetUp close to you. If, though, however, you can’t find a MeetUp, we invite you to just start your own and then publicize it within your own local community to meet other people like you. That’s one of – I think the most interesting and fun parts of this, is it is a community. It’s a social aspect. We hear all the time when people come to the conferences or come to the meet ups, like, I didn’t realize there were other people that are interested in the same things I was interested in. I didn’t realize there were other dorks or geeks that were tracking their lives in Excel.

[Damien Blenkinsopp]: Right.

[Ernesto Ramirez]: Or using wireless scales and really trying to understand themselves through the lens of personal data.

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: We have a how to start your own MeetUp blog post or page on the website where it details everything, but also you can get a hold of me. My contact information is up on the website as well.

[Damien Blenkinsopp]: That’s great. And just for people – I was living in Bangkok at the time where they didn’t have a QS, but I did travel a bit. I go to London, come to the U.S. sometimes, and I would just drop in. Like, whenever I’m in a city, I’ll see if there’s a QS there. So if you travel a bit, you know, you can always check out, oh, do they have any local QS’s? And you can either do that on meetup.com, or you can go straight to the Quantified Self and, as you said, you have everything listed there. I think the thing we didn’t say is all of the meets for Quantified Self are managed through meetup.com, so they’re all listed in there. Is that correct?

[Ernesto Ramirez]: That’s correct. So all of them are on meetup.com. So you can always search Quantified Self on MeetUp to find something near you.

[Damien Blenkinsopp]: Yeah, and you can just RSVP, I’m going to go and join. So, I found that helpful, personally, to see what it was like. I was in some of the early meetings for London and stuff, and then because there was nothing in Bangkok, like you said, I was just, like, okay, I’ll just create my own one. And it was surprising to see that even in Bangkok, Thailand, where you don’t exactly think there’s going to be a lot of people interested in kind of something that’s a bit more cutting edge from Silicon Valley, yeah, there’s was a whole bunch of people who joined just naturally for the meet. It’s very easy to get started, even if there isn’t one in your own town.

[Ernesto Ramirez]: Exactly. And, you know, one of the other things, obviously, you can come to one of our two conferences. We put on two a year. I was mentioning our global conference, we call it QS15. It will be in June in San Francisco. And we’re currently planning our fourth European Conference in Amsterdam in September of 2015.

[Damien Blenkinsopp]: Yeah, and that’s a great intro, because there’s such a variety of different people and things going on there. A great place to network and meet people that might be interested in similar things to you. I’m sure there are many businesses being grown out of QS, in fact, just for that kind of networking aspect.

[Ernesto Ramirez]: Too many to even name. I mean, it seems like there’s one a day. And that’s great, because the more ways people can engage with their own personal data – like we were saying, answer the questions that they find interesting and important, the better for them.

[Damien Blenkinsopp]: Yep. Are there any other resources you’ve found useful in terms of whatever, like, learning how to gather data better, or, you know, track it better, or make better decisions from it, or whatever?

[Ernesto Ramirez]: So one of the things that – I, because it’s part of my job as program director for Quantified Self, is just kind of staying abreast of different news and information. So if you’re on Twitter, the Quantified Self hashtag, which is just all one word, QuantifiedSelf, is pretty great. You know, there’s a mix of people, like news articles, people doing interesting things, but also people talking about their own data and different visualizations or projects or experiments they’ve done.

Our QS forum is great. People are always posting stuff on there, which is just forum.quantifiedself.com.

Then, gosh, I just feel self-promotional, just trying to promote all we do –

[Damien Blenkinsopp]: You can’t think of anything besides QS? Well, I guess you guys are trying to pull in anything that’s good, right?

[Ernesto Ramirez]: Yeah. So every Saturday I post on our website, and it also goes out as a newsletter called ‘What We’re Reading,’ and it’s just links to both self-tracking projects, interesting data visualizations, but also just kind of like articles around the culture of data and quantified self and what that means, people who are doing interesting stuff. But it’s also just some tech news in general.

I think the last time – this last week, I posted a random article about researchers who were able to trick computers into thinking – different images were not what they seemed. It was really interesting, about algorithms and robotics.

[Damien Blenkinsopp]: We’ll put links to all that stuff in the show notes.

[Ernesto Ramirez]: Yeah.

[Damien Blenkinsopp]: So, Ernesto, what would be your number one recommendation to someone trying to use some form of data to make better decisions about their body’s health…performance?

[Ernesto Ramirez]: Oh, my number one recommendation. That is – I said it earlier, which is, you know, start small and kind of look at the easiest possible way to do it. So try not to overload yourself with devices or systems or tools or applications.

And the second part is, I think, talk to someone else about your data. Whether that’s someone online that you know or don’t know, you know, sharing your data visualization, having a conversation. Because what happens, I think, a lot of times is when individuals sit with their own question and they engage with their own data, you already have some sort of bias. Like, you’re already looking for some kind of interesting pattern in a specific way.

And someone else who doesn’t have your own personal experience, I mean, they’re obviously not you, is going to bring a new set of eyes and a new set of experiences, and having those conversations with people, I think, can be really, really interesting. A lot of those show-and-tells that happen in person, a question will be, have you ever thought about looking at your data in this other way? And a speaker or presenter will say, ‘Oh, I really haven’t. That’s an interesting thing to do. I’ve never thought about that.’ So I think talking to someone about it, about what you’ve learned or what you’re doing, is always a great way to actually learn more.

[Damien Blenkinsopp]: Great, great. And to your first point, you were saying keep it simple, because – because basically, I know some people take on these projects, they’re too complex, and they get tired of them, because it takes too much effort every day, so convenience – how conveniently can you track this, how little effort does it take, are important considerations when you’re saying, ‘Oh, I’ve got to track this data for a month or two to get what I want out of it.’ So not trying to go overboard, I think, some projects could be dropped.

Have you seen that kind of thing? Like where people start out a bit over ambitious in terms of how much they want to collect and how much time they’re spending on it, and kind of drop the project halfway through and don’t get the value or whatever they wanted out of it.

[Ernesto Ramirez]: Of course, yeah, it happens all the time.

[Damien Blenkinsopp]: Yep, yeah. In all aspects of life. Final question. A bit more about you. What data metrics do you track for your own body on a routine basis?

[Ernesto Ramirez]: Yeah, so I’ve been tracking with a Fitbit since 2011. I had – you know, I had a space in there where I lost it, so I had – I used data from my phone to kind of back up. I used – I’m a fan of redundant systems.

[Damien Blenkinsopp]: Yeah.

[Ernesto Ramirez]: So I have – my phone is tracking my physical activity, and so is my Fitbit. I track my running both with a GPS watch and a heart rate monitor and my phone as well. I also – I’m a really big fan of geolocation, because I think it tells a really interesting story about how you move around the world. So I track my geolocation. I’ve been doing my weight – not every morning, but I try and be pretty consistent, as well with that. And then my overall productivity and computer use. I use some time tracking software to do that, as well.

[Damien Blenkinsopp]: Great. And what has been the biggest insight from all of this kind of stuff that you’ve drawn to date, that you’ve found personally most useful? It could be anything. Just that you found it personally useful for your life?

[Ernesto Ramirez]: Oh, so, even, like, as a physical activity researcher, I found it really useful to have something that tracks my physical activity, because it really kind of hit home for me that you really have to make it a priority. At least for my own. I really had to make it a priority to move. Whether that’s making sure that I go on walks, I get up from my desk, that I go on a run every so often. If I don’t – because a lot of times I’m working either from home or from another small office – that I’ll just kind of get in the zone and zone out, and it will be a few hours later, and I haven’t done anything. So really, for me, it’s really about how much of the things you kind of take for granted. Just, like, normal everyday activity, you really have to be thoughtful of.

[Damien Blenkinsopp]: Great, and tracking it has helped do that for you, obviously, by bringing it –

[Ernesto Ramirez]: Yeah, enormously. I mean, just looking at it on a day-to-day basis. But every now and then, I go back and look at aggregate information. I’ve played around with making calendar heatmaps to look at kind of my years versus each other. And it’s pretty striking to see, like, how life changes, like walking to an office versus working from home really affects overall activity.

[Damien Blenkinsopp]: Right, yeah, that’s interesting. So it’s the things we don’t really think about which could influence physical activity, for example, and it’s just some kind of life change. That’s very interesting.

[Ernesto Ramirez]: Yeah.

[Damien Blenkinsopp]: Ernesto, thank you so much for joining us today, and to introduce us to the Quantified Self. It’s been great. Like I said, we’ll put all the links to you guys and everything in the show notes, so people can find you easily and get started, hopefully, in their local towns and so on.

[Ernesto Ramirez]: This has been fun. I really appreciate it.


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A walk-through of a practical framework designed to achieve what most of us believe is impossible – completely eliminate aging. Learn about the 7 ways we age, and how scientists are trying to design tools to repair each one of them.

Today is our first episode on aging. Longevity is a subject close to my heart, and I’ve been following the career of this episode’s guest for many years.

Dr. Aubrey de Grey is a visionary and general strategist in the field of longevity and anti-aging. He applies the concepts of planning, investment, and risk management to the science of aging so that we get there as soon as possible, within our lifetimes. The basis of his plan is the seven “Strategies for Engineered Negligible Senescence” that offer a practical route to longer life.

“[The] seven major categories… was really the big breakthrough that allowed me to see that the repair of damage was not only the most promising approach to combating aging with medicine, it was actually a feasible approach that could realistically be implemented within a matter of decades.”
– Dr. Aubrey de Grey, PhD

Dr. de Grey may be the greatest activist for longevity of our time. He’s the Chief Science Officer for the SENS Research Foundation, a not-for-profit organization funding research into longevity around the world. He’s authored two books; Ending Aging: The Rejuvenation Breakthroughs that Could Reverse Human Aging in our Lifetime in 2008 and The Mitochondrial Free-Radical Theory of Aging, for which he received his PhD in 1999.

In today’s interview we examine popular longevity strategies such as caloric restriction and telomerase therapies, as well as those covered by his own research. His viewpoints on these topics contrast greatly to those you may see in the press, and offer important insights into whether we should make use of these existing strategies.

The show notes, biomarkers, and links to the apps, devices and labs and everything else mentioned are below. Enjoy the show and let me know what you think in the comments!

itunes quantified body

Show Notes

  • Aging as a medical problem versus “Aging as a disease” (3:55).
  • The relationship of aging to illness (4:35).
  • The difference between “diseases of old age” and general illness (6:51).
  • The relationship between aging and cellular damage (7:51).
  • How the “seven categories of aging damage” make the longevity problem solvable (9:28).
  • The roadmap to the end of aging (“Bridging”) (12 :12).
  • The roadmap to the end of aging (“Longevity escape velocity”) (14:16).
  • Are we waiting for expansions in biotechnology to achieve better longevity? (15:00).
  • Dr. de Grey’s and SENS’ research resources (16:13).
  • Mitochondrial damage as it relates to aging (17:48).
  • Changes in mitochondrial theory since Dr. de Grey’s first book (19:22).
  • The uncertainty as to whether mitochondrial disease affects aging (20:35).
  • The indirect route by which mitochondria may affect health (21:24).
  • Mitochondrial damage and the “metabolic theory of cancer” (24:09).
  • How current trends, such as calorie restriction, fit into the SENS theory (26:51).
  • Intermittent fasting versus long term calorie restriction (30:21).
  • How telomeres and telomerase affect aging (31:20).
  • The balance between telomerase and cancer (32:58).
  • Do telomeres really effect cell function and aging? (36:04).
  • The difficulty in finding biomarkers valuable for tracking physiological age (36:54).
  • The difference between useful biomarkers and transitory blood metabolites (40:02).
  • What can be done, today, to increase longevity? (41:13).
  • Managing longevity by managing an individual’s health risk factors (43:23).
  • More about the SENS Research Foundation and the Methuselah Foundation (45:45).
  • What biomarkers does Dr. de Grey, personally, track? (50:28).
  • The Palo Alto Longevity Competition (53:13).

Thank Dr. Aubrey de Grey on Twitter for this interview.
Click Here to let him know you enjoyed the show or what you’ve learned from it.

Dr. Aubrey de Grey, PhD & S.E.N.S.

Aubrey de Grey

S.E.N.S. Research Foundation

  • SENS Research Foundation: Foundation for the research of “Strategies for Engineered Negligible Senescence” (SENS) founded by Dr. de Grey as an offshoot of The Methuselah Foundation.
  • SENS’ tax deductible donation page: SENS is a U.S. 501-C3 tax-exempt nonprofit organization, which can also accept tax deductible donations from citizens of the UK and most of mainland Europe. By donating, you’ll be in good company. Peter Thiel, the billionaire entrepreneur, VC and co-founder of paypal, donated $3.5 million to its activities.

The Tracking

Biomarkers & Frameworks

  • 7 Types of Aging Damage Framework: The framework Aubrey discussed in this episode which he has developed as the foundation of the plan to end aging.
  • Insulin: Probably the best indicator for overall metabolic function and health. Blood insulin levels begin to rise when muscle cells (primarily) become insulin resistant, meaning they are not taking up glucose properly. Insulin resistance is a precursor to diabetes.
  • Triglycerides: An indicator of general metabolic health. The seven types of aging damage are based on the inevitable damage arising from the metabolisms of life, and maintaining general health is a factor in keeping this damage in check.
  • Homocysteine: Dr. de Grey tracks his homocysteine levels only because it’s been slightly elevated in his personal history, and not because he feels it’s a general biomarker for aging. This is a great example of personalizing your biomarker monitoring plan.
  • Telomere length and Telomerase: While Dr. de Grey did not feel telomere length or telomerase levels were valuable as an indicator of aging, he did discuss their potential value for the function of high-turnover cells as well as the possible cancer risk associated with telomere extension.

Lab Tests, Devices and Apps

  • 23andMe genetic testing: Dr. de Grey discussed the value of understanding one’s personal health risks and predispositions via genetic testing.

Other People, Resources and Books

People

Organizations

  • Methuselah Foundation: The Methuselah Foundation was co-founded by Dave Gobel and Aubrey de Grey in 2003 to shed light on the processes of aging and finds ways to extend healthy life.
  • The Palo Alto Longevity Prize: The Palo Alto Longevity Prize is a $1 million life science competition dedicated to ending aging. Aubrey de Grey is on the board of advisors.
  • Moscow Institute of Physics and Technology: Doctor Aubrey de Grey is an Adjunct Professor at the Moscow Institute of Physics and Technology (MIPT). According to his onsite bio, “[MIPT], better known as ‘Phystech’, is one of the best educational and research institutions in Europe, attracting the most talented students from all over Russia in the field of physics and mathematics.”

Full Interview Transcript

Transcript - Click Here to Read

[Damien Blenkinsopp]: Aubrey, thank you very much for coming on the show.

[Aubrey de Grey]: My pleasure, thank you for having me.

[Damien Blenkinsopp]: So, aging is a disease. Obviously this isn’t what everyone thinks today, so why would you describe aging as a disease?

[Aubrey de Grey]: Well, it is actually because that is a controversial use of terminology I don’t tend to do that. I tend to try to sidestep the ambiguity of the terminology, first of all, and cut to the chase. So let’s say whether or not we choose to call aging a disease, what we can certainly say is that it is a medical problem. It is bad for you. It makes your body and your head work less well, and eventually it kills you. And that is what I call a medical problem.

[Damien Blenkinsopp]: Okay, fine. When you are looking at it from this perspective, are there things in previous interviews where I have seen. When we are young we can die and we can get injured from certain things. And when we age, when we are older in our 40s and 50s, we tend to get other health conditions which you could say are linked to aging. Are there certain conditions where you could say that if we didn’t age, we wouldn’t have to put up with these health or functionality restrictions?

[Aubrey de Grey]: Actually, yeah. And actually let me elaborate on that by referencing your first question about the age. I think the big problem with telemetry, with the use of the word ‘disease’ is not so much that we don’t call aging a disease. The problem is that we do call things like Alzheimer’s disease and cancer and atherosclerosis – we call them diseases. That is the mistake and the reason it is the mistake is because actually the difference between those things and the things that we rightly call diseases like infections is a much bigger difference, both in terms of the symptoms and the progression of the symptoms and the ways that we might be able to treat them. That is a much bigger difference than the difference between both of these, on the one hand. And the aspect with aging that we don’t call a disease – like declining function of the immune system or a loss of muscle or gaining of fat or whatever.

I think that if we are looking truly accurate and instructive, useful classification, if you like, of the various ways in which we can get sick then a much better one is to say that aging conflicts with everything that goes wrong with the body or the mind, predominantly for those people who were born a long time ago. And diseases are things that can affect young people just as much as older people.

[Damien Blenkinsopp]: Right, so the distinction – just to give some examples to the audience, would it be things like Alzheimer’s, Parkinson’s, even multiple sclerosis? I don’t think people tend to get that before the age of 30, for instance. Cardiovascular disease – would all of these kind of things be linked into that area?

[Aubrey de Grey]: Kind of, yeah. Certainly multiple sclerosis a bit of a gray area, whether you would really call it an aspect of aging – not just because it happens rather earlier than the other diseases you listed, but also because it certainly doesn’t happen to everybody. Whereas the diseases of old age, the commonest ones – whether it is cardiovascular disease, cancers, Alzheimer’s, these things tend to affect everybody at more or less the same age. Of course, some people die of one thing and some people die of another thing, but the only real reason for that is because of small differences in the rates at which different people accumulate the damage that results in these diseases. But most people who die of cancer die with Alzheimer’s in some level or other. Most people who die of atherosclerosis die with cancer. It is just that it hasn’t got so far along.

[Damien Blenkinsopp]: Right, so in your book The End of Aging, you describe the seven causes of aging. Would all of these be classified – would it be correct to call them some type of damage to the body?

[Aubrey de Grey]: I would call them damage, yes. In fact this is another kind of terminology question. I would say really that the best way to define the use of the word damage, in relation to aging, is that we would say that damage consists of exactly those changes to the structure and composition of the body at the molecular and cellular level that on the one hand arise as side effects of being alive in the first place, side effects of the stuff that the body does to keep us alive from one day to the next. On the other hand, they accumulate throughout life. They get progressively more and more abundant and eventually they get more abundant than the amount that the body is set up to tolerate, so that means they start to impair and eventually completely eliminate their physiological function.

[Damien Blenkinsopp]: Right, so there are clearly changes which take place because of aging, because of the processes that are going on as we are living.

[Aubrey de Grey]: I would say that they are aging, it is not so much by aging or they think they are aging, but the nature of aging is the changes in molecular and cellular structure.

[Damien Blenkinsopp]: Right. That is a nice way to put it because most of us think of aging as what we are looking at outside the body – the wrinkles and when you are looking at people you can see that aging. but in a respect we could say that the actual things you have defined and are changing within the body would be aging. so could you please outline what those are and which ones are the most important for you or if they are all the same? What is this kind of framework that you have and which ones are you most focused on currently?

[Aubrey de Grey]: The classification – there are seven major categories. It was really the big breakthrough that allowed me to see that the repair of damage was not only the most promising approach to combating aging with medicine, it was actually a feasible approach that could realistically be implemented within a matter of decades. If you have got 1,000 different things to deal with, then 1,000 different therapies are going to take a long time to develop. Well, if you can classify them into a much more manageable number of categories, such that within each category you are basically doing the same treatment for every example within the category and then the whole thing becomes much more feasible-looking, and that is exactly what I was able to do. So the categories are very simple things like having progressively-fewer cells in a particular organ or tissue because cells are dying and not being automatically replaced by the division of other cell. Or we accumulate molecular waste products in the cell because the cell is creating this waste product as a byproduct of something it needs to do. And the cell does not have any machinery either to break it down or to excrete it, so it accumulates.

Now, in each of these things we can look at and we can point to particular diseases and disabilities of old age that are predominantly caused by one or another of these things, so that is what we work on. And yes, we feel that all seven of these categories of damage are equally important. Certainly – well, there is one exception I guess, which is mitochondrial mutations where we can’t 100% certainly say it matters as much as the others. Actually, it might matter more than many of the others, we don’t know. But all the others we can say they matter pretty much equally as much because we can go into a particular nature, age, relation, or [pathology 00:11:42] and kill people at more or less the same age driven by that damage.

[Damien Blenkinsopp]: I see, so you are saying that pathology can be linked to each of these aging processes?

[Aubrey de Grey]: Yes, for example, molecular garbage inside the cell I just mentioned, that is definitely the reason we get heart disease, atherosclerosis – molecular garbage outside the cell is a major cause of heart disease in certain areas. Cell loss is the major cause of Parkinson’s disease, and so on.

[Damien Blenkinsopp]: Great. Thanks for that clarification. So you have outlined a roadmap to basically end aging and you have brought to light two concepts that I understand there are like bridges and there is something called longevity escape philosophy. Did you explain how these are eventually going to end aging or stop us from having to go through this process of aging?

[Aubrey de Grey]: Sure. So first of all, let me talk about bridges. That is actually not my terminology – that comes mainly from [Ray Kurzweil 00:12:40] who has often pointed out that there is a certain amount that we can do today to postpone the ill health of old age, and that is good. That is all very well. But there is actually more. Maybe we will be able, some of us anyway, to postpone the ill health of old age today with methods already available well enough to still be around in time for therapies that are not yet developed, because they haven’t yet been developed. If that can be done then of course we get an additional amount of life and we may be around for the next generation therapy, and so on.

And that concept – well, he normally talked about three major failures – what we can do today, what we might be able to do in the next couple of decades with our technology, and then what we might be able to do in decades after that using more of the non-biological solutions such as nanotechnology. And that is a fine way of putting it. Certainly the biotechnological approaches that he favored are pretty much identical to the ones I favor. And nanotechnology is certainly not an area in which I can claim much expertise, but I think he is more or less on the mark there, as well.

There are some where we part, actually, Ray and myself, as to how beneficial for most people what things are today, things that you can do already. And I think that [Bridge 1 00:12:40] as he calls it may not be much of a bridge, but by large the concept – we stand together on this concept. So the longevity escape philosophy, which you mentioned, is indeed from a phrase that I invented. And here I am not splitting the process of getting from here to indefinite longevity into that particular number of phases, like three – I am just saying that once we get a certain way along this process we are safe because we will be improving the quality and comprehensiveness of these therapies fast enough to stay one step ahead of the problem, essentially be repairing the damage that we couldn’t yet repair well enough that the overall abundance of damage will at no point reach a level that exceeds what the bod is set up to tolerate.

[Damien Blenkinsopp]: Right, and this relies on the concept that medical technology and biotechnology will be advancing exponentially?

[Aubrey de Grey]: Oh not at all and this is something which – and again I talk a lot with respect to I owe to information technology that we can see there is an accelerating track where progress is made at a faster rate as time goes on. In the case of longevity escape philosophy that may well happen, but the key point is it does not need to happen. In fact, if we are able to say 20 years from now or 30 years from now to reach this point where people are eventually not getting older, they are getting repaired as fast as they are aging, then it turns out that thereafter we can actually proceed at only that same pace and perhaps even slow down a little bit and will still be doing well enough simply because the rate at which the damage we cannot yet repair is accumulating will diminish as the types of damage that we can’t yet repair become fewer and fewer.

[Damien Blenkinsopp]: Great. Thank you for those clarifications. So what, for you, is the first and most important step? Right now are you really focusing – because you do funding of research and you kind of prioritize things – are you kind of prioritizing any of these steps in particular? Are you are trying to spread your investments so that you kind of manage the risk?

[Aubrey de Grey]: Very much the last, we are spreading. We have our fingers in all of these fires because we feel it is pretty stupid if we focused on some of them and then the other ones didn’t get done by us or by anybody else and people carry on dying on schedule even though most of the problems have been fixed. So we need to make sure, especially for the areas which are least fashionable, are being most severely neglected by other people, that it is vital for us to move forward. In fact, that is the only criteria that we use that really does determine what we choose to work on and not to work on. So the real manifestation of it is that we do very little work in stem cells. Stem cell work is very limited simply because so many other people are already working in that area. It is very burgeoning, very fashionable. So our work effort would be a bit of a drop in the ocean where we are the leading group working in many of the other areas.

[Damien Blenkinsopp]: Great, so basically you are choosing the least fashionable topics so that other things get pushed on it? And we actually do need to fix all of these problems. I mean, that is your assumption – in order to extend life and create longevity?

[Aubrey de Grey]: That’s right. I don’t think it is even an assumption, I think we know it.

[Damien Blenkinsopp]: Okay, great, great. So one of your other books looks specifically at mitochondrial mutations and the free radical theory of disease. Why did you specifically write a book about that topic?

[Aubrey de Grey]: Great question. So that was a long time ago. That book was published in 1999 and it is actually the only other book I have written. I have only written two books total. It was simply the first area that I got interested in when I decided I wanted to work on aging, whether it being to do something about it. Of course, I started out knowing nothing about that subject. In fact, I didn’t know all that much biology. I had been a computer scientist for my research career until that point. So I had a lot to learn. And obviously you learn some things before other things just by random chance. I ended up gravitating into the area of mitochondrial mutations as my main focus before I got interested in the other things.

So for the first few years of my career in gerontology in the late 90s, that was what I was working on and that was where I published my first half dozen papers or so. And my very first paper came to the attention of a publisher who did low print run academic books and said – anyway, what I wrote, so he said that he liked what I did and asked if I could go on writing a book, so I said all right, and that was the result. So the material in there covers pretty much my first three or four years or gerontology research. And it actually was also the [inaudible 00:19:08] idea was cemented to the University of Cambridge and I got the PHD for it.

[Damien Blenkinsopp]: Great. So would everything you wrote in there still be valid today or are there things you have discovered which you would change, some of that?

[Aubrey de Grey]: So the fantastic thing is that more or less everything is actually still true. There have been, of course, some minor discoveries that have changed things, but the broad sway of what I was writing there is certainly still true with one big exception. That big exception is exactly the exception that you like to have – namely, as time has gone on, new techniques, new ideas, and new discoveries have been made that essentially provide shortcuts – they have made the job of fixing this problem easier. And that is true also for the book that I wrote for ending aging, which is not nearly half as long ago as I wrote the mitochondrial and free radical theory book. So, they are pretty good, the lead idea of standing the test of time so well – the seven point plan that we work on is pretty much identical to what I was describing more than ten years ago or 12 years ago. So that is really circumstantial, but nevertheless quite strong evidence that we are on the right line, that there is more to this robustly standing the test of time.

[Damien Blenkinsopp]: Well congratulations because that is not an easy feat given how everything is changing so fast in biology and so on. So you have talked a bit about – one thing you mentioned earlier was except for when you are talking about the seven different areas and causes of aging, you said that mitochondrial damage may or may not be one of the most important ones. Why is there that area of uncertainty around mitochondria specifically?

[Aubrey de Grey]: Simply because there is no one major pathology we can point to where we can say clearly that there is a chain of events from this particular type of damage to that particular pathology. In the case of every other – the other six types of damage, we can point to a particular pathology and say that it is established. It is not even a hypothesis, it is actually known and absolutely agreed that the main driver of that pathology is a lifelong accumulation of that particular type of damage.

[Damien Blenkinsopp]: Great. So is that because we need to do more research to understand properly this mechanism in mitochondrial damage so we can say that we understand it less than the others?

[Aubrey de Grey]: I don’t think so, actually. I think the reason is the actual fact of the biology, rather than our understanding of the biology. I think it is possible that mitochondrial mutations simply don’t matter very much in aging, but it is more likely that they do matter but only by a very indirect route. And if it is indirect then it may be very placebic and it is something that affects pretty much all aspects of aging but in a subtle manner. So if you look at my book in 1999, you will see that there is some discussion of a rather elaborate mechanism – in fact, it is so elaborate that a lot of people just didn’t like it because it was too elaborate, which basically says that if mitochondrial mutations are accumulating even to relatively low levels, they may be able to be disproportionately toxic by essentially damaging molecules in the blood stream. And if they do that then those molecules can get into other cells and spread the damage around and kind of amplify it. This model is still very much a hypothesis and it has by no means been shown to be true, but it hasn’t been shown to be false either. And in fact bits of it, occasionally here and there, end up acquiring little bits of supporting data. There was a paper actually put out in [inaudible 00:22:54] just a few weeks ago, which was the first one to support one little technical detail of that hypothesis which previously had been completely controversial.

[Damien Blenkinsopp]: Great, great. It seems to me that mitochondria have become quite fashionable lately, just from my perspective. I don’t know if you would agree with that, when you are talking about the least fashionable versus the quite fashionable. There are a lot of supplements that tend to target more mitochondria and the word just tends to come up a lot more.

[Aubrey de Grey]: So yes, in a general sense mitochondria are very fashionable. Lots of people work on them. They have the major pre-eminent conferences on mitochondria that are bigger than ever, and so on. But the particular question of how we might be able to restore health to cells that have been taken over by mitochondrial mutation, that is obviously a very, very narrow area within mitochondriology and that is not fashionable at all. We don’t know, but we think it’s because people think it can’t be done. It’s a nature of science that people work on, things that they think they can succeed on and get published and promote and those things. And that means the hardest things often don’t get worked on at all.

[Damien Blenkinsopp]: Right, absolutely. So like Dr. Thomas Seyfried is well-known for his ideas around mitochondrial and metabolism and cancer. Do your ideas connect with his or are they different?

[Aubrey de Grey]: I don’t actually know that name. Tell me about this guy and his ideas.

[Damien Blenkinsopp]: With the metabolic theory of cancer?

[Aubrey de Grey]: Okay, there are various metabolic theories of cancer, but go on – tell me the ideas a little bit and I will tell you what I think of them.

[Damien Blenkinsopp]: Well, the idea is basically about free radical damage of the MT DNA and once that is damaged the mitochondria are not functioning so they are not giving sufficient energy to the cells. The idea is that from there the cells start behaving in a different manner, which includes cancer.

[Aubrey de Grey]: All right, so certainly stated that simplistically that theory is not correct. Variations of it –

[Damien Blenkinsopp]: I am sure I am not doing it justice at all.

[Aubrey de Grey]: Variations on that idea may have some validity. Certainly we see in aging that normal cells that are not cancerous at all accumulate mitochondrial mutations. Only a small minority of cells do that, but the ones that do get completely taken over by that mutation. In cancer we don’t see those same mutations. We do see some mutations sometimes and certainly one thing that we see much more ubiquitously is a depression of mitochondrial function even in the absence of any actual mutations. So the [inaudible 00:25:36] and we certainly have a number of theories out there that describe how cancer cells may obtain some kind of advantage then and protect themselves from the immune system, for example, by doing things like that or reducing their oxidative metabolism. So if that is the general theory that is being put forward, then yes, there is a certain amount of validity to it. But the thing that counts is that there are an awful lot of ways this can occur. There are an awful lot of ways that cancer health can discover to escape the normal controls that stop cells from dividing when they shouldn’t. So they have to do a bunch of things like breaking down the intracellular matrix, they have to ignore the signals that tell them not to divide, they have to ignore signals that tell them to die. They have to, as I say, resist the attack from the immune system. All of these things are really hard and any cancer that has reached a size where it has come to the notice of the clinician it has already jumped through a million hoops. So there are a lot of different ways to be that way.

[Damien Blenkinsopp]: Great, thank you. So today we have a lot of things in the press – there are a lot of products and there is a fair amount of research around topics which supposedly could help to give us longevity. Some of these are caloric restriction and linked to that fasting, autophagy, mitophagy and then we have the telomeres, telomerase and some others. For any of these things that are available today, and we can stop and look at them separately, I understand that you feel that none of them are actually targeting any of the seven areas, or any of the seven causes of disease sufficiently to actually extend our life. So could you talk a little bit about why you feel that is? Perhaps you want to tackle the biggest one, which is caloric restriction, for example?

[Aubrey de Grey]: Yes, by and large the simple approaches that we have today are not even hypothesized to actually repair damage the way that science is trying to do. So the best that could be said about these things, the proponents will say, is that they may slow down the subsequent accumulation of more damage. So that is still good. That means you are postponing the age at which the damage reaches an abundance that is insupportable, but of course the later you start the older you are when you start doing it. And then even if it works, the less benefit you are going to get because you have already accumulated all the damage at the original rates. So that is bad enough, but yeah. So you can say I am also very pessimistic about the ability of the approaches even to slow down the accumulation of damage by a meaningful amount. In very short-lived species calorie restriction is very effective. We can certainly increase the lifespan of a mouse from let’s say two-and-a-half years to three-and-a-half years using calorie restrictions, and that is pretty impressive. But if we go further down the evolutionary chain and we ask about small invertebrates like worms, for example, that normally live only a few weeks, it turns out that calorie restriction can do a great deal more. You can multiply the longevity of a worm by a factor of maybe three or four by calorie restriction.

The unfortunate thing is that this correlation, this inverse correlation between the natural span of the species and the extent to which that lifespan can be multiplied by calorie restriction works the other way as well. So 20 years ago people did a calorie restriction experiment on dogs and they only got a 10% increase in lifespan instead of the 40% that you might get in mice. And more recently we had a couple of experiments that on for more than 20 year looking at monkeys under calorie restriction. They finally reported and they got less than 10% – in fact, one of them was basically faster. So it is not looking too good. The worst of it is that this is what we should have expected because it actually was predicted by evolutionary theory – especially simply because long famines are not so frequent as short famines. We are unlikely to have the ability – to have evolved the ability – to respond to long famines in a manner that would increase our evolutionary fitness whereas short famines we experience frequently enough irrespective of how long the actual lifespan is that it makes sense to have that ability.

[Damien Blenkinsopp]: That’s great. And of course, currently the more fashionable topic around caloric restriction and fasting is intermittent fasting, which is typically anything between 18 and 24 hours for most people. Do you have a different view of that and the idea of this, which is activation of autophagy which can help to clear up some of the cellular garbage?

[Aubrey de Grey]: No, it is absolutely the same. The kinds of metabolic changes and expression changes that are induced are basically identical, and a good approximation – whether you have continuous calorie restriction or intermittent fasting or whether you use drugs that essentially trick the body into thinking it is on calorie restriction when it isn’t like [rapamycin 00:30:59] or whether you use genetic modifications in model organisms that trick the body in that way, by turning on the same pathway. It is no surprise. All of these things are turning on the same response, they are just turning it on in different ways. So of course you are going to get the same response.

[Damien Blenkinsopp]: Great, thank you very much. So the other big area – I guess you could tell me if you see this as the other big area because you do a lot of these interviews and you probably get the same kind of rejections. I think the other big area is telomeres and telomerase, which has become very fashionable now. And I understand that of course you think that isn’t an area that is going to help us?

[Aubrey de Grey]: Sure, so the telomere is a critical part of the cell and the organism and we definitely need to understand how it changes with aging and the extent to which those changes are good or bad. But we definitely cannot say at this point that the changes we see during aging are uniformly bad and therefore the thing to do would be to stop those changes from happening. The reason we can’t say that is because it seems that large animals, or large mammals and certainly humans, have made use of the telomere as a kind of way to get a tradeoff – get the best of both worlds between two important aspects of aging. One of them being the inability of the cell to – well, let me back up and say it a little differently.

One of them being the increasing inability of cells to divide and the other being the increasing tendency of cells to get into a state where they divide when we wish they didn’t. Most of our cells, let’s remember, do not divide – or if they do, they only divide fairly rarely, on demand. Like, for example, skin cells – the bottom layer of the skin that divide like crazy when you have a cut, to close the wound. It is only a small proportion of our cells, a few cell types, the stem cells of rapidly renewing tissues like blood which divide regularly. Those are the only cells that have a potential problem of telomere shortening.

Telomere shortening is something that happens when cells divide because of the nature of DNA replication and eventually when cells have divided enough they end up getting telomeres that are so short that bad things happen in the cell. I won’t take the time to go into what bad things, but the cell basically gets unhappy.

So cells that divide rapidly need to compensate for this and they have an enzyme called telomerase which does so. They certainly don’t need that capacity because they don’t divide often enough. They just don’t make the same amount of telomerase. Now, most people believe that the reason why they don’t make it is so that if they mutate, or become cancerous, then the cancer will not be able to grow large enough to kill us because that will require enough cell division that the telomeres will get short and bad things will happen to the cancer cells and the cancer will just wither away. So the question is if we want to do better than what evolution has done, how do we address this tradeoff?

One way might be to make most of our cells create more telomerase, more of this enzyme. That would allow cells in the blood, for example, to divide more than they currently do. And that would be interesting because it might make the blood continue to work better and the gut continue to work better, and so on, but it would run the risk of exacerbating cancer. The alternative is to go the exact opposite direction to bear down on to telomerase and make it less of it. That might be a really good way to suppress cancer but it might exacerbate the more degenerative aspects in that it makes our blood age faster, for example. We simply don’t know which of these factors is going to better because really it is not just which of those things you do, it is also how you cope with the side effects that you are creating. You are going to make one or other sides of the equation worse, you have got to find some secondary therapy to alleviate that and we of course don’t know yet.

So a number of people are working on the telomerase stimulation side of the equation, going to rescue the aging of dividing cells by giving more telomerase and then trying to find some other way to deal with any cancer problems that might arise. And we are going the other way and saying we are still with cancer by suppressing telomerase and left the other cells to deal with the cell division problems that might arise.

[Damien Blenkinsopp]: Right. And that seems to be because cancer is one of the most sure things which is actually going to kill us versus the other side of the equation, which you are saying is more of a functional impact rather than a kind of end of life kind of impact?

[Aubrey de Grey]: Well, I wouldn’t quite put it like that. I mean, there is still the big question of the extent to which telomere shortening really contributes to the pathologies of old age, so definitely telomeres get shorter in the blood in older people, but nobody has really been able to show they get so short they cause loss of function. So we actually may not need to worry about that in a currently normal lifetime But for sure, if we were to suppress telomerate in the manner that I have been talking as an anti cancer therapy, then we would create a problem even if the problem doesn’t already exist.

[Damien Blenkinsopp]: Right – when we are dealing with really complex problems it has been shown that can often be the case for therapies. So a key thing we talk about in this podcast is any aspects of quantification and with respect to longevity I am wondering if there is anything that you feel that is worth monitoring to track how we are aging? Now, currently it is fashionable with telomeres to measure the telomeres and they have indexes which say your telomeres versus someone else your age are above average or below average in terms of how many you have left, basically. Are there any biomarkers that you feel can validly track the progress of aging and perhaps how it varies between different people based on their lifestyles, their genetics, or any other factors that might be affecting the rate at which they age?

[Aubrey de Grey]: That is a really tough question. They don’t actually age, the Natural Institute of Health paid a huge amount of money several years ago, many years ago now, into a long-term study trying to identify biomarkers of aging that were really reliable and it was basically completely unsuccessful. They basically found nothing. Now, people haven’t given up on this but the reason they haven’t given up is the complexity. Essentially there are a couple other things you can die of, so how do you put aside whether one means by a biomarker of aging. Well, you have to define that some how, its another way of saying the predictor of how long you are going to live, what your remaining longevity is, or that you will remain in healthy longevity, but then you have to define health and it gets a little bit fuzzy as well. So it is actually quite hard to even define what you mean by biomarker of aging, but even once you have gotten past that difficulty, because there are so many different things that go wrong you don’t expect to have one simple or even fairly simple number that says something like this.

You expect, one would think, that as you get older you are as old as your weakest link. So you are going to expect that you would want to measure a lot of things and each of them points to a probability of getting a severe case of this or that type of age-related pathology in this or that amount of time. And certainly some things are more influential than others. These things affect each other and we may be able to point to things that are a bit more indicative overall of the probability of death or disease of all types in old age. But it is a very – it is not an exact science, put it like that. I have been lucky enough to have my biological age tested, which I have been able to do maybe four times now over the past decade or more. The test I have been able to get done on me involved measuring probably 150 different things in my blood as well as all manner of physiological and cognitive tests. There is no one number that comes out of that, really. There is no one useful number. The only thing that really usually comes out of it is what to pay most attention to, what seems to be changing more rapidly or seems to be problematic levels or that of other people of your own chronological age, those sorts of things.

[Damien Blenkinsopp]: Right, so there are 130 markers. Would many of those fit within your seven areas of damage and kind of be related to that?

[Aubrey de Grey]: Oh certainly. Certainly not now because the things that one measures in the blood aren’t metabolized. These are small molecules that are constantly being ingested into the body or synthesized by the body or destroyed by the body or excreted from the body. The blood stream is just this pipeline, right? It is just this network of roads that take things from one place to another and particularly it shortens molecules whereas the seven types of damage that I talk about, types of molecules or cells, the molecular or cellular changes that accumulate over time. So in other words, yes, the concentration of a particular small molecule in the blood may change but that is because of subtle changes in the set point, in the equilibrium between synthesis and destruction or ingestion and excretion of those molecules, which are kind of readouts of the level of damage elsewhere – maybe of the activity of enzymes or the activities or numbers of certain cells, for example. But they are not the damage itself, they are readouts of the damage.

[Damien Blenkinsopp]: Okay, great. So if we wanted to live longer today – I mean, I know one answer which we are going to definitely come up with at the end which we need to talk about, like helping you fund the different areas because you see that as the most important to targeting these areas that we are not really looking at – but for the people at home who are concerned about their longevity, what would be the best strategy for them in terms of thinking about their own health?

[Aubrey de Grey]: I wish I had a better answer to this, I really do. Certainly I know that there are some people – if you are an unlucky person, so Ray Kurzweil – come back to Ray Kurzweil again because of course he is well-known as someone who thinks that one can make a big difference to one’s longevity using supplements and so on. He probably is making a substantial difference to his own longevity that way, but that is because his own longevity by default was probably going to be rather shorter than average. He has a lot of cardiovascular disease in his family, he came down with type 2 diabetes in his 30s, which is pretty unusual even though it is not unheard of. And he has been able to really completely fix that using his regime that he developed himself and I totally applaud that. What I can’t do is say that this would apply to people who are already doing okay, especially those doing better than average, like me. Only if you are somehow unlucky, we have simple ways that may be able to somewhat normalize your rate of aging. Now, of course, on top of that, there is the fact that there are plenty of ways to substantially shorten your longevity by smoking or getting seriously overweight or eating a very poor diet, for example, but you didn’t need me to tell you that. I bet your mother told you.

So unfortunately over and above that, as things stand, we cannot point to anything that can appreciably help most people. And that of course is why I always say the only thing you can really do is buy more time – not by extending the time that you stay healthy but by reducing the time before therapy had come along that would actually do much more than anything that exists today.

[Damien Blenkinsopp]: Right. So I will kind of run by you the way I think about this and see if you have ideas on this, to see if this is a decent idea or not. The way I talk to my friends and stuff when they ask me these kinds of questions is I say that basically you want to manage your biggest risks, right? So if you were talking about Ray Kurzweil has cardiovascular risk in his family. For instance, you had a 23&Me or other set of genetic tests which point out that with some probability you have – for instance, I have a higher risk of lung cancer than most people and a couple of other things in my profile and people have different risks. So I suggest they look at that and then potentially they look for the biomarkers related to that on an ongoing basis rather than the genetic longer-term risk. And they monitor that and they also look into the things that can reduce that specific health risk and to reduce the risk and to limit the risk of them actually getting that biggest risk. So it is kind of plugging the biggest gaps they have of shortening their lifespan. I am just wondering if you think that is a reasonable approach?

[Aubrey de Grey]: For sure. I think in general for most people if you have got a risk factor that puts you at risk of being considerably shorter length than average, then you are going to know about it as a consequence of the kinds of metabolic tests I was talking about. But there can certainly be exceptions to that, things that truly don’t really affect your health as measured in normal ways, so that is all they do. Like suddenly some of them bite you in the backside. So that is the kind of thing that 23&me analysis might lower. But one also has got to be extremely careful in evaluating that kind of data because ultimately it arises from basic science. It arises from people studying particular genetic variations in the population and identifying correlations between those variants and the instance of this or that to these. And those studies are notoriously difficult to do and they have a notoriously low level of reproducibility because different populations are different and because sample sizes are limited, and so on and so forth.

[Damien Blenkinsopp]: Thank you. I always appreciate your answers because they provide a different context and perspective to everyone else so it is always very interesting to get that feedback. Let’s talk a little bit about SENS organization and what you’re up to there because this is your vision basically for making it happen. So you have different activities – and I also want to know a little bit about the [Methuselah Foundation 00:45:56] which you were formerly part of. And I understand that has some similar activities although it is going about it in a different way.

[Aubrey de Grey]: Sure, and let me actually start with the Methuselah Foundation because that makes more sense chronologically. The Methuselah Foundation is a charity, a 501-C3, that was created by myself and a businessman from Virginia named David Gobel in 2002, late 2002. Our goal was, of course, was to hasten the defeat of ageing but we didn’t have any money. So we started out creating a prize pot creating competitions in which we encouraged people to give up money that would go into a prize box and that the competition would be to beat the prevailing world record for mouse longevity. So with all you had to do the mouse that lived longer than any mouse had ever lived before. And of course we weren’t saying how things would be done and we set things up so that even a small improvement would be enough to win some proportion of the prize box. And it worked.

Basically our goal was to raise the profile of longevity research to get the word out and to get people more interested in the possibility of developing medicine to postpone ill health of old age. Well, we were bringing all this money in and right about 2005 or so we had enough money that we felt we could spend some of the prize pot in advance on actually pursuing specific research projects. So that is what we started to do and then things started going pretty well in that regard. But then we had a problem which we started to recognize in about 2008, which was that if you are a research organization you have got to obviously impress people with your competence and you have got your feet on the ground and everything like that and you are doing the right stuff. Well, if you are a PR organization, to get people motivated and so on, then you want to be the opposite – you want to be very popular, sensational, and glitzy. So we felt that it would actually serve the mission better if these two themes of our activities were between two different organizations, which would thereby be able to have very different styles, discourse, and styles of communication. So that is why we created the SENS Research Foundation, which was started in 2009.

SENS Research, of course, is also a charity – a 501-C3 so anyone can get tax back. And because this is going out internationally I should probably mention that we have a subsidiary in the UK which is able to take tax-deductible donations not only for UK citizens but also from most of mainland Europe. And if anyone wants to know about that they can contact us on the website and we will tell them more.

[Damien Blenkinsopp]: Thanks. We will put all the links in the show notes.

[Aubrey de Grey]: Excellent, thank you so much. So we created the SENS Research Foundation and it has been a truly, and the Methuselah Foundation and all the assets that have been given us research into the new foundation, so both foundations have been made in parallel since that time and I think we have both done pretty well and it is pretty good. So SENS Research Foundation, to go into a bit more detail – we are headquartered in Mountain View, California, just a little south of San Francisco. We have about 5,000 square feet of space in a facility, most of which is lab space. We have a variety of projects going on here. We actually have more than two-thirds of our research budget is not in our facility but rather in five university labs, again most in the USA, but some elsewhere. We have on outside Cambridge, Biotechnology Institute, and these projects are focused on all of the various areas of research there that SENS describes.

[Damien Blenkinsopp]: Yes, and I don’t think we have actually said what SENS stands for – Strategies for Engineered Negligible Senescence.

[Aubrey de Grey]: That’s right. We don’t often try to spell that out because it is a bit of a tongue twister. The name originally arose because of – well, basically historical reasons within gerontology. The phrase ‘negligible senescence’ already had a particular technical meaning and it seemed like a good place to start. But it is a bit of a tongue twister so we don’t bother to get people to remember that anymore.

[Damien Blenkinsopp]: Great, thanks. I will put links to all of those, of course, in the show notes. One last thing I just want to ask you, Aubrey, is from a personal stance you have said every few years you are going to test 130 markers or so of your own. Are there any specific things that you feel are important for you to personally track about your body for longevity, health, or performance?

[Aubrey de Grey]: Well, yeah. I mean, I think that first of all, coming back to something that we were talking about earlier, if any one marker is out of whack, you know, it seems like it is really telling a much more pessimistic story than the rest, then you have certainly got to try to ask yourself why, ask yourself whether it really is an outlier, whether it actually has that much impact given everything else as people say, things like that – but it is definitely not something that would be a good idea to ignore. So my one outlier the past couple of times I have done this kind of thing has been homocysteine, and I have no – I am not really sure why my homocysteine level is unusually high because everything else that it is supposed to interact with has not – but it is still something that I pay attention to.

From that, I can certainly say that there are certain things that are really at the nexus of metabolism, things that really if they are extremely good then you will be pretty safe, pretty much with whatever else is happening. Insulin is the best one. And of course, insulin is the hormone that mediates the absorption of sugar after you eat a sugar-rich meal so that the overall concentration of sugar in the bloodstream is maintained at as constant a level as possible. And the precursor of diabetes, type 2 diabetes, is something called insulin resistance, where the cells that take up sugar in response to insulin, which are mainly muscle cells, start to be a little sluggish about it and to only respond when they are given a large amount of insulin. So if your insulin is high, then even if your glucose tolerance, as it’s called, your ability to normalize your glucose in the blood is still good, then the indication is that it won’t be good for very long. Whereas glucose tolerance is good and also your insulin is really low then that says that you are in the best possible state. I would say if you have one thing, that would be it.

Perhaps another one would be triglycerides, whether it is a type of fat which seems to be good to have very little of in your blood stream and again, I am pleased to say that I do.

[Damien Blenkinsopp]: Thank you very much because those are basically the biggest diseases that we have today, like metabolic syndrome, so those are good markers for that. I guess one of the confusions with biomarkers we are always facing is that we are not sure if it is the end point. So one last question I did have for you was on a Palo Alto longevity prize. I am not sure if you know about that?

[Aubrey de Grey]: I certainly do and I am invited to it.

[Damien Blenkinsopp]: Oh, great. Because I understand they are running a competition or they have been running a competition for heart rate variability in connection with longevity.

[Aubrey de Grey]: That’s right, yes. So, businessman in the Bay Area in Joon Yun has put up a million dollars as a prize fund for progress against aging. It is divided, actually, into two separate prizes. One of them is looking specifically at heart rate variability, as you say, but the other one is a bit more general. It is looking at what they call homeostatic control or something like that. I forget the exact terminology. But the point here is that the competition is for the attempt to actually extend longevity [inaudible 00:54:06] in this manner. And I think this is great. I mean, the heart rate variability aspect is a bit unusual for people who have not really bought into the idea that this could be a real fulcrum of aging but it might be. And we think it is great to encourage research in any area that hasn’t been terribly well looked at. The main thing is simply putting a million dollars on the table as a great way to get people pretty excited, and a lot of people are paying attention now, especially since in the Bay Area there is a lot of identity of people interested in longevity in general. It’s a great way for a research foundation to be located. So yes, I absolutely applaud them for doing this.

[Damien Blenkinsopp]: Great to hear you are part of that also because we had heard of that from one of our previous guests. Aubrey, thank you so much for your time today. I love to hear all your different ideas of course because you are working at a very high level compared to most people, so you have this perspective that stands back a bit, which can be very helpful to people. Thank you so much for your time and have a great day.

[Aubrey de Grey]: Thank you, and to you. Bye.

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