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

ANDREW HUBERMAN: Welcome to the Huberman Lab podcast, where

we discuss science and science based tools for everyday life.

[MUSIC PLAYING]

Hello, everybody, and welcome.

I want to thank all of you premium Huberman Lab podcast

subscribers for joining.

This is an exciting one.

Even though the backdrop here looks very much like the studio

back in the United States, I am doing

this AMA live from Sydney, Australia,

where I and the Huberman Lab podcast team

have been for well over a week.

We were in Melbourne.

And we just did two live shows here in Sydney.

And we're headed off to Brisbane tomorrow.

And it's been absolutely delightful.

We've had so much fun talking science, learning from people.

It's a wonderful place.

I want to get right into your questions

and do my best to answer as many of them as possible, as

thoroughly, clearly, and succinctly as possible

over the next hour.

So I'm going to dive into those in just a moment.

Just one last important thing before I

do that, which is that I want to thank everyone

for being a premium subscriber and let you know that we, based

on your contributions to the premium channel, have already,

as you know, supported four laboratories

at Stanford Columbia University Salk Institute and elsewhere

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leading to important therapeutic breakthroughs

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to secure no fewer than three dollar for dollar match

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Those are going to head out to a number

of different universities and researchers

working again on human studies, so no animal studies.

Human studies on important projects.

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on immunology and cancer, mindsets and immune system

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I can say this because I'm familiar with the challenges

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So thank you, thank you, thank you.

And now, without further ado, let's get to your questions.

The first question was, is how are you

managing to achieve your key health

pillars while in Australia and any other place

you've enjoyed doing so, all while working so hard?

Well, thanks for the question.

I'll answer this question in the context

of what I think we all can, and should, and really

will do because if you're a premium channel subscriber,

I'm certain that you're taking your health seriously.

So first off, I think there's a bit

of a misconception about the protocols on the Huberman Lab

podcast being that we are all, including myself,

super, super regimented about them to the point where

we don't enjoy other things in life,

and that's simply not true.

So I view the protocols of the Huberman Lab podcast

as science-based, actionable, low cost,

zero cost, minimal cost in almost all situations.

There are a few exceptions to that.

But it really designed to mesh with the rest of life

and enhance mental health and physical health, which

of course, means remaining social staying,

on typical sleep schedules, et cetera.

So the big ones for me when arriving here

were, of course, to get morning sunlight as often as possible.

We saw a beautiful sunrise this morning over Sydney.

But even on the overcast days, we've

had a few rainy overcast days to really

make it a point to get outside and to get that morning

sunlight.

Also, our crew did travel in with a red light.

Not a red light panel, although I do have a couple red light

panels.

Those little portable ones that I use from time to time.

The red lights I'm referring to in reference to answering

this question are the red lights which are just red light bulbs

that I actually travel with a little red light bulb unit.

It's just like a small screwing unit.

You plug it in here with an adapter of course.

And then in the evening, we've switched off

the lights in the place where we're staying,

and it just brings the overall levels of cortisol

down low very quickly, and it makes it very easy

to get to sleep each night.

It makes a big, big difference.

And this is a very low cost tool.

You could essentially purchase any red light, even red party

lights, and put those up, and then switch off

the regular overhead lights.

It makes a big difference, and it's probably even cost-saving.

We've also stayed fairly regimented about exercise.

So this morning, we took a great jog down to the ocean,

jumped in the ocean.

If you don't have access to an ocean on vacation,

just getting outside and getting some movement early in the day

can help shift your rhythm.

Really the quadfecta of shifting your circadian rhythm

in a new place or becoming an early riser

if you want to do that is morning, sunlight movement,

social engagement, and in my case, caffeine.

Although some people would opt for eating breakfast,

I just happen to prefer to eat a little bit later in the day.

So when you combine those things,

you are really amplifying that morning cortisol increase

that I've talked about on the podcast.

Morning catecholamine release.

So dopamine, epinephrine, and norepinephrine.

And those act in synergy to create

more early day and daytime mood focus and alertness

and enhance the transition to nighttime sleep.

But of course, that dimming of the lights and maybe even red

light in the evening really, really can help.

And so those are the biggies.

And then of course, if you want to shift your circadian rhythm

really quickly to be on a local schedule,

it helps to hop on the local meal schedule.

But for me, that always means skipping breakfast.

I'm not a big breakfast eater.

I like lunch and afternoon snack sometimes and dinner.

So when you do all of those things,

it makes it very easy to stay with the health pillars.

And of course, stress control is important.

We're doing lives.

There's a lot of work to do.

So there's a daily for me non-sleep deep rest

or yoga nidra protocol.

By the way, you may be familiar with non-sleep deep rest

and yoga nidra.

Terrific zero cost practice for reducing stress, replacing

or replenishing dopamine and mental and physical vigor.

I've talked about this and the studies that

support this on the podcast.

There's a Huberman NSDR script on YouTube.

That's, again, zero cost.

But while down here, we recorded a 10-minute, 20-minute,

and 30-minute NSDR script with a view of a beautiful Sydney

sunrise.

Those should be posted to our Huberman Lab clips

channel in the not too distant future, probably

in the next couple of weeks.

And then you can have different duration NSDR scripts

that you can use, again completely zero

cost, any time you like.

We've recorded also some additional meditations,

and we're considering putting out

a Spotify album, if you will, of NSDR and meditations

that are science-based, of different durations.

So if you like that idea, maybe just

give a shout into the internet, and hopefully we'll

hear it, or put a comment on the latest episode of The Huberman

Lab podcast on YouTube.

And if that sounds like a good idea to you,

we will do more of that.

These are, again, zero costs, zero

to access tools for enhancing mental health

and physical health.

So combining all of those is really what we've done.

Next question is I have followed your sleep advice,

and I have seen a huge improvement.

Great.

Happy to hear that.

Wonderful.

But I still wake up at night and only get five or six hours.

Is that enough?

Can you please give more advice if possible?

Well, first of all, thanks for tuning in to the sleep advice.

So the question of whether or not five or six

hours is enough really depends on person context.

And by context, I mean it can even

change across the course of the year by life circumstances.

The criteria for insomnia are very clear.

Insomnia is excessive daytime sleepiness

due to lack of sleep at night.

Excessive daytime sleepiness due to lack of sleep at night.

So if you're not falling asleep during the day

and you feel reasonably good throughout the day, maybe

you only need a brief 10-minute to 30-minute nap

in the afternoon.

Some people nap.

Some people don't like to nap.

Doesn't matter.

But if you feel pretty good throughout the day

and you have enough mental and physical energy and focus

to complete the activities that you need to complete,

then I wouldn't worry so much about five to six hours,

and I wouldn't obsess over these kind of scary things

that we hear.

Oh, if we're not getting seven to eight hours,

that we get dementia, et cetera, because that's not necessarily

the case.

Everyone has different sleep needs.

The other thing, and this is perhaps

the most important thing for everybody listening

to this really to think about is QQRT, which is quality,

quantity, timing, excuse me.

Quality, quantity, regularity, and timing.

QQRT.

QQRT.

Which is an acronym coined by the great Matt Walker, author

of the book Why We Sleep.

He has his own terrific podcast in his own right,

has a series on the Huberman Lab podcast coming out soon.

QQRT is what you really need to think about when

you think about your sleep.

So you want to think about the quantity.

How much are you getting?

Well, you, Rema, who asked this question,

are getting five to six hours a night.

OK, what about the quality of that sleep?

Is it consistently five to six hours with no breaks,

or is there a break in the middle?

One trip to the restroom in the middle of the night

is considered normal and healthy for most people.

If you're making multiple trips to the restroom in the middle

of the night or you're waking up multiple times

throughout the night on a regular basis,

that's something to try and overcome.

So the quality piece is important.

Also, whether or not you remember your dreams

or you don't, you want to make sure

that you're getting ample amounts of slow wave

sleep, which dominates the first half of your sleep night,

and rapid eye movement sleep, which dominates

the second half of your sleep night

because they have different roles in recovery

of brain and body.

Namely slow wave a.k.a. deep sleep

is responsible for growth hormone release.

Rapid eye movement sleep responsible for the unpacking

or the uncoupling of emotions to prior day and previous day

experiences.

And in that way, acts as a kind of scrubbing out

or a therapy for your emotional state.

So are you feeling emotionally rested when you wake up

is a good indication of whether or not

you're getting enough rapid eye movement sleep.

Some people like to sleep trackers,

using their Eight Sleep or their WHOOP

or their Oura Ring or something like that.

I'm a fan of sleep trackers, but I

think that relying too heavily on sleep scores can be risky.

There are data from Alia Crum's Lab at Stanford showing

that if people receive a poor sleep score, even though they

slept well, their performance will drop.

If people get a good sleep score,

even though their sleep was lousy,

their performance is maintained or even enhanced.

So you don't want to take any one sleep score

and overinterpret it.

You want to look at the average and compare that

to your subjective experience of sleep.

Maybe I would say go about halfway through your day

if you can bear to do it before looking at your sleep score

and see how you feel.

Then look at your sleep score as opposed

to the other way around.

That might be a good way to adjust for that belief

effect I just mentioned.

But if you're getting enough quantity,

let's say you get five to six hours and quality,

you're sleeping through that bout

maybe with one epoch of waking up.

And then the regularity of your sleep

is that you're going to sleep more or less at the same time

each night plus or minus an hour on let's say five to six days

per week because sometimes, we like

to stay up on a weekend night and have some fun

or something like that.

And then the timing, you know, where

that sleep is falling in your 24-hour schedule is really key.

And here's what we're learning as a field,

that for many people who are early to bed, early to rise

types, if they go to bed around 9:00 PM, 9:30,

and they only get six hours of sleep, they feel great.

Whereas if they get the equivalent amount of sleep

but go to bed at 11:00 PM or midnight, they feel lousy.

Similarly, if you're a night owl,

you're somebody that really prefers

to go to bed around 1:00 or 2:00 AM and wake up around,

let's say, 10:00 AM, if you take that equivalent amount sleep

and you go to bed earlier, you're

going to feel not so good.

So getting the timing of your sleep

in the 24-hour cycle correct and fairly consistent,

that's the R part of QQRT.

Correct is going to be beneficial.

So I wouldn't worry so much about five to six hours only.

Here's what I would do, Rima.

I would take that five to six hours.

And before getting out of bed each morning,

I would do a 10 to 30-minute NSDR non-sleep deep rest

protocol, which will allow you to feel deeply rested

and frankly, to recover whatever bits of sleep

that you perhaps missed during the night.

I found that to be a tremendously beneficial

practice.

Waking up, if I don't feel thoroughly

rested, doing a 10 to 30-minute NSDR.

Then getting out of bed and continuing the day.

And if you don't have time to do that,

do that 10-minute, maybe 20-minute later

in the day at any point.

And I think you'll see terrific results not just because you're

recovering some sleep that you lost perhaps during the night

or maybe you just need five to six hours,

but also because you'll get better at falling and staying

deeply asleep through the practice of NSDR in the morning

or at some point throughout the day.

I wouldn't recommend anything else

elaborate unless you're feeling really

exhausted during the day.

In which case, then I would move to some of the more advanced

sleep tools.

I've had vertigo.

I should announce, this is a question.

I'm not just telling you about my vertigo.

I've had vertigo on and off and wonder what causes it.

Is it hormones, adrenals, otoliths moving around?

Oh, this person knows about the cochlea.

Hydration, virus exposure.

Zenana I think is how you pronounce your name.

Forgive me if that's not the correct pronunciation, Zenana.

So vertigo is very interesting.

Unfortunately, it's uncomfortable,

but we can learn a thing or two right now that

should be able to help you, Zenana and others,

even if they haven't had vertigo.

So vertigo, this perception of falling or dizziness,

needs to be distinguished from lightheadedness.

So if you're ever feeling dizzy, it's

worth stopping and sitting, or if you

can't sit, standing and closing your eyes

and asking yourself a question.

Do I feel like I'm ready to fall straight down,

or do I feel like I'm going to spin and fall down?

Because in answering that question,

you can determine whether or not you are lightheaded,

that would be the straight falling down,

or you have vertigo, which is you're dizzy,

which is that you're going to spin and fall down.

Now do this in a safe place, please.

You can do this while bracing yourself against a wall,

or that's why I said, ideally seated,

so you don't actually fall.

But in most cases, if you're feeling that spin,

if you're feeling truly dizzy, you're feeling vertigo,

and I move my head around like on purpose,

then chances are you've got some issue

in either your visual system or your inner ear.

OK.

So since this is being recorded on video,

I can display what I'm about to say.

So your visual system and your inner ear system for balance

have some really important features.

I'm going to make this a very quick tutorial.

Your head, as you move through space,

is experiencing visual images going by all the time.

Your retinas, your eyes are essentially exposed to a lot

of what's called visual slip.

Imagine you're walking and you're

trying to take a picture on your iPhone,

or if you have an Android phone, on your Android phone.

And you're moving, it's going to be blurry, right?

Well, there's a stabilization process in your body and brain.

It's a magnificent one that frankly is

built into all jawed animals.

Whereby your head, because it can move forward,

so think nodding, right?

So this is pitch for you pilots, right.

Yaw, moving from side to side.

This would be the no.

This would be the no.

No.

So pitch, yaw, and roll, which would be like the puppy look,

right?

Pitch, yaw, and roll.

Pitch, yaw, roll.

Those are the three major angles of visual slip.

And in an absolutely magnificent set of things,

your inner ear has three hula hoop like shaped structures.

One that's arranged vertically, so up on its end.

One that's at an angle of about 45 degrees to that.

And another that sits like a hula hoop flat on the ground.

And inside of each of those little hula hoop like tubes,

there are little stones called otoliths, OK?

You heard that word earlier.

That roll around on the bottom, just

like marbles at the bottom of a hula hoop.

Such that when you pitch, nod, the marbles

in the vertical hula hoop slide back and forth.

When you say no, the marbles in that hula hoop

lying essentially parallel to the floor move around.

And then the one at 45 degrees, when you roll your head

from side to side, those move.

And each of those sends neural signals

that converge on the neural signals coming from the eye.

And get this, when you move through space,

there is a precise offset of whatever

visual slip you happen to be experiencing by walking.

The images are moving, you're looking up.

You're looking at buildings.

You're looking around.

You're talking to somebody.

They're moving their head.

And your eye is making little tiny movements,

little microsaccades on the millisecond time scale

that act as a perfect image stabilizer.

So what this means--

this is, by the way, called the vestibulo-ocular reflex.

Vestibular system, ocular reflex.

And it's mediated through a structure called the cerebellum

in the back of the brain.

This is why when you're on a boat, when the horizon is

tipping back and forth, I have to be careful with this

because I have such a prominent seasickness based

on a prior experience that if I think about this too much,

I might get nauseous.

When that horizon is moving around,

your system becomes uncalibrated because you can't really

keep the system jolting about in a regular way.

To be really careful here, I'm getting dizzy.

Notice I said dizzy, not lightheaded.

And you will end up disrupting that slip process,

and you'll essentially overcompensate,

which is why whenever you feel sick on a boat, they say,

look at the horizon.

Fixate to something at a distance.

OK.

So if you have vertigo, almost certainly,

there's something going on in your inner ear.

Yes, it can be caused by viruses.

Yes, it can be caused by hormones.

These things tend to be transient.

But the most important thing is going

to be to anchor the visual part of the vestibulo-ocular reflex.

So what you're going to want to do

is you're going to want to fixate on a point

maybe three or four feet away.

And then you're going to actually want

to move closer to that point, or if you don't have access to it,

you would want to look at your hand, your finger

out in front of you, and then slowly move it

in toward your nose.

At some point, you'll feel like you're going to go cross-eyed,

and you can stop at that point.

Then move out again.

Then in again.

What are you doing when you're doing this?

What you're doing is you're overriding the error signals,

the incorrect error signals that exist in your kind of default

setting when you have vertigo, and you're

forcing the visual component to dominate.

And then your inner ear mechanisms will adjust to that.

So this is a very powerful tool.

If you ever feel nauseous or seasick,

it's a very powerful tool.

If you've ever been like me, you sit in the back of an Uber,

and the Uber is too small.

You get out and you're like walk into a building

where there are no windows.

And you're, like I don't really feel good.

Get outside and look at a fixation point

some distance away.

This actually happened the other day.

We went to the gym.

We went inside this gym.

We'd been in a van and then went inside

and weren't feeling well.

So we decided to get out, and just take a walk,

and fixate to the longest distance possible.

The fresh air probably helped as well.

But when doing that, you are anchoring the visual part

of the vestibulo-ocular reflex.

Now that's far and away better than trying

to avoid moving your head to not get

those little stones moving around

in the semicircular canals.

Lots to say about this.

I could go on and on.

But hopefully, you learn some biology,

and you learn to howl to not be nauseous if ever you feel dizzy

or nauseous based on movement.

Motion sick.

And we can talk about why you get motion sick,

but it's through the vagus nerve, et cetera, et cetera.

But this is a very useful tool.

And if you're ever just not feeling well,

unless you have a fever or something like that,

I recommend getting outside and looking

at the furthest fixation point with your vision

that you possibly can and then walking toward it

as far as you can safely.

If not, by actually just doing a few of these exercises

of looking at your finger up close,

that's going to be very good for anchoring the vestibular ocular

reflex and not every time but many times people

report feeling better, especially if you've

moved from one closed environment,

to another closed environment, to another closed environment,

and so on.

OK.

Next question is what can be done

to improve brain function for people that

have been negatively impacted by things,

such as poor sleep, poor diet, and TBI early in life?

James.

Yeah.

This is a great question, and I get this a lot.

I think that it reminds me that a lot of the conversation

that we have on the podcast is about the good things that

happen when you do things right and the bad things that happen

when you do things wrong.

And while I think that's an important conversation, what

I've frankly failed to do enough,

and that's why I'm grateful for this question,

because it gives me the opportunity

to talk more about the fact that your system is very robust.

There is neuroplasticity.

And also, as my graduate advisor used to say,

time is broken, which is not to say you're out of luck.

But I wouldn't spend any extra energy thinking

about how many seats--

not seats, excuse me.

How many, I have to be careful, the seed oil debate

is still a debate.

It's unclear how many trans fats you

were exposed to in childhood.

We know trans fats are bad.

Everyone agrees they're bad.

Governments agree they're bad.

This is perhaps one of the few things

that everybody agrees on in the nutrition

space trans fats are bad.

When I was growing up, trans fats were abundant in foods.

There were probably fewer of certain things

that we have more of now that are bad.

But we ate a lot of trans fats.

We had margarine in our fridge.

There were other things that were probably weren't

good for us that we consumed.

And every once in a while, I'll think,

gosh, if I'd only been eating grass-fed meats, and fruits,

and vegetables, and healthy grains as I do now back then,

imagine how much healthier I'd be.

But I really don't spend too much time on it,

and I don't think you should either.

I think the most important thing to remember

is that biological systems, unless they're really damaged,

you know, you're talking about a major injury,

and even then, they're very robust.

You can overcome years, decades of poor use

or misuse of those systems.

That said, if you have the opportunity

to take care of them now, I highly suggest you do.

So for instance, if you haven't slept well for years,

now's the time to get it right.

I wouldn't worry about the past, truly.

You can always rescue some of your health and healthspan

and lifespan.

Poor diet, same thing.

It's a just do it kind of thing.

Just hop on the train of getting things right 80% to 90%

of the time.

TBI, traumatic brain injury.

Well, the episode of the Huberman Lab

podcast that's out right now with Dr. Mark Esposito.

He's an MD, a neurologist, originally trained

at University of Pennsylvania, now at University

of California Berkeley.

We talk about TBI.

There are a lot of different forms

of TBI, different origins.

Everything from bomb blasts, to car accident,

to construction work, to just slipped on the stairs

at a party.

I know someone that slipped on some wet floor at a party

and has a brain injury.

What do we know?

Well, you get back to the basics.

Sleep is going to be important.

But there are some things like transcranial magnetic

stimulation, certainly things that reduce brain inflammation

like glymphatic outflow.

So glymphatic outflow is this washing of the brain at night

that removes debris.

Very, very important in the weeks and months

after traumatic brain injury to get adequate sleep

for that reason.

But then there are things that also seem to perhaps improve

outcomes from traumatic brain injury,

such as hyperbaric chambers.

So hyperoxygenation treatments, if you have access to those.

Even things like elevating the feet slightly

when you sleep by about 5 to 15 degrees

is known to increase glymphatic flow during sleep, which

can, we believe by way of increased

clearance of a bunch of basically debris,

reactive oxygen species within the cells

but also debris outside the cells in the extracellular

space, so between neurons.

So it isn't just empty space.

There's all this like heavily glycosylated stuff, which

basically just means this kind of like spongy carbohydrate

stuff that fills in the spaces.

The clearance of some of the metabolites

and some of the debris that's accumulated there

by just sleeping with feet slightly elevated.

Definitely not falling asleep in a chair upright.

That's the worst thing for glymphatic flow.

Things like that.

Some people will go kind of bonkers on all things

anti-inflammation.

They start taking tons of curcumin,

and they kind of get obsessed with inflammation as the enemy.

I wouldn't do that.

In fact, there are some negative effects

of things like curcumin, turmeric,

if you take it in high doses, like limiting

the amount of dihydrotestosterone production,

which is not good.

You don't want that.

Male or female, you don't want to take

too much turmeric or curcumin.

There are real issues with that.

To say nothing of the studies that have shown

lead contamination in a lot of turmeric.

So you want to check the sourcing

very carefully if you do consume any turmeric.

A little bit is probably fine.

Cooking with it is fine.

But here, we're talking about supplementation.

And just really not trying to turn inflammation

into this terrible thing to the point where

you're starting to do other things that

are potentially damaging.

There's some really interesting evidence

that 5 grams, maybe 10 grams, depending on your body weight,

of creatine monohydrate per day can enhance creatine phosphate

metabolism in the forebrain and enhance brain function

under conditions of high altitude or TBI.

I take 5 to 10 grams of creatine, just

creatine monohydrate powder.

Frankly, any creatine monohydrate powder

should be sufficient.

There are other forms of creatine.

They are not any better creatine.

Monohydrate is the least expensive fortunately.

That mixed in water.

You take it with or without food.

Some people ask, does creatine make your hair fall out?

No, it does not.

Make your hair fall out, but some people

do experience an increase in DHT with creatine monohydrate,

and there can be a DHT hair loss link.

So if you think you're losing your hair from taking creatine,

then stop and see, do the control experiment.

It should grow back.

But 5 to 10 grams of creatine monohydrate,

something to explore.

Hyperbaric chamber, something to explore.

Excellent sleep, definitely do that.

And I just wouldn't obsess over past ills or wrongs

to the extent that it impacts your ability to try and correct

those in the present.

I would say that about most everything.

But then again, I understand that as humans,

because we can remember the past, the present,

and the future, that sometimes it's

difficult to let go of the mistakes of past that we made.

But that's just simply being human,

and I don't have a solution to that.

Are we any closer to finding the cause of OCD?

Well, I think we know what causes OCD.

I think it's pretty clear that OCD is some form of miswiring

in the basal ganglia.

The structures of the brain that are involved in

go action and no go, withholding, action type

behaviors.

And some malwiring of those structures

to the dopamine reward system because here's

what's interesting about OCD.

OCD involves obsessions obviously.

That's the O in OCD.

Compulsions, the actions.

That's the C in OCD.

But in a kind of weird twist of the neurology,

OCD is a situation where the compulsion does not

remove the obsession.

Rather, it exacerbates it, OK?

The compulsion does not remove the obsession.

It exacerbates it.

So unlike an itch that you scratch, with OCD,

the scratching of the itch makes it worse,

which is actually what we experience

when we have a mosquito bite, which by the way,

I absolutely loathe mosquito bites.

It's one of my least favorite things in life.

I have about 3,600 and counting pet peeves.

That's definitely high on the list of those.

The obsessive compulsive disorder

is one that really needs to be treated, frankly,

neurologically.

It's one for which there are behavioral interventions,

but it's clear that adjusting the pharmacology

of the neural circuits involved in OCD really can help.

Again, there are behavioral treatments.

But for severe cases of OCD, it's just very, very clear

that interventions, which include SSRIs,

which have been demonized.

A lot of people say, oh, selective serotonin reuptake

inhibitors are terrible.

Blah, blah, blah, blah.

You know, the serotonin hypothesis of depression

isn't true.

Well, listen, the reality is this

that all treatments for depression that are effective,

which include SSRIs, in some cases,

cognitive behavioral treatments, all of these sorts of things,

which are shown efficacy, are all about what?

They're not about serotonin.

They're about neuroplasticity.

That's why some antidepressants center

on dopamine and norepinephrine.

Others center on serotonin.

They're about neuroplasticity.

They're about changing neural networks.

They're not about neurochemical per se.

But the neuromodulators such as serotonin

allow an access point.

They are a wedge into the neuroplasticity process.

Now with OCD, in order to overcome these malwirings,

it's very important to get plasticity.

How do you get plasticity?

Well, in my belief, you work with an excellent psychiatrist

who can prescribe the appropriate dose of drug

to release the appropriate amount of neuromodulator.

Then, and this is really key, you

have opened up the window for plasticity,

but then it's really important that the proper behaviors

are engaged in.

And when I did an episode on OCD,

I talked about what some of these are.

For instance, the person is exposed

to the stimulus that causes the obsession,

or maybe the obsession arises spontaneously.

They feel the impulse to complete

the compulsion, the behavior, and they

resist with the support of a therapist,

but they're doing this in the context of having

elevated levels of serotonin or some other neuromodulator

that then allows fewer trials of resistance.

Fewer times of needing to withhold the behavior

that this person so badly wants to perform because it's

coming from within.

It's this compulsion literally.

Then they are able to achieve plasticity more quickly.

Perhaps also transcranial magnetic stimulation.

So a conjunction of correct behavior,

the withholding behavior, maybe a replacement behavior

that's often used.

Use a replacement behavior with the appropriate neurochemical

milieu is the solution to OCD.

OK.

Next question is if I'm just going to New York City from San

Francisco, how do I control shifting my circadian

rhythm by only three hours?

So if you're going to New York City from San Francisco,

the best way, frankly, would be to get up

an hour earlier two days before you head off to New York.

And then another day, you might try and shift by two hours

before you go and then head to New York

and do the last shift on the last day.

Most people won't do that.

It takes a little bit of work, but they just

don't have the time ability or your discipline to do that.

But it is perhaps the best way.

I would say the best thing to do is to know your temperature

minimum, and I'll try and keep this pretty simple.

If you typically wake up at 8:00 AM,

let's say, just by way of example.

That means that your minimum body temperature is at 6:00 AM.

Which means that if you want to get up earlier in the days

where you travel to New York, well, in the couple of days

before you leave, any time between 6:00 AM and 10:00 AM,

get some bright light in your eyes,

even if you go back to sleep.

So for instance, get up at 6:00 AM.

Set an alarm clock.

I know you normally like to get up at 8:00 AM.

Get up at 6:00 AM.

Get some bright light in your eyes from artificial sources

or from sunlight, maybe 5 to 10 minutes,

then go back to sleep until 8:00 AM.

You do that again the next night.

And then you head off to New York.

You'll find the shift to be much easier.

Now here's what you don't want to do.

You want to make sure that you do not view

bright light before 6:00 AM.

So in the middle of the night, if you get up,

you need to use the restroom, try

and use dim lights as dim is as safely possible, et cetera.

And what are you doing when you're doing this?

I could get into a long description

of the science behind this, and I'll probably do a podcast

all about this at some point.

But really what you're doing if you get up at 6:00 AM

and getting some bright light exposure is you think about it,

you're kind of looking at a New York sunrise of sorts, OK?

If it's not a sunrise, you're getting

some bright light that mimics sunrise

at least to some extent.

Nothing's quite like sunrise, but to some extent.

So in that sense, even if you go back to sleep,

what you're doing is you're sending the light signal,

the zeitgeber, the time signal, to your circadian clock

of your hypothalamus that it should shift,

that you need to get up earlier.

And indeed, that will happen over the course

of about two to three days.

The other thing you can do, and I know this

is kind of rare these days to get an answer like this.

The other thing you can do is just fly to New York

and force yourself to get up.

And just drink caffeine, and get out, and exercise and use

the social rhythm of the activity of the city in order

to get up earlier.

But you will feel lousy late morning.

And so you would only want to do that if you could access

a brief nap of anywhere from 30 to 90 minutes late morning,

and then you'll feel fine.

But my suggestion would be to, something

back there like some animal or something

likes that answer so much.

It would be to just try and get a little bit of light exposure

a couple hours before your normal wake up time.

Then go back to sleep in the two days

before you head off to New York City.

And of course, everything here was

set in the context of the New York City, flight

from San Francisco and New York City.

But the principle, the logic holds.

And if you have any questions about this temperature minimum

and wake up time, and you want to get your circadian clock

right for travel, check out the episode

that we did on jet lag and shift work.

And I'm realizing now as I say this, and my team is here,

and they're listening, that I will do a video on the Huberman

Lab clips channel where I explain temperature minimum

and how to plug in your normal wake

up time in order to essentially arrive at whatever

time shift you want.

We should probably put that out as a newsletter too,

where it's a little chart, where it says I currently wake up

at 8:00 AM, and then which means my,

and then it'll say subtract two hours.

My temperature minimum is 6:00 AM.

And I want to travel to whatever it is.

I don't know.

Sydney, Australia on this date from this city.

And then we know the time change.

And then I can tell you exactly what

to do for a couple of days.

I've done this for various military groups.

I've done this for people and close friends who travel a lot,

and it works fabulously well.

I can't eliminate jet lag for you.

I wish I could just eliminate jet lag.

I can't do that.

But I definitely can have the time

that it takes for you to shift maybe more.

Hi.

Hi.

I love the Sydney Show.

Thank you.

Thanks for coming out.

Thanks for coming to Australia.

Thanks for having us.

I take fish oil, but I'm not sure I'm

getting the dose right.

What are your thoughts on fish oil and dose?

I have lots of thoughts on fish oil.

I think it's a terrific tool.

I think every time I see a study or a news article

saying fish oil not shown to--

I just go, oh, gosh.

All right.

Well, listen, whoever's reading, wrote that article,

I take no pleasure in your declining health span

or lifespan, but whatsoever.

But the rest of us are going to be taking fish oil.

And here's why.

There's just, oh, so much evidence that

getting enough omega 3 fatty acids

is great for brain health, body health.

And I think that the issue around fish oil

is typically around contaminants.

So you want to make sure that it doesn't have loads of mercury.

So things like sardines, cod liver oil, et cetera.

You can get those from natural sources,

except there's one problem.

I hate sardines, and I don't want to slurp down

a bunch of cod fat.

I'm just not interested in that.

So if you eat a lot of fatty ocean fish and it's

really clean fish, great.

I don't.

Most people don't.

So I believe in taking a high quality fish oil.

There are a lot of different sources of these.

In fact, in the episode that we did with Dr. Rhonda Patrick,

there's a link in the show note captions

I believe that takes you to a chart of the different fish oil

sources and their relative levels of contaminants,

et cetera.

But most of the reputable brands out there

are not going to have any contaminants because they've

been cleaned out.

It's been checked for.

So I take the fish oil from G1 or from Momentous.

That's just me.

There are a lot of other great sources out there.

But I will say this.

That's when I'm traveling, and I take capsules.

Typically, I like to take it in liquid form,

and I will take it in liquid form.

I have no financial relationship to the liquid non-capsule forms

of fish oil, and I get the one that has a lemon flavor

to overcome the absolutely disgusting flavor of Cod liver

oil.

I guess, I don't know, presumably cod,

like the taste of cod liver oil.

But I don't.

So that's what I do.

I'll take a tablespoon of that once a day and a protein shake.

It tastes like lemon.

It doesn't taste like cod, thank goodness.

And when I travel, I take the capsules from AG1,

or Momentous, or there are excellent ones

from other sources.

Lots of great sources out there.

Now what are we trying to do when we take fish oil?

Yes, it can reduce inflammation.

Yes, it can do a number of different things.

But that's all by way of omega 3 fatty acid intake, right?

Most people get far too much omega 6, right?

This is why there's a seed oil debate.

We're not going to have that debate now.

We'd put us all to sleep frankly.

The key thing is to get enough omega 3s,

and they're hard to get unless you're eating krill.

So unless you're a large baleen whale,

you're probably not eating that much krill.

If you're getting fatty fish, great.

But when you take an omega 3 fatty

acid in the form of fish oil or you

eat sardines for that matter, what you're getting essentially

is the substrate for a lot of other important building

blocks, not the least of which is the lipid bilayer

that surrounds the neurons of your brain.

And so basically, the omega 3 fatty acids

provide the substrate for some key building

blocks of nerve cells and other cells in the brain and body.

And, this is perhaps the most important reason

I can think of, when you get out past 1 gram of the EPA

form of omega 3, OK, 1 gram of EPA form of omega 3 per day,

it's clear there's either mild to moderate

antidepressant effect, so much so that one can, in some cases,

talk to your psychiatrist or psychologist, partially

offset the dosage of any antidepressant.

I am not telling you to go off antidepressant medication

and go on to fish oil.

That is not what I'm saying.

I'm just saying that there's some impressive clinical trials

showing that fish oil, if taken at dosages

of 1 to 3 grams of EPA per day, can have a mild to moderate

antidepressant effect.

And I don't know anyone that wouldn't

want to have better mood.

So I take 1.5 grams of EPA, which is not

to say 1.5 grams of fish oil.

You need to look at the package and see how much

fish oil but then look at how much EPA.

And typically, it's less than 1 gram per serving.

So you may have to take two servings.

Some people say, well, is it safe to take two servings?

I don't see any reason why not.

And then of course, there are the high potency fish

oils for which there is certainly 1 gram or more

of EPA.

Keep in mind that all this discussion about fish oil

might sound kind of health food hippie store.

Forgive me, hippies.

Health food store kind of stuff.

But the reality is that EPA, high concentration

EPA is actually a prescription drug in the United States

and elsewhere, prescribed often for enhancing mental health,

enhancing cardiovascular health, and on and on.

So we're not out on a limb or out

on a fin as it were when we're having this discussion.

We're actually just talking about something

for which there's a lot of clinical evidence.

There's a lot of biochemical evidence.

There's a lot of mechanisms.

So I take anywhere from one to 2 grams of EPA per day,

even if that requires taking six rather than the suggested three

capsules per day or taking a full tablespoon or even

two tablespoons of fish oil.

And frankly, most people are getting too much omega

6 fatty acids and not enough omega 3.

So shout-out to the fish oils.

What is the recommended protocol for measuring hormone levels?

Interesting.

How frequently do you advise monitoring

these levels to accurately determine their typical range?

And I just have to try and pronounce your name.

Vallad Resnichenko.

What a cool name.

Vallad Resnichenko.

I'm a big fan of like two-syllable first name.

All right.

So Vallad Resnichenko, thank you for this question

and the opportunity to try and pronounce your name.

So hormone levels.

I think a good thing to do is, in the absence

of any apparent or suspected endocrine dysfunction, right?

So we're talking about you feel pretty good.

You're wondering if you're good under--

if I say good under the hood, that just sounds like weird.

It rhymes.

So if you're feeling pretty good,

I recommend getting your hormone levels checked once if you can,

if you're still in your teens, in your late teens,

after you've gone through puberty to establish

a sort of baseline.

Most people won't do that because it's too late.

I didn't do that.

Once in your mid-20s.

Again, we're talking about no suspected or apparent endocrine

dysfunction in your mid-20s.

You have a baseline.

Something to compare to when you were in your say 18 to 20

and again, when you're 25.

That would be ideal.

And then again, I would say when you're 30.

And then start once a year starting

when you are 40 or older.

I think that just logically, I would

love to know what my hormone levels were

when I was 25, when I was 30.

Maybe when I was, yeah, when I was 18, 25, 30, 35.

And actually, 35 is when I got my first blood draw for just

getting a look under the hood.

Like what's there?

What are my estrogen levels?

What are my testosterone levels?

What are my growth hormone levels?

This kind of thing.

And then once you're 40 and older,

I think once a year minimum.

And I realize that some people out there

are going to say, well, that's ridiculous.

What are you going to do with that information?

Well, you're going to do a lot with that information.

You're going to figure out whether or not

your LDL cholesterol is in healthy range.

You're going to figure out whether or not your ALT is

in the healthy range.

You're going to figure out whether or not

your ApoB is in healthy range.

You're going to figure out a lot more than just whether or not

your testosterone is 400, 600, 800, or 1,200.

And I think we also need to be careful about overinterpreting

results of hormones because a lot of it

has to do with the ratio of testosterone

to estrogen or the ratio of free testosterone to testosterone,

both in men and women.

So for instance, if your testosterone level is 900

but your free testosterone level is 2,

well, then you have a problem.

Whereas if your total testosterone

level is 500 or 600 but your free testosterone level is 15,

well, then you're probably doing pretty well.

So I would say getting your hormone levels checked

once a year after age 40, and prior to that,

once every three to five years starting at about age 18

would be ideal.

But most people don't do that.

They either don't have the disposable income.

I certainly didn't when I was 18, 20, 25.

And at that time, it was really hard to get

that measured unless you had a clinical problem.

Now if anyone has a clinical problem that they suspect

or is real, then obviously more testing.

I think great sources for endocrine profiling

are things like InsideTracker.

Full disclosure, they are a sponsor of the podcast,

but they do an excellent job.

They'll even come to your house.

The phlebotomist will come to your house if you want,

or you can go to a clinic, so they make it all very easy.

But there are other sources as well, right?

I'll never make these AMAs or anything else about

specific companies for its own sake.

I just think InsideTracker does a great job.

There are a number of clinics like Marek Health and others,

online clinics that will do that,

but it's part of a more comprehensive package

of agreeing to work with them.

At least that's how I understand it.

I hope I didn't get that wrong.

But check and see.

Nowadays, it's pretty easy to find ways

to get your hormones checked.

But I would suggest that the following things at least

be on there.

Growth hormone or IGF-1 rather.

IGF-1, testosterone, estrogen. This is true for women and men

by the way.

So IGF-1, testosterone, estrogen. It'll

show up as estradiol on there.

Free testosterone, dihydrotestosterone, cortisol.

Keep in mind, morning cortisol is always

elevated relative to afternoon cortisol.

It will be impacted by food.

So you want to go in fasted in the morning,

ideally get this done early.

Your creatinine levels, which by the way, will be

elevated if you're taking creatine

or you're exercising hard.

Your doctor will say your creatinine levels are elevated.

And you say, well, great.

Well, my creatine intake is elevated too.

So take that.

It's not going to be a problem necessarily.

Do check with your doctor.

LDL cholesterol, ApoB.

And there are probably a few others that

would be good to have in there.

For men and women, sex hormone binding globulin, SHBG.

And for women especially, progesterone and prolactin,

and any of the progestins are going to be important.

And of course, for women, the trick

is going to be when you get your blood taken

with respect to your hormone cycle, your ovulatory cycle,

and to try to make that at least consistent from test to test,

not necessarily having to go in both during the follicular

and the luteal phase of your cycle,

but always going in during mid-follicular or mid-luteal,

and that can be challenging to do perhaps.

But that's going to be important because of course, those

are widely fluctuating levels across the cycle.

But unless you're really obsessed with your hormone

levels, and analyzing them, taking them

at multiple times throughout your menstrual cycle,

probably not necessarily unless you're

starting to think about conceiving,

or there's some issue, PCOS or other issue.

OK.

I find that I need to do NSDR after working out.

Any thoughts on this?

Yes.

Well, first of all, I'm glad you're using NSDR,

zero cost tool, known to replenish mental and physical

vigor, works oh so well.

I think it's great.

I think it probably is accelerating your recovery.

I think this tells me that you're probably

working out really hard and hopefully not too long.

If you find that you work out in the morning

and then you're really, really sleepy

in the afternoon and the next day,

you might be working out too long or too hard.

So maybe ratchet back the intensity a little bit

or the duration.

It's amazing how great we can feel

when we work out to 80% to 90% of our maximum output

and duration.

And we did this the other day.

We went out for a little jog, run, bounding,

skipping, jumping jack thing, and stopped at like 80% to 90%

of maximum and went about the rest of the day

and evening feeling great.

If you do this consistently, you'll

find you have more energy.

And there's actually a lot of solid physiology and physics

to support why that is.

As opposed to if you go to the gym and you do every set

to failure, or even every exercise,

you include one set to failure, and you're grinding out four

straps, or you're--

I don't know what kind of exercise you're doing.

Or you're running more and more distance each day

or with more intensity.

It's understandable how one gets kind of drawn to

or addicted to that burn or the effort.

But keep in mind, that is stress.

You're stressing the body to produce

a certain kind of adaptation, either endurance,

or strength, or hypertrophy, or et cetera adaptation.

So there's real beauty in learning

to love working out hard but to leaving the gym

or ending the run with 10% to 20% of the gas in the tank.

And knowing that you can come back and do more,

and you actually want to do more.

It increases vigor, as opposed to taking yourself

over that cliff even a slight 10% to 20%

and then finding that you're kind of depleted.

And this is something that we don't hear enough about

because most people that are into fitness

are into pushing themselves.

It's also true for work.

I think some of the best advice I ever

got in the professional landscape

was when I was a graduate student at UC Berkeley.

And an excellent neurologist by the name of Bob Knight

said the key is to figure out how much can you

work each day consistently?

If that's four hours a day, fine.

If that's eight hours a day, fine.

We're talking with weekend breaks

because that was in the era of weekend breaks.

Maybe a weekend every once in a while

where you have a deadline.

But by thinking about what you personally can really

do consistently while maintaining

sleep, and mental health, and physical health,

you're going to go a lot further than doing like,

for instance, what I did, which was maniac

and working 100 hour weeks as a graduate student

and then ending up sick four times a year

and missing out on a bunch of days

when I could have been in lab.

So these days, I try and get as much focused work

done as possible but try and make

that as consistent as possible, if not from every day

to the next, over time.

Figure out what those averages are, and don't be ashamed

of those averages.

I would say declare those averages to people,

so they know what to expect.

And the fact that you can do more

does not necessarily mean that you

should do more because I think one of the best

pieces of advice I ever got in the world of fitness

is more important than training hard, more important than doing

any particular exercise, more important

than anything is to not get hurt.

Because if you get hurt, you can't train.

So I love that you're doing NSDR after training.

I love that you're making that part of your practice.

But maybe also throttle back a little bit

because you said I have to do it after training.

Maybe throttle back a little bit on the duration or intensity

of exercise and see how you feel.

What can we do to optimize the functioning

of our gut-brain axis?

That's very simple.

Get enough sleep.

In addition to that, avoid excessive intake

of antibiotics.

But if your doctor prescribes them, take them.

I am a believer in antibiotics, OK?

Before the internet jumps on me, I'm not anti-antibiotic.

I always want to say.

That I'm not anti-antibiotic.

I am not pro-antibiotic, but I am pro-probiotics.

I'm probiotic.

So I think you should ingest one to four servings of low sugar

fermented foods per day.

So sauerkraut, kimchi, natto, or kefir,

or otherwise, whatever you like and fits with your nutrition

preferences and plan.

I think it's also very important that you

don't overuse antiseptics, like antiseptic mouthwashes,

and hand rinses, and all that stuff.

This was all discussed on a podcast episode

I did with Dr. Justin Sonnenburg on the Huberman Lab

podcast, which is just to say that Justin, who's

a professor at Stanford and is amazing,

even said that he lets his kids eat lunch when they've been

playing outside without washing their hands before eating lunch

because he wants the probiotic makeup of their gut

to be diverse, including from outside.

Now I'm presuming that's not a public park.

I'm assuming it's their yard.

So we're not talking about gross stuff being on their hands.

We're talking about a little dirt here and there.

It turns out owning a pet increases the diversity

of your microbiome.

Lots of things like that.

You don't want to go around licking people's pets.

It's OK to let them lick you.

And depending on what your preferences

are, but don't lick them.

But when you interact with people,

you shake their hands or pets, you're

increasing the diversity of your microbiome.

When you eat low sugar fermented foods,

you want to make sure also you get

enough fiber, both prebiotic and probiotic fiber.

So fruits and vegetables.

The fiber debate for me just makes me roll my eyes.

I mean, it's so clear that fiber is good for us,

for gut motility and for offsetting cancers of the gut.

I mean, I realize there are the people out there who

are really into elimination diets

where they just only eat meat.

But I mean, there's just so much good data on fiber, especially

from fibrous vegetables.

It just seems like what, yes.

I mean, it's almost silly that we have the debate frankly.

But I'm sure someone out there who's pure carnivore

will be shouting.

But guess what?

You're shouting and you're constipated.

Last question.

Regarding the subject on tongue cleaning from the oral health

episode, can you please share a bit

on brushing tongue, scraping tongue,

and generally how best to clean the tongue?

So tongue cleaning came up on the oral health episode.

I talked to four different dentists and a periodontist

in preparation for that episode.

Almost all of them, remarkably, extraordinarily

converged on the same advice except

for some slight deviations around frequency of flossing.

It's kind of cool, right?

A field where almost everybody seems to agree.

I realize that it isn't the hugest sample size,

but I picked them from diverse locations, backgrounds,

trainings, et cetera.

Every one of them said brush and floss your teeth.

Every one of them said antiseptic, alcohol-based

mouthwashes are bad.

And every single one of them said

that brushing your teeth before sleep

is especially important because at night, you

produce less saliva, and you want

to be able to remineralize your teeth, that

is fill in cavities that are starting to form brush.

So brush your teeth, floss ideally as well before sleep,

but at least brush.

And of course, in the morning too, for everyone's sake.

But if we're talking about tongue brushing and scraping,

it was clear that tongue scraping was

advised if done correctly, OK?

Because there are certain bacteria

that grow on the tongue that you don't want there.

And that scraping can help with the turnover

of healthy bacteria there in addition to removing

some of the bad bacteria.

But that most people scrape their tongue too hard.

And rather, it would be wise to brush your tongue gently

with a soft toothbrush.

And by the way, you should also use a soft brush for your teeth

but not the same one that you use for tongue brushing.

So the takeaway that I was told, and it

makes a lot of sense to me based on what I know now

about the biology, physiology, and care of the mouth

is that you want to use a different soft toothbrush

to brush your tongue than the soft brush

that you use to brush your teeth and that you do not

need to use anything on it.

But if you wanted to put a little bit of salt and baking

soda, that is perfectly fine.

A lot of people wonder whether or not

baking soda scrapes the enamel off the teeth.

It actually is low on the abrasion scale.

Dentists have, believe it or not,

an abrasion scale with a list of things

of how much enamel it scrapes off at a given pressure.

These dentists have done their work.

It's really, really cool.

I can't say I always liked dentists.

I didn't like going to the dentist.

They always seem like nice people.

But now I have newfound respect for dentists.

They really care about their craft,

and oral health has been kind of pushed

to the back seat of the different aspects of health.

I consider it one of the major pillars

of mental health and physical health

because taking care of your teeth, your gums, your mouth,

including your oral microbiome is

critical for cardiovascular health.

It's critical for brain health.

One of the bad bacteria, Streptococcus mutans,

that can proliferate in the mouth,

especially after eating sugary foods,

can make it through the blood-brain barrier.

And maybe, it's thought one of the causes of dementia,

can disrupt your neurons.

Your brain and body is a system.

Everything is talking to everything else.

And so yeah, brush your tongue but use a separate soft brush

to do that and replace it every few weeks to months.

I suppose get expensive but probably

not as expensive as some of the other health

issues that were just described.

So I appreciate that question.

We didn't talk about oil pulling on the podcast.

A lot of people asked about that.

Some people like to swish oil and then spit it out as a way.

That's oil pulling for oral health.

All the dentists I spoke to said nah, not big fans

of oil pulling.

But none of them said it would be particularly bad.

So if you enjoy it or you think it works for you, great.

But none of them really pointed to any clear evidence

that it was going to be beneficial.

So I was told that was the last question,

and we are coming up on the hour.

Again, I want to thank everybody for joining this AMA.

I'm doing this from Australia.

Sydney, Australia.

What's interesting down here is because we

are below the equator, everything is reversed, right?

So this was actually--

it's being presented to you.

I'm actually upside down, but they turned the camera,

so I would appear right side up to you.

Also, when I'm down here, I drink my AG1.

Normally, I swish it counterclockwise,

but I notice here, reflexively, I'm swishing it clockwise.

So anyway, lots of interesting stuff going on.

We'll talk about how that all works.

It's not through the vestibulo-ocular

reflex it turns out but maybe on a future episode of the podcast

about the relationship between location

relative to the equator and neural functioning.

And I'm just kidding.

But what I'm not kidding about is

I appreciate that you tuned in.

And last but certainly not least,

thank you for your interest in science.

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