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Arthritis Diet and Exercises

Tim Ferriss on Ketosis, Microbiome, Lyme Disease, and Biomarkers

All right. Dr. Rhonda Patrick here. Today I’m very excited to be sitting here
with my friend Tim Ferriss, a notorious self-experimenter, a three-time New York Times bestselling author,
an angel investor, startup advisor, and much, much, much more. So before we start, I really just want to
say that I really enjoyed the last time you had and I had a conversation. Me too. It was about a year ago, I think, on your
podcast. Oh my gosh. Time flies. Micronutrients, aging, epigenetics, stem cells,
all that stuff, super fun. So I’m very excited to have the opportunity
to interview you on my podcast. Yeah. I’m intimidated. But I’m looking forward to it. Great. I kind of want to start off with the self-experimentation. Sure. We were actually just having this interesting
conversation that we’ve stopped so that we can continue it live and that has to do with
a little bit about the night you just had and what you’re doing to recover from that
night. Do you want to talk a little bit about that? So I had, like a lot of people on Saturday
nights, a little more booze than intended or anticipated. We were talking about mineral excretion. I was talking about some of my pregame tactics,
whether that’s consuming carbohydrates. I tend to drink the most booze on cheat days
for that reason because I’m retaining whatever it is, I guess 4 grams of water per gram of
carbohydrates, something like that. So it helps to counteract the effects of inhibition
of vasopressin because vasopressin is an anti-diuretic hormone, which means it prevents you from
peeing or minimizes peeing. So it’s used in children who bed wet past
a certain age. I think they use desmopressin. I became, jumping around a little bit, but
I became interested in vasopressin first because when I was in college, I was reading up on
the smart drug literature at the time and it was purported for being very effective
for boosting short-term memory. So you would take hits in each nostril, study
whatever you had to study and then quickly scurry off to the test before it evaporated. Right. But then you had some very interesting comments
on vasopressin. Yes. So I did use vasopressin for a period of time,
found the headaches and side effects ultimately not worth it for me the way that I was using
it. But it is something that’s kind of stuck with
me when someone says, “Oh my god. I was at the bar and then all of a sudden
I time traveled and I was at Denny’s.” I’m like, “Aha, it might have something to
do with vasopressin because you just gave yourself sort of a reverse smart drug.” Very interesting. Yeah. I’m familiar with vasopressin because it’s
also a hormone. It’s a social hormone. And it’s particularly important. It’s kind of like the counter, or not the
counter, it’s the male version of oxytocin. So in females, oxytocin is this notorious
love hormone. When you produce oxytocin, you feel good,
you bond, social bonding, things like that. Well, in males, vasopressin serves a similar
role to oxytocin in females. Vasopressin is associated with pair bonding
and specifically with monogamy. So they’ve done studies in prairie voles where
they actually genetically engineer them to not be able to respond to vasopressin. So they like engineer their vasopressin receptor
to be non-responsive. And these prairie voles, which are monogamous
become polygamous like that. So it’s very interesting. Also, they’ve done human studies where they’ve
looked at gene polymorphisms which are just variations in the sequence of DNA of a gene
that changes the function. We all have various polymorphisms. You’re familiar with that. So there’s a particular variety of this polymorphism
in the vasopressin receptors that males have that make them less responsive to vasopressin. These males are more likely to be either divorced
or never been married, whereas males that don’t have this polymorphism are more likely
to be happily married. Surprise, surprise. So yeah, alcohol, there may be actually a
mechanism through vasopressin that leads to polygamy or being more promiscuous, I guess. I wonder if that’s in the water in San Francisco. It’s sort of ground zero for all the polyamorous
flag wavers. So on the self-experimentation topic, you’ve
been self-experimenting for many years and I was wondering if throughout your years of
experimentation if there are three or four biomarkers . . . so, you typically measure
blood biomarkers routinely. If there are three or four really important
ones that you think are important that you routinely measure and if they have anything
to do with performance or mental acuity or perhaps aging. Yeah. There are a few . . . well, there are many
blood markers that I look at. I had a fun conversation with Pete Attia on
the podcast not too long ago about this. But my markers, the markers that I’m following
right now are number one, my millimolar concentration of ketones. So I have a device just on the counter over
there, a Precision Xtra device by Abbott Labs that allows me to use both glucose strips
and ketone strips. So I can look at my fasting or waking fasting
glucose level and then ketone level and monitor that after certain types of, say, exercise
when the ketone level can drop and so on and so forth. Because I’ve identified for myself, part of
the reason I have fat in my tea, is I operated best mentally at around 1.1 to 1.7 millimolars
and I only figured that out by tracking. Very interesting. Some people, for instance, perform much better
the higher concentration. The higher the concentration of ketones, the
better they feel. I don’t fall in that camp. I was having a conversation with a scientist
a few days ago about this. He said, “Well, really,” and this is not a
new observation, “But your blood level of ketones can be gained or increased in many
different ways.” So you can just eat a meal that’s full of
medium chain triglycerides or eat a meal that’s just full of fat in general and you can spike
your ketone level. That’s not necessarily indicative of an endogenous
production of ketones or you could be fasting and like deep fasting after five or six or
seven days. In my particular case, I think you also want
to look at–and this is true, a lot of very smart people like Pete Attia, Dom D’Agostino,
very, very smart guy, Dominic–would say likely that it also could be some people utilize
ketones better than others. Yes. So just because you have a high level of ketones,
doesn’t mean you’re necessarily doing a lot with it. So in my case, a high level of ketones, my
hypothesis is well maybe past a certain point, my kind of machinery gets very inefficient
or gets damaged. So between 1.1 and 1.7, my brain operates
functions at a level reminiscent of pre-Lyme. That’s a whole separate thing. I kind of knocked out normal cognitive function
for nine months due to severe Lyme disease. But when I am focused on at least a nominal
amount of ketones, I feel like my old self. So that’s one. Other things that I focus on or look at . . . there
are some esoteric things that I play with every once in a while. But if you’re looking at the routine levels,
I’m going to look at obviously the sex hormones, look at free testosterone. I’ll look at free testosterone as relative
to sex hormone binding globulin, for instance. I’m not convinced that higher sex hormone
binding globulin is always a bad thing. That’s a whole separate. Because my testosterone in experimenting with
high fat, total testosterone has gone from 650 to 950 in a span of nine months. It’s a non-trivial increase. Now, sex hormone binding globulin has also
increased over time. But I’ve gained so much lean muscle tissue
that I have other ideas. I was talking to Steven Phinney about this–scientist,
very well known for looking at the ketogenic diet–and what he was saying is independent
of insulin levels, insulin made very anabolic . . . sorry, we’re getting into the weeds
here. It’s possible that my lean mass gains can
be account for by decreased degradation of branch chain amino acids. I was like, “That’s really interesting.” Maybe that explains by fasting plus chemotherapy
is very, very effective, for instance. People can recover faster from chemotherapy. So you have the ketones. You have the sex hormones. Hemoglobin A1c, sort of like your running
three-month average of glucose levels just as an insurance policy to ensure that I’m
not skewing towards pre-diabetic in any way. And then a laundry list of like five or six
different pages of stuff. So your biomarkers tend to be a lot of performance-related
biomarkers. Yeah. And I’ve done the genetic stuff. So I know, let’s just say that I’m a poor
methylator, the motherfucker gene, as they say. Yes, MTHFR. Yeah. I’m not in an ideal spot. So taking, say, l-methylfolate could be a
good option for me and I’ve experimented with that in the past, looking at how that can
lower homocysteine or things like that. Have you noticed any differences after experimented
with 5-methylfolate, L-5-methylfolate, methylcobalamin? Yeah. I haven’t noticed many changes in blood markers
and I haven’t noticed subjective changes in, say, performance or clarity or anything like
that. Yeah. It doesn’t mean it isn’t doing things. Yeah. I have an anecdotal story. So I’m very into looking at different gene
polymorphisms. 23andMe is a great service that can do that. So my friends, family, etc., I’m telling everyone
to do it. So my mother-in-law got genotyped and we found
out that she is homozygous for MTHFR, meaning that her MTHFR enzyme only is working at about
10 to 20% efficiency. She’s always had really high blood pressure,
to the point where doctors were wanting to get her on medicine for it and she’s always
refused. Nothing she did . . . she’s done various diets,
lots of exercise, lots of things she’s tried, nothing has gotten her into a normal range
until we identified she had MTHFR, got her supplementing with 5-methylfolate and methylcobalamin. But she’s been taking pretty high doses of
it. But now her blood pressure for the first time
is in like a normal range. So I was kind of curious if you had ever . . .
I have very consistently what you would consider excellent blood pressure. So I haven’t looked closely at that. The question that comes to mind for me always
because I’ve noticed . . . so, I’m a big fan of Richard Feynman. Richard Feynman, and I’m not saying this is
the case with your, you said mother-in-law? Yes. But the importance of not tricking yourself
because you’re the easiest person to fool, basically, is what he would say. I know that what I have initially thought
were sort of causal relationships with high correlative value . . . for instance, I’ve
talked to people who have gone on fill in the blank diet. They’re like, “This thing changed. I’m so glad I found this diet.” I’m like, “So you haven’t changed anything
else?” “No, no, no. I started running in the morning. I started doing this. I started doing that.” I’m like, “Hell yeah” . . . because like one,
it’s so hard. That’s where the observational data gets so
challenging, when you look at, say anything, whether it’s the China study or whatever. We don’t need to get into that one. That’s a sensitive one. But any observational self-reporting and so
on, the data is almost always so flawed because humans almost never change just one thing. Yeah. I think that’s why it’s so important when
you’re looking at epi studies that are associative that are not a clinical, randomizable trial,
coupling that data with mechanistic data done on animal models or lower organisms, I think
coupling the two is very important because then you go, “Oh, okay. We’ve noticed this observational data and
here we’ve done X, Y or Z to manipulate it in a worm or in a fly or a mouse.” Right. So you have a plausible mechanism. Right. So you have a mechanism. That’s where I think looking comprehensibly
at the whole . . . At the intersection. Yeah, scientific is very important. Totally agree. It’s interesting. You mentioned the ketone thing. I just want to briefly give you my story. Yeah. So I’ve never noticed, really, any extreme
mental benefits or mental acuity changing when I consume large amounts of MCT on empty
stomach, on whatever. I found out that I have one ApoE4 allele. And of course, at that point, I became terrified
of Alzheimer’s because it increases the risk for Alzheimer’s by two-fold and I’m writing
an academic paper on this right now and getting into all the mechanisms–diet, lifestyle,
things like that. But what I found really interesting are the
studies that they’ve done where they give, for example, people who have dementia or people
in the early stages of Alzheimer’s, they give them beta-hydroxybutyrate, which is a ketone
body. And there’s improvement. I have some synthetic jet fuel in the freezer
if you want to try it. We’ll probably both vomit on my couch. So let’s do it later. Yeah. I’ve heard it’s disgusting. So people who were ApoE3 responded very well. So they had improvements in learning and memory. With a supplemental MCT? With beta-hydroxybutyrate. They gave them beta-hydroxybutyrate. But what was interesting to me and also very
discouraging was that people with ApoE4 allele did not have those benefits. If you look at Alzheimer’s, people with Alzheimer’s,
between 65 and 80% of all people who have Alzheimer’s have one allele of ApoE4. Oh, well I bet I have that on both sides of
my family, then because I have Alzheimer’s on both sides. Yeah. I wanted to ask you, so you mentioned that
you have Alzheimer’s and Parkinson’s on both sides of your family. So I’m curious. Has this changed your diet, your lifestyle? Oh, definitely. How so? Well, the Parkinson’s maybe a bit less so. But on the Alzheimer’s side, I have just looked
at it like some scientists look at it, which is as brain diabetes. I think that’s a helpful, simplified way of
looking at it. You I’m sure know much more about this than
I do. But there’s the prevalent theory of why I
say Alzheimer’s has the effects it has on cognitive performance or, in this case, degradation
or otherwise. For a long time, I was like, “It’s the plaques,
kind of like, plaques, it’s this, it’s that.” And it turns out to be more complicated than
that because you have people who have massive tangles of plaques but they seem asymptomatic. They’re 100 and x years old but they still
play the piano every day or whatever it may be. Great movie called “The Lady and Number Six”
as a side note, 109 year old piano player. It doesn’t get into Alzheimer’s. But where it has led me is just to be more
cognizant of insulin, things that are related to and/or affect insulin. To look at not only ketosis but fasting, to
look at cyclical ketogenic diets and so on, targeted ketogenic diets where you’re timing
carbohydrate intake near workouts, which a lot of endurance athletes do so they can consume
like 300 or 400 grams of carbohydrates in a day and still say in ketosis, pretty wild
stuff. Wow. But what I start wondering, for instance in
the case . . . because if I take supplemental MCTs or even beta-hydroxybutyrate, and there
are tasty ways to do it now. I think it’s Patrick Arnold and Prototype
Nutrition. They have a . . . well, people say KetoCaNa,
C-A-N-A, but it tastes like Gatorade, basically and it’s beta-hydroxybutyrate. If I take that when I’m not, say, above 0.6
millimolars ketones, I don’t feel much. But when my body has shifted into that fat-adapted
state, I do feel it. Off hand, I don’t know what my status is from
the genetic standpoint. But what’s been very interesting say for me
when I’m thinking about it from the standpoint of brain diabetes is it’s not just enough
. . . and this comes back to how people, if they focus solely on the millimolar concentration,
they can fool themselves because you can be in non-nutritional ketosis but consuming a
lot of supplemental beta-hydroxybutyrate and be like, “Oh, I’m killing it. I’m at two millimolars concentration.” Whereas I’m also taking my glucometer readings
precisely because I don’t want to be running at 120 glucose and dismiss that. If I wake up and I’m fasting 120 glucose each
morning, something funny is going on that I need to pay attention to. Whereas if I drop into nutritional ketosis
and let’s just say I’m at 74, 80, even lower and I have high millimolar, my response to
at that point supplemental beta-hydroxybutyrate is totally different. That’s interesting. Anyway, I’m still kind of a novice in this
space, but it’s interesting stuff. So the cyclical ketogenic diet is something
that you do now practicing. And that’s, you think, as a consequence of
thinking of Alzheimer’s like type 2 diabetes. It’s really interesting, that connection between
insulin resistance and type 2 diabetes. I don’t know if you measure any blood biomarkers
or if you’re aware of this, but there is a biomarker that is present in blood that’s
called insulin-like receptor 1, IRS1 and it’s recently, very, very recently been shown to
be a diagnostic for Alzheimer’s 10 years in advance with 100% accuracy. [inaudible 00:19:13]
So I don’t think it’s like something that . . . well, you can modulate. So 10 years in advance is a long to change. Just by the way, you are fucked. You’re screwed. Good luck with that. Yeah. It’s inactive. IRS1 using [inaudible 00:19:32]
Yes. What’s interesting to me is I typically think
of the connection between type 2 diabetes and insulin resistance and Alzheimer’s as
the connection between inflammation and a nerve degenerative disease because inflammation,
we’ve now recently found that the lymphatic system connects directly to the brain. The lymphatic system is what carries blood
cells, cytokines, inflammatory molecules and inflammation is a major, major downstream
consequence of being insulin resistance. Inflammation causes reactive oxygen species,
things that damage all sorts of cells. But the inflammatory molecules get into the
brain and they do start causing all sorts of immune type reactions and aggregation of
more amyloid beta plaques and all that stuff starts to happen more quickly. So I think that the inflammation . . . because
if you look at people, type 2 diabetics, being type 2 diabetic, you have a two-fold roughly
increased chance of getting Alzheimer’s. But if you look at people with Alzheimer’s,
a small percentage of them have type 2 diabetes. So I think that it’s not just the insulin
resistance. I think there are the consequences, the byproducts,
the indirect things that are associated with . . .
100% . . . type 2 diabetes that lead to Alzheimer’s. Yeah. It’s rarely, if ever, just one thing. I think humans strive for simplicity and in
sort of a sea of noise, especially if you’re not a trained scientist, it’s like, “God,
thank goodness somebody gave me a definitive answer. Now I know A causes B.” It’s like, okay, maybe
as a temporary holding bay, we can use that answer. But it’s probably not right. But on the inflammation side, I’ve been thinking
a lot about this recently because number one, and this is not that uncommon, but I’ve noticed
that if I consume carbohydrates, cycling carbohydrates and I’ll do a cheat day like yesterday where
I’m eating an entire pound cake by myself, this kind of thing, and then even several
hours later, I get acupuncture and that’s a whole separate conversation, but I will
bleed more. I will bleed much more than if I am, say in
a ketotic state. But then I have all these questions that come
to mind. For instance, I’m consuming like turmeric
with ground pepper. I always read it. I never say it, piperine? Yeah, piperine. There we go. So to increase the bioavailability and absorption. So that’s pretty old school. You’ve got turmeric, curcumin pills or whatever. There are a million ways to go about it. But I’ve tried to whenever possible . . . so,
you have like L-methylfolate, let’s say. Very interesting to me. But unless I’m mistaken, pretty new kid on
the block. It’s a relatively new addition to the supplement
arsenal. Whereas like turmeric, it’s like, Ayurvedic
medicine, they’ve been doing that for thousands of years. I feel pretty comfortable bringing in turmeric
tea with some ginger and black pepper to counteract unnecessary inflammation. At the same time I’m like inflammation . . . this
is where maybe you can help me gain some clarity, but I’m like inflammation also serves some
really important purposes, right? If, for instance, you have people go do a
weight training workout, there’s a fair amount of empirical data, I don’t know if there’s
research data to support this, where athletes will be like, “Oh my god, I don’t want to
be so sort out of my workout. I’ll take like NSAIDs, Advil, Ibuprofen, whatever,
to facilitate recovery.” In fact, then they have less hypertrophy and
they have less muscle growth as a result. So it’s like what is the inflammation that
we want to not interfere with versus the inflammation that we should try to prevent. Yes. I think that it’s something I’ve been thinking
about in a similar way with inflammation and also antioxidants because I think that the
type that you want to interfere with is the colonic inflammation, the kind that’s coming
from your gut, that’s leaking endotoxin, which is released from like dead bacteria and it
causes all sorts of damage because it binds to cholesterol. Anyways, I can get into this whole conversation. But it’s the bad stuff. The inflammation that’s causing that chronic
reactive oxygen species which damages DNA, proteins, lipids in your cells which gets
into the brain and stops serotonin from being released, so it causes depression and things
like that. Sounds like a bad cycle. Yes. Very viscous cycle too because then you start
to activate more inflammatory molecules. I think the good type of inflammation, the
good type of damage, the good type of stress is when you exercise, is when you’re doing
that type of exercise or heat stress or cold stress or that type of transient stress on
the body that induces all these, the expression of genes that deal with stress so you’re increasing
the expression of all these good genes that deal with inflammation expressed. Having that inflammation, having that stress
is critical to do that. That’s how turmeric works and curcumin. One of the ways it works is it’s actually
slightly toxic to us. Because it’s slightly toxic to us, our body
goes, “Oh wait a minute, I need to increase the expression of all these genes so they
make more of the gene to do all this good stuff, to fight inflammation, to fight reactive
oxygen species, all that bad stuff. So I think it’s sort of like . . .
It’s like what Dread Private Roberts did in “Princess Bride” with iocane powder. Yes. A little bit every day. Yes. But it’s like the chronic versus acute, good
type of stress. So that’s what I think about. I also have been thinking about it in regards
to supplemental antioxidants. I used to take a lot of vitamin C, supplemental
vitamin C. And there were studies that we’re showing taking two grams of supplemental vitamin
C a day with lower C-reactive protein and there are all these reasons why I was taking
it. But then, studies started to come out where
if you take the supplemental vitamin C like after a workout, the half life is like an
hour in a half in the plasma or something. Then, when you work out, you create oxidated
stress and you want that. That’s what induces mitochondrial biogenesis. That stress is what signals to the mitochondria
to make more mitochondria. But if you dampen that by like sequestering
that stress with an antioxidant, we’re not going to get those benefits. There are studies now showing this both in
humans and mouse animals. So now I’m kind of a little more cautious
about supplemental antioxidants specifically because they can sequester some of that good
stress that you want from things like exercise or intermittent fasting, for example, things
like that. Wow. Interesting. So you think antioxidants could negate some
of the benefits of, say, intermittent fasting. Yes. They can. And it’s been shown that that can. That’s good to know. Supplemental antioxidants, because when you’re
intermittent fasting, a lot of things are going on, but it is a type of stress. When you’re stressing your cells, you’re creating
reactive oxygen species. That’s what happens. And part of that, there’s a hermetic effect. So when you create these reactive oxygen species
. . . and this is the good type of stress. Creating the good type of species because
you’re chronically inflamed because you’re eating processed carbohydrates and you’re
poking holes in your gut leading to inflammation and blah, blah, blah, that’s not the good
type. You don’t want that constant reactive oxygen
species being made every day. But when you’re intermittent fasting or you’re
exercising, that burst of it, which is much more powerful, so it’s not like a little bit
each day, it’s like, “Boom, here I am.” It’s enough to signal to your genes, to other
cells, “Make more of this gene that deals with inflammation. Make more of this gene that deals with stress. Make more mitochondria.” It’s just enough to do that. You want. Some of the benefits of intermittent fasting
and exercise rely on that. You know, just as another random side note,
this could be the alcohol that I was fed by Polish people yesterday, but you said reactive
oxygen species, ROSs, sounds a lot like ROUS, rodents of unusual size, also from “Princess
Bride.” I’m wondering how much biochemistry you can
teach using metaphors from “The Princess Bride.” But that’s a whole separate conversation probably
not worth having. But the one thing that I’ve been pondering,
I’m not an expert in this area, but vitamin C, if you look at protocols being used at,
say, the University of Kansas for antiviral purposes or anti-cancer purposes, the vitamin
C is thought of when it’s delivered intravenously as a pro-oxidant. So then I’m wondering could you use vitamin
C in a pro-oxidant capacity, or I guess it’s being converted into like hydrogen peroxide,
to not mitigate but exaggerate the benefits you want of, say, intermittent fasting. That’s interesting. Yeah. If you were doing not even necessarily intermittent. Let’s say you do a seven-day water fast. Could you do like 50 to 75 grams of vitamin
C each day? Would that end up nullifying a lot of the
effects or dramatically enhancing the effects? So here are my thoughts. I’m speculating here. Intravenous vitamin C, you get much higher,
up to millimolar concentrations of vitamin C in your blood. So vitamin C is constantly going through the
cycle of being reduced and oxidized and reduced and oxidized. When it’s oxidized, it can act as a pro-oxidant. That’s part of the way it kills cancer cells
because cancer cells, they’re ready to die but they’ve found a way around death by increasing
all these genes that stop them from dying. But all they need is a little push. That little push is like reactive oxygen species
or a pro-oxidant like vitamin C. It just pops them, pushes them to death. So intermittent fasting, for example, one
of the benefits of intermittent fasting is that your autophagy occurs. Your body is clearing out all these damaged
cells. So that would, in theory, if you’ve got damaged
cells . . . so, the problem is with damaged cells, if they don’t die, they become senescent. When they’re senescent, they sit around and
they secrete pro-inflammatory cytokines. So then they damage nearby cells because the
inflammatory cytokines. So it’s like this vicious cycle and it’s why
you need to get them back. You need to get the cellular Zamboni to clear
that stuff. That’s a funny analogy. I used to be an ice skater. That’s my ring name. Oh, really? For many, many years I was a competitive ice
skater, both freestyle and drills team. So you want to clear them out. I would think that if you have this senescent
cell, that would help get rid of it. So very, very interesting observation. I’ve been thinking about it also because cancer
generally . . . by the time you’re 40, we all have pre-cancerous little cells. But the question is do they grow? Do they then metastasize or become a problem,
or do they just remain these little mutations that don’t cause any particular harm among
other things obviously? For me, I’ve become also interested in . . . I’d
love to get your opinion on metformin. There are people who’d say, “Well, if you
want to try to dodge that cancer bullet, we know that cancer cells, they love sustaining
themselves anaerobically . . . or let me rephrase that, with glucose. They love glucose. So if we can dramatically lower, whether it’s
storage of glycogen, plasma, glucose, whatever it might be, then in theory, we should be
able to lower the risk of cancer and limit cancer growth, cancer cell growth. What are your thoughts on metformin and why
are you taking it or not taking it? I’m not taking it. The reason I’m not taking it . . . I think
it has been shown, like you said, it can possibly prophylactically prevent cancer so far. I think the studies that have shown that have
been pretty short-term. My concern with metformin is the feedback
mechanisms that happen when you’re taking this drug. How is that going to affect other cells and
how they respond to glucose and things like that over the long-term, like 15 years down
the line? I think that limiting your sugar intake is
probably . . . if you haven’t damaged yourself by eating a bunch of crap, a bunch of processed
sugars and carbohydrates and things like that, then I think limiting your sugar intake is
probably good, good enough. To a certain component, there’s a certain
component of cancer that there is a genetic component. What I mean by that is not that you’re born
with it but . . . so, downstream of a cell that’s glycolytic, that’s only using glucose
to make ATP through this glycolysis pathway is inflammation again. I come back to it because it’s just downstream
of everything. And inflammation damages DNA and eventually
you get it in the right gene that’s saying, “Oh, this gene usually protects,” whenever
there’s any damage, it kills a cell. It’s called a tumor suppressor gene. You get it in that tumor suppressor gene,
you’re screwed. Now any time you get damaged, that pathway
isn’t activated to go, “Whoa, wait a minute, this is not good. I’m going to die. And it just keeps living.” Yeah. If you look at, for example, our lymphocytes,
our lymphocytes are glycolytic and they’re not cancer. So it’s not as simple as a glycolytic cell
is going to give you cancer. No, no. But definitely starving . . . I think before
you get to the point where you’re starving a cancer cell, you can kill the damaged cell
before it becomes to that point where it’s shifted its metabolism. What do the lymphocytes do in a ketotic state? I don’t know. Do they derive glucose form lactate or something? Yes. They do get it from lactate. Lactate is something that they do use. Yeah. Cool. It’s interesting because lactate also is much
like ketone bodies, energetically thermodynamically favorable. So it takes less energy to make energy. Yeah. So you’re consuming less oxygen because you
don’t need as many ATP molecules to make ATP. But back on the ketones since we’re back on
the ketone, I do want to get to the Lyme disease because it’s a topic that I avoid. I’ve never talked about it. It’s one I avoid too. I always have this knee jerk reaction because
the signal to noise ratio is so small. I feel like there’s just a lot of confusion. So much nonsense. But I’d be really interested because you’re
a very analytical person. I try to be. So obviously it’s a real disease. People suffer from it. You can observe spirochetes under a microscope. So it’s definitely real. It’s just a lot of craziness that seems to
be associated with it. But maybe you can talk a little bit about
. . . because you mentioned going on the ketogenic diet to treat your Lyme disease. Can you talk a little bit about what you found
in terms of your experience with Lyme disease and how you got to treating it with ketogenesis? Yeah. I can talk about it. So where to begin with this . . . First of
all, I’d just like to agree with you and sort of emphasize for everybody that the amount
of nonsense and charlatanism out there surrounding Lyme is just beyond belief. There are so many fraudulent companies and
practitioners who are just printing money by either misdiagnosing people with Lyme or
treating Lyme in the quackiest of quackery. Why Lyme? So here’s my thinking. So I contracted Lyme on Easter in Long Island. If you look at the CDC map, the Center for
Disease Control heat map for Lyme disease, that is ground zero. That’s where the bomb went off. Lyme is named after Lyme, Connecticut. So it really has historically focused on that
Northeastern area–Pennsylvania, Upstate New York, Hudson Valley. I think Lyme has become this popular topic
of conversation for a few reasons. Number one, it’s poorly understood on a lot
of levels. So there are ample opportunities for non-scientists
and quacks to sort of invent stories around it. That makes sense. Number one. Number two, it’s scary. It involves a bug biting you and you catch
this disease, so the media loves it. The media loves it. The media writes about it. Then the media sometimes correctly, often
incorrectly lists the symptoms of Lyme disease–joint pain, depression, fatigue–it’s like, “Well,
that’s one out of every two people in the United States at some point every year.” And then people go, “Oh, my god. I’ve had my . . . ” I got an email from a
friend of mine who says, “My shoulder has been bothering me for a couple weeks and two
of my friends said it might be Lyme.” I’m like, Oh, god. I would bet $1,000 it’s not Lyme disease. Given where you live, given the likelihood
of having contracted it, it’s just so unlikely for most people. Now, all of that having been said, Lyme is
a real thing. Like you said, you can observe the spirochetes
under a microscope. I think another reason it’s popular to talk
about is people love saying the word “spirochete.” I’m not kidding. They love saying spirochetes. They imagine this screwdriver, this horribly
evil like Maleficent like spiral bug that like digs into your body and like the antibiotics
come in and they’re like, “Oh no, we’re going to hide from the antibiotics.” It’s not that sentient. My husband’s grandmother says spirochetes
like at least every conversation that I have with her. People love saying spirochetes. So you get it. Yes. So for all these reasons it’s popular to talk
about. I think primarily because the symptoms overlap
with a million other conditions. What I came to realize for myself is like
yes, it’s a real thing. It’s almost certain after Western blot tests
and ELISA tests and looking at all the diagnostics, which are really primitive, it’s very likely
that I already had Lyme disease at some point because I’ve been bitten by ticks hundreds
of times. Almost everyone in my immediate family has
had Lyme disease. On Long Island, it’s just kind of like, “Suck
it up. Take some antibiotics. You’re fine. Move on with life.” It’s not viewed as like a huge crisis by everyone
who gets it on Eastern Long Island because it’s so common. So I shrugged it off. I took three or four deer ticks that were
embedded off of me in the span of two or three weeks. It historically hadn’t been a big deal. So I was like, “That sucks.” Pick it off, make sure the head is not in
there, move on. I did not develop what’s thought of as the
trademark bullseye rash. So I ignored progressively worsening symptoms
for eight weeks where my joints started getting very sore, swollen. I had trouble getting out of bed in the morning. I started getting slow cognitively and had
trouble recalling friends’ names and just really common words and eventually got to
a point where my assistant was like, “I’ve seen you sick. I’ve seen you tired. I’ve seen you burning the candle at both ends. This is none of those things. You need to see a doctor.” It sounds like dementia, like not remembering
friends’ names. Yeah. Things are really funny. If you look at the advanced symptoms of severe
Lyme, it takes on dementia-like qualities, even cerebral palsy in some cases, really
scary stuff. So long story short, then I get diagnosed
with Lyme. When I walk into the clinic on Long Island,
to give you an idea of how common it is, so this walk-in emergency clinic open on the
weekend, they had a poster up that was like, “Hey, allow us to send your blood sample to
such and such lab, Upstate New York, to do research on Lyme,” and there’s a picture of
a tick, “And we’ll give you a free $50 Amazon gift card.” It’s that common. But then the question was, “Okay, I have Lyme.” I’m taking doxycycline. I do that for eight weeks or 12 weeks, whatever
it was. I still feel really shitty. Now what? That’s a long antibiotic course. Yeah. Some people take antibiotic for years, which
I think is not the thing to do. This is where I am and I’ll try to sum it
up because this can be a very long conversation. I think that there are very, very credible
scientists and infectious disease specialists who do not believe that chronic Lyme exists. Their position would be there’s no evidence
that the whatever it is, the borrelia spirochete cannot be eradicated with broad spectrum antibiotics
like a doxycycline or something else. There’s no evidence to suggest that they burrow
away and hide and come back, hide in biofilm or whatever. Yeah, right. Right. Then you have people, and there aren’t that
many, but a handful of people who are like, “Well, it is possible that this Lyme could
behave something like herpes simplex,” where it’s like a recurring infection essentially
and maybe it takes root in the nervous system somehow and only comes back out in times of
stress. There are people, credible doctors who have
been like, “It’s not completely beyond the realm of possibility that is has some recurring
nature.” Okay. Still, kind of descriptive, not prescriptive,
what do we do? Right? Then the theory that I kind of came up with,
and I’m sure other people have come up with it, but I haven’t read it, I was like, “Well,
let’s look at the symptoms of Lyme. You have like depression, fatigue. What are other potential causes after a long
course of antibiotics? Well, maybe you just completely scorched earth
your microbiome among other things. So one of my theories is that what people
perceive as chronic Lyme is in fact a collection of similar symptoms caused by the long course
of antibiotics. So you should focus on prebiotics, probiotics. I have had a tremendous amount of difficulty,
at least as measured in common stool testing and so on, in repopulating my gut diversity. It’s been extremely hard. I have consumed just about every type of pre
and probiotic imaginable. I’ve also tweaked my diet to be more favorable
for certain types of gut repopulation. It’s been really tough. I did like a three-month intense protocol
of all sorts of stuff. So I’d love your thoughts. I did a follow-up stool sample analysis and
it was still like, “No, you’re fucked.” I was like, “Wow . . . ” depressing. So you’re talking about measuring your fecal
bacteria population using uBiome? Yeah. UBiome or there are others, like Rocky Mountain
blah, blah, blah doctors data, whatever it was. Okay. There are other ones. Yeah. UBiome has a slightly different approach,
but along those lines. I agree with you for one. First of all, I heard a podcast that you did
with Jessica Richman from uBiome and I think you had talked about this and that’s how I
became first aware the link between . . . when you mentioned having this hypothesis that
you thought possibly some of these symptoms of Lyme disease were a symptom of complete
gut disbiosis where you’re taking several rounds of antibiotics and you are obliterating
your gut bacteria, a lot of the good ones are going away. If you don’t take a very strong probiotic
immediately after antibiotics, it repopulates with all the bad stuff and it’s really hard
to get because they occupy space. They’re sitting in what’s called the mucin
in the gut. They have to stick in the mucin to stay, otherwise
anything you take will kind of just flow through. It’s kind of like the flow through. So it’s really hard to repopulate. I’ve been doing a lot of self-experimentation. I’ve been using uBiome to track my gut bacteria
genotypes. But have you tried VSL3? I have it in the refrigerator right now. Do you? Yeah. Okay. So the sachets are what I recommend because
. . . Yeah. I have the capsules. The sachets have 450 billion, which is more
than what the capsules have. 450 billion is ten times more than what most
probiotics have. The thing about VSL3, very interesting, so
it’s the probiotic that I take. I’m taking it because I’ve had some gut issues
that started in graduate school because I got MRSA. Yeah. That’s not fun. Antibiotics were the prescription and I had
several courses of strong ones. Finally, it kept coming back and I was like
fed up. How do you get MRSA? I don’t really know. I worked in a hospital. Is that methicillin-resistant Staph? Yes. Aureus. Staphylococcus aureus. Staphylococcus aureus, yeah. So I worked at a children’s hospital. That’s a good place to get it. They’re everywhere in hospitals. Who knows where I got it? The point is I got it and it sucked. Finally after like, I don’t know, three or
four rounds of antibiotics, I would take it and it would go away and then a month later
it would come back again and again. I was like, “I can’t do this.” So I read the literature, with the help of
my husband Dan, that garlic and grapefruit seed extract, a concoction of things, I applied
both topically and made a cream and I orally took and within 24 hours I got this thing
to come to a head, pus out, it never came back. Interesting. But as a consequence of antibiotic use, I
had serious gut issues, led to IBD. I’ve finally been able to recover. IBD, irritable bowel disorder. Inflammatory bowel, yeah. Inflammatory bowel disorder. But it’s been a really, really long journey
in tweaking my diet. Doctors, of course, I went to see doctors
and they were just like, “Here, take an SSRI, it helps with the pain.” I’m like, “I’m not going to take an SSRI. Yeah. No thanks. I walked out of that doctor, like, “You’re
insane.” This was like a pelvic pain specialist doctor. So I’ve just had terrible experiences with
doctors. Finally, I’m like, “Why aren’t you asking
me about my diet, fiber, things like that?” So I tweaked my diet and did lots of things. But VSL3 . . .
With the uBiome testing, have you seen . . . I haven’t done a follow-up test in a few months,
but I have been taking VSL3, so now I’m optimistic hopefully. So I did a 30-day VSL3 course with the sachets,
which are 450 billion and did a stool test. I’m still waiting for those results. My husband and I both, Dan, he’s done a recent
course of antibiotics. So I had him do his baseline and then right
after, literally the day he stopped taking antibiotics, did a sample for uBiome. I got that data back, so I’ve been looking
at that. So I’m going to talk about all that. It’s really complicated and things in the
literature are confusing and some people think some things and they’re actually not true. So I’ve been looking at other people’s uBiomes. I’m going to be doing a series of talks on
this. Cool. I’m pretty excited. I’ll check them out. May I add just a little bit of color on the
ketosis? Yes. The color there is I began looking at fasting
as a tool for many, many different reasons. And whether that be related to, say, longevity
or the reason I was excited about it is I was looking at it as a reboot of the immune
system, even shorter fasts, three days. I began playing around with fasting. Then, of course, you fast long enough and
you go into pretty deep ketosis. Correct. So it was almost an accidental discovery for
me whereby I had not been in nutritional ketosis for 10 years, 15 years. I did a lot of experimentation with the cyclical
ketogenic diet when I was in college and competing as an athlete. Then I just stopped because it was kind of
a pain in the ass and it was really boring. But then I did this fasting to help reboot
my immune system. I’ll keep it simple. So rebooting my immune system kicked over
into deep ketosis and it just felt amazing. My cognitive function just went through the
roof compared to what I had felt up that point after Lyme disease. I was like, “Well, this is very interesting,
isn’t it?” I said, “Well, I don’t have to fast to be
in nutritional ketosis. So let me now play around with ketosis and
see what I can discover just by tracking and logging a lot of data.” So I have my pet hypothesis about the gut
biome and the antibiotics leading to symptoms that appear to be Lyme when in fact they’re
caused by something else. Another hypothesis, and the reason I’d like
to dig into this, but I haven’t come up with a great plausible explanation for this, is
that Lyme or the antibiotics or both somehow interfere with carbohydrate metabolism. That’s just a starting point. But because I’ve been public about the Lyme
stuff because I was incapacitated, I had to tell people. I was like, “Sorry, I’m not going to reply
to your email. I’m archiving 2,000 emails. Sorry.” “Why?” “Lyme.” And then people started coming out of the
woodwork to be like, “Hey, my wife has Lyme. She’s been debilitated. What should we do? What have you learned?” And the only advice that I gave a few people
was like, “Look, there’s a lot of BS out there.” So number one is put your thinking cap on
and be a good scientist to the extent possible. Number two is try a carb-restricted diet. Ideally, go into ketosis. All of the people who have gone into ketosis
have had the same experience I have. Now, it’s a handful of people. So the sample size is really small. These are people that like, “Cannot function,
had to quit my job,” serious cases, go into ketosis, “Wow, I feel like my old self.” Have you measured any changes in gut bacteria
after going into ketosis or after doing the ketogenic diet? I haven’t. That is also a very interesting topic of discussion. So what effect does ketosis have on the gut
biome or the repopulation, the rate or the diversity of repopulation? The short answer is I don’t know. Part of it is, and this is where maybe I’m
not being a thorough scientist. But I felt it worked so well to me that I’m
so excited to get back to building things and creating things and being my old self
that I haven’t taken the time to dissect it to the extent I probably should. Your carbohydrate . . . I have this interesting
hypothesis that sort of is related. People that have a severe imbalance of gut
bacteria, let’s say they have a lot less of the commensal bacteria which is making short
chain fatty acids and metabolites like lactate that are feeding other good bacteria, they’re
feeding your gut cells. So you have less of those and you have more
of the bacteria that are methane or hydrogen sulfate producing, so you get bloated, more
of the more pathogenic type of bacteria. So you have this overgrowth of bad bacteria. The thing is let’s say you eat something that’s
typically supposed to be good. You eat something that has a lot of fiber
or like vegetables. So you’re getting this fiber that’s supposed
to be not digested, but the bacteria can digest it and make it into this good stuff. Well, bad bacteria can digest that as well. So you’re feeding this bacteria substrates
to keep going and to make more of the bad bacteria. Right. Now, the interesting thing that I don’t know
is there are certain species of bacteria. There’s phyla, class, species, it’s incredibly
complicated, but certain species only metabolize fat and I don’t know which ones those are
and if they’re good or bad. It sounds like you’ve had a positive experience. But that would be really interesting to measure
in general. But I’m glad you’re feeling better. Yeah. The ketogenic diet is something that I’m interested
in diving into and understanding more about. I’d like to talk to Peter. Peter is a smart guy. I’ve listened to the podcast. I don’t know if he’s done more than one podcast,
but I listened to one he’s been on. Yeah. He did one with me which was our conversation
and then he did a follow-up with me which was answering the 10 most popular questions
submitted. Okay. I listened to the conversation and I heard
him and I was like, “I want to talk to this guy. He’s a scientist. He thinks like a scientist. I respect what he’s saying and I think that
he and I have a lot of interesting overlap.” He’s also compulsively performance driven. And he walks the talk. What I like about Peter is that he’s not an
academic who takes his breaks at the hospital like going outside and smoking cigarettes
and has like a paunch. He’s a competitive athlete. I say that because I literally saw a bunch
of people standing outside of a hospital in their scrubs like smoking cigarettes on break. I can’t believe people smoke still. It’s crazy. Oh, my god. But Peter on the other hand is still a very
competitive, driven athlete. So he just has a unique perspective on all
this stuff. So on the athletic side, I have a question
for you. In “The 4-Hour Body,” you talk about the minimal
effective dose. You mention high intensity interval training
and how you can get long lasting effects with less effort, basically. At first I was like, “Hmm . . . ” and then
you went on to talk about biomarkers and studies that have shown high intensity interval training
increases mitochondrial biogenesis as much if not more than, let’s say, like an hour
and a half or something of cardio. And then you went on to the brain. That was my real concern. I was like, “Well, fine, if you’re going to
get the same amount of muscle mass or more by doing this, but what about the brain benefits?” Because I’m interested in staving off Alzheimer’s. Like I mentioned, I’ve got an increased risk. So exercise has been shown to people with
ApoE4 allele are much, much less likely to get Alzheimer’s if they exercise, the more
intensely the better. Part of that is your BDNF, your increasing
neurotrophic factors that are growing your neurons because you need to repair a lot of
that damage that’s going on in the brain. So I’m interested in whether or not you are
still engaging in high intensity interval training and what, if anything, you measure
to know that minimal effective dose is working. Yeah. That’s a good question. So I am coming off of and rehabbing some very
serious leg, knee and ankle injuries that inflicted on myself doing the crazy parkour
episode for my TV show. So I’m not doing a lot of interval training
that would be recognizable as, let’s just call it tabata training or some type of sprint
training because it’s too high impact. So I have concluded yes I am still practicing
the minimal or minimum effective dose in a lot of facets of exercise. I think that most people do as much as possible,
not as little as is needed. You can land somewhere in the middle. But the higher the level of athletics, generally
speaking, the more coaches work on holding their athletes back and not pushing their
athletes. I think this is a very poorly understood idea. But at the highest level, pushing the athletes
is not the problem. With some team sports it’s different, like
even in the NFL. But if we’re talking about, say, track and
field, the coaches spend more time pulling their athletes back. So in my case, for instance, most people go
to the gym one hour a day, five days a week if they’re trying to change body composition
would get better results by doing two or three sets of kettlebell swings per weeks. I’ve seen this hundreds of thousands of times
in readers already. For me, with mental performance, and there’s
the book “Spark” that talks about a lot of this stuff and like you said, the brain drive
neurotrophic factors and so on, from a subjective standpoint, I’ve seen as good results if not
better results in terms of cognitive performance from resistance training of almost any type
when compared to, say, steady state or even higher intensity interval training that could
be thought of as cardio, like sprinting or cycling or what not. Mechanistically, I don’t have specific before
and after biomarkers that I’m tracking. But I am looking at, say, pages per day output,
quality of writing, which can get very subjective. But I think that as these studies hopefully
get funded, we will see that resistance training, if you think about it, weight training is
very effective cardio. Yes, if you push it. Either way. If you’re using, and Doug McGuff has talked
about this quite a bit, if you’re utilizing musculature to move your body through space,
particularly with resistance, your heart has to work really hard generally to supply all
the necessary nutrients and so on to get that job done. So I think that on top of that, if you’re
looking to prevent age-related cognitive end physical decline, one of the key correlates
with all the bad stuff is sarcopenia, so loss of muscle mass, to which I would say targeted
resistance training, much more effective bang for the book in not only preventing lean muscle
tissue loss but increasing muscle gain than say most types of internal training, even
if you’re temporarily spiking certain hormones. But that’s also because I hate doing endurance
work. Yeah. I really hate doing metabolic conditioning. I find it miserable. I usually avoid it. But I do think if you were to just do two,
three sets. I really focus these days personally in my
exercise regimen on high intensity very brief duration or very, very long duration, typically
walks, like two to four hour walks. I have a bar bell approach. So it’s kind of like my investing approach. But my physical training approach is very
barbell-oriented. So it’s either like these sprint-like demands,
which could be, say, overhead squats are really fantastic for a whole host of reasons for
preventing a lot of the physical maladies that plague people as they get older and then
long two to four hour walks. Awesome. Humans have made a lot of evolutionary tradeoffs
to be able to walk long distances. So I feel like maybe that’s something we need
to do more of. We’ve made so many compromises to be able
to walk long distances. I find quality of life suggestively assessed
a lot higher when you’re doing long, steady-state walking. And it’s also the meditative aspect of it. That’s something that you get from walking
long distances. For sure. Especially if you’re in a calm and peaceful
environment. Yeah. A lot of parks out there. Get outside. I’m interested to know. You do talk about meditation a lot and being
mindful and how that’s important for a lot of things and it’s been shown to improve learning,
memory, things like that. Have you ever tried floatation tank? I have. You have? I have. I’ve tried flotation tanks. I like floatation tanks. There is a new location, actually, in the
city that I have not been to. Reboot Spa or something, I think is . . .
Yeah, Reboot Spa, maybe Float Lab. I’m not sure exactly what the name is. I think it’s Reboot. The only location that I had available to
me beforehand was a real pain to get to from where I am kind of in the Noe Valley are. As a result, I went a handful of times, but
could never make it a regular trek or didn’t want to make a regular trek. But I could see using floatation tank for
all sorts of different experiments, including potentially incorporating microdosing of various
types. But do you use floatation tanks? I’m actually going to try it for the first
time next week. So this new floatation tank place reached
out to me, I think it’s Reboot, and gave me some free passes and I’m like, “You know what? I’ll do it. Let’s get it a go.” So I’m going to go next week. Cool. Don’t shave the day before. Oh, okay. Yeah. You’re basically in the Dead Sea. It’s all salt. So you will be really unhappy. I’m excited. I wouldn’t shave for a couple days beforehand. Just a couple not particularly health-related
questions I just wanted to ask you before we close. Sure. One is in your books and also on your TV show,
“The Tim Ferriss Experiment,” you talk about doing some silly things that help people push
past anxiety, like laying on the floor of a crowded place or going and ordering a cup
of coffee and asking for a discount arbitrarily. So what do you think some of the positive
benefits that can be reaped from that are and are there any specific fear-inducing things
that you’ve engaged in that have given you benefits in your life? So I think the benefits of practicing discomfort
is realizing repeatedly that the worst case is just isn’t that bad. So becoming comfortable with increasing levels
of discomfort, especially something that’s ridiculous and has no real tangible downside
other than embarrassment . . . and this comes back to my obsession with stoic philosophy. But if you were to look at, for instance,
Cato, who is considered the perfect stoic for a period of time, he would wear a tunic
that was an unusual color to train himself because he would get ridiculed for it, to
train himself to be embarrassed about only those things which are truly worth being embarrassed
about, clothing not being one of them. So going into, say, Starbucks or whatever
and just kind of calmly sitting down and laying down on the floor for ten seconds, super awkward,
people are going to think it’s weird. Some people might take five steps back and
kind of freak out. Then you get back up and be like, “I’m fine.” It’s a small way of inoculating yourself against
succumbing to peer pressure about stupid things or holding off on making important decisions
or having uncomfortable conversations because of this irrational fear of this massive downside
that you’ve never actually thought about. So something like laying down, asking for
a free coffee or asking for a discount is really just rehearsal for the things that
happen outside of your control or the more important conversations so that you have a
certain level of calmness and have repeatedly had the realization that the worst case scenario
you’re imagining is almost never that bad. So those are just training mechanisms. Yeah. So you’re basically dealing with stress. You’re inducing stress to deal with it better
for the next time when there actually is a stressful situation. You’re more calm. Yeah. Right. If you want to negotiate a raise with your
boss, probably not the best to practice your negotiating in that first conversation. You should go to a state fair and like learn
how to haggle. Take $100 and that’s your tuition, that’s
your MBA in haggling. Don’t be a jerk and negotiate with everybody
and not buy anything. But it’s like all right, you have $100 to
spend. Your job is to get $300 worth of stuff for
like $100 at a state fair. It’s like go practice. That’s a great suggestion. I’ve actually overcome . . . I had a lot of
fear of public speaking. I would go into the mall and tell jokes to
random people. I am not a comedian. I’m a scientist. I’ve been in a lab most of my life reading
books. Social interaction is a little anxiety inducing
for me. So I would do this and most of the time, people
would laugh at my bad jokes and look at me like I’m insane. I’d still get that. I did get over that anxiety of having people
think I’m crazy or just like that awkwardness of like talking to someone. Now I’m communicating science to people. So it worked for me. Yeah. And the baby steps that seem so ridiculous,
like the telling of the jokes or asking for a free coffee, it’s hard for some people to
realize how much those experiences transfer because they’re like, “When am I ever going
to have to ask for free coffee?” It’s like you’re missing the point. The point is to subject yourself to the same
types of fear and discomfort that you will experience in a million other circumstances
and to overcome that in a very sort of rehearsed way. For instance, for me, in the dating episode,
the dating game episode of the TV show, Neil Strauss, who wrote “The Game,” forced me to
do cold approaches at the Ferry Building here in San Francisco, which was like my ultimate
nightmare. It brought back like every stressful sweaty
palm miserable situation from like eighth and ninth grade. It’s giving me sweaty palms thinking about
it. Yeah, I mean it’s just so bad. But I enjoy like every week, it’s like plan
something out that is going to force you to do something potentially funny, right, that
is going to be stress-inducing. Just figure out what that is and go do it. Maybe it’s getting a milk crate and a hat
and going out and try to busk without getting arrested, but trying to busk and be a shitty
dancer and make $5. That’s your goal. You have an hour to make $5 being a shitty
dancer or being a terrible mime or whatever it is. The more you practice that type of thing . . . I’m
going to disappear from camera for a second. I have this. I don’t even know how to pronounce his name,
which I’m embarrassed by, but this quote is, “Life shrinks or expands in proportion to
one’s courage.” If you can pronounce that, you’ve got me beat,
A-N-A-I-S, with a umlaut over the I, N-I-N. So this is something that I have reminders
like this in front of me constantly so that I realize that very rarely are the things
we’re afraid of worth being afraid of. To overcome that, you just have to practice. Most of the time we’re not. It’s very hard to think your way out of something
you didn’t think your way into. So if you’re afraid of asking for a discount
on coffee, that’s not really a rational fear. It’s just not. The way you overcome that is not by sitting
down and drawing out a decision tree, although that stuff can help, like fear setting, this
exercise I do a lot can be very helpful. You go out and just try it. That’s how you overcome these irrational reptilian
fears. Absolutely. Like you said, next time you have that fear,
you’re more calm, you’re thinking more clearly. I’m sure if they were to do MRIs of people
before they do the sort of microdosing themselves to this type of fear, then after when they’re
in a difficult situation, they may see that their amygdala isn’t as hyperactive or something
like that where you’re really training your brain. The mediation, you mentioned that, the meditation
helps a lot. The meditation helps you to not overreact. I’m a very like aggressive, bull in a china
shop kind of guy. So the mediation is particularly helpful for
me. Let’s say you ask for a discount on the coffee
and the guy is like, “Who the fuck do you think you are?” My instinct would be like, “Who the fuck . . . ” and
instead to be like, “Hmm . . . that’s a good question. Give me a second.” And then to calmly respond, get a laugh, and
then the guy gives you the discount. Like having that composure to have a delay
between the immediate like . . . That impulse. . . . is really, really helpful in almost
every circumstance. And if people are looking to get started with
mediation, it can be a super nebulous . . . people can get very sanctimonious about their meditative
stuff. Just think about it as bringing your attention
back to one thing. Get distracted, you bring it back .You get
distracted, you bring it back to any number of things. That translates a lot to productivity and
being effective throughout the day so you’re not like, “Oh my god, I just spent two hours
on Facebook. What the hell happened?” to avoid that kind
of experience. Just get an app like Calm or Headspace and
start doing like 10 minutes a day. Headspace, all right. I’m going to try it. I’d like to get more into the mediation. It’s super, super helpful. It just trains you to be able to calmly kind
of come back to what you’re supposed to be doing or what you want to be doing. You do that 10 minutes a day. Especially when you get like five or seven
days straight, it’s amazing how something that neurologically or cognitively just clicks. After five or seven days of doing it consistently,
I do it first thing in the morning. You do Headspace? I do transcendental meditation. Transcendental. So I just kind of sit there and focus on my
breathing. Like I did that before you guys got here. How long? If you do that every morning for five to seven
days, it’s really profound how much more calmly effective you are. And I’ve never been a big woo-woo meditation
guys. I’m just like, “Eh . . . I’ll just have a
cup of coffee. It will do me twice as good.” Not true. Ten minutes in the morning will make you calmly
efficient. You’ll get 50% more done if you do that every
day for a week. Ten minutes is not a lot of time. It’s not a lot. My magic number for me is 20 minutes. But don’t start there because it’s too much
to start with. Start with whatever you’re going to do, baby
steps. Start with whatever you’re going to actually
do. If it’s three minutes, make it’s three minutes. If it’s 30 seconds, then make it 30 seconds. But use an app like Headspace with guided
mediation makes it a lot easier. Just commit to doing it for a week or two. Then it becomes self-perpetuating. You’ll see the positive effects. But yeah, I think mediation, sometimes mindfulness
practice plus practicing humiliation, super potent, valuable combination. Quite frankly, the practicing humiliation,
and nine times out of 10 you don’t end up being humiliated, it’s just fun. It’s a good way to get laughs. You can do it with your friends too. Exactly. Well, Tim, this has been great. I’ve got one last question I’m dying to ask
you and then we’ll close. So I did read on, I think it was your Reddit
Ask Me Anything, you talked about how you were interested in recruiting Hollywood talent,
whether it’s directors or actors, etc. coupled with your interest in fiction writing, it
leads me to believe that you’re writing the next “Matrix” or something cool, totally hoping
to blow your cover here. Are you writing a cool . . . ? Is this . . . ?
I am working on some screenplay stuff. Yeah. Awesome. I hope it’s science fiction. Yeah. Whether it will be cool or not is to be determined. One of the main reasons I’m spending more
time in Hollywood and spending more time with people who are good at, whether it’s screenwriting,
directing, fill in the blank is because I want to start to absorb the gestalt understand
of how that whole machine and ecosystem functions but I also want to get to know people who
are like the good guys and the good gals, the people who are not only really good at
what they do, but the cool people I can be friends with for 10-15 years. So I’m spending more time down there. I’m not in a rush. I’d rather do it right than do it quickly. That doesn’t surprise me. Yeah. So I’m taking time. Honestly, for screenwriting, for books, for
blogs, for podcasting, whatever, the power, for those people who have a direct audience
is growing by the day. So making a movie the way I would like to
make a movie I think will just get easier. Six months from now it will be easier than
it is today. A year from now it will be much easier than
it is today. Two year from now it will be even easier than
it is today. That’s very exciting. Just like science. Just like science. Very exciting, Tim. I really enjoy talking to you as always. Likewise. Thanks a lot for coming on the podcast. My pleasure. Most people know where to find you. You’re pretty famous. But for those that don’t, where can they find
you? They can find me at FourHourWorkWeek.com all
spelled out and there are a million ways to misspell that, which is like in retrospect,
oops on me. But four as in the number four, hour, H-hour,
not O-U-R, FourHourWorkWeek.com. On Twitter, @TFerriss with two R’s and two
S’s. Facebook, I put up a lot of videos, like Q&As
and stuff on Facebook. That’s just Facebook.com/TimFerriss, two R’s
and two S’s. Awesome, Tim. Yeah. Thanks a lot for doing this. My pleasure. Thanks for having me. I look forward to talking to you again. Yeah. Until next time. All right. Awesome.

100 thoughts on “Tim Ferriss on Ketosis, Microbiome, Lyme Disease, and Biomarkers

  1. Get the show notes and transcript here!

    Also… there's a blooper at 0:13. Tim's book titles in the corner should read… "The 4-Hour Workweek", "The 4-Hour Body", and "The 4-Hour Chef".

  2. Rhonda you're into something with ApoE 4 allele, after 2 yrs of nutritional ketosis without feeling the benefits of ketosis, I changed my diet and health was restored along with better energy focus and blood sugar regulation. Ketosis was extremely stressful on my body which leads me to agree with you that Apo4 doesn't use ketones efficiently. Thanks!

  3. I've been eating a paleo diet for 6 months, cutting out the majority of sugar intake and no dairy or bread but I feel like crap. I have zero energy and a swollen intestine. MCT oil, coconut and almond milk for coffee, collagen powder for shakes and paleo bars for snacks. I felt better eating regular food and drinking alcohol. Even drink that nasty gut shot fermented drink 😝.

  4. wow she really has a strong back sitting like that for more then an hour says alot about her health.

  5. no booze for me… poison – so now every married woman is going to spike their husband's morning drink with vasopressin.

  6. Thru hiking the Appalachian Trail and more recently the Pacific Crest Trail are excellent ways to walk long distances. 🙂

  7. The period then ketogenic diets and ketosis was peaking, but not people began see to these topics without rose glasses.

  8. Here we go with ketone and ketosis again. I wonder how our cavemen ancestors kept track of their ketone level in their blood? Were they able to buy ketone strips at their local CVS? I reckon they weren't. How did they ever survive!

  9. I wonder your opinion and Tim's about Betaine for the purpose of lowering homocysteine (keeping in mind that at certain high doses it might affect LDL levels). Betaine, Methylated Folate, B12 and B6 seem to work well

  10. This man does not have a full understanding of Lyme Disease. Borrelia has been PROVEN time and again to persist long after course of antibiotics. It has been discovered in biofilms. Dr. Eva Sapi is not a quack. Lyme disease and it's treatments can permanently ruin your life. Educate yourself. https://www.youtube.com/watch?v=AmvgOfIN_8c

  11. the lyme story was interesting; so many people fundamentally misunderstand how infections work. the idea that once you get rid of the bug you must be fine. … no. that assumes the bug did no damage while alive – because all you took was a substance to kill it, not fix you. like being hit by a car – if your legs breaks it will then heal. whether it heals properly is a different question. you can be knocked off centre as it were by a trauma or infection that then isn't resolved properly. it doesn't mean the cause is still active, it just means the cause did enough damage to re-centre a given aspect of your body that may now be defective and unable to repair.

  12. Never knew Tim had Lyme, he never mentions it in his videos I have seen. He has some wacky theories. I doubt he has Lyme, he doesn't really say how he cured it except ketosis, but come on. And I love how people get well and then forget about all the people suffering. Our is he donating to Lyme research? So much bs

  13. Very interesting discussion. I have not started Keto yet and procastinating. I suffered mild stroke twice in dec 2014 and again in march 2015 (fortunately did not suffer paralysis, however first my left hand then my right hand fingers became numb, but soon recovered somewhat) and have done 60 sessions of acupuncture with acuinjection of neuro-B, about 40 times at the point where the spinal cord starts, with quite a lot of recovery in mental capacity and sleep ( which was normal at the beginning but deteriorated to 2/3 hours from 5-7 hours) now the sleep improved, along with walking coordination and speech. I had bypass operation in 2007 and take medication for thinning blood, BP and Atova for liver.
    I have not found any reason why I cannot start Ketogenic diet. Can anyone please advise me, if I should start Keto, hoping it will help me improve my brain function, probably preventing further stroke, alzhaimer etc.

  14. Even though these are very smart people with degrees, what about those people lke my 96 year old father, who don't read or study nutrition? He is a x-smoker/drinker and does not watch what he eats. He does however without realizing it do intermittent fasting. He eats his last food at 7 pm and does not eat until 11 a.m. or so. I don't think he knows what prebiotics or a good gut means.

  15. Wow what a fantastic video with personal sharing to make self help biohacks so meaningful. Nothing like having skin in the game to go beyond just following the treatment recommendations of doctors. We are all overtreated and under cured (as Brownlee says) and at such great expense!

  16. I'm pretty sure I'm caught up in that inflammation cycle Dr. Patrick describes at the 22:45 mark. I was hoping somebody might know how to disrupt that cycle and put an end to it? its awful! thanks

  17. Glad i came across this. Ive had lyme disease for 40 yrs. Been in ketosis for 2 months. It has revived me. I have never felt so good my entire life! Also exercising. My body is so happy on ketosis! I think the theory about Lyme interferring with carb digestion is right on.

  18. I really wish you would list the studies (at least some of them) in the transcript. Like, I would love to see the one about mice, vasopressin and pair bonding. that is so fascinating.

  19. 10 minutes in and Tim has slurped down his drink 6 times. Good heavens, lay off the drinking during an interview. It's distracting and obnoxious.

  20. I'd like to see more data on natural probiotics. I was hacking up alot of mucus after each meal. I recently did a couple of 3-4 day fasts to starve off all bacteria. I feel great now, and trying to repopulate my gut with bone broth and sauerkraut.

  21. Need to repopulate the gut after antibiotics? Why haven’t these two consumed a spoon full of ferments which will have way more bacteria than anything in a capsule. Ferments are the key.

  22. Awesome interview! Really enjoyed this. For myself personally, keto launched an entire interest for me in micronutrients, gut health etc. Because of the emphasis on getting your electrolytes and nutrients given limiting certain foods. I found myself going down the Google hole regarding vitamins and minerals, gut health, exercise etc. Obviously there's those that just eat nothing but bacon and eggs all the time and their focus is weight loss not health. But I think there's a lot of people that, keto has launched an interest and focus on overall health. I mean I was always getting 8-10 servings of fruits and vegetables but was riddled with inflammatory diseases and autoimmune diseases. Now I've cut fruit with the exception of blueberries and get about 5-6 servings of veggies a day and feel better than I have in over 20yrs. I also never would've considered eating nutrient dense meats like liver and heart but now I've added it to my diet. I've cut basically all grains but will add ground flax, ground hemp, adaptogens like maca root or ginger, to a green smoothie. I'm really focused on getting my omega 3s and cutting down on my intake of 6s. Getting my magnesium potassium vitamin D vitamin C. Getting enough fish and healthy fats. Did away with canola oil and switched to avocado oil, increased olive oil. Introduced avocado and MCT oil to my diet. I'm eating a more nutrient dense diet than I ever have, and eating less. As a result my crohns disease is non-existent, my chronic pain from Arthritis is gone. I know the results aren't just cutting carbs and sugar. But the introduction of keto put me down a research hole that lead to being cognizant of what my body needs and overall nutrition. It also made me focus more on how my body feels, and listening to it. No more accepting that, I'm sick, I have diseases, it's just the way it is. Everybody is different. Every body is different. We all have different tolerances and reactions to foods. What's working for one person may not work for me and vice versa. Having my quality of life back is something I am inherently grateful for. Will I be on Keto forever? I don't know, I may reintroduce some foods on a moderate level. But right now I find geto highly beneficial and extremely easy to do. No problem with energy. No cravings. Limited hunger.

  23. Hokey dokey. As a fairly recent practitioner of ketosis and intermittent fasting and follower of you both along with Dom D, Pete Attia, Mark M and Ted Naiman, et al, my #1 main concern and focus right now is on inflammation of the gut – weathering the disruption in the gut biome plus the weird lack of waste byproducts. It conflicts with all the good stuff happening simultaneously. This is what I hear from both of you too though not necessarily dealing with the same co-morbidities. I'm def experiencing restoration of cognitive excellence, increased longevity, sustained weight loss accompanied by no loss in lean muscle mass. It's both wondrous and disorientating, like discovering patients in the asylum treating the mainstream doctors whom we suspected were all fíng nutz. Okay I'm 73 yr old former runner, an 11 yr stroke survivor who woke up paralyzed in a Bauby moment, was supposed to die and walked out of rehab 3 months later. It took another six months before I came to my senses and threw out all prescribed meds, regained control of BP and now I don't even take aspirin. No I'm not bragging. I don't know what to believe anymore. I'm completely confused. My brain and waistline say stay the course, but the gut says don't buy into the hype just yet. Am I going to have to get an MS in biochemistry just to keep up?

  24. Oh my god I just spent an hour and thirteen minutes on YouTube. What the hell happened!?

    Even though I'm late to the party, thanks a lot for the insightful interview! Very interesting, as so often.

  25. Dr. Patrick, there's an intriguing body of evidence on meditation, including fMRI's performed on monks, that you might gain value from in the literature. Practicing it yourself will help you as a scientist, partner, and new mother (which can be an overwhelming experience on the best of days!). Thank you for your addition to the public conversation on diet, aging, and health. I've learned so much from you.

  26. I was trying to catch whats wrong with this interview—> they both never look at camera. I feel creepy like I m watching them without permission😅😅😅

  27. Very educational and well-done interview! Loved the little pop-ups and links. Actually, I did order few of the things that Tim mentioned.

  28. Ask Tim about how he claims he gained over a pound of muscle mass per day for over a month. Read that again, he actually claims he did this shit. He’s a uneducated nut bag when it comes to health. He made money by selling some snake oils and then posterizes as some sort of guru. Guy is a simpleton.

  29. Hi! Love the video. So much value. I took a 15 billion CU probiotic for the first time the other night and got extremely sick.. do you know what could have caused this? Possibly very little good bacteria in my gut and it was reacting to the new bacteria that ingested?

  30. Does Tim Ferriss know Anaïs Nin is an author famously well known for her erotica writings? The quote, “Life shrinks or expands in proportion to one’s courage,” is great on its own, but I can’t help but wonder if the quote was written and given to him on hardwood for a more fun, let’s say more titillating, reason!

    Great talk btw…Thanks for sharing your conversation with us, smart/informative.

  31. This talk was way to smart for me to wrap my head around I like it more when there both on joe rogan's podcast u can understand what's being said

  32. Am surprised Tim even talk about chemiotherapy; if you are in HEALTH therapies, or NATURAL therapy research you should know that CHEMO-THERAPY is an overload of CHEMICALS on your body in order to KILL cancer cells it NEVER THE MOTHER CELL of the cancer and destroyes one’s inmune system.

  33. First thank you for your content. Most people who watch this, me included, watch health podcasts to improve their well-being. A breakdown of some of the topics would be great. Tim and you may understand what blah blah blah eludes to but not me at least. I love watching your stuff Dr Rhonda and have learned a lot by researching after but would learn more with a little further explanation. Your convo with Peter Attia same thing. Things like mTOR etc.

  34. An other crazy thing i experienced about one month ago in Canada is deep hypnosis in past life experience,the lady who is a beginner as hypnotherapist was quite good, really crazy, nothing i had never expected meeting my higher self, what an experience…really awakening.Funny last summer Paul Mcartney mentionned in an interview he had met God…So no he just met himself….That is this effect meeting ourself doing…

  35. This guy is kind of a dick he is so comfy on couch and having his coffee and Rhonda’s back is not supported at all. He also is lit so well and she is in the dark!

  36. So interesting to hear about Tim's hypothesis of antibiotics and carb intolerance. I was on rounds and rounds of antibiotics for chronic sinusitis and various episodes of bronchitis and pneumonia. This all happened after the birth of my first child when (I think) I may have had a massive zinc loss from giving birth because I couldn't taste or smell anything for over three months. I didn't know anything about nutrition, minerals, the need to repopulate the gut, etc. Long story short: ended up with systemic candida that almost killed me, Severe chronic fatigue, not able to stay awake past 4pm, brainfog galore. I have genetic markers for celiac disease and gluten intolerance. I've never had problems with wheat or gluten until the heavy rounds of antibiotics. I avoid all gluten-containing grains and I'm happiest when I get my carbs from vegetables and legumes only. I fought my way back to much better health, It took me five years but along the way I have learned so much, nobody can dupe me into taking any pharma crap anymore. I'm taking full responsibility for my own health and have stayed away from doctors for five years. No stepping it up and learning about ketosis. Just completed my first 36 hr water fast (full moon), I'll get myself a glucose and ketone meter for the next fast in two weeks (new moon). Thanks for all the wonderful interviews you post, Dr. Patrick, I'm learning a lot!

  37. 2 very intelligent and attractive people saying a lot of big words very quickly. Oh there Tim goes taking another sip of tea again … again 😂

  38. I couldn’t take watching this video for more than 18 mins. The guy is self-absorbed, loves the sound of his own voice, doesn’t listen to what she is saying all that well and is preoccupied with drinking his tea which is incredibly annoying. He is not serious enough plus he thinks he knows a lot but it’s not convincing.

  39. At 22:16 Tim says “empirical data” and “research data” as if they’re different. Did he just mis-speak? I don’t understand.

  40. im doing keto and found this product to keep tab if you are in Ketosis https://ca20a51d.kckb.st . No urine or blood test.

  41. All very interesting isn't it? if you do not have a personality construct like these two you are not going to be able to benefit to the degree that they have in any way and perhaps not at all. An interesting project for Rhonda would be to determine what percentage of the population can attain and maintain this intense level of self focus apparently typical of the celebrity community across all of its domains and not just in Science and Medicine or Politics because this is the real foundation from which all the rest flows. The work demonstrated may even be excellent but were you built like these two? Think about this carefully because it is important and illuminating.
    In any case unless you have deep deep pockets most of this will be completely out the window because this is purely personal consumption- no health plan is going to fund these sort of protocols. Take reasonable measures on things you can work with at your income level and understand that you will get old, sick, and die so try for a good life and either your body will disintegrate conserving the brain to some degree or the destruction will seem to affect the brain disproportionately

  42. Tim Ferriss is motivated by performance. At 23:00 discussion of inflammation via gut vs exercise. At 26:00 the discussion is about discontinuing antioxidant supplements during intermittent fasting. 35:00 Lyme disease.

  43. they talk so fast that I can not understand what she was saying about the test she recommends for everyone that her mother in law did. Does anyone know which test she was referring to?

  44. Hello Dr Rhonda: can you please share details of your personal protocol when you successfully
    dealt with MRSA ?

  45. Narcissism/codependency maybe due to gluten. Narcissists may want more than one woman at the same time. They may run from love and relationships are short 4-6 months.

  46. Lyme people maybe Celiac….gluten/GMO may hurt the intestines in addition to Lyme/coinfections/antibiotics. Homepathic help may help. Yes…Keto diet may help, but still people need to stop gluten usually.

  47. That was one boring dude! Usually like her podcasts but there was something about him I just couldn’t stand.

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