Tired But Wired? The Hidden Loop Destroying Your Energy | Dr. Scott Sherr, MD

I eat perfectly. I exercise six times a week. I try to get to bed on time at sleep. I'm feeling depleted and I think people are in this state and they don't have a name for it. But you call it the sympathetic spiral of doom. And it's a loop. You have sympathetic activation which is your fight or flight, your nervous system being activated. You have mitochondrial dysfunction. The challenge is anytime you try to downregulate your nervous system, it actually might make you feel like you're crashing. People feel like they crashed when they go down and try to do their breath work, try to do their meditation. Oftentimes they feel terrible when they try to do it. If they can even do it in the first place, you've only been able to function because you've been at that high of a state. You can't meditate your way out of this like physiological stress to your cell's amount of conjures, what you're saying, right? So what do we do? If someone's stuck, what's the first step to getting out of this loop? Today on the podcast, I'm joined by Dr. Scott Shere. He is a board certified physician and a pioneer in health optimization medicine. As an expert in mitochondrial function and the chief medical officer of transcriptions, he's helping people break the sympathetic stress loop to rapidly restore energy, focus, and resilience. I want to share something personal about my own health journey. Now, while back I went through a period where I was recovering physically and working hard to rebuild my strength, I was doing all the right things, eating well, exercising, I was focusing on sleep and recovery, but I started looking more closely at how the body actually uses protein as we age. And here's the thing, our bodies don't always utilize protein as efficiently as we get older. So even when you're eating well, you may not always be getting the essential amino acids your body needs to support muscle repair and recovery. 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Learn more at chorus.com/DrHyman and enjoy 15% off their newest product, Oyo Sphere, with the code Hyman Sphere 15. That's K-O-R-R-U-S.com/Fear and use the code, Hyman Sphere 15. Welcome back to the podcast, guys. So good to have you. Thanks for having me, Mark. Last time it was online. Today it's in- Yeah, it was online. We talked about hyperbaric oxygen. Today we're going to talk about a really important topic, which honestly affects so many people, including me. And you know, I never heard it quite describe like this, but you call it the sympathetic spiral of doom, but about a bump. That's exactly an easy way to escape. And you know, at first I was like, "God, that's kind of hyperbolic, whatever." And then I started reading about it. Yeah. I'm like, "Oh, this is what it is." It's basically the way in which your system breaks down from too much stress from your life and your psychology, but also too much stress from the environment because it's top-down bottom-up. So it's primarily toxins and infections and all the stuff that we're supposed to. And it creates a breakdown in our ability to regulate our nervous system. And then it influences our mitochondrial function, which kind of makes it worse. So the body's this big web networker. Everything's connected. And so you're kind of untangling the web to telling this story in kind of a new way. It's an old story. We all know that stress is bad for us, right? But like this is a very different frame of it. And I love it. And I think it's going to help a lot of people because you have to be systematic about it. And a lot of us are feeling burned out. Like we're doing everything like I eat perfectly. I try to get to bed on time and sleep. But sometimes I'm feeling depleted. And I think a lot of people out there are probably feeling that. And I think people are in this state and they don't have a name for it. And they just feel like crap. And they don't know what's going on. They're exhausted. They're wired. They're anxious. They're burned out. And today, really, one of like people who are listening to understand what is going on with their energy, what is going on with stress, what are the psychological and the physiological causes of stress? And how do we start kind of navigating this for me therapeutic perspective? Because like we all want out of this. I as soon as like, yeah, I made this simple that experimental doom. And I want the hell out of this thing. So what is it? Explain to us unpack it for us. Well, thanks again for having me, Mark. And you know, what I would, what I like to just describe here is it's not a diagnosis for people. This is more of a pattern. As you mentioned, it's an age old pattern. But I realized recently that it was really a significant discovery for me to understand that it's a spiral and it's a loop. You have sympathetic activation, which is your fight or fight, your nervous system being activated. Mitochondrial dysfunction might a condra as all your listeners know is a part of their cells that make energy. The combination of sympathetic activation might a control dysfunction is a loop. And what happens here is that this loop can either start with mitochondrial dysfunction directly. That's what I call bottom up or it can start with sympathetic activation from outside stressors say it's your job, your relationship, you have a snoring partner that is snoring and you can't get to sleep at night. Outside stressors or even like worse things like trauma or things that happen, you were younger that have maintained you in this place where you can't stay safe. Either way, whether it starts with mitochondrial dysfunction directly or it starts with sympathetic activation externally or for most people it's both. And then it's something that just makes you fall off a cliff. It could be. Let me pause your second. Yes. Define sympathetic activation. Yes. People are like, what is that? And define like a little bit better mitochondria because these are central to your thesis for sympathetic exposure. So let's get our terms right because I think a few like, well, there was, there'll be just be talking doctors. I'm sympathetic, you know, I'm not sympathetic. No, no, it's not that. The sympathetic nervous system, so sympathetic is your fight or flight part of your nervous system. So it's your, it's running away from the proverbial saber tooth tiger as we somehow always refer to. I don't know why, but you're getting chased by something. Yeah. But unfortunately, we're getting chased all the time in modern sense. Whether it's with our phones that are actively in our faces all the time and doom scrolling at three o'clock in the morning, going, why is this the way it is? Or it's outside things like your job, your relationship, but we're not, we don't reward people, right, resting or relaxing. So the sympathetic nervous system is part of your autonomic nervous system. You have your sympathetic branch, which is your activation. What if brain fog, anxiety and mood swings aren't simply on your head? What if the health of your mind actually starts deeper in your body and your gut and your hormones, metabolism and your immune system? Well, let me tell you the connection is real and it affects how you think and you feel every single day. And that's why I created Brain Shaping Academy, a six week program that shows you how healing your body can help you heal your mind. Brain Shaping Academy relies on the same target nutrition and lifestyle strategies that I've used for 30 years to help my patients improve their mental, emotional and cognitive health. So if you want to feel calmer, clear and more in control and stay sharp and protect your brain as you age, check out brain shaping academy at drheimen.com/brainshaping. That's drheimen.com/brainshaping. Fight or flight and you have your parasympathetic, which is your rest, digest, detoxify and heal. But modern society doesn't reward that side, right, rewards the hustle. I mean, in medical school, my friends and I had shared said sleep is for quitters. Yeah, not surprisingly, right. I grew up in New York. Surgeons don't have lunch. That was ours. Yeah, there you go. Same kind of thing, like you just you hustle, right? You go and you grind, right? That's what we reward. And then unfortunately, that's how society has created this stress externally for us that we have to perform. We have to have more meetings. We have to do more, do more, do more, do more all the time. And so instead of just running away from the saber-toe tiger and then hanging out the rest of the day because hopefully we lived. Maybe we probably didn't. But in some case, we did, right? Then you have the time to relax because your nervous system would be activated and then it'd be shut off. But that's not how modern society works anymore. As you know, we're constantly stressed, constantly on pressure, constantly on meetings. And that's that sympathetic activation. And most of us kind of think we thrive in that in that environment. And we can for a little while. But the problem is that when you're sympathetic all the time, you're releasing hormones like cortisol, your neurotransmitters like noripinephrine and epinephrine and adrenaline. And adrenaline, yes, nor an origenne adrenaline adrenaline that are stimulating the whole system to work harder. Because if you're in that sympathetic nervous system activation all the time, I call it sympathetic overdrive, you're just shoving all those neurotransmitters. and hormones out all the time. And that causes deterioration in immune system function, in hormone function, and in your mitochondria itself. So, to define mitochondria, which we can do now, the mitochondria are part of the cell that helps make energy, right? When I was in high school, my daughter is in ninth grade. She learned she's got the basic cell. She just learned she's like, "Dad, check out the basic cell. It's got a nucleus, it's got cytoplasm, it's got gold-gibodies, and it's got this one little cool organelle called the mitochondria." I'm like, "Huh, this is what I learned when I was probably that age two. You learned that cell has one mitochondria, but that is far from the case. Some cells in our body have thousands of mitochondria per cell, and some cells actually there's one human cell that has zero, and that's the red blood cell. Yeah, they're red blood cell. Right. But most mitochondria per cell are in our reproductive organs. Eggs, oocytes, sperm, or the number one. You guys swim, prenatal energy to swim. Yeah, and the eggs have more, though. Women have to create and make the baby, and so they have more. But just behind that is your brain, your heart, your liver, your musculoskeletal tissue. So detox, everybody is hugely and genetically intensive. Lever, yeah, liver is. People don't realize that. If you're going to be able to detox, you have to have a huge amount of mitochondrial energy. We have thousands of mitochondria in our brain, for example, as I mentioned. The problem is, and the statistics are crazy, it's like 94% of U.S. adults have some element of metabolic dysfunction. If you have metabolic dysfunction, you also have mitochondrial dysfunction, which means you can't make energy effectively. Our cells are like gasoline-powered cars, right? We make ATP, as you know. We make also carbon dioxide, we make water, and we also make what are called reactive oxygen species. Free radicals, yes. Exactly. And so we need those. But if we have too many, or if we're stimulated for such a such a long time, or a period of time, like you're sympathetic ly overdriven, right? You're stimulating the mitochondria to make so much energy you're trying to. And what happens over time is that the mitochondria can't keep up. They can't keep up with energy production. They can't keep it up with the detoxification required because you don't have an antioxidant around. And then the mitochondria become under significant amounts of stress. And so you're in this place now where you have separate that-go overdrive, mitochondria's function in the majority of people. And it's a spectrum now, but all of these people, everybody, as so many of us are on this sympathetic spiral as a result of that. And what's really interesting is the connection between the stress response, which we all can relate to, and our mitochondrial function, which is basically something that most of us don't think about. And by the way, most doctors don't know much about that we learned basically in biochemistry in the first semester of medical school, how to food and oxygen go through our little crebs cycle mitochondria. You memorize all the intermediates. And we memorize it for five minutes before the test. And we forget about it. But mitochondria are essential to most every single disease that we see in chronic illness whether it's dementia, or cancer, or heart disease, or obesity, or diabetes, or all the neurodegenerative diseases. It's just quite profoundly important. And you're right. If you are in this stress response, and then you're also exposed to all the stresses of being in the modern world with microplastics and pesticides and heavy metals and latent viruses and infections, long COVID, tick infections, mold exposure. In some resistance. In some way. Like the whole thing. And then of course, our ultrasound process diet that I was getting to that. Yeah. Yeah. You know, our highly sugary process diet. So, you know, we all are stressing our stress response because you're by the way, eating crap makes your body stressed, even if you don't psychologically feel stressed. And also, it stresses your mitochondria. So then you get all these installs. You talk about this sort of metabolic stress. Yeah. What would it like to mean symptoms people are in this synthetic spot? I would do my how would people listening? I have this. So when it comes down to when the mitochondria is so stressed, they shift over from being being able to make energy effectively. Instead of making energy like with oxygen, they actually shift over into something called the glycolic state, which is making less energy because they're trying to protect themselves from all the stress that's that they're on. And when that happens, it's there's an overcompensation of the sympathetic nervous system. The sympathetic overdrive gets even higher because you physically feel worse. And these are symptoms you're talking about. We're talking about feeling tired, but wired, feeling like you can't recover anymore from anything that was pretty small before something small. Now it takes you two or three days like you go to the gym. You don't feel like you really could recover for two or three days. You go on an airplane. You don't recover from much longer or you have a bad night of sleep and you feel terrible the next day or your mood is all over the place. It used to be pretty stable throughout the day, barring going through paramedics or something like that. It used to be stable and now it's all over the place. You also can find that just overall your energy level is just kind of up and down throughout the day. Like you're relying on things like caffeine and stimulants to try to give you enough energy, giving enough brain function and the challenge oftentimes and I have patients like this, it's like duck. I just need to feel better. I need more stimulation. I need more energy. And oftentimes it's not about giving them more energy. It's actually about calming down the whole system, this whole loop, this spiral and then allowing them to get back to making energy more effectively. And so there's a spectrum here, Mark, and you and I know this. We have people that are super complex and they've been sick for a long time and have very significant mitochondrial issues. And then you have people that are on the other side of the spectrum where they just don't feel very good anymore. They're just not waking up, feeling like they have energy. Their energy is waning throughout the day. Their recovery just not as good. And like oftentimes that those people that it's something often happens where they feel like they just fall off a cliff. It's like that extra little stress that just did it and then all of a sudden the things go down. Yeah, they kind of manage along the way they crash. Yeah. As 66, I pay close attention to how my body feels, especially my energy, my strength and my resilience. And aging doesn't mean we have to slow down or stop doing things we love. And that's why I'm genuinely excited about timeline powered by myadipur and I've been talking about it for years. 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So you talk about this feedback loop between the nervous system and the mitochondria. I think it's a little bit hard to conceptually for people to understand how do that work. Your nervous system, your sympathetic, your sympathetic, your stress response, your relaxation response. But how does that relate to your mitochondria and your energy system? What is that connection and loop feedback loop? One of the main hormones that's being vilified right now is cortisol. Cortisol is your stress steroid hormone. As you know, when you're under fight or flight, when you're in sympathetic overdrive all the time, you're pumping out cortisol all the time. We're supposed to have cortisol rise when we wake up in the morning. It helps us wake up from being asleep and then it's supposed to slowly go down throughout the day. The challenge is that most people do not have that pattern anymore. And what cortisol does is it stimulates the production of its steroid hormone. It also stimulates and initiates the neurodrenelin and the system too. And what happens when you have a lot of cortisol around and a lot of those neurotransmitters is that you are just telling your mitochondria that you're under stress. You need energy now. And as a result of that, it is going to your mitochondria and saying mitochondria, you need to make more energy now because you're under a lot of stress. This This court is all high. And as a result of that, you're getting the mitochondria that are like, "We can't keep up. There's too much energy requirements that you're giving us." And so that's why it flips over into something called a "self-danger" response, which I know you know about, which is when the cell says, "We have to protect ourselves." And the mitochondria says, "We're sensing too much stress. We can't actually keep up." And so when it does, it tries to protect itself, but that when that happens, you start making less energy. And when you start making less energy, you start feeling like you're not able to compensate. You're not actually able to show up. You're tired. You're tired. This is the tired, but wired kind of feeling. The ability of the mitochondria to kind of like register this danger is interesting. And you know, you talked about this new concept, this cell-danger response. But if you actually look in the medical literature, there's a lot of scientific papers about this. It's not just some woo-woo thing. It sounds kind of crazy, but you actually look at it. And I think most physicians don't understand what it is. No. You know, what I'm just hearing, as you say, is when you have chronic stress, either from the top down or bottom up, from your brain or from, you know, the toxin crap and shit we're exposed to, it stresses your mitochondria. I mean, it flips into this cycle, the cell-danger response, which is that the same thing as a sympathetic spiral of doom? That's part of it, right? Because when you're in that sympathetic spiral, you're almost always flipping over into that cell-danger response. And so it's going to unpack, what is a cell-danger response? The cell-danger response is a natural response that the cells do when they're under stress. There's multiple stages of the CDR, and there's a very. CDR is still dangerous. So they're in response, yes, sorry. And as a result of having this pattern, we have a way of either going anabolic or catabolic, which means that we can either build up or break down in the system. And what the CDR does when the cell-danger response is active. We get into more of a catabolic state. We start breaking down parts of our body to try to protect it. Where in the anabolic state is really when we're building up and getting stronger. That's when you're in a safe space, right? When you're in safe spaces, you're parasympathetic. I call it the parasympathetic edge, really, and we can talk about that. But the idea is when you're in the parasympathetic mode, you're resting, digesting. You can turn off the cell-danger response. But you can't turn it off if you're always in stress mode. And the cell-danger response is basically protecting you from stress. It's protecting you so that you can survive. It's a survival mode. It's also activated in the short term when you have acute stress, when you have acute infection, you have acute additional stress outside, external stress. But it's supposed to turn itself off. But it can't turn itself off if it doesn't have that anabolic parasympathetic activation. And that's the challenge. And in addition to that, what happens over time is that you deplete a lot of the intermediates, a lot of the vitamins, minerals, nutrients, and cofactors that are responsible for shifting you out of the cell-danger response. So just the very fact of trying to manage the danger you're using a lot of nutrients. Tons of it. You need to deplete your nutrients. Yes. And then you're in a vicious cycle where you need the nutrients to fix the problem, but you don't have the nutrients and it depletes them. And you're still in the stress mode and you're still right. So the major question is, well, how do you approach it? How do you work on optimizing somebody's capacity and increasing their reserve, getting them out of the sympathetic, but also supporting their capacity to flip out of that cell-danger response and support mitochondrial function? Well, that's an important question. I want to get into the practical aspects of how to people and the sympathetic spouse do them. And how do they stop the cell-danger response? But before we get to that, I want to unpack a little bit about your top-down bottom-up idea here. Because it's important because you can enter into this sympathetic spouse-danger from your psychological state, for sure, trauma, or from your biological state, from things you're exposed to in the environment you may have control over or you die, which you do if you're control over. So can you walk us through the top-down bottom-up explanation? Yeah. And where are the contributors to this sympathetic spouse-danger response? So I think we understand what those are. We can start to think about how we might approach them. The top-down part, let's talk about that first. The top-down part is how are we stressed? What is causing our sympathetic activation? And the amount of things that can be doing this is unlimited in this point. We can talk about it from social media to politics to what's going around in the world right now with wars and things like that. Not that they're stressed in the world right now. I mean, a little. I mean, a little. I mean, it's not going away. And we are wired as humans to do two things. Survive and reproduce. That's it. That's what we are wired to do because that's what the species requires. And so as a result of that, what do our news media, what does our social media do? It wires you, it's wired or it's created to fit into those two patterns. Survival and reproduction, mostly survival. So fear, right? Fear is the biggest one. And so there's tons of things that are coming outside of us all the time that are trying to instill fear in us. It could be everything from the things I mentioned. It could be within your own home, right? If it's a relationship, that isn't great. If it's a job that's too hard. If you're not getting enough sleep, that's a huge one. Because if you're not getting enough sleep, you're not going to be able to regulate your nervous system either. And so that's what I call the top-down aspects. And I could fill in maybe-- That's all the psychological stuff. I was like, can you give me your childhood trauma? Yes. And I had-- I mean, you've had patients like this too that they're abused as a child and they never feel safe in their own body. There's no way they can ever heal. There's no way they can ever really fully truly be their best self because they're always in this locked-in sympathetic state. But there's a laser for you to come out of that. 100%. Yeah, we'll talk about that. And then that's exactly what this is all about. It's about understanding the pattern and then seeing if it breaks. That's the top-down. That's the top-down. And the bottom-up is-- The bottom-up is really-- you did a great job earlier when we were talking about direct mitochondrial stress. Things like infections and-- They're very sensitive. It might have conjured very sensitive. They are. Everything affects that. They do. They do. I mean, they're a sensitive organelle. There's a lot of them. There's quadrillions of them in our bodies. Huge amounts of them. That's a big number. I can't count that eye. I can either, but it's a quad. I think after that I can remember it's like, I don't know if it's quint after that. But it's-- after trillions is quadrillions, everybody that's listened. And so it's a lot of mitochondria. And so we need a huge amount of energy. In fact, we need to make about 150 pounds of it every single day of ATP to maintain our energy capacity. And as I mentioned, 94% of us can't do this on a regular basis. And that's because of the things you mentioned. You talked about insulin resistance and toxins in our environment. Medications that we take on a regular basis that actually have a dysfunctional impetus or actually do worse. Things like metformin, even things like birth control pills, even, because they'd deplete nutrients that help with mitochondrial function. Not to say people should get off their medications, but even proton pump inhibitors, which are good ones. That's acid blockers or a big one that's thoroughly in cause of abusive drugs, which is acid blockers from people eating a crappy diet. Yeah, but statins too. Statins also have significant impacts. And that's the number one class of drugs. Yeah, so number one in three class of drugs is causing mitochondria. The statins and they have effect on both complex one and complex two, which are the two first proteins in the mitochondria that help you make energy. And that pesticides do it, infections do it, we talked about it. And then of course, the sympathetic activation, which can be overarching to everything. But on its own can cause mitochondrial stress. And I think that with the way I kind of picture this and I talk about it with my patients, is that you know, we're talking, it's not just one thing. It's often a combination. And you're going, you're riding long. Kind of a little package. Yeah, of course. You know, it's the bundle. And like, you're riding long, you're doing okay until you hit around for most people, though it's getting worse now. Like around like your mid 30s, late 30s, like early 40s, and then things start going a little, you know, pear-shaped as they say in Ireland when my favorite expressions. And they're like, yeah, a little pear-shaped. And things go like, why am I not recovering as well? Why do I need more sleep? Or why don't I feel as rested when I wake up in the morning? Or why does when my son comes in when he gets home at school at four o'clock, and he says like, hi, dad, I go, what do you want? You know, I start like, what's going on there? And so you start noticing these things. But as you said, Mark, it's happening at earlier and earlier ages because of just the amount of toxic exposure that people have on a regular basis, which is crazy. Yeah, it's a lot. It's a lot. And you know, the truth is we have a lot of mitochondria, but they're fragile. Yeah. And they're very sensitive to any insult, even like, disturbances in your microbiome. For sure. And the bacteria in your gut can cause harm. Yeah. You know, the microbiome mitochondrial connection, people don't even think about it. Yeah, the interkingum crosstalk stuff is so cool. But it's very impressive. And you know, you mentioned quickly my foreman. I think I want to just quickly double click on that. Yeah. This is a drug that's widely been used for diabetes. I've used it for years in my practice. Yeah. It can be a good drug for diabetes. But it does have a weird side effect, which is an inhibits mitochondrial complex one. And this is like one of the first steps in producing energy from food and oxygen. And one of the studies that most concerned me was they did a randomized control trial. Where they did progressive resistance training, meaning muscle strength training. And two groups, one taking midformin and one is taking midformin. And the one taking midformin didn't have any muscle gains and it inhibited muscle growth. Yep. And that concerns me. So it's being used a lot for longevity and aging. I feel strongly that it's not something people should use for that. I think in certain cases, in certain patients, it can be an adjunctive. Yeah. There being a transition to get off of drugs because you can reverse all that with lifestyle. But like, yeah, I think it's important. So you've got all this top down bottom up stuff. It even gets more interesting now because a lot of new research on the Pagpris pomeranum, another is talking about the mitochondrial role in mental health. Oh, yeah. So aside just that you lose energy and you're tired from the stress, your mitochondria play a big role in dysregal. regulating your mood and your brain function. So talk about that. - Yeah, that's a big piece of it. I'm glad that you had Chris on. I think his work is so great. Looking at metabolic dysfunction and the reversal using the ketogenic diet, for example. And that's a big symptom of what we just described here. - And by the way, we talk about metabolic dysfunction. It's kind of confusing to metabolic dysfunction. This context means how we turn food and oxygen into energy in the mitochondria. That's our metabolism. - Yes, and then I would just add to that how we are able to address the stress of making energy as well. In the sense that when we make energy, we make ATP, we're also making waste products as I mentioned. And that's the other part of metabolic health is that you're able to make energy effectively and you're able to neutralize the stress of making energy. But I love your definition because people get so confused by it. So I appreciate you mentioning it. So when it comes down to brain health and mental health disorders, depression, bipolar, even schizophrenia and some of the major ones, you see amazing capacity to work on mitochondrial function and see these things get so much better. I mean, people throw out and don't like the word cure, but in some cases people come off of medications entirely. And I've seen this-- - Like hearing schizophrenia would die. - I've seen it, it's amazing. And I have a colleague that's with bipolar disorder. And so I feel like where it comes down to is that this is a mitochondrial dysfunction, at least a significant component of it. There might be neurochemical things for sure, but you and I both know, I learned in medical school that depression was a serotonin deficiency. (laughing) But we know how to that work out. - Not so bad. - So maybe depression isn't a pro-sect deficiency? - It's a pro-sect deficiency, right? And so everybody, we need to put pro-sect in the water. That was like not a LSD anymore, but the pro-sect. And we know-- - Yeah, let's see what'd be better. - 100%. (laughing) I've been able to just experiment in New York City back in the day. We know that depression is not a serotonin deficiency. And we know the people that have depression have no lower levels of serotonin than people that don't have depression. So I think that's an interesting thing that we all learned that's completely wrong, right? And that's what I learned in medical school. And as we now know that mitochondria's function is so much more of the actual game here. Now, understanding why people have the mitochondria's function is absolutely essential. We talked about the top down the bottom up and how you have to address the causes for sure. But in the essence of this conversation, what I would say to those who are listening is that we can help people right now by working on mitochondrial function and sympathetic activation. While long-term trying to figure out what those inputs are that are causing it to. But seeing mitochondrial function improve and then all of a sudden depression, anxiety, insomnia, get better is it's been transformative to people that I work with. - No, it's huge. And I think just people should stay tuned to the end of this podcast. So we're gonna get to fix this. But I have a few more. - No, I keep foreshadowing. - No, no, it's good. It's good, it's good. We're gonna get there. One of the ways as people are listening, I imagine they're thinking as well, you know, okay, I know how to activate my parasympathetic system. I can meditate, I can do breath work, I can do yoga, I can be exercised to improve my mitochondria. But, you know, co-plunges, sonas, whatever. But you've said something which is interesting. You said you can't parasympathetic your way out of cell danger. What does that mean? - So this is the thing, right? Because-- - You can't meditate your way out of this like physiological stress to your cells and mitochondria is what you're saying, right? - Yeah, you can't. I mean, because you're in this sympathetic locked in kind of mode and the challenge is anytime you try to downregulate your nervous system, it actually might make you feel like you're crashing. Because when you try to get yourself out of sympathetic and get into parasympathetic, but you've been in sympathetic for long period of time, so you're in that fight or flight. You're mitochondria, as we've been talking about, had been under a lot of stress for a while. And we've depleted vitamins, minerals, nutrients. We're in that cell danger response, location of your cell spectrum of capacity to make energy. And then you're trying to bring down the nervous system, but what can happen when you do that is that you've only been able to function because you've been at that high of a state. And when you bring down the nervous system without enough support on the mitochondrial side, especially immune system will really be helpful too, you'll see that you have this crash. People feel like they crash. When they go down and try to do their breath work, try to do their meditation, oftentimes, they feel terrible when they try to do it. If they can even do it at the first place, because the other challenge of this to mark is that people don't even know what it feels like to be back in parasympathetic mode. They don't even remember what it felt like to calm down their nervous system. And so it can be very difficult to do breath work or tell somebody to meditate, or the last thing you want to do is to tell them to calm down, of course, right? That doesn't work. If anybody's married or has a partner, they know rule number one of being married is that you don't tell your partner to calm down, right? Doesn't work. I was talking to my son, who's eight. He's like, Dad, I guess three sisters, three older sisters and my wife. And he's like, Dad, what are the things you never tell a girl? I'm like, number one, do not tell them to calm down. (laughing) Good advice. Yeah, yeah. So that's the thing, right? If you're in this locked-in state where you're in this metabolic dysfunction related to being in this cell danger response, not being able to make enough energy, you can't just breathe your way out of it. And so you've got to really deal with those root causes. Like, you know, say if you're mercury poison or you're each other's fish in your throes and it's hard to get enlightened, you gotta like, you gotta deal with those biological things. Yes. And then often the psychological things or the physiological stress gets better. But it takes time. And you know, it's interesting. I really started fasting when you came up with this 'cause I noticed this for years in my practice. I was like, gosh, when people have a physical stress, meaning a toxin, an allogen infection, and it's poor diet, whatever, it actually causes a, like a trouble with the whole system. Like it's not just, it's not just causing like a mental stress, causing stress. It's physiological stress. It creates the same fight or flight, the same sympathetic activation, the same, even if you're kind of cool and everything's fine, you can still feel stressed because of having mercury in your system. 100%, for example. And I think that's something people don't realize. So it's not just psychological. It can be biological causes of psychological stress. 100% and that's what I tell my patients all the time. It doesn't have to start with that sympathetic activation. But it begins somewhere. And then at some point, they both have to be addressed. Which is you can't just address the mercury exposure. If you don't address also the sympathetic activation, that was caused by the mercury exposure. Even if it wasn't a top-down issue before, maybe that's a mile things in that were stressful, but not too bad. But all of a sudden, your mercury toxic, that's a different story. So when you work on mercury toxicity, you also have to work on a sympathetic activation too. Because if you don't do them both, you're still going to be left in a place where you're still sympathetically activated. And you know how it is. Like you've worked with patients like this. You know that if somebody's so citer flight dominant, there's no healing that you can do with these patients. No, it's here. It's impossible. And it's really difficult. It's like the one time I agree with our conventional colleagues that if you're giving them supplements, it's like giving them expensive urine. You know, if you're not addressing the sympathetic activation, along with the root cause, if it was mitochondrial first, right? And so that's why it's so nuanced here. And but it's so important to kind of piece this out as you are and discuss it. But then even like if the mitochondrial stress from toxins or whatever, it actually makes the body stay in a fight or flight. Yeah. So it's like that connection between the mitochondrial stress from things that are just insults that you didn't have to do with like that are not mental insults. Right. So causing this due to be in this mental state of fight or flight. Right. So the idea is that when you have a lot of mitochondrial stress, you're not making enough energy. OK. And when you're not making enough energy, the system goes, oh no, I need more energy. And what it does is tries to compensate by increasing your sympathetic nervous system, increasing your capacity to find out psychologically how you can help the situation. So it's almost like it's a bottom up where you have these sensations and activation of inflammatory pathways and et cetera in the body related to mitochondrial dysfunction that will virtually psychologically this manifests and you trying to figure out why this is happening or trying to give you more energy. So to maintain the capacity that you need to make any energy at all. And so you get in this loop where it doesn't have to be any that over sympathetic activation from outside sources. All of a sudden it's just the mitochondria itself that are not making enough energy and then causing the system to compensate for that. OK. So let me see if I can illustrate. You've got this thing that you describe, which is something that I think most of us who practice this way for years have already seen. We never call it this, but this sympathetic spout of doom, which can come from the top down bottom up. It's a lot of mitochondrial dysfunction stress, a lot of inability to produce energy in ourselves, which runs everything. And we end up in this cell danger response. So we've got like sympathetic spout of doom, cell danger response. So people listening go, yeah, that's me. Right, I'm listening. Oh, yeah, that's kind of me. So like what do we do? Like what if someone stuck? What's the first step to getting out of this loop? The first step-- The spiral of doom. --is to escape the spiral. That's what you want to do over the long term. But initially, you want to figure out ways to help somebody now to help break the spiral and get them additional support so they actually can maintain and benefit from long term support. So the idea is that you're a functional medicine expert. You've founded the field basically with Jeff and others. You know that working with people and optimizing their health, vitamins, minerals, nutrients, optimizing their gut, the neurotransmitters, they can take a long time to do. And if you're in this spiral, it's very difficult to do as well because, again, you're clamped down. You're sympathetically activated. So the goal of breaking the spiral is to support the mitochondria now as much as possible. And at the same time, slowly start down regulating the sympathetic activation, slowly downregulating the nervous system so it can calm down. But you have to do it in that order. You have to start off with supporting mitochondrial first, mitochondrial function for you. - So is that meditative first and then, is it just fix your mitochondrial first, then meditate? - Because what can happen is if you go too soon on the parasympathetic side, trying to calm down the nervous system, without having mitochondrial support, that's when you get into trouble too, because you physically and mentally can't compensate because you don't have enough energy capacity. And so your energy capacity is still low. You've downregulated your nervous system, and now the sympathetic activation, the fight or flight is down. You're trying to calm down the nervous system, and you don't have energy that you can make. You don't have enough energy. And so as a result of that, you crash. And I've seen this in my practice all the time, where if you start working on the nervous system too soon, people crash. And so the key is to work on mitochondrial function now and give immediate support so that when you start downregulating and calming down, that this nervous system has enough capacity, the whole system has enough capacity because the mitochondria is supported. - Okay, so let's talk about that. How do we fix mitochondria? Because it certainly wasn't something that we all learned in medical school. It's something that's one of the central features of functional medicine, which is understanding how to diagnose and treat mitochondrial function. It's a little bit tricky, 'cause the best way to look at mitochondria is to a muscle-bobsy, but that's not fun. - Yeah, no. - But there are other tests. How do you think about approaching mitochondrial function? 'Cause yes, it's got to be focusing on the causes. Like if you're eating something that's bad, or if you're got exposure to toxins, but let's assume you're working on those, 'cause you have to. What else can you revive these little poor baby little mitochondria that don't feel so good? - Well, I think you're kind of leading to the idea of testing the sea mitochondria are working and there are new tests out there that are working on giving you a direct sense of what's happening in the mitochondria and there are a number of them on the market already. Some of them might be more ready for prime time than others. - What do you think is the. - Well, I mean, there's a couple out there. I mean, the ones that I use are more the indirect measures. Like you do organic acid testing, for example, looking at the intermediates that are associated with making energy and also oxidative stress markers and flammatory markers. Like those are really good indicators, really, of mitochondrial function. There's things like me screen and mitoswab and others that are out there that I think are interesting. I think they're new. In the end, what I see here is, it's really nice to have the data for sure, because then you can get a sense of how people do over time. But so much of this, as you know, mark is subjective. People really do know how they feel. If you, even guys who are not as good as women as we know about telling you how they feel, well, how did you feel last five years ago? Tell me about your energy now versus five years ago. Like, oh, yeah, I had a lot of energy. I had no issues. And now I get brain fog. I get that dip during the day and I feel terrible. People can typically give you a sense. So, subjectively, such a big part of this. And I know that's hard, but it's so important because it's how you feel on some level. But what it comes down to is that when you're looking at optimizing mitochondrial function, it is giving the mitochondria what it needs to make energy effectively and to address the stress of making energy. Vitamins, minerals, nutrients, antioxidants, getting rid of heavy metals. This is your work. This is my work. The challenge with all of that, though, is that it takes time. It doesn't happen overnight. And so I've kind of fallen in love with a compound called methylene blue that you know of. That is a very novel compound in some respects, but it's been around for a long time. But it's one of the most effective ways at supporting mitochondrial function right now. And the reason is that it works on the energy production cycle of things. It helps with energy production. And it also works directly like an antioxidant. So, our cells are like gasoline powered cars. Methlene blue at low doses, as long as it's a clean source. Four milligrams to 25 milligrams or so works both as an energy enhancer and as a detoxifier. So, it more like an electric power vehicle rather than a gasoline powered one. And so it's become one of these big levers that I can pull with patients to be a bridge. To be that bridge. I like a picture. I often will put up a picture of the Brooklyn Bridge. I love the Brooklyn Bridge. And it's this bridge where you can help people right now while they're on that path. So, if you're starting it like letter A through H or something in the alphabet on your path to optimizing your health, that first beginning can be really hard, really hard because you don't have energy to go take a walk around the block. You don't have enough energy to make your own food. You don't have enough energy to maybe get out of a relationship that's toxic, right? But once you start giving people enough energy, supporting that capacity without causing stress on the system, that's when they can make huge gains across the alphabet in my analogy here, getting them to LM, O or whatever. And then they're able to start really making changes that they really want to make. And so, I see Methylene Blue as a fantastic bridge for so many people on this path to their own health optimization journey. - And the mechanism of action is really interesting, right? It kind of acts as an electron carrier, which is what electrons really would go through this little mitochondrial assembly line to make energy to make ADP. And it kind of bypasses some of the complexes like two and three that are kind of in the way. So, there's mitochondrial dysfunction. It kind of like leapfrocks over it a little bit, right? - Yep, it bypasses them. - And then you get more ATP and you get less oxidative stress. And my practice, one of the doctors was sharing with me how they were doing intravenous Methylene Blue and how they had a Parkinson's patient and they immediately improved their symptoms. And I don't know if it was a long lasting effect, but it was an incredible thing because we know that Parkinson's is fundamentally a mitochondrial disease in the heart of the brain that has to do with motor function. - Right. - And so, can you kind of explain how that might all be possible? - Yeah, so in the end, neuro-cognitive disease metabolic as we've been talking about everything has these parts of the cell called the mitochondria that help make energy your immune system, everything. And so if your mitochondria aren't working well, you have significant incapacity in the areas that have the most mitochondria that are affected. And so in Parkinson's, it's in the substantial nigray in the brain, for example. So, one cool thing about Methylene Blue, I should mention is that it is highly bioavailable, which means that orally absorption, orally absorption of Methylene Blue is almost as good as IV. The only difference with IV is that how fast it gets in the body, but most people don't need IV. Most people can use oral and get the same mitochondrial benefits. And so, what you were describing on, it's called the electron transfer chain in the mitochondria. So the mitochondria has these proteins that are all kind of aligned up and electrons that we get from our food, mostly carbohydrates and fat. They get donated to these chain using something called NAD and FAD, which people know NAD these days, right? That's a hot topic I know. So you get these carriers, electron carriers, NAD and FAD that bring electrons into the mitochondria. So what happens is if you have those first couple proteins, not working very well, complex one or complex two, the whole rest of the system breaks down. You don't have the capacity to make energy. And most of the mitochondrial toxins out there are affecting complex one and complex two. We talked about stadons, we talked about metformin, infections, pesticides, more are affecting those first four complexes, those first two complexes, excuse me. And so those first couple of complexes aren't working the rest of the system breaks down. So what Methylene Blue can do is it can come in, it can bypass the complexes that aren't working very well, and donate electrons directly up the chain. So all of a sudden, you're able to start making energy in these cells. - So it's almost like a bypass road, if those are broken road, you just kind of goes around it. - Yes, and it also can recycle things like NAD and FAD, so those can maintain their capacity to take electrons from your food, even if those particular complexes aren't working as well as they needed to. So it's this amazing capacity to bypass and compensate for almost any capacity or incapacity of the electron transport chain to work. And that even to the much as so as it's actually the antidote for cyanide poisoning. So cyanide is actually a- - It kills you by stopping your mitochondria from working. - Complex four. So the fourth complex in the mitochondria, complex four is destroyed by cyanide. And what Methylene Blue can do is it does these ninja moves of going across membranes and being an electron acceptor so you can maintain electron flow through those protein complexes, even if you're poisoned by cyanide. And so that's just demonstrating the power of this particular. - Yeah, and it's actually how I learned about it was in the emergency room, as the emergency room doctor, if someone comes to the side and poisoning, this is the drug that you give to cure people. - Right, it's not common, but it's there. There's another one called Methemoglominemia, which is more common, and that's also why it's used in emergency rooms although it's a contrarmonoxide poisoning. Also if you've like the huffing glue or like the stuff, if you have too much of that, that gives you the incapacity to carry oxygen on your blood cells. And Methylene Blue changes the iron state to make sure that you can. - I recommend magnesium to most of my patients and for good reason. It's involved in hundreds of biochemical reactions in the body including regulating the nervous system, supporting muscle recovery, and helping your body transition to a restful sleep. Now what's interesting is that newer research just starting to look at how certain forms of magnesium may support brain health and sleep quality. Now one randomized clinical study, adults who took a brain-available form of magnesium, report improvements to sleep quality and daytime functioning compared to placebo. Now magnesium is one of the most common nutrient deficiencies I see, and low levels can contribute to stress, poor sleep, muscle, tension, and low energy. And the challenge is that most magnesium supplements only contain one or two forms, and they're not always well absorbed. And that's why I recommend magnesium breakthrough by bio optimizers. It's a full spectrum formula that includes seven different forms of magnesium, designing to support your brain, your muscles, your stress response, and your sleep. I take it as part of my eating your team. Try it today and go to biooptimizers.com/heimin and use the code "heimin to check out" to say 15% off your order. it's B-I-O-P-T-I-N. IZERS.com/heimen and use the code "heimen." As a doctor, one of the questions I get all the time is, how bad is alcohol for me really? Now, many people reach for a drink at the end of the day to unwine, to order to feel social, and it works in the moment. But even moderate alcohol, as little as one drink can disrupt sleep, it can leave you grogging the next morning and it puts stress on your body in ways most people don't realize. Plus, alcohol is classified by the World Health Organization as a group one carcinogen, meaning there's strong evidence linking it to certain cancers, including breast and colon cancer. So while an occasional drink isn't catastrophic, alcohol isn't actually a health promoting substance. And if what you're really looking for is relaxation, connection, or that subtle eating lift, is there a smarter, gentler way to get it? Well, yes, that's where bestper comes in from peak. Bestper is a non-alcoholic, adaptive genic, a pair of teeth designed to give you a mindful alternative to your usual drink without the next day sleep disruption or the next day brain fog. Ingredients like alfiniin and lemon balm, help your body relax while the gentian root adds a subtle uplifting effect. You feel calm, bright, and present, not sedated. I've been paying close attention to this category and Vesper is the most thoughtfully formulated option I've come across. If you're ready to rethink your eating ritual, Vesper is a thoughtful, healthier option. And get up to 20% off for life at peak.com/hymon as PIQELife.com/hymon. And it also acts as an MAO inhibitor, which is, MAO is like a monomyne oxidase. It's really regular, it's neurotransmitter function, but you get higher serotonin dopamine, or an effrene, it can have proved mood, neurocognitive effects, right? So it's dose dependent. So lower doses of methylene blue will increase noropinephyrin and serotonin. Higher doses will also increase dopamine once you do about 100 milligrams or so. The key, as I mentioned, is that it's dose dependent, meaning that a little bit will do a little bit of that, and more of it will do more. So there are people that have talked about how methylene blue just helps people feel better because it increases serotonin, but that's not the case at all. We're talking about small amounts compared to the huge effect on mitochondrial function. - People are listening to them, I don't know how to take it. What are the doses like, how do you do it? I see a lot of people sucking on these laws just makes their tongue all blue. - They can just swallow it, it's okay. - It's swallow it. - Yeah, because as I mentioned, it's almost 100% bioavailable, which means if you ingest it, whether you dissolve in the mouth, as a trophy, or if you swallow it, you can get the same mitochondrial benefits. The key here, Mark, and I think this is important for your audience to know is that methylene blue is not a natural compound. It doesn't come from the earth, it's a synthetic ingredient. And as a result of that, it can be sometimes contaminated with heavy metals, things like lead, mercury, cadmium, and arsenic. - In the manufacturing? - In the manufacturing process. And so to take the synthetic thing, just for a minute, is I know some people don't like the idea of taking anything synthetic. The way I like to talk about this is that, not everything natural is good for us. Okay, you can forage. - Arsenic is, yeah. - Arsenic is what kill you. - Mushrooms, like I was in medical school, and I saw two people die of liver failure because of foraging for the wrong mushrooms, for example. So, and of course the dose makes the poison, right? So you can have low doses of natural products that can be okay, but high doses of nicotine, for example, can kill somebody, right? And so on the other side of things, synthetic argument, not everything synthetic is bad for us, is what it comes down to. We live in synthetic worlds. We live lots of synthetic things all around us, right? My son, when he was four, he had a tracking cellulitis or a skin infection up his leg. And I was looking at it, go up his leg in front of me. And so I took him to the hospital and I got a antibiotics, which are synthetic. Okay. And if you're taking insulin right now, as a diabetic, if you have type one diabetes or type two, it's a synthetic ingredient. It's not from a pig anymore, right? And so there are reasons why we need synthetic things. And I think methane move falls into this category and we earn it's a synthetic compound that can help so much, especially in the short term. And then I think over the long term, as you get more optimized, you don't need it as much. And do you use it in conjunction with other mitochondrial support? So in this film, as we talked about Cocute 10 and creatine and carnachine and I poke ass in it. And as you'll see, it's this team in riboflavin and magnesium potassium isparachate. All these wonderful ribos that can be supportive. And I've used them in practice to great benefit, often together with things like hard failure. Of course, but you have to use them in conjunction with methane blue or not as much. - It works better when it's being used in more of a synergistic mutual way as you just described it. Because not only, so methane blue, what it's gonna do is the increase in metabolic rate because it's gonna increase the amount of energy you're making. So low doses are very supportive. They don't cause a huge amount of stress. But it is much better to have it as a full ecosystem that you're creating in the mitochondria. So you're creating all the substrate, meaning you have the capacity from vitamins, minerals, nutrients, all the things that you just mentioned to support mitochondrial function and use the methane blue. It's like a supercharge. Like because the things you mentioned do a great job with mitochondrial function, but it takes time for all of those to work. Whereas you give some methane blue in the system within about three days, once you find the right dose, you will feel a difference. It's not something that happens 30 days or a month later, which can happen with many of the things that you mentioned, which I love and I use a myclinical practice too. And they're so supportive and necessary. But what methane blue can do is in that short term, give you the boost that you need and so that you start feeling the difference much sooner. - So this is the most important tool for getting out of this sympathetic spallog doom. - I found it's the fastest tool to be able to do it from a mitochondrial perspective, right? Because you wanna be able to support the mitochondria to help it relax and a good example of this. - And it's okay to take it every day. - So in the beginning, yeah, as long as you're keeping the dose low, my sense of this is that- - That is a dose low, me. - Right, so usually- - A milligram amount. - So typically milligram dose that I find that's really great for the mitochondria, is somewhere between eight to about 25 milligrams a day. If you're keeping the dose less than 30 milligrams per day, you don't even have to take a day off and you can take it every day. If you're taking above 70 or 100 milligrams of methylene blue, then you do need to take more days off. So the thing about it, methane blue kind of has this sort of bi-modal capacity. When I mean by that is like low doses of it around what I just described as a range, fantastic mitochondrial function. Sometimes a little bit higher than that. But when you get to about a milligram per kilogram, which is around 50 to 70 milligrams of methylene blue and above, what happens then is it becomes more of an anti-infective. Actually, it's a fantastic anti-micropeid higher doses. And it does that because it produces something in the body called hygiene peroxide. In hygiene peroxide, you know, you can buy this door. - That's why it's actually what your white blood cells produce to kill infection. - Exactly. And so what methylene blue does is it creates more of a hygiene peroxide capacity and you kill bugs easier. And you also enhance your antioxidant systems. If you have the capacity and that's the key and that's why if you have an acute infection, I use it all the time in high doses. But if you have a chronic infection, chronic Lyme, chronic mold, I use it at the higher doses, but I ramp them up. - I don't start off. - Yes, because if you give somebody a high dose of methylene blue right off the gate and they have chronic Lyme, they're not gonna feel good. If you give them 50 or 100 milligrams right away. So slowly increasing their dose might accundral support and then higher doses can be fantastically effective for chronic Lyme, for chronic mold, for even people with spike protein, I've seen some interesting things as well. And also, as a result of that, even viral infections as well. I've seen some really interesting things. But the majority of people are gonna use lower doses from mitochondrial function. That being said, some people have these chronic infections that are causing significant infection. Or cause significant mitochondrial dysfunction. But I was gonna say, I was gonna tell a story about a friend of mine as a colleague, he's like, "Doc, I've had anxiety for my whole life." And I started taking methylene blue and it's gone. You ask, "Well, why is that the case?" Is that because we changed this neurochemical stuff? No, it's because we gave him significant mitochondrial support immediately. And then he's like, "I've never felt this good." And as a result of having enough mitochondrial support, his system started being able to unclench itself. And because now you're making enough energy and now the system can start healing. And I found my methylene blue at these low doses to be fantastically effective, Mark. And I haven't, and initially I was very skeptical. Because I was like, "This is a compound that doesn't come from the ground." And my dad's a caropactor for 45 years. Like in the beginning, he was militantly against Western medicine. But over the years, he now knows that it's important to use too. But so I was blown away the first couple of years when we started using it. People, we had this one lady with my own cognitive impairment. She started telling stories about her child so that nobody in her family had ever heard of before. Her brain came back online. I had another lady that had chronic mold, done all the remediation in her house, in her body, still felt terrible. Started giving her some methylene blue. She was back to work in two weeks. It was crazy. And then I had another lady with chronic ankylosing spinalitis, like severe pain disorder, in the back, inflammatory issues, nothing had ever worked. She started taking methylene blue and her pain just went away. And I was like, "This is back in 2020." So, you know, we were the first people to really pioneer this back then in 2020 at the company, at our company. And so, we've seen gigantic amounts of anecdotal data. And then there's researchers that have been doing this and showing that there's models of Alzheimer's, models of Parkinson's, you know, others, looking at an intramatic brain injury, looking at an in stroke. And so, it's just, it's a fantastic compound that, you know, has gotten more popular over the last couple of years, which is great. But understanding what you're doing, like dosing wise and making sure you're getting good quality stuff, is absolutely essential. Like the stuff on Amazon is garbage mostly. Most liquids out there are not as potent. Even if it says it on the label, it's, you know, it's a huge deal. So, I'm very much a proponent of using it, but using the right company stuff, the right products and the right dosings. And you're just to be transparent. You have created a company called those subscriptions, which I use. But it, you provide a, Metheling Blue. Yeah. And you have different forms of it, but you run through all third party testing and make sure it's the right dose and that there's no contaminants. So is there a method that you've kind of developed that I can't be able to do that? - So at Tristcriptions, which is our company, we decided to make this company by the way, Mark, we actually evolved it out of a nonprofit organization. So we have a nonprofit called Health Optimization Medicine and Practice. You've met Dr. Ted in the past, who's our founder, Dr. Ted Ochoco. And the idea with the nonprofit was to create an ecosystem for practitioners, for training, and for learning how to optimize health rather than focus on disease and very much align with functional medicine. And out of that, we birthed the Tristcription company because you wanted to help people right now along that path. And Tristcriptions was the first company to come out with a commercial product of Methlene Blue using it in 2020. I thought Ted was crazy at the time. I'm like, what are people gonna, they're gonna want their urine to be blue because your urine will turn blue. - Well, by the way, yeah, you make sure you're in green or blue. - Exactly. - You're dying. - The concentrates in the urine, so you gotta watch out for that. And you have to, so you don't surprise-- - Just a junior close, are we gonna go? - Yes, you gotta be very careful. And so we came out with the first commercial product in 2020, and I was a little bit hesitant to be honest because I was like, I saw the research, it was very compelling. But then the other issue that I was very hesitant about is that it took us about a year and a half longer to launch the company to find a good source of Methlene Blue. Even when it said pharmaceutical grade, USP grade, it was contaminated with heavy metals. Or it was not as potent as it said on the label. The challenge is, and you know this, you get a compound from another country. We get ours from Japan and Korea, even China. I mean, it doesn't matter where you're getting it from. You're gonna get what's called a certificate of analysis with your product, with the ingredient itself. As a certificate of analysis is technically, supposed to be a third party assessment of that particular ingredient. But can you trust that that's coming from another country? - No, right, China is China policing itself. - Right, we're not doing China under the bus. Any other country, right? And so what we do, which most companies don't do, unfortunately, you know this in the supplement world, even across the board, is that we test it again once it comes into United States with another independent lab to make sure that it's safe, to make sure that it meets our specifications. And only then do we put in our products. And then we test it again, final product to make sure it's the exact amount of milligram dosage. And we've tested a lot of the things on the market. But in the end, I didn't get into this to sell Methlene Blue. I get into this because-- - Creating patients. - I saw this pattern. I didn't know, I didn't name it in the-- - I knew you were using conjunction with your other areas like Hyper-Beric Oxygen, Red Light Therapy, which kind of also helped modify my Neconjural function, right? - 100%, yeah, this is not just a zero sum game. It's not like one thing. And what I find with Methlene Blue, it's just a fantastic supercharger, accelerator bridge for our patients that are just stuck. And then all of a sudden we unstick them. They could become unstuck, I guess. And then we can actually let them finally heal, finally maximize their potential. Because you can't heal when you're mitochondria stuck. And you can-- - It's one of the sticky issues in functional medicines. How do you unburden someone's mitochondria? How do you get them out of this cell danger response and what you call the sympathetic spiral of doom? So let's kind of talk a little bit about what you call the parasympathetic edge. What is that? Why is it important? And people talk about pushing hard and just going through and going through the barriers that you feel, kind of overcoming resistance. But you're seeing, maybe that's not the best way. - So what is the parasympathetic edge? - So this is the opposite of the sympathetic spiral. This is the parasympathetic edge. But the deal I have a friend of mine, he's the only Olympic skier and former wide receiver on the Philadelphia Eagles, his name's Jeremy. And he told me when he first started doing his competitions, he would listen to like Metallica and like hard metal. But by the time he was Olympic level, he was listening to Mozart and Beethoven. Why? He didn't need his nervous system to be functioning at a sympathetic level. He needed to drop down just a little bit to find that edge so that he was right in there. And you talk about people that are high performers, they are not in sympathetic overload. They are just below that in a place where they can maintain their capacity. Navy SEALs are famous for this, right? They can find ways when they're in, when they're actually in operations, they're not sympathetically dominant. They've done training so much, like a Michael Phelps is a great example of this too, right? You have trained so much for every eventuality that nothing is going to make your nervous system go too high. Is if it goes too high, we can't function that high. We don't do well. And this is where the classic example is like you have that dream where you're supposed to give a speech and you can't remember your lines. Because when your sympathetic nervous system is so high on such high alert, you actually lose blood flow to the front of your brain, which is where you have, what's called your executive function. Your capacity to maintain things, come bring things from your long-term memory, like you go blank. You go blank, that's sympathetic activation. And so we want to have people learn is that when we down regulate the nervous system, you're going to function better than you're even thinking that you're functioning at a higher capacity when you're at sympathetic dominance. Because when you teach people that you can bring people down and have them function at a better level, it is like night and day. I mean, the main good example of this another one, just to give another example is recovery. Like, when now in 2026, people care about recovery, right? We were kind of like, oh, but five or 10 years ago, if you were an athlete in the professional sports, nobody gave a crap about recovery, right? And so people were burning out, they were getting injured and things like that. But now if you focus on knowing you can strengthen three times a week at most, and it's better than strengthening five times a week, why? It's the same deal. Because are you going to exercise optimally? That is sympathetic, but as soon as you finish exercise, you need to drop yourself down into parasympathetic to actually gain muscle and actually build. Because you build most of your muscle when you're out of the gym. Right, because cortisol actually causes you to lose muscle, right? Yes, it's catabolic. But the GABA system, and that's the system that is involved in calming down the brain, GABA is your primary inhibitory neurotransmitter. That is your neurotransmitter that puts the brakes on your firing, calms down your nervous system, and it's enhanced when you have increased insulin, for example. So when after you eat, your GABA levels go up, for example. But GABA is deficient in so many of our people, in so many people, because of the lives that we leave, with stress all over the place. So GABA deficiency is actually more associated with depression, anxiety, insomnia, than any serotonergic issues that you could ever imagine. But you say that you're taking GABA, because you can buy GABA supplements over the counter. Right. So GABA as a supplement is not a good idea. Yeah. But you're saying there's another compound that comes from the toxic mushroom, the eminium, the scarier mushroom. Yeah. Which is agarine. Yeah, agarine, agarine. Agarine. Yeah. And so what it comes down to, like to break it down, and just briefly, so GABA, again, your brakes of your brain. Right. If most of us are running around GABA deficient because of the sympathetic activation, the spiral that we've been talking about. The challenge is that if you go to your regular doctor, and you say, I have anxiety, I have stress, I have depression, they're probably going to give you an SSRI. Maybe they'll give you a benzo, which, you know, they don't want to give you, but they might give you a short amount of it. Now, when it comes to benzos and alcohol-- That does like valium. Like valium, out of vein. Out of vein. Yeah. Right. So those medications and alcohol, they all bind to the GABA receptor. But they've vastly deplete GABA in the process, giving you more GABA issues over time, and more anxiety, more stress, and then you have more tolerance to those drugs, and you take more of them, et cetera. And so GABA supplements sounds like a good idea, right? But the problem with the GABA supplement is that GABA is too big of a molecule to get into the brain. If you take GABA, and it works for you-- You have a leaky brain. Leaky brain. Meaning that your blood brain barrier is not doing what it's supposed to, keeping things out. And so what do you really have there? Oftentimes you have a leaky gut, as you know. So if you optimize the gut, I've had patients like this where GABA works for them beautifully. They feel nice and calm and relaxed. But you optimize their gut, seal it up. GABA supplements stop working. And when I first started talking about this number of years ago, I had a number of clinicians that came up to me and said GABA supplements. If they work for my patients, it's diagnostic. They have a leaky brain. And I was like, this is interesting. And I started learning more about it and seeing it in my own clinical practice. When you optimize the gut, which you know I do in practice at the time, the brain gets better. So GABA supplements don't work. If they do work, go see some practitioners. But there's something else you can take, which is from the mushroom. Yeah. So the aminita mushroom has a very cool compound called Agaran, or a Garen. And it's a long-acting molecule that works in the GABA receptor, binding to where GABA would bind. The cool thing about the GABA receptor is that there's a, it's five subunit receptor, not getting too technical, but you have a place where GABA binds itself. And then you have separate sites called, you know, separate sites are allosteric sites where other things can bind. Where agaran binds is where directly where GABA would bind. So when you take it, you're not depleting GABA in the process. The thing is, if you're binding something out of a separate site to the GABA receptor, say it's CAVA, for example, or CBD, or CBG, or Ninoleabark, or Valerian. These are all binding to separate sites, increasing the amount of GABA to bind. But if you don't have enough GABA around, all that's not going to, what's going to happen is over time those aren't going to work very well for you. They're going to stop working. - Scott, so this is really fascinating stuff. And I think that, you know, getting a pair of sympathy edges key, getting the sympathy that expires Jim is key. How do, how do you kind of support people to kind of maintain, they've sort of broken the cycle a little bit? - Yeah. - You, you, you, you, you, you, you, you, you, and we're, we're going to refer you to resources. I know you've written a lot about this. And I want to ask you, it's not a word people can find a more information, but how do you maintain a more stable state, rather than keep falling into the sympathetic spiral of doom? - Yeah. I think the first place is to know what it feels like to not be in that state, right? Because when you know that the sense system is now calm down, you're going to feel better. You may not feel like it. 100% better right away because you still need a lot of long-term support. You need support with your vitamins, your minerals, your nutrients, your diet. These things can take time, as you know, and be difficult. And then you fall off the wagon and you come back up and things like that. So I think what it comes down to for me is that you need to have short-term ways to intervene. Right? Short-term way for me is methylene blue is just a great capacity enhancer in the mitochondria. Optimizing the GABA system can be great. And Triskcriptions does have some products there. If something that's called trocom and in Jersey, they can be helpful. You don't have to go product. You can also learn how to meditate and do breath work and start taking more walks in nature. Get better sunlight. These are all going to be helpful too. It doesn't matter where people are on their level of capacity to start doing something. Right? Sometimes it's helpful I found is to give them something like something that downregulates the nervous system, something that's GABA, or an object that works on the GABA system, to give them the experience of what it feels like to not be in that sympathetic state. And doing it in a very supportive way. So there might a conjure supported, typically is what I try to do first, as I mentioned. And then I'll have, give them the experience. You can still get some reactive anxiety when that happens because you're used to being at a certain level. So that's short-term. So short-term giving people the experience of where they're is, we talked about in meditation, there's no there there, but in perceptetic edge, they're absolutely is there there. They're knowing what that feels like. And then you can try to modulate that in various things that you're doing in your day to day life. Oh, powerful. And but that's the thing. Like your day to day life becomes your meditation, becomes your life. You have to find ways during your day to break down, not break down, but calm down the system, right? Taking more breaks, getting outside in the sunlight. And then that's more medium term. Long term is like, okay, why are you so sympathetically activated? We talked about this. Is it external stuff? Is it the top down? Do you need to get out of a bad marriage? Do you need to sleep in a different room? Did just get a sleep divorce from your partner? I think about 50% of US couples sleep in different beds, different rooms. This is not it's not a small thing. They have a more PC word of sleep union or something like that now instead of sleep divorce and make it doesn't sound as bad. But if you need to sleep in a different room, so you get better sleep, you should, but that can be hard, right? So trauma, you mentioned this as well. And this is where things become harder, right? This is where your experience is with psychedelics, specifically, are very interesting, right? Like looking at psychedelics like ketamine and MDMA and sleep. And I began like you did, right? Like these are huge. And I know you've already spoken openly about this, which I really commend you on because I'm very often sending my patients to go get ketamine with our friend Dave Reibon. And others that are out there that are really good at creating a huge neuroplastic response to these medicines. And that's where the real healing is going to occur a long term. We can give the people the experience of downregulating their nervous system now. We can give them modes of operation at a day to day basis. But if there's elephants that are hanging around in the room, those are still there, you know? And we have to address those. And from the mitochondrial side, it's the same thing. We have to address the mercury toxicity. We have to address the toxic exposures or the. Like this functional medicine basically. Exactly. Yes, exactly. Like that's. Words the system. Yeah. You have to be the system is and your system is fantastic for that, right? That's what you do. And that's what's beautiful. But that takes longer. Yeah. It takes longer. So can people stand methylene blue long term? Or is it like a maintenance thing? What I have people typically do is that find your right dose. What I. My main way of doing that is start off at a low dose somewhere, I'm at four or eight milligrams, which is a quarter or a half one of our trokeys. And then increase your dose every three to five days. See how you feel at one dose. Take it in the morning. Take it in the whole trokey is. Take it at 16. Yeah, one whole trokey is 16. And then one quarter is four milligrams. So take four milligrams in the morning. See how you feel. Take it out an empty stomach. You don't have to dissolve in the mouth, okay? You can if you like, but your mouth is going to be blue. That's okay too. It works faster up here, but the same amount of methylene blue is going to get in the body. See how you feel for about three days. Even the morning. Don't feel much. Go to eight milligrams. See how you feel. Take it at an empty stomach in the morning. If you don't feel much, go to 12, then go to 16. But somewhere between eight and 16 for most people is when they're going to start feeling, wow, I do have more energy. Wow, my brain's functioning a little bit better. I don't have as much brain fog. I'm not getting that energy dip in the middle of the day. My inflammation is better. My pain might be better. My mood seems to be more regulated. You will know. And that's what I find. Is that. And then when you start increasing dose more from there, you don't typically see as much return on your investment. It usually is like a sweet spot for people. And once you find that right dose, how often should you take it depends on what you're taking it for. If you're taking it as a bridge, you're kind of early on in your process, you might need to take it every day. And I have patients that are on it every day for a while. But over time, the goal is always to come on it less or use it less, only needing it when you only using it when you need it. So for example, when you get more optimized, you're still going to have a conscious stress. And the question is when you use it. So a good example is when you're traveling on an airplane. On an airplane, you're going from about 21% oxygen in the air that you're breathing at sea level to about 18% relatively on a plane. That's a huge hypoxic stress, low oxygen stress on an airplane because you're pressurized about 8,000 feet above sea level. The best jet lag hack that I've ever found, Mark, is to move to Colorado because I live at 5,500 feet. And so when you go on an airplane, it's 8,000 feet pressurization. When I come to Austin to visit you, I'm at sea level. I feel great because I've been at altitude for a while. And I was just at 8,500 feet in Montana and I felt it. You need metheling blue for that, man. Because what I have is anybody that's coming to visit me, I always get the metheling blue before they get on the plane. And then I was actually with our nonprofit, Dr. Ted and Boomer, who's our CEO of Transcriptions at Home Hope, we were in Tibet. We were at Mount Everest Base Camp at 17,800 feet. 70,000. It was very, very high. We had intermittent oxygen. We had oxygen canisters. But we were using metheling blue. It was game changing. That wasn't the only thing we used. We used diamox and we used. I got pretty significant altitude sickness. And I was in Bolivia. We drove right up to 16,000 feet. There was no climatization. That's. There was a hotel there and my oxygen saturation was down in the 70s. I'm sure. Yeah. And that's where the two. We had them on oxygen. But we were using diamox, which is a drug for altitude. We were using Viagra as well. Yeah, right. And we got back side and blood flow and then we're using metheling blue. So, as you get more optimized, Mark, you don't need it as much. And you don't need it as often. And that's. But I have everybody. All my patients have a higher strength metheling blue in their medicine cabinet, just in case. Which is. Which is 50 milligrams in strength. So we have something called TRO+ blue, which is available to practitioners. So if you're a practitioner listening, we have a practitioner. And why would you use it? You could use it. So the 50s are great for acute infection, acute stress overall. And so I use it for acute infection and acute stress. So if somebody has a concussion or has a acute injury, I give them higher doses. Or a short period of time. Yeah, for a short period of time. And sometimes I combine it with anti-biotic. So my mom, for example, was bitten by a lime tick in New York. She's around 70. And so, sorry, mom, I gave her your age. But I gave her metheling blue, about two milligrams per kilogram, about 150 milligrams for five days. And she also took doxy at the same time. We wanted to give her doxy because she's in New York, lime ticks are everywhere, right? But her recheck for lime titers four weeks later, they were negative, right? And so it's not like it's the only thing sometimes. But it's also being used as monotherapy for urinary tract infections as well. At these high doses. So I give higher doses. That's amazing. Intermittently, but it's the lower doses that I use and maintain. So for me, I'll use it about three times a week, four milligrams every day, every four milligrams at a time, sometimes twice daily. You can dose it in the morning. Because I'll dose it again, really in the afternoon as well, because it doesn't typically keep you up. It's not like caffeine or a stimulant. It should just give you more energy. It feel like you can just kind of go. That's the idea. And then when you find that right dose, often you'll know it. If you're pretty well optimized, you can also use it for endurance. I have guys that use it because it increases aerobic capacity. Oh, good. Okay. So I have cyclists that use it. I have an electric December movie. Yeah, exactly. And I have ultra-marathons that I use it. I know you've used it as well and had some experience as well. Yeah. Great conversation. Working people learn more about your work about the sympathetic spiral of doom, which will danger all that stuff. A couple of different places. And thank you for having me, Mark. So my personal website is my name. It's my name, Dr. Scott Schur. DRS, C-O-T-T-S-H-E-R-R.com. The company that makes some of the products we've been talking about today is called Tro-scriptions. It's the word trokey and prescriptions mashed up into tro-scriptions. We are pharmaceutical grade, we're physicians that run the company, and we have precision dosing with all of our products. I really care about all of that, so does Dr. Ted. You can check it out at tro-scriptions.com. We have JustBlue, which is our pure methilim blue. We have something called Blue Canotine, which is combination with methilim blue, nicotine caffeine and CBD, which is fantastic for focus. It's more for stimulation, but great as a stimulant. Then we have tro-com and tro-z, which are more on that gabbicide, turning that brain off that gabber urge excite. We have a tro-com and tro-z, and then we have a whole practitioner. Tro-z is for sleep. Tro-z is about the most comprehensive sleep formula that I've seen on the planet. It's got eight different ingredients, including the gabbicide system. Tro-z is fantastic. We also have a practitioner ecosystem, so if you're a practitioner, you can sign up for our practitioner account. You can either buy for your office or we have direct shipping. We have a huge portal and ecosystem that I've developed over the years with my team. It's not that transcriptions.com. Then the nonprofit is called Health Optimization Medicine and Practice, or Home Hope. For short, it's homehope.org. There you can find, if you're just in training, we have CME certified courses. We have a Holy Ecosystem there that's. very much aligned with functional medicine as well. And then where else? I think on our website, on our transcription's website, there's a lot of information on the sympathetic spiral of doom. I've been talking a lot about more about this and I will continue to be doing it as well. And again, this is not a diagnosis. It's a pattern that you and I have seen in clinical practice for a year is marked. But the key I think is the sequence here is mitochondrial support first, then sympathetic down regulation. And in that order is the key. And then we break the spiral. We escape from it long term using the work that you do and then I do in clinical practice. Amazing. Well, thank you. Thanks for your generous God. Thanks for always helping me when I reach out to you on the hyperjuaction stuff. Oh, yeah. And then finally, I have one other company called OneBase Health. And that's a company that's involved in the hyperbaric space. I know you have a chamber now and-- Yeah, yeah. --you have some good experiences doing some. Thanks God. Thanks for your due. Just bringing the scientists everybody and being dedicated to helping people live a healthier, better life. Right back at you, Mark. Thanks for having me. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. 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