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It seems that in todays world we are doing much more of our content in the audio format but sometimes we want to see the written explanations. This is what this area is going to be about. More pictures, explanations and deeper ideas...
CRYOTHERAPY: What Does the Data Say?
I've gotten a lot of questions about cryotherapy, how does it work? what does it actually do? Does it help with....
Can cryotherapy help with weight-loss or body maintenance
Is it bad for your heart?
Can Cryotherapy help with pain relief?
Will it help with actually healing pain/problems?
What does it do for StemCells?
Can it help with athletic performance?
Cryotherapy - not much risk shown if used and screened
Cold water plunge: After drop
prolonged cold exposure can cause the cold water in the limbs to overwhelm the warm water in the core organs and cool off the blood too fast and cause heart arrhythmias. - We don't see this is cryotherapy.
Science: Norepinephrine: is a hormone and neurotransmitter involved in focus, attention and mood. Cold induces a Robus increase in NE. NE increases vasoconstriction for vascular treatment etc.
RBM3 is a cold shock protein. Cold boosts the activity of RBM 3 - RNA binding motif 3 (RBM3)- which plays a role in restoring damaged synapses after cold therapy. THis is potentially excited because we can stimulator a repair of damaged nerves, help with neurodegeneration issues and improve long term protection of synapses if we have a family history of dementia, alzheimers etc.
Inflammation: NE inhibits the inflammatory pathway by decreasing TNFa a potent inflammatory molecule. TNFa has been implicated in most disease, diabetes, ibd, cancer etc. Somewhere between 2-3x/week appears to change these markers in humans.
Soft tissue repair: Cryotherapy has been shown to inhibit collagenase activity that breaks down collagen. This can be a good thing if we have had a soft tissue injury to ligaments, muscles, tendons etc. I believe this is where we see some of our patient's speed through the healing process so much faster with the addition of cryotherapy.
Pain: Reductions in systemic inflammation are, for the most part, usually unambiguously positive. One such example that stands out and where this might especially be the case is arthritis. In a randomized controlled trial patients with arthritis underwent whole-body cryotherapy three times a week for 1 week had a significant reduction in pain. Some of the pain alleviating effects of cold exposure, particularly in the case of whole-body cryotherapy, may, in fact, be due to increased norepinephrine since inflammation itself causes pain. In fact, spinal injection of compounds that induce a release of norepinephrine has been shown to alleviate pain in human and animal studies
Immune function: Immunosenescence (Nonfunctional immune cells) - Cryotherapy - increases certain types of immune cells like white blood cells, cytotoxic t lymphocytes that kill cancer, natural killer T cells increased in number and activity in one study a cell type that kill viruses and tumor cells. This may explain why studies done on winter cold water swimmers lowered their incidence of infections by 40%.
Weight Loss - Metabolism: Cold causes something called cold thermogenesis - this is where our body increases metabolism to produce heat. One type of cold thermogenesis is non-shivering thermogenesis basically where your muscles are not contracting to produce heat. If we experience this, it can cause an increase in something called UCP1 uncoupling protein 1 that through some reactions in the body can convert white adipose tissue to brown. This is great because the benefits of BAT are widespread, and the harm of WAT are just as widespread.
Antioxidant/Detox: A side effect of using oxygen for energy is the production of exhaust: those damaging reactive oxygen species (ROS) that damage nearly everything inside cells, including DNA by contributing to things like DNA damage and cellular senescence, are a huge component of the very process of aging. Studies show 20 sessions doubled the activity of one of the most potent antioxidant enzyme systems in the body called glutathione and increased another potent antioxidant enzyme called superoxide dismutase by ~43%. Another study showed 10 days/sessions increased the activity of superoxide dismutase by 36% and glutathione peroxidase by 68%. Superoxide dismutase is the enzyme is in your mitochondria cleaning up all that damage that is being produced every second of every day. It is also important to note that the increase in antioxidant enzyme activity, in this case, took multiple sessions of the whole body cryotherapy...meaning the more frequent cryotherapy was done, the more robust of an increase in activating these powerful antioxidant enzymes.
Performance: Activities that are more characteristically aerobic place a greater demand on the cells to be able to utilize oxygen for the purposes of energy production. In other words, aerobic activities have a greater need of supporting mitochondria! Depending on the nature of the exercise (endurance vs. resistance) and the time of the cold exposure (preexercise, immediately after exercise, or later) there may be very different and somewhat opposing outcomes. Strength: Strength Training Whole body cryotherapy at 220 to 319°F (−140 to −195 °C) done 1 hour after plyometric exercise (squat jumps and leg curls) showed improvements in a variety of performance measures up to 72 hours after the treatment. These improvements include power at the start of the squat jump, and squat jump work up. In addition, pain measures (both at rest and at the next squat jumping session) were also improved. blunted? -Men that performed leg presses and squat jumps twice per week and then immediately engaged in 10 minutes of cold-water immersion (in other words, at the point of peak inflammation) had only ⅓ of the increases in muscle mass in their quadriceps 10 weeks later compared to those that did no cold-water immersion posttraining. Endurance whole-body cryotherapy is slightly more positive. This may be characteristic of the type of adaptations that occur that are more specific to endurance activities Cold increases mitochondrial biogenesis. Cold stress is able to boost mitochondrial biogenesis. The reason this mechanism exists is pretty straightforward: mitochondria are able to create heat (something you need when cold) as a byproduct of energy production. As the powerhouses of the cell, it can be said that mitochondria are pretty darn useful for most of our cells, except red blood cells, which don't have them, however, they're especially important if we want to talk about endurance activity… That's because mitochondria, and the density or number of them on a per cell basis, affects our aerobic capacity . Aerobic activity uses a lot of oxygen causing a lot of ROS so the immune changes we talked about may have something to do with the endurance improvements, but we definitely see good improvement in endurance training. Most of the research showed it being done after runs or endurance. This increased mitochondria in those cells so they could produce more energy easier. Performance improvement: Elite runners that engaged in whole body cryotherapy 1 hour, 24 hours, or 48 hours post hill sprint running had a 20% increase in speed and power up to two days later. This 20% performance enhancement post-cryotherapy may be attributed to the reduction in inflammation and increase in anti-inflammatory factors.
The Thousand Mile High Summary Patients:
We've covered a lot, so I think now is as good of a time as any to take a step back and ask what's the big picture message here. In other words, what does all of this mean? I think there's many key take homes from all of this. I'll try to summarize just a few. ● ONE. Cold shock shows some interesting promise for helping diseases of neurodegeneration through a special cold shock protein known as RBM3… will we be taking people and putting them through super traumatic freezing temperatures in the future to prevent Alzheimer's? I don't know, but the fact that this neuroprotective, synapse fixing effect happens in mice is a very good sign and hints at some really profound things we may find out in the future are applicable to humans as well. ● TWO. Norepinephrine, which can go up a huge amount from a variety of different cold stressors, has some pretty interesting properties and is a very versatile neurotransmitter and hormone! We need it for vasoconstriction, as part of our body's dynamic response to cold, but it is also antiinfammatory. For this reason it may have special relevance for diseases of inflammation, like arthritis, as well as mood and even depression. ● THREE. Giving yourself short bouts of intense cold stress may be applicable if you have some degree of chronic pain, because of the analgesic effect, which may also be partly mediated by… you guessed it… norepinephrine. ● FOUR. There may be some truth to winter swimming improving immune function in regular practitioners. ● FIVE. In contrast to old dogma, adult humans have brown fat and exposure to cold increases it. Brown fat generally decreases as we get older, especially if we're obese. Having more of it, however, is associated with trending towards a lower body fat percentage, and, finally, the amount of brown fat is directly affected by our exposure to cold. Coldwater immersion can definitely increase brown fat, but so can cold air, which means whole body cryotherapy is probably also effective for this purpose. ● SIX. Using cryotherapy and coldwater immersion in the context of exercise is sort of complicated! You can definitely undermine your gains in the context of resistance training if you're doing coldwater immersion immediately after training. In other contexts, however, there may be improvements as well. We still have some unanswered and very interesting questions surrounding this. I'm hopeful that the more deleterious effects will turn out to be mostly constrained to the hour long window of time immediately after training, but I'm not really sure. We need more studies to say for certain!
This time of year, many people are working on starting new habits. While I love and encourage this idea some (many?) people would be better served by breaking a few of their bad habits first.
The steps to break bad habits have been well studied:
RECOGNIZE: the behavior AND the trigger.
What triggers your bad behavior? For me if I didn't eat breakfast or have a lunch with me it creates a trigger that allows me to eat bad foods offered. For some its an emotional trigger, environmental or location.
ALTER: the environment or access to the trigger
If you are triggered to drink every time you go to the bar with Tom, don't go to the bar and tell Tom you're busy and will see him in a few months. Once you recognize the trigger you can put steps in place to avoid it. This is the positive side of out of sight, out of mind. If you can make it difficult for yourself to access the trigger you'll be much less likely to participate in the bad habit.
REWARD/PUNISH: Create a punishment/reward system in response to the habit
We live based on rewards and punishments. If you reward yourself when respond well to a trigger you'll be more likely to respond that way in the future. If you endure even a simple punishment for a bad habit you'll be less likely to repeat the behavior. These can be anything from the rubber band snap to a loss of phone privileges or anything else you can do to tell your brain that habit is no longer supported.
REPLACE: Initiate a replacement behavior
This is a bit counterintuitive but a study by Fritz et al found that if you perform a replacement behavior after you gave in to your bad habit you activate a part of your brain that helps you to overcome the bad habit in the future. So no matter how you responded to the trigger, good or bad, you immediately perform your replacement habit. ie. People around you are drinking, trigger, leads to you having a beer. Immediately do something good instead (yes even after you gave into the bad)- drink a glass of water and do a breathwork session. You can insert anything into this.
While this may seem simplistic truly going through the steps to break your bad habits can be life changing. If we want to be healthier, happier and better the simplest path is the stop being unhealthy, unhappy and making things so hard. Good luck and remember do that one thing to get a little bit healthier today!
Stop Sabotaging Your Sleep
Are you ruining your sleep before you even lay down? Poor sleep is associated with increased rates of chronic pain, stress, anxiety, risk of Alzheimer’s, cancer, diabetes, weight gain, dementia, and countless other problems. Poor sleep is basically negative for you in every way. Your brain, body and emotions all function worse if you don’t get good sleep. Yet, research tells us that more than 50% of people don’t get quality sleep at night.
Today we are going to start you down the path to fix that. Before you start adding habits that will improve your sleep it is often much more beneficial to correct the things you are doing wrong first! Basically learn what you need to stop doing before you start trying to add some new activities in.
Top 6 habits that are ruining your sleep quality:
Too much caffeine - There are many people who are very slow caffeine metabolizes to the point where if you drink 4-6 cups of coffee (keep in mind 1 mug is usually 2 cups) then they still have high amounts of caffeine in their body when they try to shut down. If you don’t know your caffeine metabolism but you don’t sleep well you’d do best to have <2 cups of coffee and do it before noon.
TV/Phone Screens in bed - when bright lights particularly of blue wave length stimulate your eyes, your brain assumes that light is coming from the sun. This delays your body's natural production of melatonin (the sleep hormone) for up to 90 minutes. SO when you play on your phone getting ready for bed for those 10-30 minutes your body won’t be ready for sleep hormonally for another hour and a half! If you must have screen time we’ll get into how you can cheat later but for now start limiting screen time the last hour before bed.
Sleeping too hot - most people make the mistake of keeping the thermostat in their house too high at night. Research says that you should sleep between 64-68 degrees to get the best quality sleep. This is because the temperature drop is one part of what stimulates your body to shut down and get into deep, restorative sleep. Turn that temperature down!
Irregular bedtimes - Yes as adults we need bedtimes too! If you change the time you prepare for and go to sleep each night your body can’t find a good rhythm. Many people change their bed time depending on the day of the week and their body hates them for it. Keep a more regular bedtime and try to change it by no less than 60 minutes on the weekends and watch your sleep quality continue to improve.
Not expending enough energy during the day - if you aren't burning calories, moving a lot or exercising then your body won't have as strong of a signal to shut down for recovery. I find that I sleep the best when I do zone 3-4 type of exercise (fairly intense HIT type exercise) but some research shows benefits to zone 2 or slow cardio training.
Staying inside all day - not getting a moderate amount of sunlight during the day will ruin sleep very quickly. Your natural circadian rhythm relies on you getting sunlight during the day. Even just 30 minutes of sunlight will help to regulate your circadian rhythm.
Next week we'll dive into some of the habits you can add to your daily routine to get the best sleep of your life. In the meantime start cleaning up the bad habits that may be ruining your sleep!
Training Your Nervous System?
Your nervous system is the controlling system of all function of your body but how often do you think about actually training your nervous system to improve its performance?
In my conversation with Applied Neurology expert, Elisabeth Kristof. We did a deep dive into:
How your function, pain and health can be affected by a dysfunctional nervous system.
Where pain comes from in your nervous system?
How STRESS levels affect your nervous system and health
Can you actually improve balance in your nervous system
Before we get into that lets talk about the nervous system.
Your nervous system is comprised of a few different parts:
In this picture there is quite a bit of information but the main thing that I'd like to point out is that the autonomic (think automatic) nervous system is split into two parts: Sympathetic and Parasympathetic. The sympathetic is our fight and flight - it basically activates everything that would help us in a fight situation. The parasympathetic is our rest and relax system - it helps to restore a calm and relaxed state. In today's world we tend to live in the overactivated or sympathetic state. This imbalance can create many issues including chronic stress, anxiety, pain, burn-out, inflammation, disease and more. In today's world we need to pay more attention to nervous system balance than ever. Our nervous system doesn't know the difference between a real fight/flight situation and one made up in our minds. It responds exactly the same. Some ways that we can improve the health of the nervous system are: stimulate each aspect of our nerves.
Move your eye's in their full range of motion. Look all the way left, right, up, down, and large circles.
Use a tune up ball to roll the bottom of your feet and hands feeling the sensation and tightness.
Move your tongue in large circles over your teeth, around the top teeth, bottom teeth - making larger and larger circles with the tongue, reaching further back in the mouth as you progress. Do 5 each direction
Do four 4-7-8 breaths each day
Start a mindfulness practice that begins with paying close attention to your breath coming in and going out. Count the breaths up to 20 then start back at 1. Do 10-minutes each day.
Do a new/challenging movement or exercise twice each week. Learn new ways to move your body to challenge the system.
For more information and ideas listing to my entire conversation with Elisabeth here or check it out on Apple, Google or Spotify.
Also check out her free video series at www.brainbased-wellness.com.
NERVE PAIN? Can A Supplement Be Better Than Medication?
PEA (palmitoylethanolamide) is a compound naturally produced by your body to combat pain and inflammation. It targets nerve inflammation and nerve protection responses. In our office we have seen many nerve pain patients heal much faster when adding PEA to their advanced pain therapy treatment. But what does it do?
Research shows improved pain and healing times for Sciatic nerve damage, carpal tunnel and likely thoracic outlet syndrome. 300-1200 mg/day Speeds pain relief and healing over 50%.
Research Review CONCLUSION: PEA is effective at treating nerve injury, pain and repair by changing the growth factors, cell function and inflammatory reaction at the cell level. PEA is specifically helpful for nerve compression such as sciatica, carpal tunnel and thoracic outlet syndrome as well as signs of fibromyalgia and neuropathic pain.
It works by addressing nerve inflammation and protection at the microglial cells. Microglial cells lead to peripheral and central sensitization and inflammatory and neuropathic pain because of the over-release of TNF-alpha and IL-1Beta. These neuromodulators are produced after injury or infection of peripheral and central nerves. This means that chronic pain is actually a result of imbalance in the immune system. The immune system is activated to aid the nervous system when the microglial cells ask for help. The microglial cells are always surveying at the cellular level. When pathogens or injury are discovered, cytokines are released that call in the immune cells to clean up and fight off the pathogenic insult. This promotes an inflammatory response which creates neurotoxins. The neurotoxins in turn induce more inflammation. Without a good system to control the toxins produced during the treatment of the pathogen or injury to the nervous system, neuroinflammation will occur.
Palmitoylethanolamide, a naturally occurring disease-modifying agent in neuropathic pain - PubMed (nih.gov) PEA a member of the N-acylethanolamine family which is produced from the lipid bilayer on-demand, is capable of exerting anti-allodynic and anti-hyperalgesic effects by down-modulating both microglial and mast cell activity has led to the application of this fatty acid amide in several clinical studies of neuropathic pain, with beneficial outcome and no indication of adverse effects at pharmacological doses. Non-neuronal cell modulation relieves neuropathic pain: efficacy of the endogenous lipid palmitoylethanolamide - PubMed (nih.gov) PEA delayed mast cell recruitment, protected mast cells against degranulation and abolished the nerve growth factor increase in sciatic nerve concomitantly preserving the nerve from degeneration, while reducing microglia activation in the spinal cord. These findings support the idea that non-neuronal cells may be a valuable pharmacological target to treat neuropathic pain since the current neuronal-direct drugs are still unsatisfactory. In this context PEA could represent an innovative molecule, combining a dual analgesic activity, both on neurons and on nonneuronal cells.
Roughly 40% of women report PMS pain and irritation. I see many women who experience set backs in recovery around their cycle and over the last few weeks diving into Omega-3 research I found it interesting that there were some changes.
In this research review we see a few things that can move the needle if you are having PMS symptoms.
Omega 3 https://pubmed.ncbi.nlm.nih.gov/23642943/ The second study was done on 124 women taking 2 grams of omega-3's per day (1g 2x/day) They found that after 45 days of taking the omega-3 depression, concentration, bloating and anxiety were all improved in the Omega-3 group! They also found that the treatment improved bloating, headache and breast tenderness. The effects increased by longer duration meaning it kept improving the longer they took the omega-3's.
Zinc Sulfate https://pubmed.ncbi.nlm.nih.gov/28188965/ The last study was done supplementing zinc sulfate at 220mg containing 50mg of elemental zinc from the 16th day of the cycle to the first day of the next cycle. They found that of the 142 participants that the Zinc group decreased from 9.5% reporting moderate to severe PMS to 2.6% by the 3rd month.
So for those who experience significant symptoms if we combine these studies you'd take 1-2 grams of Omega-3 in the form of the fish oil or krill oil as we spoke about last week and for the last 2 weeks of your cycle add in Zinc Sulfate. Do this for at least 3 months and see where you are.
Omega - 3 Benefits explained
Its another research review: So thanks for the feedback on Omega-3 info. I did get some questions about what Omega-3's are used for.
Tonight we're looking at a few studies First is Migraines:
Aging is another important one for Omega-3's. Telomeres are a protection buffer for aging DNA and a general aging marker. The double-blind randomized controlled trial involved 106 adults between the ages of 40 and 85 years who were sedentary and overweight. Supplementation of both 1.25 grames or 2.5 grams of Omega-3 FA were associated with longer telomere length! This suggest Omega-3's could slow aging! https://www.sciencedirect.com/science/article/abs/pii/S088915911200431X
Another bit of research is in Cancer. In this study done in mice: Fats with the least saturation (meaning the most double bonds) were most effective, with the omega-3 fat DHA demonstrating the most cancer-fighting ability. However, this result only occurred in cancer cells with an acidic pH compared to a neutral pH. Mice that received the fish oil supplementation lost harmful white adipose tissue but gained metabolically beneficial brown adipose tissue, improving whole-body metabolism. The fish oil diet delayed cancer growth and increased survival, and this effect was magnified by the addition of a ferroptosis-inducing drug. Peroxidation of n-3 and n-6 polyunsaturated fatty acids in the acidic tumor environment leads to ferroptosis-mediated anticancer effects - ScienceDirect
It’s #researchreview time! Tonight we’re looking at omega 3’s, fish oil and krill oil. When we look at absorbing the omega-3 fatty acids EPA and DHA there are a few considerations that go into what we should take. First off is how is the fatty acid stored. In Krill oil the FA is delivered to the body in a phospholipid while fish oil often delivers the fatty acid in a triglyceride form. Research has shown that the brain likes to absorb phospholipids better and the stomach can absorb them at a 40% better rate. The issue comes in when we look at the amounts in normal supplements where many krill oil supplements only contain 1/10th the amount of EPA/DHA that fish oil does. Thus even if we absorb twice as much we’re still not getting as much. Conclusion: if you can take the same amount or even close krill oil wins the race but if not maybe taking a very high quality fish oil is a good starting point. The wildcard is that krill oil also contains the antioxidant astaxanthin that helps with inflammation, cell repair, HDL etc.
Morning Routine for a better life?
In 2018 I went to a conference with some of the worlds best anti-aging health hackers and scientists. During that conference a lot of doctors and researchers presented amazing ideas and techniques to get healthier and heal faster. I’m all better lifestyle recommendation The one that influenced these influencers the most was to wake up and spend every morning looking at the sun for 20 minutes with your feet on the earth. This practice was anecdotally explain as changing cell function in the body, brain function, stress and anxiety, Eichel and overall wellness. If that is the upside of watching the sunrise and the downside is you have an extra 20 minutes to yourself every morning it’s a practice That’s worth a shot. 30 day sunrise earth challenge.
Great question - first off the stress of the heat causes a survival response getting your body to release norepinephrine. Heating up the body and blood also activated heat shock proteins, transcriptional regulators, and pro- and anti-inflammatory factors.
Regular sauna also activates transcription regulators that have a strong role in aging and lifespan. They help to protect cell damage, dna damage and stem cell function.
These effects and others play a role in the benefits of sauna for heart health, aging, life span and Alzheimer’s prevention
Sauna is one of my favorite health and wellness #biostacks. It helps a lot on its own but when you stack it with other treatments it really does some amazing things. The research on the benefits of sauna have continued to grow in recent years. This study done with 2,300 middle-aged men, showed beneficial effects with sauna use reducing risk death and disease. Men who used the sauna two to three times per week were about 27% less likely to die from cardiovascular-related causes than men who didn't use the sauna. When compared to men who used the sauna 4-7 times per week they found the increased dose gave almost twicethe benefits – those men who did more sauna sessions were 50% less likely to die from cardiovascular-related causes. They also found the men were about 40% less likely to die from all premature death causes. This was even after age, activity and lifestyle was factored in. The researchers also found that the frequent sauna use reduced the risk of Alzheimer’s and dementia. Both reduced around 66%! Not a bad reason to sweat...
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