Welcome to the Huberman Lab Podcast,

where we discuss science

and science-based tools for everyday life.

I’m Andrew Huberman,

and I’m a professor of neurobiology and ophthalmology

at Stanford School of Medicine.

Today, we continue in our discussion about sensation

or how we sense things.

On previous episodes,

we talked about sensing light and sound waves

for things like vision and hearing.

Today, we are going to talk about our sense of self

or what’s called interoception.

Interoception is our sensing of our internal landscape,

things like our heartbeat, our breathing, and our gut,

how full our gut might happen to be

or how empty our gut might happen to be,

but also our inner landscape with respect to chemistry,

how acidic or how good or bad we feel on the inside.

This discussion about sense of self and interoception

has many important actionable items

that relate to bodily health and brain health,

and believe it or not,

our ability to perform well or perform poorly in life.

Indeed, it has profound influence on our rates of healing.

So today, we are going to talk about

all the aspects of our inner landscape

and how our brain and body communicate,

and there will be many actionable protocols

as we go along that discussion.

Before we begin our discussion about sense of self,

I want to highlight

some very recently published research findings

that I believe are immediately actionable

and that everybody should be aware of.

These are data that were published

by my colleague, Justin Sonnenberg’s laboratory

at Stanford University School of Medicine,

and the data were published in the journal Cell,

which is a very, very high stringency cell press journal.

So phenomenal data.

What this study showed was that

individuals given a high fiber diet

actually experienced less diversity

of what’s called the gut microbiome.

The number of positive or health-promoting bacteria

in the gut was actually reduced by a high fiber diet,

whereas individuals that ate just a couple of servings

of fermented food each day

experienced important and beneficial increases

in anti-inflammatory markers,

and that could be traced back to improvements

in the gut microbiome diversity.

The diversity of bugs, literally,

little bacteria that live in the gut,

which might sound bad,

but they are actually very health-promoting.

I’m going to get into all the details of this study

later in the episode,

but I just wanted to emphasize these findings

because they are immediately actionable.

I think for most people,

ingesting one or two servings of fermented food each day

is reasonable and does not bring with it tremendous costs

or tremendous inconvenience,

and I think many people are ingesting high fiber diets

thinking that that’s the best way

to improve their gut microbiome.

So while these data may prove to be controversial

among the folks out there in the nutrition community

that really promote high fiber diet,

I want to just emphasize that these data

were looked at in a very unbiased way.

They were done with large-scale screens

of all sorts of inflammatory markers.

There was no specific hypothesis going in.

It was purely exploratory,

but the data are very, very clear.

It doesn’t mean you shouldn’t eat fiber.

It doesn’t mean that fiber is bad,

but it really shows that eating fermented foods,

just one or two servings a day,

and maybe even ramping up to three or four servings per day

can be very beneficial for many aspects of health.

Before we go any further,

I’d like to emphasize that this podcast is separate

from my teaching and research roles at Stanford.

It is, however, part of my desire and effort

to bring zero cost to consumer information about science

and science-related tools to the general public.

In keeping with that theme,

I’d like to thank the sponsors of today’s podcast.

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If you’re somebody who cares about your immediate

and long-term health,

and if you’re somebody who’s interested in performance

of any kind, in work, in relationships, et cetera,

today’s topic, I believe,

is among the more important ones for you.

Of all the topics I could cover,

this thing that we call sense of self,

which is also called interoception,

has perhaps the most foundational level of importance

for all that we feel, all that we do,

and all that we are capable of doing.

In fact, I will go so far as to say that interoception,

or our ability to sense our inner real estate,

is right there next to sleep,

and perhaps one other feature of our health

and bodily function that primarily determine

how good we feel in the now, in the short-term,

and in the long-term,

and sets the stage for everything we are capable of doing.

And if we don’t take care of this thing

that we call interoception,

just like if we don’t take care of sleep,

we cannot perform well, and we will not remain healthy.

Interoception and sense of self

are essentially the same thing.

I will use those terms interchangeably,

at least for sake of today’s discussion.

And I promise that if you can learn a little bit

about the mechanisms of self-sensing,

of understanding what’s going on in your internal milieu,

as we say, your internal environment,

you will position yourself to do some very simple things

that can lead to outsized positive effects on everything,

from sleep, to body composition, to mental focus,

to mood, your ability to regulate stress,

and indeed, even your ability to heal and recovery

from injuries of different kinds,

brain injury and bodily injury.

So sense of self is absolutely crucial.

It’s sometimes called our sixth sense,

right alongside the other five senses,

like hearing, vision, touch, taste, smell, et cetera.

But sense of self is different.

Sense of self is really about what’s going on internally

within the confines of our skin.

And it involves two key features

that if you can understand those features

and you understand what modulates

or changes our ability to sense those features,

there are a lot of things that you can do

in terms of how you structure your nutritional practices,

how you relate to your exercise practices,

perhaps even certain things that you take

in terms of supplementation

that can basically make you feel better,

more alert, and more capable for everything.

I don’t think that’s a hyperbolic statement.

In fact, I know it’s not a hyperbolic statement

because we have a system in our body

that connects our brain to all of our bodily organs

and connects all of those bodily organs to our brain.

And that communication between brain and body

in both directions creates a situation

where either we are positioned to do things well

or we are positioned to do things poorly.

So I really want to dive in and dissect

what is this system of brain-body communication?

What does it look like?

What are the actual neurons and connections?

And as I do that,

I promise that I’m going to place protocols,

tools that you can apply

in order to make sure that those neurons and connections

are working optimally.

So let’s begin by talking about what system

communicates the brain to the body

and the body back to the brain.

The system that’s most often associated with this

is our 10th cranial nerve called the vagus nerve.

The word vagus relates to the word vagabond,

which is to wander.

And indeed, the vagus nerve is a vast,

enormous, wandering set of nerves.

So it’s not one nerve.

It’s not like one fiber, one axon, as we say.

In the nervous system, we have these wires we call axons

that let neurons communicate.

It’s a bunch of neurons

and a bunch of wires that go everywhere.

So where do they go?

Well, they leave the brain and the brainstem.

The brainstem is kind of the back of your brain.

If you touch the back of your neck,

it’s about three inches deep to where you’re touching.

The neurons that are there send information into the body

to control your bodily organs.

How fast your heart is beating,

how fast you’re breathing,

how fast your digestion is occurring.

Even things like whether or not you are going to secrete

so-called killer cells, your immune cells,

from your spleen to go ward off bacteria.

Now, the neurons there don’t know what to do

unless they receive information

about what’s going on within the body.

And within the body, your heart, your lungs,

your diaphragm, your gut,

so everything from your intestines to your stomach, et cetera

and your spleen are sending information

also up to the brain.

So as I mentioned before, it’s a two-way street.

So the vagus nerve is a very important nerve,

but just by saying vagus nerve, it sounds like a singular.

It sounds like one thing,

but actually what we’re talking about

is a series of super highways.

It’s like Google Maps.

It’s got stuff going everywhere with alternate routes,

communicating back and forth.

There are two fundamental features

of what’s going on in your body

that need to be communicated to your brain,

these neurons in your brainstem,

in order for your brain and your body

to work together correctly.

And the two types of information are mechanical information,

so things like pressure, things like lack of pressure

and chemical information,

whether or not your gut is acidic

or whether or not it’s not acidic,

whether or not you have some sort of pathogen,

something that you ate or that got into your body somehow

and is making you sick

or whether or not you don’t have a pathogen in your body.

So you’ve got mechanical sensing and chemical sensing.

So when you think about your sense of self

and your ability to understand what’s going on in your body,

if you feel good or if you feel bad,

your sense of self is dependent on these mechanical

phenomenon and these chemical phenomenon.

And for every organ in your body,

whether or not that’s your heart or your lungs

or your spleen,

both the mechanical information about that organ,

for instance, is if your gut is full or empty,

whether or not your heart is beating fast

or beating slowly, that’s mechanical.

And chemical information,

whether or not your gut feels nice

and whether, you know, when I say nice,

I mean, whether or not it has a balance of acidity

and alkalinity that feels right to you

or whether or not your gut feels off,

it doesn’t feel quite right, that’s chemical information.

If you are not getting enough oxygen

and levels of carbon dioxide and other gas go up too high,

so your lungs can register that

and that chemical information is sent to your brain

and then your brain does certain things.

Actually, it really encourages you to do certain things

in order to adjust that chemistry.

So the first principle that everyone should understand

about their sense of self is that they are sensing

mechanical and chemical information

about every organ in their body,

except for one, and that’s the brain.

Your brain actually doesn’t have pain receptors.

It doesn’t even have touch receptors.

The brain is a command center.

It helps drive and govern changes

in the organs of the body,

but your brain doesn’t move, at least not much.

It can move a little bit.

Fluid moves within it, but as long as you’re healthy,

it’s not moving that much.

Your brain has no sensation of its own.

In fact, when they do brain surgery on people,

they will anesthetize or put some anesthesia on the scalp.

They’ll cut away the skin there

so that people don’t feel anything.

They’ll use some anesthesia.

They’ll peel back the skin,

and then they’ll use a, well, let’s call it what it is.

It’s a bone saw, and they basically saw open

a little window in the skull.

I’ve actually done this before and seen this before.

I’ve done this many times before.

And once you’re inside the brain,

you can put electrodes in there,

and you can put various things in there,

of course, all for therapeutic purposes.

And you do that without any anesthesia

to the actual brain tissue,

because it has no receptors to sense anything.

It doesn’t have pain receptors.

It doesn’t have pressure receptors, none of that.

When you have a headache and your head feels

like it’s too much pressure,

well, that’s because of receptors that lie outside the brain.

So your organs are different.

They need to tell your brain what’s going on.

And there are ways that you can control the mechanical

and the chemical state of your organs

in ways that are very powerful.

And this is crucial to do

because if you can properly regulate the mechanical

and chemical environment of your body,

your brain functions better.

This is absolutely clear from data

that if your gut is healthy,

if you get the alkalinity right, the acidity right,

and if your spleen is healthy and happy,

and if your lungs are working properly,

not just breathing and pumping in and out air,

but you’re breathing at the right cadence

for a particular activity,

then your brain will function better.

So let’s talk about how you can adjust the mechanical

and chemical environment of your organs

in order to make your brain better

and how your brain can make the mechanical

and chemical environment within your organs function better.

For instance, we’re going to talk about

how you can change the chemistry of your gut

in order for your brain to be able to focus better,

think better, remember better, and sleep better.

And we’re going to talk about how you can change

the chemistry of other organs in your body

such that your immune system will function better

than it would otherwise.

And you can actually heal faster

from small cuts and bruises,

but also injuries of any kind, even major injuries.

So as I mentioned before, we’ve got these organs,

the heart, the lungs, the diaphragm,

and I’ll explain what that is,

the gut and the spleen, and the spleen is this immune organ.

Let’s take one example of these

and explain how mechanical and chemical information

from this particular set of organs

communicates to the brain

and how that changes how our brain works.

And the organ I’d like to focus on first

are the lungs and the diaphragm.

So we’re all familiar with our lungs,

these two big bags of air,

but they’re actually not two big bags of air.

They actually have little tiny sacs within them,

actually millions of little sacs

called the alveoli of the lungs.

The alveoli of the lungs are like little tiny balloons

throughout our lungs.

And the more of those balloons we have,

the more air that we can actually contain.

So we are not two big bags of air in there, our lungs.

We actually have millions and millions

of little tiny bags of air within those lungs.

Those little bags of air can fill up or they can deflate,

right, just like your lungs overall can fill up

or they can deflate.

The diaphragm is a muscle.

It’s kind of shaped like a dome.

So it’s kind of a, you know,

think about a basketball or a soccer ball

that has most of the air pushed out of it.

And so it’s kind of crescent shape or dome shaped,

and it sits below our lungs.

And the way the diaphragm and the lungs work together

is very interesting.

The diaphragm is actually skeletal muscle.

So it’s just like a bicep or a quadricep.

And the fact that it is skeletal muscle is important

because it has a unique property,

which is that you can control it voluntarily.

You can decide to take control of your diaphragm

by just consciously deciding you want to breathe

in a particular way.

Just like you can take conscious control over your legs.

They will work just fine if you’re not thinking about them

as you walk, provided you already know how to walk.

But at any moment,

you can decide to change the rate of your walking,

your so-called cadence of walking.

So the diaphragm as a skeletal muscle

also has that property.

The diaphragm moves up and down

depending on how you breathe,

or rather I should say,

how the diaphragm moves up and down

determines how you breathe.

How you breathe is also dependent on little muscles

that are between your ribs,

the intercostals and other muscles.

If you’re a martial arts fan,

Bruce Lee was famous for having these

very pronounced intercostals

from doing all sorts of bridging exercise, et cetera.

But those are the muscles.

And we all have them even if some of us,

most of us don’t have intercostals like Bruce Lee.

So when you breathe, a couple of things happen,

but let’s talk about the mechanical things first.

And then let’s talk about how those mechanical steps

relate back to the brain

and what that does for the brain.

And I can promise you that if you develop an awareness

of these mechanical changes,

you do not have to go through extensive breathwork practice

or do extensive breathwork.

You will immediately, believe it or not,

develop a sense of your breathing self,

of your lungs and diaphragm.

It takes no practice, but once you do it,

you will forever be changed

in terms of your awareness of your breathing

and your ability to leverage your breathing,

kind of like the steering wheel on a car

in order to shift your brain

in the direction that you want to go.

So it’s a very powerful system.

And the way it works is the following,

and this will also incorporate the heart.

So, and by the heart, I don’t mean it in the emotional sense,

although we don’t rule out emotions

here at the Huberman Lab Podcast, we like emotions,

but I’m talking about the heart as an organ,

as a beating organ that circulates blood.

So when we inhale,

these little sacs in our lungs fill up

and our lungs expand.

And when we do that,

we take up space in our thoracic cavity

and our diaphragm moves down, okay?

When we exhale, the diaphragm moves up,

the lungs get smaller, okay?

So inhales, diaphragm moves down,

exhales, diaphragm moves up.

This actually controls our heart rate,

but it does it by changing the way that our brain works.

And it works in the following way.

So when we inhale, our lungs fill,

our diaphragm moves down,

our heart actually has a little more space

because the diaphragms move down.

So the heart gets a little bit bigger, physically bigger,

not in the emotional sense, but physically bigger.

And as a consequence,

whatever blood is in the heart flows at a slower rate

because it’s a larger volume.

So bigger volume heart,

same amount of blood inside the heart means slower flow.

Okay, sort of like expanding a pipe.

The brain registers that

because there are a set of neurons on the heart

called the sinoatrial node.

It sends that information to the brain.

That information is registered by the brain

and the brain sends a message back to the heart

to speed the heart up.

So every time you inhale,

because of these mechanical changes

in the diaphragm and lungs,

and because of the mechanical changes in the heart,

your brain sends a signal to the heart

to speed the heart up.

So if you do long inhales or you inhale more vigorously,

you actually are speeding your heart up.

Now, of course you have to exhale as well.

But for instance, if I were to inhale very long,

like the entire time my heart rate is increasing.

And then if I did a quick exhale,

something else will happen.

But if I kept doing that,

my heart rate would increase.

It’s not going to increase linearly and forever,

but it will increase with each inhale.

Or I can simply make my inhales more vigorous

and my heart rate will speed up.

This is an autonomic and automatic relationship

between the diaphragm, the lungs, the brain, and the heart.

Now, if inhales speed the heart up,

what happens on exhales?

When we exhale, the diaphragm moves up.

It’s a little counterintuitive,

but you can kind of think about it

as like pushing the plunge on a syringe, right?

When you exhale, this thing moves up.

And as the diaphragm moves up,

the heart has less space,

meaning it gets a little bit smaller,

which means that whatever volume of blood

is inside the heart moves faster

through that smaller volume.

That information is sent to the brain

via these collection of neurons

called the sinoatrial node, for you aficionados.

The brain then sends information via the vagus nerve

back to the heart to slow the heart down.

So while inhales speed up the heart, that’s the net effect,

exhales slow the heart down.

And the reason they slow the heart down

is because of a register in the change,

a mechanical pressure between the diaphragm,

the lungs and the heart.

So this is to me,

the simplest and most straightforward example

of how the brain is changing the way our organs work,

our heart in this case,

according to changes in mechanical interoception.

Now, we’re not always aware of this.

Some of us are aware of it, some of us aren’t.

If you do it right now, you will be aware of it.

So if you can try this, you can basically,

this is an experiment or an example in interoception,

in sensing one’s self.

So if you inhale, it doesn’t matter how long you inhale,

I’ll do it for a couple of seconds.

And then exhale twice as long.

Nose or mouth, doesn’t matter.

The entire time that you’re exhaling,

you’re slowing your heart down.

So just as a car has an accelerator and a brake,

or you can slow a car by coming off the accelerator.

When you exhale,

you’re effectively coming off the accelerator,

or if you want to think about it differently,

you’re hitting the brake,

you’re slowing down your heart rate.

Now, normally your heart rate stays in more or less

the same range for a given activity,

because you’re inhaling and exhaling.

But this is just a simple way of showing

that mechanical changes in your viscera

can change the way that your brain works,

and then your brain changes the way that those viscera work.

And it’s a very concrete agreement.

It’s like a contract between the organs of your body

and the brain.

In fact, you can think about this contract in more detail,

and you can leverage this in a very powerful way

to set the conditions of your mind.

If you want to be more calm, emphasize exhales.

And the simplest way to do this,

I’ve talked about this many times before,

but if you haven’t heard me say it,

this will become immediately clear,

is to emphasize exhales through

what’s called a physiological sigh.

Two inhales, could be through the nose or the mouth,

but ideally through the nose.

So, followed by a long exhale.

Those double inhales are kind of important

because what they do is they maximally fill

all those little sacks in your lungs.

And then when you breathe out,

you’re exhaling as much of the so-called carbon dioxide

in your system as possible.

We’ll talk about carbon dioxide in a second.

So, the fastest way to calm down is to emphasize exhales.

When you make exhales longer,

you’re slowing your heart rate.

You’re calming down.

You don’t need any sophisticated training.

You don’t have to do this for minutes on end.

You don’t have to do anything.

You don’t even have to call it breath work.

It’s just respiration.

And in fact, you do this every night when you go to sleep,

and carbon dioxide builds up too much in your bloodstream,

or if you hold your breath or something,

or you watch an animal or a small child that’s sleeping,

they will occasionally do these double inhale long exhales.

It’s a way of slowing the heart down

and eliminating carbon dioxide.

The opposite is also true.

If you inhale deeply or vigorously,

and then exhale less long or less vigorously,

you will increase your level of alertness

through these purely mechanical aspects

of your interoception.

So for instance, if I were to take a big, deep inhale,

and then a short exhale,

and then another one, big inhale, short exhale,

it only takes two or three of those

before you start to feel more alert.

And that’s because your heart rate is increasing.

And actually, if you keep doing that for 25 or 30 breaths

of inhale deep, short exhale,

you will start to secrete a lot of adrenaline,

this hormone that comes from your kidneys

and from your brainstem,

make you feel really alert.

You will actually feel as if you’ve had a couple of espresso

you will immediately wake up.

And there’s an intermediate form of breathing,

which is sometimes called box breathing,

but it’s really equal inhale and exhale duration.

And these, it basically goes like this.

You’re going to inhale.

So do this for maybe two, three seconds, inhale,

then hold, two, three seconds,

then exhale, two, three seconds,

then hold, two, three seconds.

Most often people forget to hold.

So it’s inhale, hold, exhale, hold for equal

or more or less equal durations of,

could be one second, could be two seconds,

could be three seconds.

Most people find that when you get out past five seconds,

they start to struggle to maintain

the so-called box breathing.

And most people can’t consciously box breathe

for too terribly long without having to think about it.

But the point here is that

through purely mechanical means,

changing the way that you breathe,

emphasizing inhales or exhales or keeping them the same

will change the way that your brain works,

how alert you are and how well you function in anything.

And again, this doesn’t mean that breathwork has no value.

It’s just simply to say that

long extended protocols of breathwork are simply,

they are truly simply just an exploration

of this fundamental relationship

between the mechanics of your internal organs

and your brain and how your brain controls

those internal organs.

Now, you might ask, well, how is this pressure known?

How does the body actually know how full the lungs are?

Now, this is an answer

that’s more for the aficionados out there,

but I’ve had a few requests,

or I should say thousands of requests

for more in-depth science.

So if you’re not interested in more in-depth science,

just this will allow you to tune out now

for maybe just 10 seconds.

And if you are interested, pay careful attention.

There is a set of receptors,

which are called piezoreceptors, P-I-E-Z-O, piezoreceptors.

Piezo means pressure.

And these were discovered a few years ago

by a couple of different laboratories.

But one of the main ones,

one of the main laboratories

that discovered these piezoreceptors

is the laboratory of Ardem Parapuchin.

I love saying his name,

even though I’m probably mispronouncing it.

He’s a friend and a former colleague.

When my lab was down in San Diego,

he’s at the Scripps Institute.

He’s a Howard Hughes Medical Institute investigator,

which just basically means

that he’s a total stud of science

and has made many important discoveries.

The piezoreceptors line many tissues

and inform the brain about pressure in those tissues.

But the lungs have a particular category of piezoreceptors

called piezo-2 receptors.

And as you fill your lungs

and these little sacks of air, the alveoli fill,

the piezo-2 receptors,

because of the way they react to that filling,

send information by way of a bunch of neurons,

a bunch of wires up to the brain

and tell you how full your lungs are.

So that’s the kind of mechanistic detail.

If you want to learn more about that,

you can look up Ardem’s lab at the Scripps

and the beautiful work that they and other laboratories

are doing on piezos.

Piezos are pretty cool.

I think I also just like saying piezo,

so that’s why I brought that up as well.

So mechanical sensing of the lungs, heart, and diaphragm.

And now let’s talk about chemical sensing

because there’s carbon dioxide and there’s oxygen.

And this is really simple.

You have oxygen and carbon dioxide

and you need them both.

I sometimes hear people talk about carbon dioxide

as this bad thing and oxygen as a good thing.

You need them both and you need them

in the appropriate balance.

You have a collection of neurons in your brain

that register when carbon dioxide levels

get to a certain point in your bloodstream.

When that point, that threshold is reached,

these neurons fire and they cause you to breathe.

It’s sometimes called the gasp reflex.

It just makes you want to inhale.

And as a consequence, you bring in more oxygen.

Okay, so we don’t really breathe to get oxygen.

That’s a byproduct of inhaling to eliminate carbon dioxide.

You don’t want carbon dioxide levels to go too high.

In fact, if you want to freak somebody out

and we do these in experiments

and I don’t recommend you do this,

you just increase the levels of carbon dioxide

that they inhale and the brain will go

into an almost immediate panic response

because the health of all our tissues

depends on keeping a nice balance

between carbon dioxide and oxygen.

You don’t want carbon dioxide levels to go too high.

So the impulse to breathe, if you’re underwater

or if you hold your breath is triggered by these neurons

and the triggering of those neurons

comes from elevated carbon dioxide in the bloodstream.

And for those of you that don’t quite know

how to conceptualize the relationship

between bloodstream and breath,

I do think it’s important.

And maybe you remember this from high school biology,

but if you don’t, I’ll make it clear for you now.

It’s very easy.

You inhale air and that air and the oxygen molecules

in that air actually move from your lungs

into the bloodstream because these little avioli

of the lungs, those little sacks of air,

they basically have a lot of little micro vessels

and capillaries, little tiny, basically blood vessels,

essentially, although they’re mostly capillaries,

micro capillaries are the little tiny ones that line them.

So there’s actually an interface,

an opportunity for air and molecules within the air

to pass into the blood

and then they move in your bloodstream.

And when you exhale, the opposite is true.

So you can move things from the air into your bloodstream

or from your bloodstream into the air by way of the lungs.

And there’s a lot more detail to it.

And I’m sure those of you that are experts out there,

if you want to put some stuff in the comments,

maybe a little bit of an kind of intermediate tutorial,

you might even title it intermediate tutorial.

If you know a lot about this, just I’ll check it,

but make sure you get the details right,

make sure you know the process.

And I find that for people that are interested

in understanding how breathing really works,

it’s really nice to think about the relationship

between the heart and the vascular system,

the blood and the air system,

the respiration system and breathing,

because those two things are very,

we say they’re interdigitated,

they’re interwoven with one another.

So how’s this work?

Well, carbon dioxide is too high.

You breathe in, you inspire, you inhale.

As a consequence, when you exhale,

you offload carbon dioxide.

There’s a really cool way that you can explore

this chemistry of your breathing and your bloodstream

and the way that your brain works

in ways that can really benefit your health.

And it works the following way.

You want to essentially sit or lie down,

doesn’t really matter.

You definitely don’t want to be anywhere near water,

not a bathtub, not a hot tub,

not a cold dunk or something.

In fact, don’t even be in a puddle.

And what you want to do in this case

is you’re going to breathe in deep,

so that’s going to increase your heart rate

and then exhale passively

by just letting air fall out of your mouth.

So it would look something like this.

So it’s like you breathe in vigorously

and then you let the air just fall out of your mouth.

When you do that, what you’re essentially doing

is you’re bringing in a lot of oxygen

through that deep breath

and you’re exhaling a little bit of that carbon dioxide.

But if you were to repeat it 25 times, maybe 30 times,

doesn’t matter if it’s 25 or 30, somewhere in there,

you would essentially start bringing in a lot of oxygen

and blowing off or exhaling a lot of carbon dioxide.

So you’re actually going to change the chemistry

of your internal landscape and you can then sense it.

You can intercept what that is like.

And there are some really interesting reasons

for wanting to do that.

So I’m not going to do all 25 or 30 now,

maybe do five or 10 so you can get a sense

of what it looks like so that it’s clear.

I’m going to essentially demonstrate now.

So it’s inhale, exhale through the mouth.

I am inhaling through the nose.

So it’s essentially, excuse me, a two second or so inhale

and then a one second or so exhale.

And as I was doing that,

I can kind of feel my face get flush

and my body is heating up and my brain is heating up.

What’s happening there?

Well, that pattern of breathing is increasing levels

of adrenaline in my brain and body

and I’m getting more alert.

Then after 25 or 30 of those, you exhale all your air.

You dump all your air.

You can do that, your nose or your mouth.

And then you hold your breath with your lungs empty

for about 15 to 30 seconds.

Now, for those of you that want to explore this

and please be careful as you explore this,

don’t do anything stupid like do this while you’re driving

or something like that.

You can exhale all your air.

And what you’ll find then is you can hold your breath

for a very long time.

And the reason you can do that

is because you’ve blown off all the carbon dioxide

or most of the carbon dioxide in your bloodstream.

So you’ve shifted the chemistry of your blood

by breathing in a particular way.

And by doing that, you are no longer triggering

these neurons that cause the gasp reflex

or the reflex to breathe.

Now, of course you have to breathe sooner or later,

but what you’ll find is if normally your ability

to hold your breath is a minute or so

before you really feel that gasp reflex kick in,

you might find that you can go 90 seconds or two minutes.

And with some practice,

people find that they can start holding their breath

for three or four minutes or longer.

This is actually how free divers do what they do.

I do not want anyone free diving.

If you’re going to learn free diving,

please learn it from an expert.

Many people die trying to teach themselves out of free dive

or trying to teach their friends out of free dive

when they don’t know what they’re doing.

This is not what this is about.

Again, don’t do this anywhere near water,

but it is a very interesting exploration

of how you can shift the chemistry of your bloodstream

by modulating your air,

by modulating the mechanics of your diaphragm and lungs,

and thereby shift the way your mind works, your brain.

In fact, what you’ll notice is that even though

during that 25 or 30 breaths,

you’ll feel very alert.

When you exhale all your air and you’re in the breath hold,

you will feel very alert, but very, very calm.

Now, this is interesting because it’s a state

that we all sort of want to achieve, alert but calm,

but have a hard time achieving.

And so for those of you that have a hard time

obtaining focus for sake of work

or focus for sake of anything, I should say,

and when you are able to achieve focus,

it’s through the use of things like stimulants,

or you feel like you have to have a cold shower or ice bath,

or you have to have four espresso in order to be alert,

but then you’re too alert.

You’re jittery, you can’t focus.

This pattern of breathing can lend itself very well

to entering states of alert, but calm for the follow,

the 10 or even 20 minutes that follow that breathing.

And then you could repeat it if you want.

So it’s a very useful practice to explore.

Some of you may be familiar with this practice

as so-called Wim Hof breathing.

Wim Hof is a practitioner of what’s called Tummo breathing.

Tummo breathing has been around for centuries.

And for those of you that are familiar with breath work

and yogic practices,

I acknowledge that nothing I just described

is new based on science.

However, the science informs why those practices work.

And just as a little mini editorial,

I just want to emphasize as well

that one thing that this podcast is really about

is trying to remove fancy nomenclature,

whether or not it’s yogic nomenclature

or scientific nomenclature

so that people can access protocols.

Because the moment we start naming things after people

or calling them Tummo, et cetera,

I have no problem with that,

but it doesn’t inform how the practices are done,

nor does it inform the underlying mechanisms.

So here I’m trying to teach you the mechanisms.

And as a final point to that,

the most powerful form of breathing

is the one that takes into account

the fundamental mechanisms that inhales increase heart rate,

that exhales decrease heart rate,

and that carbon dioxide and oxygen

relate to the bloodstream and the brain in particular ways.

Once you understand those components,

then you can create your own so-called breathwork practices.

You can breathe in the ways that best serve you

as opposed to thinking that one protocol

is the best or holy protocol for everything

because it’s simply not.

As a final, final point,

I want to say that as you shift the way that you breathe,

whether or not you’re blowing off more carbon dioxide

or bringing in more oxygen,

you are fundamentally changing the chemistry

of your internal milieu of your body.

And that has been shown to have important effects

on the way that your immune system functions

and the way that you deal with inflammation

and all sorts of different sort of things

that can enter your body and cause problems

or conditions of stress, et cetera.

So I will explore that further as the episode goes on,

but I want to move on to just touch on one other aspect

of breathing that’s purely mechanical,

which I think is very interesting and important,

which relates to a particular reflex

that you’re going to be very familiar with in a second,

and that can serve you very well in times of extreme stress.

The reflex I’m referring to

is something called the Herring Brewer Reflex.

I’m not going to go into details

about how the Herring Brewer Reflex works,

but it has to do with particular classes of neurons

and cells that are called the baroreceptors.

Those are basically pressure receptors.

They sense pressure.

And basically what the Herring Brewer Reflex is about

is that when your lung is inflated,

your desire to breathe is reduced.

So you can try that right now.

You can inhale, huge big thing of air, and hold, okay?

Your desire to breathe will kick in later

than were you to exhale all your air and hold your breath.

When you exhale all your air and hold your breath,

unless you’ve done the sort of protocol

I described a few minutes ago

of doing a bunch of inhales and exhales first,

in a very deliberate way, you will feel empty.

Those baroreceptors are going to be firing like crazy,

saying there’s no pressure in here,

there’s no pressure in here, I got nothing in here.

You need to breathe, you need to breathe,

and the gas reflex will kick in sooner.

You can apply that in all sorts of situations

related to exercise, related to modulating stress, et cetera.

So the Herring Brewer Reflex is a very powerful one.

This is why you take a big deep breath

before you go underwater, all right?

You’re not going to exhale all your air and go underwater.

If you were to exhale all your air and go underwater,

you would absolutely feel the need to come up sooner

for a breath of air than had you a full tank,

so to speak, lungs full of air.

And this is also the way that people teach themselves

to feel comfortable underwater.

So when you learn how to swim,

you learn how to swim both by having air in your lungs

while you’re underwater,

and no air in your lungs while you’re underwater.

In any event, the Herring Brewer Reflex

is yet another dimension to the way

that mechanical pressure influences

your brain’s decision-making about what to do with your body,

in this case, whether or not to breathe.

So now I want to shift away from breathing

and diaphragm and lungs

and move toward another organ within our viscera,

which is our gut.

So this includes our stomach and our intestines,

our esophagus, and so forth.

It’s been said before, both by me and by others,

that we are but a series of tubes,

and indeed that’s true.

Believe it or not, every system in your body is a tube.

Your brain is actually a tube

that connects to your spinal cord, which is also a tube.

You started off as a tube.

You were like a churro.

You know those churros?

I don’t know, if you’re not familiar with churros,

they’re like donuts that are shaped like a tube.

That’s essentially what you look like early in development,

not long after conception.

And the front end of that churro grew and grew and grew,

but you always maintained a hollow through that tube.

That’s why you have what are called ventricles.

They’re gaps or a space in your brain and spinal cord

that run the length of your brain and spinal cord,

and fluid, cerebral spinal fluid,

and other things move through that space.

We’re going to return to the ventricles later.

They are very, very important.

They’re just space filled with fluid, but they do a lot.

Similarly, your digestive system

starts with the tube at your mouth,

and of course goes down through your throat,

and then you’ve got all the elements

of the stomach and the intestines,

and then it comes out the other end.

So you are, but a series of different tubes,

your vascular system, a series of other tubes.

So your tubes, the way your digestive system works

is to communicate to your brain about the status

of the mechanical pressures along this tube.

So within your stomach and your intestines, et cetera,

and the chemical status of that tube

at various portions within that tube,

to inform your brain about how your brain

should control that tube.

So let’s start with the mechanical sensing of your gut.

If you drink a lot of fluid, or if you eat a lot of food,

your gut will fill up, your stomach will fill up with food.

Now it gets digested there,

it gets digested elsewhere

along your digestive tract too, of course,

but it starts getting digested there

because along this tube,

you have a series of what are called sphincters,

which basically are like little droplets.

If you’ve ever had a laundry bag

which has a drawstring on it,

you pull it and then it cinches shut,

and then you can open it again,

that’s what those are, those are sphincter openings.

And you have them in your throat,

you have them along your digestive tract

all the way to the end.

Food will enter your gut,

and if there’s a lot of that food,

pressure receptors, some of which are these piezo receptors,

will communicate to the areas of your brain

that are involved in feeding,

and will say, don’t eat anymore.

You don’t need to consume anymore.

Now, some people bypass that.

These, I guess they have these

like hotdog eating competitions.

I’m always struck by how some of those people

are like, seem to be rail thin,

but they actually train for those competitions

by ingesting large volumes of water.

Actually a very dangerous practice.

You can actually kill yourself by drinking too much water,

and you can kill yourself by ingesting

too much of anything really to expand your gut.

Not a good practice, not a big fan of those competitions,

but even if you’re one of those people

or you’re the world heavyweight champion of them,

they are informative toward what I’m talking about now,

which is that as you expand the gut,

a signal is sent by neurons,

literally nerve cells that are in the gut to the brainstem

up to the areas of the brain that are involved in feeding.

I did a whole episode on feeding.

You can find on feeding metabolism and hunger.

You’re welcome to listen to that episode if you like,

and it will shut down the neurons

that drive the desire to put more stuff in your mouth.

That thing that people say sometimes on,

well, in this country frequently after Thanksgiving meal,

I can’t put another bite in my mouth.

Literally they shut down some of the basic movements

of the musculature to take another fork bite.

I know it sounds crazy,

but they can actually control your brain.

So your gut is so full that it’s controlling your brain

such that this action of spooning food

towards your mouth is actually inhibited.

It’s made more difficult or less likely to occur.

It’s incredible.

The converse is also true.

When these piezo receptors signal to the brain

that the gut is empty,

independent of your need, your actual need for food,

there’s a signal that’s sent to your brain

that says gut is empty and neurons get stimulated

in areas like the arcuate nucleus

and these areas of the hypothalamus, et cetera,

that drive the desire to make this action,

to open the mouth and to put stuff in it,

in particular food.

So when you find yourself at the refrigerator

or you find yourself almost, you know,

manically trying to get food of different kinds,

you’re not even thinking about what you’re eating

because you’re so hungry.

In part, that’s because the lack of food in your gut

has sent that information to your brain

and is driving particular fixed action patterns

that are associated with eating.

In fact, one of the first things children learn how to do

is open their mouth when something is presented to it.

And then they learn how to move a spoon or a fork.

They’re not very good at it at first,

they get all over the place,

but eventually they get good at it,

at least most people get good at it.

If you watch how people eat, you know,

it’s kind of variable out there.

In any event, this is a purely mechanical phenomenon

and this purely mechanical phenomenon

is driving our brain to drive certain behavior.

You can get better at registering sense of fullness

or lack of fullness in a very particular way.

Some people have a very keen sense

of how full or empty their stomach is.

So if you’ve eaten anything,

even if it’s a small volume of food

in the last hour to three hours,

it’s actually a worthwhile practice to take a few moments,

maybe 10, 20 seconds,

and actually just try and concentrate on sensing

the neurons in your gut and how full you are.

Like for instance, I ate a few hours ago

and I had a little snack about 30 minutes ago or so,

and my gut feels neither terribly full nor terribly empty.

It’s kind of, I would put it at kind of like 30, 40%.

Okay?

So by just taking conscious awareness

of how full or empty our gut is at various times,

between meals, after a meal, before a meal,

you can very quickly develop a sense

of how full or empty you are.

Now, what’s the consequence of that?

The consequence of that is actually rather interesting.

It’s been shown that the consequence of that

is actually that you can better override

the signals of these piezo receptors

and gut fullness or emptiness.

So for those of you that find that you eat

kind of compulsively or non-consciously,

or subconsciously, I should say,

you probably have to be conscious enough

to be awake to eat, but subconsciously,

you just find yourself eating,

and here I’m describing myself.

I’m a drive-by blueberry eater.

If there’s a bowl of blueberries,

every time I walk past it,

I sort of have to grab a handful of them

and pop them in my mouth.

But if you develop this sense of how much mechanopressure,

it’s not really a word,

but how much mechanosensation is in your gut,

very quickly, you can learn to override that.

You might ask, why would I want to be able to override

whether or not my stomach is empty or my stomach is full?

Well, there are many reasons to want to do that.

Many people right now are interested

in so-called intermittent fasting.

They’re doing fasts of anywhere from 12 to 16 hours

every 24-hour cycle.

That’s actually what my practice is.

I do that on a regular basis.

Sometimes, yeah, I eat breakfast,

but normally I push breakfast out to about 11 or noon,

or sometimes a little later.

Some people are doing longer fasts,

and there are really wonderful data

published in excellent journals

from my colleague Sachin Panda

at the Salk Institute of Biological Studies,

and of course, from other laboratories

showing that intermittent fasting

can and will have some positive health effects

on things like liver health and brain health

and other aspects of health.

Whether or not it’s the best form of dieting

for the sake of losing weight, that’s very controversial,

but it’s clear that having a period of fasting

every 24 hours or perhaps even longer from time to time

can be beneficial because it stimulates

what’s called autophagy,

the clearing away or the body’s ability

to eat certain dead cells, so-called senescent cells,

and for many people, they struggle with fasting

because they feel they have a very keen sense

of their stomach being empty,

and they feel as if they have to eat,

and in a kind of counterintuitive way,

there’s some data that indicate that being able to sense

whether or not your gut is full or empty

and just the knowledge

that that’s communicating information to your brain

about whether or not to eat or not,

just that awareness, that understanding

allows them to override the signal.

They think, oh, you know,

I’m not actually in need of nutrients right now.

It’s just that my stomach is empty,

and these piezoreceptors and some other ones

that I’ll tell you about in a moment

are signaling to my brain that it’s empty.

I don’t actually need food.

It’s just that my brain is reacting

to the fact that my gut is deflated, so to speak,

or smaller, doesn’t have food in it.

So there are other ways

that our guts communicate with our brain.

It’s not just our stomach talking to our brain.

It’s also our intestines talk to our brain.

The Lieberles Lab, the guy’s name is Steven Lieberles.

He runs a lab at Harvard Medical School.

It’s a terrific lab,

does excellent work on gut-brain communication

and other aspects of viscera-brain communication.

They discovered a category of neurons

called the GLP-1R neurons.

These are neurons that are basically in your neck.

I mean, they’re part of the nervous system,

but they can be found near your neck,

and those neurons send little wires

down into the intestines and deep into the stomach,

but mostly into the intestines,

and they sense stretch of your intestines.

So this is pretty wild.

These neurons sense how stretched out your intestines are

and how fast things are moving through your intestines,

slow or fast, or if there’s nothing there,

and then those neurons send another branch.

So they have a branch in one direction,

senses what’s going on in your intestines,

and they have another branch that goes up from your neck

into your brain to either trigger the desire to eat more

or to stop eating.

So these are really, really cool neurons,

and they’re basically stretch receptors.

They look a lot like the piezo receptors

that we talked about before.

So these GLP-1R neurons are sensing stretch,

so purely mechanical sensing,

and in addition to that,

the Liberlis lab discovered neurons

that detect nutrients themselves.

Now, the main reason why we need to eat

is to bring nutrients into our body,

and there is another set of neurons.

Those are called GPR65 neurons.

If you want to know, they don’t have to remember that,

that do the same thing in terms of their connections.

They send connections down into the intestines

and into the gut, into the stomach,

but mostly into the intestines,

and then send that information back up to the brain

as to whether or not there are certain kinds of nutrients

in our digestive tract.

Now, these neurons are the ones to pay attention to

if we’re talking about chemical signaling,

and in the next couple of minutes,

I’m going to tell you about how you can understand hunger

and how to modulate your hunger for the right foods,

in fact, for healthy foods.

The way this is done

is by leveraging the activity of these GPR65 neurons,

these neurons that sense nutrients, okay?

They’re telling your brain

what’s in your gut and intestines,

and you have another set of neurons

that were discovered by another guy.

He’s out at Duke University.

His name is Diego, excuse me, Diego, Diego Borges.

He’s a wonderful scientist.

He has a degree in nutrition, but also in neuroscience,

and he found that there are neurons that line the gut,

and those neurons, in collaboration with these GPR65 neurons

are sensing for three things, okay?

So we say nutrients, which nutrients are they looking for?

What are these neurons paying attention to?

Well, these neurons are activated

by the presence of fatty acids,

in particular, omega-3 fatty acids,

sorts of things that come from fatty fish, fish oil, krill,

certain kinds of animal and plant substances.

You can look up what has a lot of omega-3s,

and those omega-3s make these neurons fire electrically,

like crazy up to the brain,

and make you want to eat more of those things,

but it turns out in pretty appropriate levels.

These neurons also respond to amino acids.

So when you eat a food, it’s broken down in the gut.

Actually, the way it’s broken down in the gut

is kind of interesting.

Your gut basically cinches off a sphincter up top,

cinches off a sphincter below it when there’s food there,

and then you have a series of smooth muscles

that tumble the food and literally physically break it down,

and then of course, enzymes come in

and start digesting the food,

and we’re going to talk about digestion

and how that’s communicated to the brain in a moment,

and for those of you with any autoimmune issues

or digestive issues,

this is going to be a very important conversation,

but meanwhile, there are these neurons in the gut,

and as these fatty acids float out of the digested food,

so literally fat molecules,

and as amino acids are coming from the proteins

as they’re digested in the gut,

and as a third food item,

sugars are coming from the foods that we eat.

These neurons will fire a lot to the brain that says,

hey, whatever you’re doing up there, do more of it, okay?

Now, the sugars are a little bit cryptic

because when I say sugars or I say amino acids

or I say fatty acids, this has nothing to do with taste.

In fact, beautiful experiments have been done

by the Borges Lab and by other labs showing

that even if you numb the mouth,

even if you gavage, which is a really just a,

it’s a fancy word for basically tube feeding.

You put a tube down in the gut,

you just deliver the food to the gut,

so you get no opportunity to taste it.

Sounds pretty awful.

If you force feed by gavage or you numb the mouth,

these neurons don’t care about the mouth.

They only care about the nutrients coming from these foods,

and then they signal to the brain, hey, do that thing.

Do that thing where you lift that object,

which we call a fork or a spoon.

Do that thing where you drink the milkshake.

Do that thing where you move your mouth like this,

not talking, but do that thing where you swallow.

So that’s how the nutrients in our gut control us.

And this is why for people

that experience extreme sugar cravings

or even mild sugar cravings,

replacing those foods with foods

that have high levels of omega-3

or amino acids can reduce sugar cravings.

And I’ve talked about this on a previous episode,

but if you didn’t catch it, no big deal.

I’ll tell you right now that for many people,

the solution to sugar cravings is to ingest a small amount,

maybe a teaspoon or so of an amino acid called glutamine.

And if you have really extreme sugar cravings,

you can even mix that glutamine with a full fat cream,

which actually makes it taste pretty darn good.

And you drink that anytime you have a sugar craving,

just a sip or two of that.

And what you find is that the sugar cravings disappear

because you’re basically giving fat and amino acids

to those neurons in the gut and in the intestine

that signal to the brain that you want more.

Now, this doesn’t give you a kind of runaway hunger

for full fat cream,

although it will say when I was in high school

for various reasons,

but mostly because I liked the way it tastes.

I was using half and half in my cereal

and I was waking up in the middle of the night

and drinking half and half.

And that stuff tastes pretty darn good

once you get used to the high fat content,

not something I do now.

But the point is these neurons don’t really know taste,

they only know nutrients.

And so you can work with that system.

If you crave sugar,

and I do believe that most, if not all of us,

should be trying to limit, if not eliminate simple sugars

as much as possible most of the time,

then things like glutamine,

things like high omega-3 foods, et cetera,

maybe even want to supplement with fish oil

or something similar to get omega-3s,

there are other reasons for wanting to do that too,

can be very beneficial.

And here’s what we’re talking about is interoception.

It’s your ability to sense your inner real estate,

but in this case, by way of chemical signaling,

not by way of mechanical signaling.

So now I’d like to talk about another aspect

of gut chemistry that has profound effects on the brain,

as well as on the immune system.

And for those of you with autoimmune conditions,

or for those of you that know people

with autoimmune conditions,

this is going to be a very important discussion.

Your gut needs to maintain a certain level

of acidity or alkalinity.

For those of you without any chemistry background,

basically the low numbers on the pH scale,

that means more acidic.

The higher the numbers, more alkaline.

So more alkaline means more basic,

and acidic means acidic.

And it has to do with the number of hydrogen atoms

and all this other stuff,

but you don’t need to worry about that right now.

We’re not going to pH your gut right now,

but we are going to talk about the pH of your gut.

Your gut needs to be more acidic

than essentially all other tissues of your body

in order to function properly.

Bacteria thrive in alkaline conditions.

I think this is important for people to understand.

People are always thinking,

oh, you should be more alkaline.

Being acidic, that almost sounds like being inflamed.

Well, you know, it’s a complicated discussion,

but I think the semantics can be confusing sometimes.

You want your gut to be acidic.

You may ask, well, why are people taking anti-acids?

Well, those anti-acids are there for a particular purpose

to essentially combat acid reflux,

which is the sending up of stuff in the gut

towards the esophagus,

and it can cause heartburn and things of that sort.

And the way that anti-acids work

is they essentially cause the sphincters

above the gut to cinch shut,

but they really are only dealing with a symptom,

not the cause.

So rewind about 10, 20 years ago,

the discussion about gut acidity

was quite a bit different than it is now

in the scientific and medical literature.

In fact, for many years,

long before I’m going to say it here,

people have been saying

that it’s important to maintain proper acidity of the gut,

but the science and medical professions

sort of looked at that as a kind of a scant,

like, you know, what’s going on there?

I don’t know that there’s any evidence

that that’s actually true.

There are communities of people that were prescribing,

or I should say recommending

that people take hydrochloric acid, HCL,

and adjusting gut acidity that way,

and it was kind of frowned upon.

Now, in looking over the peer-reviewed literature,

it’s clear that this business

of trying to make the gut a little more acidic

is actually one way in which people treat

or try and ameliorate acid reflux.

So it’s kind of counterintuitive,

increasing acidity in the gut to try and reduce acid reflux.

I thought you’re supposed to take antacids.

Well, the field has shifted quite a bit,

and so we’re going to review what it is

to maintain the chemistry of the gut

at a slightly more acidic level,

or a more acidic level, I should say,

because it turns out that there are a number of things

that are in gut, I just call it what it is,

it’s gastric juice, sounds kind of gross,

but gastric juices are actually powerful modulators

of brain state.

Put differently, one of the best things that you can do

to have a healthy brain, a well-functioning brain,

and a healthy and well-functioning body

is to maintain proper gut chemistry,

and that’s basically accomplished

by getting the right level of acidity

and alkalinity in your gut.

Now, this is not quack pseudoscience,

this is not based on cleanses or anything of that sort.

What we’re going to talk about now

are peer-reviewed data in very high-quality journals

like the journal Cell,

which is one of the three apex journals,

Science, Nature, Cell,

and journals of that sort that point to the gut microbiome

and its relationship to acidity of the gut

and how the gut microbiome can help enhance

autoimmune function and various other aspects

of brain and body health.

So within all the mucosal line tissues of our body,

we have what are called microbiota,

little microorganisms that we didn’t make

that actually come from our environment or our food

and live inside us,

and there are good microbiota and there are bad microbiota.

Whether or not we have good microbiota or bad microbiota

depends on one thing,

and that one thing is how acid or alkaline

the given mucosal tissue is.

So we actually have a microbiome in our nose,

and just as a very brief aside,

because I’d be remiss if I didn’t say this,

if you emphasize nasal breathing most of the time,

except when speaking or eating,

and if you downplay mouth breathing,

meaning you refrain from mouth breathing,

especially in sleep,

you improve the nasal microbiome.

It gets better at fighting off infections.

This was shown in a beautiful paper

published in Cell Reports last year,

and that paper I should mention was performed in humans.

So you got a microbiome in your nose,

and by nasal breathing most of the time,

not all the time,

because there can be times

when you need to breathe through your mouth

for whatever reason,

hard exercise or eating or speaking,

but by breathing through your nose most of the time,

you are creating an additional layer of immune defense

against particles that could get you sick,

whereas when you mouth breathe,

you are taking down a layer of defense

and you’re putting yourself more at risk of infection.

This is what this paper shows.

You also have a gut microbiome that is in your throat,

in your stomach and in your intestines,

and that gut microbiome is extremely powerful

in regulating your mood and your immune function.

Now, this is not something that you can sense directly.

You don’t know when you have a bunch of good microbiota

or a bunch of bad microbiota

because you can feel them moving around in there.

Actually, that would be pretty awful.

That would be pretty creepy feeling.

Rather, according to whether or not your gut is alkaline

or acidic in the appropriate ways,

you will populate your gut with the appropriate microbiota.

So you want your stomach to be pretty acidic,

but other elements of your digestive tract

are going to be more pH.

And basically there’s a gradient,

meaning there’s a low to high pH gradient along the gut.

You don’t have to know what the pH

should be at any one given point

because you’re not going to go and put microbiota

at one location and not another.

What you essentially want to do is create an environment

where the proper microbiota can thrive.

Because when you do that,

you greatly decrease what are called inflammatory cytokines.

So these are things that are secreted

both by cells within the body and cells within the brain

to impact brain health and brain function and bodily health.

They go by a particular name.

So there’s something called TNF-alpha,

tumor necrosis factor alpha.

It is inflammatory.

It’s not a good thing to have at elevated levels.

You have something called interleukin-6, IL-6.

Also causes inflammation, causes damage to tissues.

Not a good thing to have elevated for long periods of time.

And then you have anti-inflammatory cytokines,

things like interleukin-10, which reduce inflammation.

And there are hundreds of these,

if not thousands of these different cytokines,

some of which promote inflammation,

some of which reduce inflammation.

The simple way to adjust these things in the proper ratios

is to adjust your gut microbiome.

The best way to adjust your microbiome

is to ingest certain types of foods.

So there is a beautiful literature on this now,

but the most important literature

is the one that I referred to

at the beginning of this episode,

which is what to ingest and what not to ingest

in terms of foods in order to create

the best conditions in your gut

so that you can create the best conditions

in your brain and body.

There was a study done by my colleague, Justin Sonnenberg

at Stanford School of Medicine.

Justin’s actually my upstairs neighbor

in the building at Stanford where I work.

And they explored how different foods

or different diets, I should say,

impact the gut microbiome and inflammatory markers.

And this is a beautiful study

because it was done in hundreds of human patients.

These actually weren’t patients that were sick.

I should say human subjects that were otherwise healthy

from a huge variety of backgrounds.

So you had men, you had women,

you had people of different races, different ethnicities.

You had a huge range of backgrounds

and they tracked all of that.

And what they did is they explored two types of diets.

One is a high fiber diet.

So dietary fibers are non-digestible

or only partially digestible carbohydrates typically.

And they compared that to diets that were unchanged

except for the inclusion of a few to a few more servings

of fermented foods each day.

Things like sauerkraut, things like kimchi.

They even explored, sounds pretty disgusting to me,

but who knows, I’ve never tried it,

which is fermented cottage cheese.

And what they found was that after initial period

of a few weeks where they had people

either eat a lot of fiber or eat one or two servings

of fermented foods, they had those people ramp up

their ingestion of either fiber or fermented foods.

So they kind of ease them into it.

So they went baseline, then ramp up to the point

where they were ingesting four or five servings of fiber

or of fermented foods per day, which sounds like a lot,

but for fermented foods, that would be four

or five tablespoons of sauerkraut or kimchi.

It’s not quite, it’s not like huge platefuls

of fermented foods.

And then they looked at a number of things.

They looked at the proteome, which is a kind of like looking

at the genome, but a bunch of proteins

that are made in the body.

And they did this by fecal samples, by stool samples,

and they did this by blood draw, which is great.

It’s a real power of this study.

In fact, the most comprehensive study that I’m aware of.

By looking at these different tissues

across long periods of time, so many, many weeks,

and then returning people to the diet that they were on

before they went into the study,

they were able to establish in a causal way

how ingesting fibers or fibrous foods

versus ingesting these fermented foods on a daily basis

could impact the gut microbiome

and many, many inflammatory markers

and many, many markers of immune function

and autoimmune function.

And the takeaway message from this study

is that the fermented foods far outperformed

the high fiber diet.

In fact, the high fiber diet in some people was beneficial

and in other people caused issues with inflammation.

This is very different than what I was taught growing up

and what many of us were taught.

Interestingly, they also observed that people

that ate the high fiber diet had increases

in certain enzymes that lend themselves

to better digestion of carbohydrates.

And I think there’s an important insight to come from this.

Nowadays, we kind of live in the age of extremes

where people seem to either want to be carnivore,

like never ingest a vegetable.

I hear they don’t even, they’re like allowed pepper,

but they’re not even allowed sauerkraut or something,

like very extreme or pure plant-based, pure vegan,

or pure, so essentially pure carbohydrate

or pure animal protein, very extreme.

I’m an omnivore.

I like to eat a mixture of different things

at different times of days, but very extreme.

But this is interesting because what these data show

is that perhaps ingesting a high carbohydrate,

high fiber diet, which is really what these,

the high fiber condition really was,

actually makes people better at digesting carbohydrates.

This may explain why people who are used

to a kind of more paleo type or carnivore type diet

might eat carbohydrates and say,

oh, that doesn’t work for me, I don’t feel good.

It might also explain why people

who predominantly eat plant-based foods

and carbohydrate foods will try eating meat

as an experiment or because they lost a bet

or whatever it is, or desperation, or they’ll do that.

And then they’ll say, oh, I don’t feel good when I eat meat.

How good you feel, it seems,

how well you can utilize that food

and how much of that food you crave may be determined.

In fact, it appears is determined

by your food eating history, the types of food you eat.

And I think this might explain some of the divide

and hopefully might bridge some of the chasm

between these different groups

that are saying it should be one way

or it should be another.

But at the core of the study was the bigger message.

The bigger message is that all of us should be ingesting

on a regular basis, daily basis,

two to four servings of fermented foods of different kinds.

And why I say that is

because the inflammatory markers went down.

The markers of autoimmune disruption went down

and the chemistry of the gut, therefore,

was adjusted in the appropriate ways.

Now it’s not to say that high fiber is bad

or that fiber is bad.

I don’t want people to confuse this.

But even though this is a discussion about interoception,

about sensing the self,

this is a subconscious mechanism

by which the gut communicates to many, many organs,

including the brain.

And it’s been shown in other studies,

also in quality peer review journals,

that when the correct gut microbiota are present

and these inflammatory markers are reduced,

cognition improves, so ability to focus,

ability to sleep, ability to ward off infection

and wound healing all enhanced.

In fact, even in autism spectrum disorder,

in people that struggle with various mental conditions

or disorders of the mind,

improving the gut microbiome seems to have powerful effects

on improving brain symptoms.

Along the lines of autoimmunity,

there are a number of conditions

that we call autoimmune conditions.

And we will do entire episodes about these going forward.

But for people with so-called irritable bowel syndrome,

for people with Crohn’s disease,

for people with leaky gut, Hashimoto’s,

which is a kind of an immune system self-attack

on one’s thyroid gland,

and things like eczema, skin conditions,

adjusting the gut microbiome has been shown to be useful

in positively adjusting the symptoms of all of those.

Will it fix those conditions entirely?

Probably not.

But can it have a significant positive impact on them?

Probably yes.

There is one thing that’s worth mentioning in that list,

which is leaky gut.

What is leaky gut?

Here we’re talking about the guts.

What is it to have a leaky gut?

It sounds awful.

It sounds like something sort of like leaking out

the end of the tube and maybe that too, I don’t know.

But leaky gut is actually because your gut

is not a tube that’s continuous one cell.

It’s actually made up of many, many cells.

And those cells form a barrier

and they form what are called tight junctions.

So if you have two cells and you want to create a fence

out of those cells, you bind them together.

The way that the body does this is to bind them together

with what are called tight junctions.

These are, they go by names like Cloudins

and things like that, if you want to look them up.

These tight junctions form a nice barrier

like a cyclone fence that things can’t get past,

but like a cyclone fence,

only molecules of a certain size can go through those holes.

So you’re not going to pass a soccer ball

through an intact cyclone fence, but you could pass

for instance, a feather through that fence.

So leaky gut is when the conditions

in the gut are too alkaline

or the gut microbiota are off in the gut,

meaning microbiota that like alkaline guts

are living there.

And those tight junctions can’t function

at that particular pH.

And you create little holes in that fence.

And then what happens is when you ingest foods,

some of those foods literally leak out of the gut

and into the extracellular space and into the bloodstream.

And because foods include proteins

and antibodies react to proteins,

what ends up happening in leaky gut,

and the reason we talk about it in autoimmune conditions

is that you start developing antibodies

to particular food proteins.

And then people start feeling like they have food allergies

and they do, they actually create particular food allergies.

Now, one way to prevent leaky gut is to get the rest

of the gut situation happy by ingesting the proper foods

that we talked about before, ingesting fermented foods

on a regular basis.

The other is our old friend glutamine again.

There are some data and I should say

it’s a limited number of studies showing

that ingesting glutamine anywhere from one to three,

excuse me, teaspoons per day can help alleviate leaky gut.

Now, the mechanism for that still isn’t clear

whether or not it’s adjusting pH

or whether or not it’s creating more favorable environment

for the microbiota, but it is clear that supplementing

with glutamine can in some people enhance

or I should say improve conditions of leaky gut.

So that might be useful as well.

And then the final thing about this I want to talk about

is we’re talking about chemical sensing in the gut

and how that impacts wellbeing is about gut acidity.

And this, I confess is a little bit controversial.

Some people are on board this, other people are not.

And so I’d love your feedback on this.

If you agree, please tell me, if you disagree,

please tell me, but please tell me why you disagree

in particular experience or data, although it’s always better

if you can point me towards peer reviewed studies.

There is a practice that some people embrace.

I’m not recommending people necessarily do this

and you would definitely want to talk to your doctor,

but where people have food allergies

or they’re having mood or auto-immune issues

and they treat this.

Some people recommend treating this through the ingestion

of HCL, hydrochloric acid tablets.

Now, hydrochloric acid can burn you, right?

Acids can burn you.

They literally can melt away skin.

You want to be very careful with acids of all kinds, truly.

But hydrochloric acid is sold as in supplement form

in capsule or pill form.

And there is a practice of starting to ingest

one or two hydrochloric acid tablets

midway through a meal.

And then what people will generally do is examine

to see whether or not that improves their symptoms

of indigestion, how it relates to mood,

how it relates to wellbeing,

how it relates to their sensation of their gut viscera.

By changing the acidity, you also change the way

that the gut communicates with the brain

through the mechanisms we talked about before.

And there are a growing number of people embracing

these practices of taking HCL.

It’s often combined with other things.

It’s usually combined with an enzyme.

And that enzyme is pepsin.

So most of these supplements come in the form

betaine HCL pepsin.

And while they’re not a cure-all,

I certainly don’t want to suggest that they’re a cure-all,

many people that have a hard time adjusting the pH

of their gut and have a hard time adjusting the microbiota

of their gut in the appropriate ways have benefited

from taking these betaine HCL pepsin tablets

or capsules during meals.

And the general instruction is to start slow,

to start with one or two,

and then to find a level that you’re comfortable with

that doesn’t create an excessive feeling of warmth

in the stomach, that doesn’t throw off your digestion.

So it takes a little bit of experimentation.

Again, definitely talk to your healthcare provider

before exploring this.

But this has become a very common practice

for people with autoimmune disorders

and accessing the gut because it is accessible

by taking things has also become a way

in which people with various mental conditions

are trying to adjust their mood and adjust their wellbeing.

Along these lines, I do want to mention

that there are studies that show that people

that supplement with a lot of probiotics

or even prebiotics can sometimes experience brain fog.

This isn’t discussed a lot

and the data are a little all over the place,

but it is worth thinking about.

The goal here is not to create

as many microbiota as possible.

What you want is microbiota diversity.

And I should mention this again

in reference to the Sonnenberg study,

which was what the high fiber diet does

is it increases certain microbiota,

but it limits their diversity.

And what the fermented food diet does,

or I should say the diet that includes regular ingestion

of fermented foods, a few servings a day,

is it increases microbiota diversity.

Now, lack of microbiota diversity

has a name in the medical profession.

It’s called dysbiosis and dysbiosis is bad.

Dysbiosis is what you see when people are spending

long periods of time on bedrest

or when they’ve been chronically ill.

And so here again, we’re talking about creating

a positive environment in the gut,

either by adjusting acidity,

maybe you explore the betaine HCl pepsin thing.

I think if you have healthy digestion,

if you feel like you have a good relationship to your gut

and it has a good relationship to you,

sort of a silly phrase because it is you and you are it,

then I don’t think there’s any means

or any need to pursue this.

But if you don’t, that might be one avenue to pursue.

However, I think primary in all of this

is the fermented food findings.

And it’s not just one study,

it’s many, many findings that now bring us to a place

where a huge center of mass of data

are pointing us in the direction of saying,

ingest fermented foods on a regular basis.

I should also mention that conditions like sarcopenia,

which is the loss of muscle tissue as we age,

has been shown to be offset by improving the gut microbiota.

So while today is about interoception,

we’re talking about sensing,

we’re also talking about subconscious sensing.

What are we talking about subconscious sensing?

We’re talking about subconscious sensing

of the milieu of the body.

When the milieu of the gut and the body is right,

then the brain and the immune system function very well.

And so this isn’t something where you can sit back and say,

oh, you know, I feel all those good microbiota in my gut

or, oh no, those are bad microbiota.

You can’t do that unless you’re going to take fecal samples

and blood samples and analyze them

with the extreme exhaustive nature

that the Sonnenberg and other labs do.

You’re not going to get that kind of information.

I know there are companies out there that do this

and I don’t want to knock on any of them,

but I do want to emphasize that to do this right,

to really analyze which cytokines you’re making

and which ones you’re not,

you really need to look at a huge number of them.

And that requires large-scale proteomic and genomic

and inflammatory marker screens.

It’s just not the kind of thing

that most commercial enterprises can really provide

to people in a way that they can interpret.

Rather, this is a case where you can simply go

to the effector, to the thing that can actually move

the needle in the right direction for you.

That’s fermented foods and that’s keeping the stomach

slightly more acid than one might think you would want to.

So let’s talk about barfing first.

Barfing, aka vomiting,

is when the contents of your guts run in reverse,

meaning when they go up from your stomach,

sometimes even up from the intestines,

even though that sounds horrible, it sometimes happens,

up out the esophagus and mouth

and onto whatever surface happens to be in front of you.

It’s a terrible thing, nobody likes to do it,

but it’s a very interesting aspect to our biology

because it reveals a beautiful

and absolutely fundamental relationship

between our chemistry and our brain.

So your brain is actually locked behind a gate

and that gate is not your skull.

That gate is the so-called blood-brain barrier.

So just like your gut has these epithelial tight junctions,

the things I talked about before

that provide a fence so things can’t get through

and get through in leaky gut,

your brain has tight junctions that are very, very tight.

It’s absolutely fundamental that only certain molecules

get across the blood-brain barrier and that others don’t.

And the reason for that is that most all,

99.9999% of your neurons do not regenerate.

I don’t care what you’ve read,

especially in the news recently

about how psychedelics cause neurogenesis

because they don’t, it’s absolutely wrong.

Psychedelics have effects on brain plasticity,

but they have nothing to do with neurogenesis,

at least no data support it.

But because you can’t make new neurons,

you also can’t damage the ones you’ve got

or you shouldn’t as much as possible.

And that’s why you have a blood-brain barrier or a BBB.

So the BBB, as it’s called,

prevents substances from getting to the brain.

However, like any fence,

it is not always uniform along its length.

And there are little spots within that fence

where chemicals can sneak across to the brain.

And through a beautiful design,

I don’t know anything about the design.

As I always say, I wasn’t consulted the design phase.

I’m not talking about any kind of intelligent design

or anything.

That is not the topic of this podcast.

This is not a philosophy podcast,

nor is it a religion podcast.

It’s a science podcast.

But through a beautiful design of some sort,

there are little holes in that fence

and there are little neurons

that sit right behind those holes.

And those neurons sense what the chemistry of the blood is.

So I’m guessing you probably didn’t imagine

that today’s discussion about sensing the self

would be sensing your own blood, but you do.

There is a little area of your brain that’s little indeed,

but is very, very important called area postrema.

P-O-S-T-R-E-M-A.

And area postrema is an area of the brainstem

that sits right next to another brain area

called the chemoreceptor trigger zone.

And when the contents in your bloodstream

are of a particular kind,

meaning when there are pathogens or it’s too acidic,

the neurons in area postrema

and the neurons in the chemoreceptor trigger zone,

the CTZ as it’s called,

trigger a bunch of motor reflexes in the abdominal wall

that make you barf, okay?

The feeling that you need to throw up

is triggered by these neurons in the brainstem.

And those neurons in the brainstem are triggered

by the presence of certain chemicals.

And the reason why you don’t have any blood-brain barrier

at that location is because postrema has to be there

like a crossing guard,

making sure that everything

that’s coming through the blood is okay.

And if it even senses just the tiniest bit

that things are off, it’s going to trigger that reflex.

Now, the really interesting thing

is that the neurons in area postrema

respond to the chemistry of the blood,

but they also will respond to our consciousness,

to things that we think and things that we believe

and even particular memories.

This is why when certain people see vomit

or see someone else vomit or even somebody else heaving

as if they’re going to vomit,

they themselves feel as if they’re going to vomit.

I’m guessing there are probably even a few of you right now

that feel like you might vomit.

You might feel salivation in your throat,

which is always a precursor to vomiting.

Some people, the memory of,

or the thought of something like blood or vomit,

or use your imagination,

can actually trigger the vomit reflex.

And that’s because these neurons in area postrema

are very sensitive to prior experience

of interactions with negative things.

So, and actually, as I’m saying this,

I feel my gut kind of cramping up again.

I don’t vomit very easily.

I’m not one of those,

nor am I somebody who’s never vomited.

And here we are talking about my vomit history,

but I think it’s appropriate in this context.

The neurons of area postrema

are there basically to keep your whole system safe.

And thank goodness they are,

because for instance, some people,

unfortunately, they drink so much alcohol

that they throw up.

Have you ever wondered why that is?

Well, it’s because alcohol fundamentally is a poison.

I’m not saying for age appropriate folks

that ingesting alcohol is bad.

This isn’t a judgment call,

but alcohol itself at excessive levels in the bloodstream

triggers postrema to cause vomiting.

So this is an example whereby memories,

context, but also just the chemistry of our internal state

is triggering behaviors that are very hardwired.

They’re very reflex driven.

And why would it be that some people

get more nauseous than others at a given level?

Well, that’ll have to do with alcohol tolerance.

Some people have what’s called a,

we refer to as a stronger stomach or a stomach of steel.

Other people, they throw up very easily

if they don’t feel well,

or if they ingest anything that’s just a little bit off.

From a purely adaptive standpoint,

it’s probably better to vomit up things

that aren’t good for you,

rather than to pass through,

have them pass through your system,

especially if those things are contained in lipids.

For instance, if you ingest something that’s in lipid form,

because cells, literally every cell in your body

is surrounded by a little thin layer of fatty tissue.

I would call it the bilayer membrane.

It’s a little membrane.

Fat can move through fat very easily.

And so any bad stuff you ingest

can get stuck in your system.

So let’s talk for a second about how to reduce nausea,

because nausea, that salivation,

that feeling that you’re going to vomit

can be very beneficial in an adaptive circumstance,

like you’ve ingested something bad,

but some people experience nausea for other reasons.

There are good ways to regulate nausea.

And the ways they regulate nausea are very interesting.

They actually adjust the activity

of these neurons in areopustrema,

or they change the chemistry of the blood directly.

And many of you have heard this before perhaps,

but it turns out that there are good data.

11 research studies were the ones that I could find,

peer-reviewed research studies with no bias.

So independent studies showing that ginger

can cause a notable reduction in nausea.

How much ginger?

One to three grams.

What’s one to three grams?

Well, you have to measure it out on a scale

unless you’re taking it in pill or capsule form.

It doesn’t seem to matter

if you take it in pill or capsule form.

So this thing that you’ve heard before,

that ginger can reduce nausea, indeed is true.

Peppermint apparently can also do that.

And some of you will not be surprised to learn

that cannabis can reduce nausea.

Not surprised because cannabis,

which has different legality in different places,

and I understand that,

so please take that into consideration.

But cannabis, THC, and, or it turns out CBD,

can reduce nausea.

That’s been shown in at least one study.

And it probably does that,

not by changing the chemistry of your blood,

but by changing the threshold for firing

of these neurons in areopostrema.

And there are conditions such as in chemotherapy,

radiation therapy, and others,

where people are feeling very nauseous.

I’m not recommending people go use cannabis

unless they’ve decided with their selves

and their family and their doctor that they should.

But what’s interesting is this thing about CBD,

and we’ll do a whole episode on THC and CBD.

CBD doesn’t have, or isn’t supposed to have,

these psychoactive properties that THC does,

although CBD can have a mild to major anxiolytic,

anxiety-reducing effect.

But it does appear that the data are,

what the data support, I should say,

the anecdotal reports,

which are that cannabis can reduce nausea.

So to barf less, ginger, peppermint,

and if appropriate and legal for you, possibly cannabis.

Now let’s talk about fever.

In previous episodes and in future episodes,

we deal with thermal regulation,

which is the body’s ability to regulate its temperature.

Talk about cold and heat and saunas and ice baths

and physical performance.

We’re not going to deal with all that right now,

but I promise we will going forward.

Today, I only want to talk about fever

because fever directly relates to interoception.

What do I mean by that?

Well, a fever is simply an increase in body temperature.

That increase in body temperature

is triggered by neurons in the brain.

And those neurons in the brain are triggered

by the presence of particular things in the bloodstream.

What sorts of things?

Well, toxins, bacteria, viruses.

When something bad gets in our system,

the body doesn’t know it’s bad.

It just knows it’s foreign and it hasn’t seen it before,

or that it’s in the wrong compartment of the body.

So earlier, we were talking about proteins

that leak out of the gut and get elsewhere.

You don’t want a piece of steak sitting in your bicep.

That would be bad.

You would actually develop antibodies.

You would have a horrible infection.

But your body has this intelligence.

And that intelligence is to know,

hmm, these proteins are normally not seen in this region.

And then your body or the cells there,

I should say, will release something

that then will travel to the brain

and will trigger an increase in body temperature

so that your body cooks the bad thing

or the cause of the bad thing.

It’s really a beautiful adaptive mechanism.

We always think fever is so terrible,

but fever is there to cook the bad thing that’s inside you

or that has left the correct compartment inside you

and is in the wrong compartment inside you.

So what’s beautiful about the fever mechanism

is that it looks a lot like the barfing mechanism.

Basically, you have a set of neurons

that sit near the ventricles.

Remember, the ventricles is this hole in the tube

that is you, the tube that is you.

You are a tube, a series of tubes,

and your brain has a hole down the middle

and it extends down to the bottom of your spinal cord.

At the front, it’s called the ventricles.

They start with what are called the lateral ventricles

and the, excuse me,

starts with the third and the lateral ventricles.

And then it goes to the fourth ventricle

and then to what’s called the central canal.

But basically, it’s just a big space

in the middle of your nervous system,

the middle of your brain.

And you have one ventricle that I already mentioned

called the third ventricle.

And it’s shaped kind of like a thin oval upright.

If you’re listening to this, just think an eye,

just think the shape of an eye,

but it’s kind of rotated 90 degrees.

So it’s up and down as opposed to across.

And along that third ventricle,

there are little neurons that can sense

what’s in the cerebral spinal fluid

that fills the ventricle.

So in other words, you have neurons

that are sensing the chemistry

of your cerebral spinal fluid

and that have access therefore

to the chemistry of your body

because that cerebral spinal fluid

is going up and down the brain and spinal cord,

but into that cerebral spinal fluid

are signals about the various chemicals within the body.

So this is not a mechanical system,

this is a chemical system.

Remember, we’re talking about mechanical information

and chemical information accessing the brain.

So if you have something bad in your system,

you breathed in a virus,

or you inhaled some bacteria,

or you got a cut on your leg

and some bacteria are growing there,

of course, locally there will be effects.

Little things called mast cells, M-A-S-T,

little packets of histamine,

literally will go there and explode

and cause inflammation,

which is actually a good inflammation

and will release little things called macrophages

to try to gobble up the infection.

The other day, I was in Texas,

there was a mean little mosquitoes in Texas

and a lot of them,

and I would stand outside and I’d get bitten.

I didn’t feel a thing,

but then later that night,

they started swelling up and itching,

and then I’d itch them and then they’d swell even more.

That was because of the release of mast cells,

of histamines inside those mast cells

that were literally causing inflammation of the tissue.

It wasn’t the poison from the mosquito itself,

it was the immune response to those.

Well, you also have this systemic

or body-wide attempt to kill stuff,

and that’s the fever.

So the neurons that line these ventricles

with cerebral spinal fluid go by a particular name.

They’re called circumventricular organs,

meaning near, circumventricular, near the ventricles.

And you have these organs,

and there are a set of neurons

that has a really cool name called the OVLT.

I don’t know why I like that,

but I just like it.

It’s the organum vasculosum of the lateral terminalis.

Organum vasculosum lateral terminalis, OVLT,

are the neurons that respond to toxins

and bad stuff in your bloodstream,

however minor or major,

and they release things like ILK1,

which are inflammatory cytokines.

Inflammatory, in this case, is good.

You want inflammation at the site of an infection.

It’s a good thing.

It’s going to help with healing.

And it’s going to change the conditions in your body.

What’s going to happen is

when those OVLT neurons are activated,

because you have something bad in your body

or something bad is happening in your body,

they communicate with an area of the brain

called the preoptic area of your hypothalamus,

and the preoptic area cranks up your temperature

and tries to cook that bad thing.

Now, it’s worth talking about fever for a moment

and talking about thermal regulation,

because I think this actually could save some lives.

So if you are overheated to a point where, you know,

you’re getting up past 102 or 103,

it’s going to vary depending on person to person

and certainly age.

You know, kids, some people think,

can tolerate higher levels of fever than adults,

but look, you always want to be cautious

about heating up the brain too much,

because once those neurons are gone,

they do not come back,

and neurons do not do well in very high temperatures.

Once your body temperature starts getting up to 102, 103,

certainly 104, you are starting to enter

serious danger zone.

This can happen through exercise in hot environments

or an inability to escape heat,

because you don’t have covering

or adequate ventilation or cooling.

It can also be because of excessive fever

for whatever reason.

A lot of people think the way to deal with this

is to put a cool compress on the back of the neck

or to cool the torso.

In discussing this with my colleague, Craig Heller,

who’s at Stanford School of Medicine,

and he’s on the undergraduate side of the campus as well,

runs a biology lab.

He’s a world expert in thermal regulation.

It’s very clear that that’s the wrong response

to try and cool off the body.

If you put a cold towel or you put an ice pack

on the back of the neck,

what you effectively do is cool the blood

that’s going to the brain.

And if you do that, then your brain will react

by turning up the crank in, so to speak,

on the neurons in the preoptic area

and will heat you up further

and can cook your brain and organs further.

So what you want to do is, as I’ve talked about before,

you want to cool the bottoms of the feet,

the palms of the hands, and the upper part of the face.

I’m not going to go into all the details

as to why you want to do that right now,

but those are the locations you want to cool.

Now, you can also cool the rest of the body,

but it’s not okay to just stay under the covers

and just cool the neck or something like that.

You really want to try and create a systemic

or whole body cooling if the goal is to bring fever down.

But in many cases, fever is adaptive.

And so taking non-steroid inflammatory drugs

like Advil and Tylenol sometimes can be good

if that’s recommended,

but other times, because it reduces your fever,

it’s allowing that pathogen,

that pyrogen, it’s sometimes called.

A pyrogen is a substance that causes fever.

Think pyro, think fire, think pyromaniacs, think pyro.

Those pyrogens can survive at moderate to low temperatures

and they can’t survive at high temperatures.

So the fever is an adaptive mechanism

and the OVLT and the sensing of your chemistry

is how the OVLT, organovasculosome

and the lateral terminalis does that.

So we’ve talked about sensing lung volume,

speed of our heartbeat.

We talked about sensing the gut volume,

the intestinal volume, or the absence of volume.

We talked about chemistry of the gut

and the gut microbiota and autoimmune functions.

And we’ve now talked about vomiting

and we’ve talked about fever.

Lots of aspects of sensing our internal self.

Now I want to turn our attention to interoception

as it relates to feelings,

the way that interoception is most commonly described.

And I want to highlight a term

that many of you have probably heard,

which is the vagus nerve.

We talked about vagus a little bit earlier,

but the vagus nerve, this vagabonding, wandering nerve

is involved in everything I’ve talked about up until now.

And the reason I saved it till now,

rather than mentioning it all along,

is to highlight a specific point,

which is that whenever we hear about the vagus

in popular culture, it’s like the vagus calms you down.

You want to stimulate the vagus

by rubbing in front of the ear.

And it’s a parasympathetic nerve

and it will calm you down, it’ll mellow you out.

Actually, most of the time, the vagus is stimulatory.

When you ingest foods with amino acids, sugars,

or fatty acids, the vagus nerve gets activated

and triggers the release of dopamine.

It makes you more alert and go seek more of those foods

or what led to those conditions.

When you feel nauseous, it’s rarely calming.

When you feel like you have a fever, it’s rarely calming.

So you’re starting to get the picture

that even though the vagus nerve

is in the parasympathetic branch

of the autonomic nervous system,

and if that doesn’t mean anything to you,

because you’re not an aficionado, don’t worry about it,

but it’s not a calming system.

It’s a communication system and it’s a motor system.

It communicates brain to body and body to brain

and it changes the function of different organs.

Now, one thing that’s important to highlight

is that stress itself will alter the chemistry of your gut

because of the ways that it shuts down the vagus nerve

and quiets the neurons that communicate from gut to brain.

I want to say that again.

Stress will disrupt your gut and make you feel not good,

poor digestion, and just lousy

because of the way that it shuts down the vagus nerve

and the neurons of your gut.

So what stress does is it blocks the communication

between gut and brain.

It doesn’t mess up your gut.

It just doesn’t let your gut get the signals

up to your brain.

And it also then throws off the chemistry

and then there’s a whole cascade of effects.

If you want to learn more about stress,

I did a whole episode called Master Stress,

or I think maybe it was called Conquer Stress.

I think it was Master Stress.

Either one, the whole point of that episode

is to give you tools and practices

to deal with short-term acute stress,

moderate term stress, and long-term chronic stress

through behavioral mechanisms, nutrition,

supplementation, and many other things as well.

It’s chock-a-block full of protocols and tools for stress.

The vagus nerve, however, is responsible for emotion.

And the way it does that is to pool,

to aggregate the conditions of your gut,

the conditions of your heart,

and the conditions of your breathing,

which includes your diaphragm and lungs,

and takes that kind of as a collection of information

and sends it to the brain

and controls what we call your emotions.

Now, that might seem obvious to some people,

but to other people, that might seem totally crazy.

You thought your emotions were because the market was down

and you had invested,

or because something that you thought was going to happen

is not going to happen,

or because you thought that school was going to open

and then it’s not,

or maybe you thought it wasn’t and it is.

Whatever it is that bothers you,

you think of generally as a purely cognitive event.

But the brain doesn’t really know

what to do with that information.

It doesn’t act directly on that information to create moods.

Moods are created through the heart’s response

to reading that headline,

to the change in your breathing

that’s caused by someone that you love telling you

that actually they’re not interested

in spending time with you anymore, or that you screwed up,

or that they’re interested in spending

a lot of time with you.

And you like that, right?

Emotions can be good or bad or neutral.

So this thing that we call interoception,

the sense of self,

I’ve been building up from very fundamental layers,

gut chemistry, spleens, immune systems, autoimmune.

And you might’ve been thinking,

wait, I thought this was going to be about a sense of self,

a noticing or a feeling.

And indeed, all of those things are plugging in

like a series of ingredients in a recipe

that gives rise to your mood and how you feel.

And that mood and how you feel

is shown in one location in your body

that other people can see,

and that’s in your facial expressions.

And indeed, there are now beautiful data

showing that your face,

including the size of your pupils,

the tonality of your face,

how flushed you are or how pale you are,

even the degree to which you are frowning or smiling

relative to other periods of time,

that is all an aggregate of,

or a reflection rather of your gut, your heart,

and your breathing and the chemistry of your body.

And so this is why I sort of backed into this conversation

about interoception.

I kind of Trojan horse this on you on purpose,

which is that when we talk about the vagus and you hear,

oh, you know, you can get vagal tone by breathing

or rubbing on the front of the ear,

sure, that’s probably true.

But another fundamental layer is the acidity of your gut,

how fast you’re breathing.

Are you inhale-emphasized or exhale-emphasized breathing?

When we are relaxed, our pupils tend to constrict.

When we are very alert, our pupils tend to be dilated,

whether or not that alertness has to do

with being happy or being sad.

And what’s remarkable,

and this is where interoception really, really

takes a leap into the incredible,

is that there are beautiful studies that show

that for instance, when we know somebody pretty well

and they are going through some sort of experience

of any kind,

our heart rate actually starts to mimic their heart rate.

Our breathing starts to mimic their breathing,

even if we aren’t conscious of their breathing.

It’s not like we see their chest heaving,

and we think, oh my goodness, and then we breathe that way.

There’s a mirroring,

and no, it’s not carried out through mirror neurons.

Mirror neurons are more of a myth than a reality,

sorry to burst people’s bubbles,

but that bubble around mirror neurons

is definitely made of myths,

and a topic for another time, but we start to mirror.

Somehow human beings are able to register

the internal state of other beings,

and I think probably for animals too,

but certainly for other humans, even at a distance,

and these studies are many now,

and they’re really wonderful studies,

and so your sense of your internal landscape

is linked to others.

Now you can enhance this interoceptive capacity

for how you feel and how others feel.

In other words, you can start getting a better readout

of your internal state by doing a simple exercise,

what is really a tool,

and that is to learn to sense your heartbeats.

So some people are very good at this, other people are not.

Some people can do this more easily

when they have all their air exhaled,

and some people can do it better

when they are holding a breath hold,

but one thing that’s kind of cool

about this whole interoceptive capacity

is that you can enhance it very, very quickly.

You can learn or teach yourself

to have heightened levels of interoception

in a way that you can’t really

just give yourself heightened levels of vision

by snapping your fingers

in one round of one tool or exercise.

There are things you can do to improve vision.

That’s the topic of a previous episode.

I encourage you to look it up.

There are things you can do to improve your hearing

and your taste and your smell.

We talked about all those,

but within interoception,

you can get very good at this very fast,

and I think this is one of the reasons

why meditation is powerful.

I think there are a lot of reasons

why meditation is powerful,

but one of the reasons is

when you stop taking in exteroceptive information,

information from the outside world

by closing your eyes and focusing inward, as they say,

you start paying attention to your breathing cadence.

You start directing your mind’s attention

to your heart rate,

and if you can start to perceive your heart beating,

you actually are very quickly strengthen

the vagal connections between the body and the brain,

and so there’s no real practice here.

There’s no breathe this way or do this thing

except to direct your awareness toward your heartbeat.

And some people can get very good at this very fast.

Most people find that just by doing this

for a minute or so every once in a while,

they start to tap into this sixth sense.

They start to notice when they don’t feel quite right

about something or somebody or some situation,

or they start to notice when they feel quite right

about somebody or something or some situation.

So this interoceptive awareness can be tuned up.

It used to be called vagal tone,

but I think that term doesn’t take into account

all the other things that are going on with the vagus,

so I don’t really like that term.

It’s more of an interoceptive awareness.

And again, there are many studies now showing

that for sake of bettering one’s mood overall,

for sake of moving through a challenging phase in life,

for sake of just enhancing one’s experience of life overall,

whether or not it’s the taste of foods,

interactions with other people, enjoyment, focus, pleasure,

tuning up one’s interoceptive awareness is both easy,

again, by just taking a minute or two

and trying to count heartbeats.

And then this works best, of course,

if you have some independent readout of heartbeats

and you can compare, you can see how accurate you are.

But even if you don’t use a device

or have a device to do that,

without taking your pulse,

using your thumb on your wrist or something,

or your fingers on your neck,

as you typically would for taking your pulse,

trying to sit still for a minute or two

every once in a while, maybe once a week,

maybe twice a week, maybe while you’re meditating,

maybe while breath work,

maybe during the breath holds or breath work,

you don’t really have to do this

in any kind of extended way.

You can very quickly increase your interoceptive tone.

And that has a huge and outsized effect

on the brain-body relationship

and your brain’s ability to tap into

both the subconscious and the conscious aspects

of this chemical and mechanical signaling

that’s happening all the time.

And it can have real and outsized positive effects

on your ability to engage with other people

and your ability to focus at work

and your ability to notice,

ah, I’m finding myself kind of feeling

like I’m losing focus,

but really it was my heart rate was just increasing.

Maybe I just exhale a little bit

and bring my heart rate down.

So what I’ve effectively tried to do today

is to give you a window into this incredible relationship

between your viscera and your brain

and your brain and your viscera,

all these organs of your body.

And what I hope is that you’ll appreciate

that it’s a system, that you aren’t just a system of tubes.

I said that in sort of in jest.

I mean, you have a lot of tubes

and you are a system of tubes,

but that system of tubes is linked

through the nervous system.

And those links work in very specific ways.

So whether or not you remember about piezos

and all the GLP-1Rs and all that stuff,

it doesn’t really matter.

What I encourage you to do is start sort of pushing

and pulling on the various levers

within this beautiful system

that we call the interoceptive system,

this sense of self.

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