How To Maintain Muscle On A GLP-1, Why Protein Stops Working As You Get Older, The Truth About Eating “Before Bedtime” & More! Solosode #502

My name is Ben Greenfield, and in this episode of The Boundless Life Podcast: how to maintain muscle on a GLP-1, why protein stops working as you get older, the truth about eating before bedtime, and more. Welcome to The Boundless Life with me, your host Ben Greenfield. I'm a personal trainer, exercise physiologist, and nutritionist, and I'm passionate about helping you discover unparalleled levels of health, fitness, longevity, and beyond. I spent 20 years measuring and optimizing everything about my body, deep performance metrics, cold stress, heat stress, sleep scores, blood panels, peptide protocols, testosterone, telomeres, VO2 max, you name it, and somewhere in the middle of building what looked like a perfect life, I almost lost the life that I was building it for. Boundless, The Man Who Became Human, is a brand new feature documentary that follows what happened when the optimization framework that I spent two decades constructing ran headlong into the things that metrics could never measure, my marriage, my sons, my faith. The private archive footage in this documentary has never been seen publicly. Some of it I debated even including at all. It shows basically the worst of what happens when longevity becomes the ultimate goal, and how you and I can turn that around to become fulfilled by what's truly important in life. Now, this is not just another biohacking film, it's an honest look at what it costs to chase the ceiling on human performance, told through real footage of one family, my family, finding that out, and I'm giving you the chance to join me for the brand new live premiere tour of this new film in a city near you. Here's what the night looks like. You watch the film with me and my family in a theater, and then you experience a live episode of the Boundless Life Podcast on stage with open Q&A, real questions, no filters. My wife, Jessa, and my sons, River and Taryn, will be there with us as well. VIP ticket holders get to join for an exclusive after party with upgraded food and drinks. This Boundless Life Tour kicks off in LA on July 24, Austin on August 20, New York City on August 6, Miami coming down the pipeline, London coming down the pipeline. More cities to be announced. Tickets are on sale now. Grab them now before they're gone at BoundlessDoc.com, that's Boundless D-O-C dot com. And I hope to see you there.

Well, welcome to today's show. Hopefully I don't get too rambly and scatterbrained with you. I didn't have the most fantastic sleep score last night. It's kind of funny, we live in a day and age where 20 years ago I would have said I didn't sleep too well last night. Now I have to rely on a computer to tell me that fact. Nonetheless, my wife and my kids are out of town. They went to the coast, which sounds very bougie, but basically they have a great time with the family down there. I had to stay at home and buckle down with work. Had a fantastic day of work, but it's just something else to be in, you know, the middle of the sticks out in North Idaho, sleeping at home all by yourself. Yes, I have locks and I have an alarm and I have dogs, but they're still just like this, every little noise, you know, and I go to sentry mode anyways when I'm sleeping, and very light sleeper. I must have woken up like five times last night, including the time at midnight where I for sure thought I heard the dogs barking and thought I heard some kind of ruckus downstairs. Found myself in my boxer shorts wandering around my house, clutching my Walther PDP Pro four-and-a-half-inch barrel gun with the strobe light activated, sweeping the house. Finally got back to sleep, but let's just say that I am going on a cup of coffee and some intranasal Semax peptide today, and I'll get through the show. We got this, we got this. So that all being said, the show notes are going to be at BenGreenfieldLife.com/502. It's BenGreenfieldLife.com/502, and we are going to jump in with a couple of questions today.

Ben Greenfield: I haven't answered listener questions for a couple episodes now, so I figured it would be fitting for me to do so. Someone with a very difficult to pronounce, multiconsonantal name asks, Mladicubus, Mladicubus, hopefully I'm saying that correctly. Hey, I got a rare question. Do you have any idea how to beat tinnitus, or tinnitus, as some people say, after acoustic trauma. This shit is killing me. It's been two years now, and I can't cope well. The good news, or the bad news, depending on how you look at it, is this is not a rare question. Tinnitus is something that plagues a lot of people, and it can be frustrating, and it can be brought on by acoustic trauma, aka your favorite concert, with multiple concerts in a row, because the damage does have to be chronic in order for you to develop tinnitus. Most people don't develop tinnitus from one great whatever, like a country music show at the Sphere, it would be a series of loud rock concerts through college or something like that. But anyways, tinnitus is interesting because it isn't one thing, it's like a symptom with at least half a dozen different distinct generators, and the right intervention for it kind of depends on what is driving your tinnitus. So what I was just talking about was damage, and specifically, when I say damage, what I'm talking about is what's called peripheral damage, or cochlear damage, C-O-C-H-L-E-A-R, cochlear damage. This is the result of exposure to loud noise, the hair cells in your cochlea that would normally kind of vibrate to help your brain receive sound, they get damaged, they reduce their output, and your brain, which is wired up to expect this constant input from these little vibrating hairs, turns up the gain to compensate, kind of like you would turn up the gain on, let's say, an amp if you're playing electric guitar, and you get a little bit of fuzz. You're getting that same fuzz in your head. So, cochlear damage causes a sensory deprivation that literally triggers changes in your CNS, your central nervous system, and that manifests as you hearing the brain's attempt to fill the silence, or another way you could look at it, to find the noise that it's not getting, or it's not used to getting. The result is this phantom tone, at a certain frequency range. I will get to solutions here in a little bit, but that's one reason that tinnitus can occur, is just damage to the hair cells. There's also what's called neural hyperactivity, so the brain can kind of lock into that pattern even after the hair damage has been reversed. There is this neural model that's been proposed and researched since the early 90s on tinnitus that looks at what are called membrane channel mechanisms that could explain the neural changes that occur, and the long story short, not to get too deep into the weeds, is you get chronic neuronal hyperexcitability, so that means there's this feedback loop that kind of perpetuates this high-pitch sound even when the original damage is healed. Your cochlear hair cells, just like many parts of your body, can regenerate, they can bounce back from damage, but imagine it this way, and this is very common, you injure your low back, let's say you're deadlifting and you didn't warm up well, and you feel that sensation like two curtains tearing in the low back, and you spend like four weeks rehabbing, and you finally get back into the gym, but it never seems quite the same, you still got this low-level pain, and a lot of that pain can simply be nerve hyperexcitability long after the actual muscle tissue damage is gone. Of course, it can be other things. I mean, you might have a bulging disc, you might have some core kind of muscular abnormality, you might have pelvic floor dysfunction. There are a lot of other things that can happen when you injure your back during a deadlift that can result in long-term pain, but one of the mechanisms of long-term pain can be nerve hyperexcitability, and the same thing can happen after damage to the hair cells in the ear.

Ben Greenfield: Now, there are also what are called musculoskeletal or somatic causes, and this one I think flies under the radar a lot. I think that the idea of jaw health, teeth health, maybe has been popularized by the looksmaxxing community, going after the largest, most clown-like jaws possible, and also by the mewing movement, and some of this is for right reason. Right, babies grow up, they're eating soft food, they're eating ultra-processed food, people don't learn to chew properly, people eat too quick and don't chew their food enough times, and what happens is jaw weakness and jaw abnormalities. Now, of course, damage to the cervical spine can cause these issues. Teeth that haven't been cared for properly can cause these issues, but the head, the neck, and the jaw can all be areas that need musculoskeletal attention, and the TMJ, it's called the temporomandibular joint, that's the most frequent area where, if there's tightness, if there's tension, if there's misalignment, if there is a forward head posture, that can feed basically these aberrant signals into the auditory pathway and result in tinnitus. The fix there can be a little bit more complex. I mean, when I go to my dentist, shout out to Dr. Eniko Loud down in Phoenix, yes, I go all the way to Phoenix for the dentist, I met her two years ago, three years ago now, she has really helped me out with my teeth. She works with my family, but she does a really good job analyzing, like, cervical spine and jaw alignment and the formation of the teeth, and all these things that, if out of place, can cause tinnitus that results often from TMJ issues. Sometimes you're just tight, right? You're just carrying your jaw really, really tight, because you're stressed, you're anxious, you're not breathing properly, you're breathing through your mouth frequently instead of your nose. I could spend hours of this podcast delving into head, neck, and jaw dysfunction, but ultimately, for the purposes of this podcast, all I want to say is look into it, right, whether it's a physical therapist or a holistic dentist or someone who's able to actually use digital imaging to see how your jaw and how your skeleton is aligned, especially in the upper half, and then begin to work on those areas. I mean, when I get a massage, my massage therapist, Tracy, here in Moscow, Idaho, she'll literally pin, if you're watching the video you can see me doing this now, she'll pin certain areas of my jaw, like right here, and she'll say open and close, and I'll open and close multiple times as she works her way up and down the jaw, and after she finishes a series of that, it's like I don't know how tight my jaw was until after she does that, and then I realize how much that area needed work, right? And that's just one example of the type of therapy that you might need, but it can be helpful. There can be vascular issues, meaning if you have high blood pressure, for example, that can cause a little bit of vasoconstriction in the vasculature, including up around the ears, and cause what is called pulsatile tinnitus, where you kind of hear your heartbeat, and sometimes that can be as simple as a mineral deficiency. I remember when I used to do a lot of hot races, where I'd sweat a lot and be training in the heat, in Thailand, Japan, Hawaii, for triathlon, I didn't understand minerals. I had been educated in my undergraduate and graduate courses at Idaho that salt was bad, right? And yes, isolated sodium chloride from table salt or ultra-processed foods without the balance of all the other minerals can be deleterious for blood pressure, but a well-balanced intake of minerals, paradoxically, can help out with blood pressure modulation. So, you look at a lot of these companies now, like Quinton or LMNT, speak of the devil, what I'm drinking right now, trace liquid minerals, you know, Celtic salt, these type of mineral sources can actually help out quite a bit. The clue there would be, if you go to sleep at night and you can kind of feel your heartbeat pounding in your ears, that's a pretty good sign that that might be contributing to the issue.

Ben Greenfield: Some medications, both prescription and over-the-counter drugs, can also trigger tinnitus or make existing tinnitus worse. Some of the biggies are antibiotics that would fit into what is called the aminoglycoside category. This would be like streptomycin, gentamicin, neomycin, not uncommonly prescribed, if you're on one of those or have been on them, that may have contributed to the cause. Some chemotherapy agents, some quinine and antimalarials, even non-steroidal anti-inflammatory drugs, ibuprofen and aspirin, at high doses can cause drug-induced tinnitus. My recommendation for this, yay for LLMs, you can go through any prescription medications or over-the-counter drugs that you're currently using, you can feed all those into an LLM and see if any of them could be contributing to tinnitus. I'm not a doctor, don't take this as medical advice, but if that is the cause, and if there is an alternative solution for those medications or drugs, you could look into getting off of them. Again, talk to your doctor. I'm not a doctor, I don't even play one on TV, I don't even have a T-shirt that says "Trust the Doctor." Eustachian tube dysfunction, you know, I sustained a pretty hefty injury, like literally bleeding out my nose after going about 80 feet deep during a free diving incident, and had to get a hole punched in my left ear to drain it. It's horribly painful, and as a result, I still have difficulty equalizing that left ear. Well, if you've had Eustachian tube issues, if you had a lot of ear infections in the past, or when you were a kid, if you've done much diving or pressure-type work, that can also result in middle ear dysfunction or Eustachian tube dysfunction that can contribute to tinnitus. I'm almost done here, and then I'll get to some of the things that you may want to think about, even though me just listing what causes it is hopefully giving you some things to think about when it comes to fixing the issue. A lot of times, people who are chronically in vigilance mode, like me wandering around my house with a handgun at midnight, there's actual research that hypothesizes that people with debilitating tinnitus are chronically in this vigilance mode, reacting to everyday sounds like they're threats, with the sympathetic nervous system chronically activated, and that stress basically can amplify the tinnitus. Cortisol affects the cochlear blood flow. Your limbic system's threat tagging of sound makes it louder in perception, even if the raw signal hasn't changed. So stress modulation could also be a good idea, and finally, sleep disruption research, albeit in ferrets, has found that animals that develop significant tinnitus also show disrupted sleep, and vice versa, as you can imagine. So what happens is the hyperactive brain activity is dampened during non-REM sleep, so sleep temporarily masks tinnitus by engaging the same brain circuits, and so the tinnitus wrecks the sleep, and the poor sleep amplifies the perception of tinnitus. So, you know, I have an entire multi, multi-dozen-page chapter in my book, Boundless, about how to fix sleep issues. I also have addressed this multiple times on other podcasts. I just came out with a YouTube video walking you through my exact sleep routine. I will put that in the show notes, so that hopefully it serves you well. Those are all going to be at BenGreenfieldLife.com/502. But as you can imagine, with all of these different reasons that tinnitus can occur, step one is figuring out what's causing your tinnitus, right. Step two would be to actually engage in certain activities beyond those that I've already recommended, such as sleeping well and getting your jaw alignment looked at to help with tinnitus. First of all, hearing protection, right, concerts, shooting guns, grinding sessions at the gym with loud music, you're going to compound the damage, so you want to use hearing protection. Keep your volume turned down as low as you can on your earbuds or your headphones, and they do make fancy earplugs now that will drown out the higher decibel sounds while still allowing you to enjoy something like a concert. I don't remember the brand names of any, but if you literally Google or go to Amazon and search for something like high decibel masking earplugs, you can find those pretty easily.

Ben Greenfield: I mentioned that optimizing deep sleep seems to give the highest-leverage intervention for tinnitus. Deep sleep often comes down to no alcohol before bed, comes down to a very cold sleeping environment, and low light in the evening before bed. Those are three easy triggers to pull for sleep architecture. Cardiovascular fitness, right? Regular aerobic exercise is going to lower blood pressure, it'll improve blood flow to the inner ear, it'll reduce systemic inflammation, and consistent data in hearing loss research has found that people who are cardiovascularly fit have better auditory aging. And then finally, caffeine, and as I've already mentioned, alcohol, both seem to affect cochlear blood flow acutely, so if you have tinnitus and you are a hefty coffee drinker, or God forbid, a hefty alcohol drinker, you may want to track the consumption of those compounds in correlation with your tinnitus. What can be helpful from a supplementation standpoint? Well, magnesium is interesting. When magnesium is low, the protective mechanism around what's called the glutamate receptor blockade weakens, so you get more glutamate release and less receptor blocking, and that seems to be useful for noise-exposure-based tinnitus. Around 400 milligrams of something called magnesium glycinate specifically would be one to look into. There's a company, they've sponsored the podcast in the past, they're called Formula IQ. They make one called Mag IQ. It's got three forms of magnesium in it, including magnesium glycinate, I believe. Magnesium Breakthrough also has magnesium glycinate in it. Vitamin B12, one study of 40 tinnitus patients found that 42.5% of them were deficient in vitamin B12, and when they received vitamin B12 therapy, their tinnitus severity scores improved significantly, and B12 deficiency is probably causing this issue because it allows for damage to the myelin coating which surrounds nerves, including your cochlear nerves. So get your vitamin B12 tested, it's an easy blood test to do. Similarly, zinc, multiple randomized controlled trials, RCTs, have shown that people who are zinc deficient experience significant symptom reduction of their tinnitus when they begin to supplement with zinc. So that's another one to look into. You can get a serum zinc blood test. Vitamin D deficiency is linked to the actual volume of the tinnitus, and clinical trials show that helping out with your vitamin D levels can assist with that. I usually look for a score of around 50 to 80 nanograms per milliliter for serum, what's called 25-hydroxy vitamin D, so that'd be another one to look into. Supplements don't do everything, but vitamin B12, zinc, magnesium, and vitamin D would be a few to look into. I will also give a head nod to bioavailable folate, not synthetic folic acid, but I do have a section in my book, Boundless, where I discuss how folate deficiencies seem to impact hearing health in older individuals. You can also find bioavailable folate in organ meats. So, if you're a liver fan, I actually am eating heart tonight for dinner, I have it soaking right now as we speak. So, there you have it, liver, heart, kidney. There are a lot of companies now that make these encapsulated organ meats, you don't have to just cook up liver if that's not your thing. There are no FDA-approved pharmaceutical drugs that exist for tinnitus, however, some are sometimes used off label. I'm really not a fan of most of these benzodiazepines, like Klonopin, or clonazepam as it's pronounced, and Valium, yeah, they can help with tinnitus because they're highly anxiolytic, but they cause constipation, they're difficult on the liver, they kind of leave you feeling fatigued the next day. I think if anything, CBN, which I talked about in podcast 501, if you want to go back and listen to that one, would be a decent alternative to the diazepams. A similar thing can be said for antidepressants. Some people do respond to antidepressants, like tricyclic antidepressants. There's modest evidence for reducing tinnitus distress, but again, they kind of turn you into a little bit of a zombie during the daytime, in my opinion, and there are some downstream side effects that I'm not a fan of.

Ben Greenfield: Lidocaine, as an anesthetic, seems to reduce some of the abnormal hyperreactivity in the central nervous system that's consistent with tinnitus, and a physician can actually treat you with lidocaine, and again, that's something that I think would be a last resort type of thing. And then finally, something called gabapentin, that's sometimes also used to reduce central sensitization and seems to help a little bit with tinnitus, but again, I would recommend looking into some of these other things first, some of the natural supplements, addressing your sleep, caffeine, alcohol, the alignment of the jaw, the cervical spine, the head, the neck, all of that can be done via physical therapy or with someone who is well versed in deep tissue therapy or craniosacral therapy. So I know I threw a lot at you there, but I have still a few other things to think about, because there are also technologies. So, for example, vagus nerve stimulation. I've had several friends who have borrowed my vagus-nerve-stimulating devices, who have had tinnitus, and it acutely helps, meaning right away their tinnitus decreases remarkably. Vagal nerve stimulation, VNS, that basically means that you're using light or electricity to stimulate the vagus nerve, usually kind of around the auricular branch, right underneath the ear. There are devices like the ZenBud. The one I like is called Hoolest. These are headphones that you wear that have a little node that stimulates the vagus nerve. There is the Truvaga device, which you hold up next to your neck for a couple of minutes, sometimes on both sides. Works really well. For the big guns, you can literally get what's called a stellate ganglion nerve block, where they inject very close to the vagus nerve using ultrasound-guided imaging. That one seems to be highly effective for vagal nerve stimulation, and of course, top of the totem pole would be an implantable vagal nerve stimulator, but that obviously involves putting an actual electrical conducting device into your body, and again, that would be something of last resort. There's also what's called TMS and TDCS, transcranial magnetic stimulation and transcranial direct current stimulation. These use pulses, like magnetic and electrical pulses, to stimulate nerve cells in the brain. They're now being looked into as an alternative to modalities like antidepressants, and also as something that seemed to be able to target the auditory cortex directly to reduce hyperexcitability. So, vagus nerve stimulation, TMS, and TDCS would be three items that we could, of course, unpack in great detail on this podcast. What I'm just giving you are some tools here that you can begin to research and look into. I can tell you, for vagal nerve stimulation, that's kind of like, I think, the easiest and most directly effective. I'm a little bit biased, because I do it almost every day with these Hoolest headphones, or with the Truvaga. I own both, and again, I've had people at my house who have used it, who have had tinnitus, who almost immediately see results, again, not medical advice, but something to think about. Now, kind of somewhere to sleep, CBT, cognitive behavioral therapy, that's one of the best evaluated treatments for tinnitus. So, the general aim of CBT is to facilitate this modification of maladaptive patterns, but you're working on the cognitive level, the emotional level, and the behavioral level. So, you're kind of taught to downregulate threat responses, and typically you're doing so with a therapist. There are apps now that will also do CBT. There's a version of it called tinnitus retraining therapy. There are apps like Levo or Oto that use CBT protocols for tinnitus, and there's solid RCT evidence behind these protocols, not as sexy as something like a vagal nerve stimulator, because you're just doing the work, but as far as the evidence, you cannot argue with the evidence. Sound therapy, using white noise, pink noise, brown noise, purple noise, all the colors of noise next to your bedtime at night, can help to reduce the contrast between the tinnitus signal and the silence, so you could sleep better, so you don't get that kind of negative feedback loop, or positive feedback loop, I suppose, of poor sleep causing tinnitus, and then tinnitus causing poor sleep. And one last thing I'll give a head nod to is photobiomodulation.

Ben Greenfield: You've seen the red light panels and the red light beds. You do not need to stick a red light device into your ear, per se, but shining a device near your ear seems to help. You can literally have your body facing sideways next to a red light panel, and mitochondrial support of cochlear hair cells is probably why this may be effective. I suppose if you do use a red light bed, you could just lay on your side, with your ear against the surface of the red light bed, but these are all things that you can try for tinnitus. If it were me, top of the totem pole would be, I'd rule out the somatic component first, right? Does it change with jaw clenching, head turning, pressing on your neck muscles, craniosacral therapy? If yes, I would do physical therapy before anything else. Then I would rule out medication-induced causes. Review your full medication list against what's called the ototoxic drug category, oto is the word usually used when we're talking about ear-related issues. So, ototoxic drug catalog, get your labs done, look at B12, look at zinc, look at magnesium, look at vitamin D, look at folate, and then correct what's deficient before just randomly throwing those supplements in. Fix your sleep, look at cognitive behavioral therapy, and look at vagal nerve stimulation. Those would be some of the top strategies I would try before I jump into some of the other solutions that I've presented. So I know I threw a lot at you there, you may have to listen to that twice, but that is where I would start when it comes to tinnitus. So JP asks, here's an interesting one, what are your thoughts on tattoos? I know you have one, actually you have 1, 2, 3, actually you have five. Do they impact the body as negatively as many people think? Yes, they have been around for many years, so they must be healthy, right? Well, not exactly. So, ink chemistry is the biggest under-discussed problem with tattoos, and I'm probably going to just ruin the dreams of a lot of people right now who are rushing out to get their favorite tattoo. The problem is that a lot of the pigments used for tattoos were originally developed for industrial applications like automotive paint, plastics, printer toner. These were not meant for permanent injection into human skin. If I could go back all over again, I'm not sure we'd get a tattoo, knowing what I know now about tattoos, and the FDA really doesn't have much regulatory authority here or enforcement when it comes to tattoos. So the specific threats there are heavy metals found in inks, cadmium, lead, mercury, beryllium, arsenic, and these have been linked to things like cancer and degenerative brain disease and cardiovascular abnormalities, and a lot of these inks that are used in tattoo parlors exceed the limits that would normally be implemented for exposure to these heavy metals. Colored inks are the worst. Red, yellow, and orange are very frequently associated with allergic reactions and with inflammation, partially due to the metal salts, and also what are called azo pigments, A-Z-O pigments, that can degrade into what are called aromatic amines, which are inflammatory and potentially toxic over time. And we do know that ink migrates. There are studies that show that these pigment particles injected under the skin can migrate through the lymphatic system, they can accumulate in lymph nodes, and that could obviously be an issue. There was a 2024 study at Lund University, over 11,000 people, 11,905 people, in this study. They found that tattooed individuals had a 21% higher adjusted risk of overall lymphoma than non-tattooed individuals. Now, lymphoma is a rare disease, and a 21% increase relates to a baseline risk that's relatively low, and we also don't know if people who get tattoos, kind of like the healthy user bias, or in this case the unhealthy user bias, are more prone to other risky activities in life, like, I don't know, staying out late, smoking, going to loud rock concerts, hitting the bars, eating fast food or junk food. I'm not throwing everybody who has a tattoo under the bus, I'm just saying people who have tattoos generally aren't the Ned Flanders type, right?

So, the fact that people who have tattoos had a higher lymphoma risk doesn't necessarily mean that the tattoos are what caused that, and yet there is caution that you should take. And then, studio quality is an issue. Where are you getting the tattoo? That's not a problem inherent to tattoos, it's more the cleanliness of the studio. Hepatitis C has been linked to tattoos in less professional, less sterile settings. HIV and hepatitis B are potential risks. There was a CDC meta-analysis that found a significantly higher risk of hepatitis C infection among people with tattoos, but these tattoos were done in relatively unregulated environments. In a licensed, autoclave-equipped studio with single-use needles, the actual risk is probably pretty low. So those are a few things to think about. Now, if you were going to get a tattoo, if you're just like, "Dad, mom, come on, this means a lot to me, it's my impression of your parents," here's what I would think about. Go black or grayscale if you can. Carbon black inks are chemically simpler, they avoid the azo dye and the metal salt problem you get in colored ink. I know it's not as sexy, but you can find some pretty cool black inks made with carbon black. There's still a little bit of what are called polycyclic aromatic hydrocarbons, which are basically forever chemicals, but it's less risk if you're going with a more grayscale black approach. There are also somewhat reputable non-toxic tattoo ink brands, such as Eternal Ink, World Famous Tattoo, which is also vegan and cruelty-free, no animals harmed in the making of those tattoo inks, Intenze, spelled with a Z, like I-N-T-E-N-Z-E, Solid Ink, that's an organic-base pigment that's heavy-metal-free, and the Radiant Colors line. When you go to the studio, make sure they have an autoclave on site, that's a machine that uses typically high-pressure steam and heat to sterilize equipment, liquids, or other materials, and a tattoo parlor should have that. Make sure they're opening up the needles in front of you, so it's sealed single-use packaging. The artist should have fresh and clean gloves. The ink should be poured into a single-use cap, right, not double-dipped from the bottle after needle contact. And ideally, if you can ask around, you should be getting a tattoo at a licensed shop with state health department inspections, not "please, in your cousin's garage." And then, pre- and post-tattoo support, I think about things that help to support skin repair, right, collagen, red light therapy, vitamin C, zinc, all of these would be a good idea, your immune system is a little bit more hammered post-tattoo for the reasons that I mentioned earlier. So, getting good sleep, taking care of your gut, eating a clean diet, all of those can help out a little bit with your lymph circulation. I've just given a huge presentation to a bunch of docs down in Boise on the lymph system, and there is a ton there, maybe I'll do a future podcast on everything that you can do for your lymph system, but looking into it and taking care of it post-tattoo is a good idea. Those are some of the major considerations. I have an older podcast I did also, where I talked quite a bit about tattoos. I'll link to that one in the show notes, but that is where I would start. You can get one, just make sure you proceed cautiously, use the right inks, use the right tattoo parlor. So, best of luck, JP. Last piece of advice, don't tattoo your girlfriend's or your ex-girlfriend's name on your butt crack, or get any tramp stamp for that matter.

So, let's dig into a few quick research studies to round things out. So, new study, some people are aware of heat shock proteins, great for cellular resilience, great for immunity. One of the reasons that a lot of people do a sauna, but it turns out if you don't have access to a sauna and all you have access to is a normal-temperature gym with weights, here is what a recent study in the Journal of Strength and Conditioning Research found. They took these men and had them do six sets of 10 reps of back squat, that's it.

Ben Greenfield: Now that's still a pretty brutal load, because they're doing these things at about 75% one-rep max. Anybody who squats knows that 75% of your one-rep max for six seconds, and they were getting 90 to 120 seconds of rest between sets, that is a tough protocol, but then what they looked at was what's called extracellular HSP70, extracellular heat shock protein. Heat shock protein increased significantly post-exercise, remained elevated for a significant period of time post-exercise, and then eventually came back down. So this is the same reason that a lot of people hit the sauna, is for the cytoprotective increase of heat shock proteins. What it looks like is that doing heavy weightlifting with a pretty good load with minimal rest periods causes that same effect. So when you're in the sauna, the heat shock protein induction is mostly thermal, right, a rise in core temperature. Resistance exercise instead elevates core and contractile skeletal muscle temperature, reduces pH, increases calcium concentration in muscles, decreases carbohydrates in muscles, and causes an increase in reactive oxygen species production, and all of that triggers HSP release, even if you didn't hit the sauna. Now, the difference is that saunas produce a more sustained, long-term elevation of heat shock proteins, however, you still get a significant cytoprotective dose of them in response to heavy weight training. So, in my opinion, I go for the best of both worlds. If I do a hard workout, typically a couple times a week, I try to get hot after that workout, because research shows that if you go in the sauna post-workout, you get a big increase in red blood cell production, basically erythropoietin, these precursors for red blood cells, you get a cardiovascular response, you seem to get a little bit of an increase in muscle growth signaling, and of course, the further increase in heat shock proteins. What's that look like? I flip on the sauna before my hour-long weight training routine a couple of times a week, and then I go in there and I stretch after I finish my weight training routine. Occasionally, I will go in there and crank out some squats and some push-ups, that's pretty tough after you've already trained, but nonetheless, weight training alone can do some of what a sauna does, and then throwing in sauna after weights seems to amplify that even more. And no, you do not have to wear one of the dorky elf sauna hats while you're weight training, nor do you need to wear the ice diaper, ice testicle cooling underwear while you're weight training, you're not getting that hot in the sauna, though it's a great look. All right, let's move on to a new study, and this study shows that eating before bedtime actually isn't bad after all. Well, who knew? You know, you've got guys like Brian Johnson, bless his heart, finishing his last meal by, I think, noon or something like that. You have a lot of people stressed out about "don't eat after seven or after eight" because they want to sleep well. Well, did this new study just debunk all of that? Well, always check the actual paper first. The name of this study was Sleep-Aligned Extended Overnight Fasting Improves Nighttime and Daytime Cardiometabolic Function, and they looked into sleep quality, blood pressure, heart rate, glucose regulation, and the time that people actually went to sleep, and it turns out that, in my opinion, these people really weren't eating right before bedtime. What they actually compared in this study was eating four and a half hours before going to bed versus eating two and a half hours before going to bed.

Ben Greenfield: Well, most people who don't sleep well after eating are not going to bed at 10pm after finishing dinner at 7:30pm, they're having dinner, maybe finishing by eight, going to bed scarfing down Trader Joe's dark chocolate almonds, you know, often in their bed, or punishing a half pint of ice cream. And it turns out that eating two and a half hours before bed versus four and a half hours before bed is not really, in my opinion, a realistic comparison of people who are actually eating right before bed, which is usually people who are literally finishing, let's say, a late night dinner with a bunch of friends at a steakhouse, taking an Uber or driving home, the steakhouse dinner finished at, I don't know, 9:30, and they're trying to be in bed by 11, with the meat sweats. That is a much more realistic illustration of eating before bed. So, there is some large population data that backs this up. There was one study using American Time Use Survey data. It found that eating or drinking within one hour of bedtime was associated with significantly increased wake after sleep onset, meaning that people basically had poor rest following a meal that was done within about an hour prior to bedtime. So, most of the studies that show that eating before bedtime is bad for you are looking at like 30 to 60 minutes before sleep. A large population study using the American Time Use Survey data found that eating or drinking, I believe in this case it was alcohol, within an hour of bedtime was associated with poor quality rest. There was another, what's called polysomnography, sleep lab study that found that food intake within 30 to 60 minutes of bedtime is associated with delayed sleep onset and decreased sleep efficiency, and you can find plenty of other studies that suggest that food, especially food that is heavy, that is spicy, that includes alcohol, can all disrupt sleep because they raise body temperature, they shift blood flow to the gut, they can result in a little bit of a sympathetic nervous system response, and wreck your sleep. However, the whole idea of eating before bed being bad for you, for most people, is not a problem if you're like the 7pm dinner, in bed by 10 type. I personally think that you can make a pretty good case that you should be done eating at least an hour and a half before you go to bed, and for our family, our family dinners often happen later at night, when my sons are done with sports, or people are done with a day, and we actually have the time to sit together and enjoy a family dinner, and I think the benefits of sitting down together and enjoying a family dinner outweigh any potential cons of me usually being done eating by eight or 8:30, but then in bed by 10pm. So, don't beat yourself up too much. You always have to look at the studies a little bit more carefully, and yeah, it appears that even in this case, for this study, if you're two and a half hours before bed, it's really not an issue, and I think you could look at some other literature and make a case for an hour and a half before bed still being safe, and then once you start to cut under that 90-minute mark, that's where you would begin to run into sleep disruption issues, around that 90 minutes. All right, so now that we have established that you should not eat dark-chocolate-covered almonds from Trader Joe's, or many of the processed-sugar-infused, so-called health food from Trader Joe's, while in bed, or in the hour to hour-and-a-half leading up to bedtime.

Ben Greenfield: Let's move on and talk about muscle and protein, and for those of you who are watching the video and may have astutely noticed that my hair and my shirt have changed, that's just because I needed to step away briefly and come back to finish recording today's episode. So we're going to move on to a really interesting article that recently came out. Kion, K-I-O-N, GetKion.com, they have been doing some bang-up work on amino acids, protein, and muscle, and recently they got into a lot of the nitty-gritty of maintaining muscle on a GLP-1, meaning, basically, yes, if you're going to inject your tirzepatide or retatrutide or whatever "tide," make sure that you eat adequate protein and lift weights. Duh. There are subtle nuances, however. So, quick reminder, GLP-1 receptor agonist, that's a class of medication that mimics glucagon-like peptide 1, and in the case of something like retatrutide, we are triggering receptors beyond that, such as ghrelin and GIP. Mechanism of action aside, we do know that these cause weight loss by putting you in a sustained caloric deficit. There are many other, mostly beneficial, side effects, but that deficit, in particular, that caloric deficit, is where the problem is when it comes to muscle preservation or muscle building, because when your appetite is significantly suppressed, even with small doses, like I've taken 0.25 milligrams of retatrutide approximately once every two weeks for oh, three months or so, and whenever I take it, I have a harder time eating much food for the next two days, and that's with a baby dose. I mean, I can't imagine people who are taking two, four, six, eight, 10, even 12 milligrams, far more than what I'm taking, in terms of how they're eating any food at all. The average amount of caloric intake that is reduced when you're on a GLP is about 30 to 50%, and often that includes, I should really say always includes, protein. So, if you look at the link between caloric restriction and muscle loss, it really comes down to amino acid availability, right? So, you have these essential amino acids, there are nine of them that you can't make on your own, you can list them off like Santa's reindeer: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Okay, so those, because they're essential and your body doesn't make them, they need to come from food or they need to come from supplements, and you need all nine to fully support muscle protein synthesis, or as we say in the nutrition industry, MPS. Five days of a 30% calorie deficit, meaning if you're used to, oh, let's say, eating 2,000 calories a day, and you get on a GLP and you drop to 1,400 calories a day, research has found that five days of normally being on 2,000 calories a day and dropping to 1,400 calories a day could require a threefold increase in essential amino acid intake to maintain a positive whole-body protein balance, meaning as you cut calories, your body is breaking down muscle protein to supply the necessary amino acids, and muscle protein synthesis will decline unless essential amino acid intake is sufficient to catch up. So that's kind of like the core issue with GLP-1 use and muscle, is that that medication suppresses appetite, that reduces food intake, that reduces protein intake, and that reduction in protein intake occurs at the exact time when you're at a caloric deficit and your body needs more, not less, essential amino acids. Now, on the bright side, recent studies on GLP-1s, including retatrutide, have shown that a lot of the lean mass loss that we used to attribute to skeletal muscle can actually come from liver glycogen, hepatic fat, and stuff that's actually beneficial if it decreases, yet you still lose a meaningful amount of muscle. Now the standard dietary reference intake for protein right now is about 0.8 grams per kilogram of body weight, that's, rough math, I believe, 0.55 grams per pound.

Ben Greenfield: I don't think that's anywhere near enough to preserve lean body mass, especially if you're on a GLP-1 and you're in a caloric-restricted state, so the actual evidence-based protein targets tend to range with age, and I'll include a link to this article with some great graphs on this. I'll let you do the grams-to-pounds conversion, because I'm going to be lazy and give you grams per kilogram, but if you're sedentary and you're on a GLP-1, you should be getting around 1.2 grams per kilogram per day. If you're an active adult on a GLP-1, 1.4 to 1.6 grams per kilogram per day. If you're an older adult on a GLP-1, well, guess what, your protein absorption from food decreases, your ability to engage in muscle protein synthesis diminishes, so you need 1.6 to 2.0 grams of protein per kilogram of body weight per day, and if you're an active adult over 50 years old on a GLP-1, if you're not getting 1.8 to 2.2 grams of protein per kilogram of body weight per day, you are likely not getting adequate protein for maintaining muscle, and definitely not enough for building it. So the other issue is that research supports spreading your protein intake across three to four meals per day to maximally stimulate muscle protein synthesis. The problem is that if your appetite is suppressed, not only are you less likely to eat adequate calories, you are less likely to eat frequently, so you're not getting that protein pulse during the day. So, big picture here, GLP-1 medications do not directly destroy muscle, but they reduce your appetite so effectively that your protein intake drops, and the caloric restriction that happens at the same time increases your essential amino acid requirements. It can be difficult to get that 1.2 to 2.2 grams of protein per kilogram of body weight per day, which is going to vary depending on your age or activity level, but if you're not doing that, you are going to run into some issues. Now, one other factor is resistance training, weight training, that actually is what stimulates muscle protein synthesis, right, that's the mechanical loading of muscle tissue. So, in an ideal scenario, you are doing that, so your body has the actual signal to retain muscle tissue. Yes, there are some studies that show that adequate protein and adequate amino acid intake, even in sedentary, bedridden individuals, can maintain muscle, but you really are not going to build any appreciable amount of muscle, and you'll always face a little bit of an uphill battle, unless you're combining that protein intake and getting adequate essential amino acid intake with resistance training. That doesn't have to be Arnold Schwarzenegger-style bodybuilding training, it can be as little as two full-body weight training sessions per week. I have plenty of content, entire chapters in Boundless, on the weight training protocols that I recommend for this, but it is something to think about. So there are other nutrient deficits that we tend to see in people who are on GLP-1s that can affect your ability to maintain or preserve muscle, or build muscle, and that would include vitamin D, your whole vitamin B12 complex, or vitamin B complex, all of them, B6, B12, folate, iron, omega-3 fatty acids, and then, of course, the essential amino acids that I talked about. So, long story short here is that if you are on a GLP, you should be prioritizing that protein intake, right, 1.2 to 2.2 grams per kilogram per day, you should be getting adequate essential amino acids, you should be testing at least for vitamin D, vitamin B12, iron, and your omega count, and if those are low, you should be replenishing. And again, if you want to lose fat, right, if you're taking a GLP for aesthetic reasons, beyond lipid management or something like that, I'm not against it, but you need to take these things into consideration. There are tons of subtle nuances in terms of recommended resistance training protocols, recommended dietary protocols, recommended essential amino acid protocols. If you go read the article, I'll put it in the show notes at BenGreenfieldLife.com/502, that's BenGreenfieldLife.com/502. Okay, the other interesting thing to know about, and this relates to what I was talking about.

Ben Greenfield: How, remember how I just said you will need more protein if you're 50 or older? Well, there's also a great breakdown on the Kion website about this idea of anabolic resistance. Anabolic resistance is basically the age-related blunting of the muscle's anabolic response to protein and physical activity. Basically, it means it's harder to build or maintain muscle when you get older. An older adult can eat the same amount of protein and do the same workout as they did when they were younger, and get a smaller muscle-building response from it. If you are an older individual, if you're pushing your early 40s and beyond, you may have already noticed this. And guess what, it doesn't get easier as you go forward, it gets a little bit more difficult, and that anabolic resistance is the main contributor to what we call sarcopenia, the gradual age-related loss of muscle mass and strength. So this is again where muscle protein synthesis, remember, MPS, comes into play, that's the process that your body uses to repair and build muscle, so the per-meal protein dose needed to maximally stimulate MPS is about 68% higher in older men than in younger men, so that means an older adult may need around 40 grams, roughly on average, of high-quality protein per meal to get the muscle response that a younger adult would get from 20 grams, right. So, if you're used to, you know, 20, maybe 30 grams of protein spread throughout the day, as you're getting older, you're going to need more than that, either getting it from whole protein sources or essential amino acids. And then the other thing to consider is that pancreatic enzyme production of the proteases responsible for breaking down protein tends to decrease as you age. I'm 44, I weighed 175 pounds coming out of Ironman triathlon, my race weight was actually 169 when I was 33 years old, I weigh 198 pounds right now, I'm 6% body fat, and I take digestive enzymes with proteases with every single meal that contains protein, which is basically every meal for me. I use a product called MassZymes by BiOptimizers, and I pulse with 10 to 20 grams, that's a lot of essential amino acids, pre-workout and post-workout, based on what I know about maintaining and building muscle with age, and that's one of my secret weapons. My son is trying, right now his goal is 187 pounds, all lean muscle gain, and he's currently taking about the same dose as me, and just piling on muscle. I realize these are anecdotes, but when it comes to muscle protein synthesis, I think essential amino acids are really clutch, and then as you age, also stacking digestive enzymes with proteases in them on top of that is a really good idea. So why is it that age-related muscle loss occurs? Anabolic resistance is not one single factor, it can be related to inflammation, which increases with age and reduces muscle protein synthesis. It can basically be due to what's called increased splanchnic uptake of amino acids, that means that as you age, your gut and your liver extract a larger share of amino acids from a meal, and that leads to fewer amino acids reaching the muscle. We see reduced blood flow to muscle, which means less efficient delivery of amino acids to muscle tissue through the microvasculature. Altered cellular signaling, okay, there's this pathway you may have heard of before, called mTOR, and that can reduce the ability to ramp up anabolism in response to protein, we see mTOR blunting with age, we see reduced appetite and lower food intake with age, a lot of times due to gut discomfort, digestive discomfort, it's just harder to eat bigger meals. And then inactivity, it's just easier to get injured as you age, your mobility decreases, so your ability to lift heavy weights declines. I'm not saying this to ruin your day, but these are all just things to be aware of. Now, fortunately, we can fight a lot of these, again, with amino acid intake, with protein intake, with digestive enzyme intake, with blood flow and cardiovascular exercise, I think you could make a case for creatine, and then, of course, resistance training as you age. Okay, so hopefully you're getting the idea here.

Ben Greenfield: I'm going to get back on the essential amino acids bandwagon, because this is one of the most powerful ways that I know of to directly stimulate the muscle-building response, besides just heavy weightlifting, and this works because essential amino acids kind of sidestep the bottleneck that results in you being able to assimilate and use less protein as you age. So remember, you've got these nine essential amino acids that your body can't make on their own and that they need to get from food or supplements, and of these nine, leucine is the main primary trigger for muscle protein synthesis, aging muscle needs a larger leucine signal to respond. Now, you may have seen BCAAs before, those have leucine in them, but you can't just take those, because it's like building a car and only having three of the components to build the car, versus the nine components necessary to build a car, that car is not even going to get out of the garage, much less even look like a car. So what you're looking for in an ideal essential amino acid blend, in order to stimulate maximum muscle protein synthesis, is about 40% leucine. That has been shown in research to stimulate muscle protein synthesis roughly 50% more than the same essential amino acid dose with a lower leucine content. There are many companies on the market that make essential amino acids, most do not use adequate amounts of leucine. As a matter of fact, in a study, and this one was in older women, a 1.5-gram, that's not much, remember, I was telling you earlier I wouldn't say I'm taking a boatload more than that of essential amino acids, but a 1.5-gram dose of leucine-enriched essential amino acids stimulates muscle protein synthesis as strongly as 40 grams of whey protein, 1.5 grams versus 40 grams. Now, for people who are trying to control their calorie intake, that's also really good to know, because yes, you could get quite a bit of protein from, say, a steak or a whey protein shake, but if you're trying to do so and also lower your calories, both of those can have a lot of calories in them. So essential amino acids can be a low-calorie way to actually achieve this, you're looking at roughly one to two calories per gram of essential amino acids, far lower than what you'd get from a food-based source of protein. Don't get me wrong, I had a ribeye steak for dinner last night, but I like to work out in a fasted or semi-fasted state. The only thing going into my body after an overnight fast, pre-hard-workout, and I work out pretty hard, is some ketones and 10 to 20 grams of essential amino acids. Post-workout, 10 to 20 grams of essential amino acids, and my whey protein shake. Right, so I'm getting quite a big bolus of protein before 10am in the morning. So those are a few of the things that you should know about the loss of muscle with age, and what you can do about the fact that protein stops working a little bit as you age. For more details, check out the article that I'll link to in the show notes at BenGreenfieldLife.com/502. The amino acids that I use are, of course, the ones from Kion, watermelon flavor is the best, but there are four different flavors, there's stick packs, there's travel packs, take your pick. And I literally pour my ketones and my four scoops of essential amino acids into a cup, and I use a latte frother, and I drink it down, and then I fill that cup again with a little bit of water to get all the extra goodies off the edges, drink that down again, and head into the gym. All right, that's going to wrap up today's show. I know you probably have questions, comments, feedback, show notes are juicy, again, at BenGreenfieldLife.com/502. Leave the show a rating or review, a thumbs up, share it with friends, that always helps me to get the word out, and I hope this has been useful and helpful for you. Hope you have an incredible week, to discover even more tips, tricks, hacks, and content to become the most complete, boundless version of you.

Ben Greenfield: Visit BenGreenfieldLife.com. In compliance with the FTC guidelines, please assume the following about links and posts on this site. Most of the links going to products are often affiliate links, of which I receive a small commission from sales of certain items, but the price is the same for you, and sometimes I even get to share a unique and somewhat significant discount with you. In some cases, I might also be an investor in a company I mention. I'm the founder, for example, of Kion LLC, the makers of Kion-branded supplements and products, which I talk about quite a bit. Regardless of the relationship, if I post or talk about an affiliate link to a product, it is indeed something I personally use, support, and with full authenticity and transparency, recommend in good conscience. I personally vet each and every product that I talk about. My first priority is providing valuable information and resources to you that help you positively optimize your mind, body, and spirit, and I'll only ever link to products or resources, affiliate or otherwise, that fit within this purpose, so there's your fancy legal disclaimer.