Ben Greenfield [00:00:00]: My name is Ben Greenfield, and on this episode of the Ben Greenfield Life Podcast.

Anders Olsson [00:00:03]: Nitric oxide is produced in our nose, right? And when we use our nose, the air we inhale will be spiked with nitric oxide. And that's really important gas because it's antiviral, antibacterial, antifungal. And it's surprising that during the pandemic, I didn't hear anyone talk about nasal breathing. Already in 2005, there was a study showing that nitric oxide, which is produced in our nose in large quantities, and which then kills viruses and bacteria that we inhale by inhibiting the replication cycle. In this study, in 2005, when you see the pictures in the study, untreated SARS Coronavirus can divide like crazy, but when it's exposed to nitric oxide, there is almost none left.

Ben Greenfield [00:00:55]: Fitness, nutrition, biohacking, longevity, life optimization, spirituality, and a whole lot more. Welcome to the Ben Greenfield Life Show. Are you ready to hack your life? Let's do this.

Ben Greenfield [00:01:19]: Well, welcome to today's show. I'm holding up this mask that has been at my desk for the past couple of weeks. I've been breathing carbon dioxide for about five or six minutes, just during my work day. Typically it's been in the afternoons when I've been checking email and, you know, I've been interested in breathwork for a long time. But this whole concept of breathing carbon dioxide, like how carbon dioxide can affect your body, is something that keeps popping up over and over again on my radar. That this idea of carbon dioxide therapy, right? And a lot of times we're led to believe that carbon dioxide is bad, and you're not supposed to have a bunch of it floating around in your body. And some people think it makes you acidic, and some people think it makes you alkalinic. And there's a lot of confusion around carbon dioxide.

Ben Greenfield [00:02:07]: But I've gotten my hands on both research and anecdotes lately from a friend of mine who's a pretty well known breathwork expert. His name is Anders Olsson. He wrote the book, a book that I've actually talked about before on the podcast called the Power of Our Breath. He also invented this device that you may have also heard me talk about called the relaxator, which I'll often go on walks with to train my inspiratory and expiratory muscles and to train me how to breathe in through my nose and slowly out through my mouth. But now he's really taken a deep dive into carbon dioxide therapy. If his name is familiar to you, you may have also come across him mentioned in the book Breath by James Nestor, a very popular book on breathwork. Anders was in that. Anders popped up around the Internet during the COVID pandemic with some interesting thoughts about how breath is related to antiviral activity.

Ben Greenfield [00:03:03]: We may have a chance to talk a little bit about that on today's show, but we've never actually done a podcast. So, Anders, welcome to the show, man.

Anders Olsson [00:03:12]: Thank you, Ben. Nice to be here.

Ben Greenfield [00:03:14]: Yeah, yeah. And for people not familiar with your background, by the way, you know, you don't talk like Wim Hof or have a big beer to play the guitar, so obviously you must come from a different background than him. But explain to me how you got in this whole realm of breath yourself.

Anders Olsson [00:03:32]: Yeah, that was back in the days. That was in 2009 when I read a book called How to Swap Asthma for Life. And it was based on the Buteyko method. And I didn't have problems with asthma, but it really changed my life because since I was little, I've had this racing mind, always on the go, always about achieving, performing. Doing better, faster, stronger. Maybe nothing wrong with that, but for me it was too much for too often and for too long. And I desperately was seeking for some tool, some ways to help me calm down and unlock my turbo. And when I started to apply the knowledge and the techniques in the book, it almost immediately helped me to calm down. And then I started to try it on friends and they got similar effect. Their different challenges, whatever that might be, they were able to overcome them or reduce them.

Anders Olsson [00:04:31]: So I was hooked. And basically then, I decided this is my thing. I'm going to be the world's leading expert on breathing, which was, I guess, a reflection of my mindset at the time.

Ben Greenfield [00:04:45]: It's interesting that you bring up Buteyko because I've mentioned that form or that style of breathwork before. Many people are used to doing these breathwork sessions that involve quite a bit of rigorous inhalation and exhalation, very long inhales, exhales. Wim Hof made that type of breathwork popular. You see it as a pranayama, as the Stanislav Grof LSD substitution based holotropic breathwork. A lot of heavy inhales and exhales. Buteyko breathing really is not about that, right?

Anders Olsson [00:05:22]: No, it's not. It's basically the opposite. It's about learning to tolerate higher levels of CO2 by slowing down your breathing.

Ben Greenfield [00:05:32]: So in terms of tolerating high levels of CO2, while slowing down your breathing, could you do a little compare and contrast for me, especially for people who might not fully understand breath physiology or respiratory physiology? How would you use those two examples? You know, something like an intensive breathwork session that many people do, to almost get high on your own supply, it's sometimes called, versus this method of breathwork that would involve CO2 tolerance.

Anders Olsson [00:06:01]: So when we inhale, we take in oxygen, right? And the oxygen is converted in our mitochondria, together with the nutrients we eat, to ATP, the energy currency of our body, and heat, water and carbon dioxide. And then we exhale the excess carbon dioxide. And when we slow down our breathing, we reduce the intake of oxygen and we increase the carbon dioxide in our body. So that is the Buteyko concept, the conscious breathing concept. While the Wim Hof concept, or the forceful breathing, they do the opposite. You do forceful breathing, meaning you blow off more CO2 than is produced in your body. So you lower the levels of CO2, which will then put your body in a state of stress. You challenge your body and you force your body to adapt. So that is the idea with those kind of exercises.

Anders Olsson [00:06:59]: One study showed that the participants, they were hyperventilating, and they measured the carbon dioxide levels and they measured the adrenaline. When they were hyperventilating, they lowered the CO2 in the blood by half, and the adrenaline increased by 360%. When CO2 goes down, adrenaline goes up. When they did the study a week later, this time, they were hyperventilating still, but they were inhaling extra carbon dioxide, which meant that they did not lower the CO2 levels in half. They stayed more or less the same. And what happened then was that the adrenaline stayed the same. So it's not the forceful breathing per se, that puts us into a state of stress. It's actually the decrease of carbon dioxide that is the biggest stress for our body, which will then increase the adrenaline.

Anders Olsson [00:07:55]: So when you say get high on your own supply, you will get an adrenaline rush from that forceful breathing.

Ben Greenfield [00:08:05]: Right. And the decrease in CO2, that's one of the reasons that someone might be able to have a very long inhale or exhale breath hold time. Because CO2, in very simplistic terms, can serve as a signal for your body to breathe. Right? Am I understanding that correctly?

Anders Olsson [00:08:28]: Yes. Well, actually, the the signal is not just a signal. It's actually carbon dioxide that is responsible for our breathing. It is not the lack of oxygen in our body that makes us take the next breath. It's the buildup of carbon dioxide when it reaches a certain level, it will trigger the medulla, the brain center in our brainstem, sorry, the breathing center in our brainstem to take the next breath, sending a signal to the diaphragm to move down. And we inhale and then on the following exhale, we will exhale the excess carbon dioxide. So yeah, carbon dioxide controls breathing. So when we lower the levels, which we do in forceful breathing, then we are able to hold our breath for longer because it takes longer time for the body to produce the CO2 to the point where it reaches the threshold set in our breathing center to initiate the next breath.

Ben Greenfield [00:09:29]: Perfect. Okay, thanks for explaining the physiology. So this might come in handy if one were say, training to free dive for a longer breath hold time or spearfish or something like that. If done responsibly and safely, the right type of breath for those activities to blow off some carbon dioxide and allow for a longer breath hold time because your body doesn't get the signal to breathe quite as soon. Another example of a benefit, I think, would be very similar to weightlifting, right? Highly stressful, big release of cortisol, big release of adrenaline, big release of glucose. All of the things that if you were to measure someone at rest, you would say, this person's in big trouble. Well, brief bouts of that type of stress from heat, from cold, from exercise, or from breathwork can then allow for better stress resilience later on. But the idea is not to be in that state of over breathing all the time or constantly, which even if they feel like they aren't exactly doing wim hof breathwork, many people do fall into that scenario.

Anders Olsson [00:10:36]: Yeah, that is one way to look at it. And if you go underwater and you blow off CO2 before you do that, always think of being really careful because if you start to mix with your breathing stimulant carbon dioxide, there is a risk if you're underwater that you run out of oxygen, but the body doesn't know it because the carbon dioxide has been mixed with. So you, if you're underwater, then you may die. So there is definitely a risk that needs to be addressed. So be careful if you do any type of breathwork before going into water. But the other aspect you mentioned, when you do, for example, heavy weightlifting or in general, just you want to use your muscles, the interesting thing is that when they do studies and expose muscles to carbon dioxide, they respond by growing bigger. The mitochondria increases in number and in size, and the blood flow formation, the blood vessels are formed to supply these muscles with more blood so this actually is similar to aerobic exercise. One study showed that when they exposed the muscles to CO2, they were two and a half times as big as in the control group.

Anders Olsson [00:12:02]: So if you think about it, we're talking about CO2 therapy. And one type of CO2 therapy that we don't necessarily realize is actually when we do Katsu blood flow restriction, when you restrict the blood flow to a working muscle, you will prevent the outflow of CO2. Right. So the CO2 will stay in the working muscle, you will produce a lot of CO2, and it has to stay there because you have restricted the blood flow. And there's response from the muscle is to grow stronger, get bigger. So I'm sure you're right in what you are saying, but there is another aspect which actually see that CO2 in itself may be beneficial across the line when it comes to athletic performance.

Ben Greenfield [00:12:51]: Yeah. So I guess what I'm hearing here is that it's not as though you're saying that breathing off CO2 in certain scenarios would be bad. And it has its time and place, but we should also be looking at CO2 tolerance as well. Like how we can actually maintain elevated levels of carbon dioxide and perhaps even more if we're doing these brief forays into low levels of carbon dioxide with something like, you know, intensive breathwork.

Anders Olsson [00:13:25]: Yeah. I think there is existence for both of them. I may just think that this is more efficient the way of going about with higher levels of CO2, but I know I'm probably quite biased here, so.

Ben Greenfield [00:13:40]: Right. And so from a very simplistic standpoint, you know, I think this might be good for illustrative purposes. You sent me this whistle-like object a long time ago. I think that was one of the first interactions we had. You know, you can hang it around your neck or put it in your wallet or your back pocket or whatever. It goes in your mouth and you take a breath in. There's the one called the relaxator. And then you breathe out, but it's against resistance and you can't breathe through your mouth.

Ben Greenfield [00:14:05]: So you're essentially retaining CO2. But can you explain to me a little bit more of a use case for that and the actual physiological benefits? It might be a good way to kind of illustrate an example of how we can engage in CO2 tolerance even if we have a, maybe a cheapo plastic straw at our disposal.

Anders Olsson [00:14:22]: Yeah. So the relaxator, you put it in your mouth and it gives you a resistance on the output and you set the resistance by adjusting the vent and what you do then is that you take longer exhales, so you slow down your breathing, you activate your diaphragm and that leads to a low diaphragmatic and slow and rhythmic breathing. And this type of breathing ensures a steady supply of oxygen to your heart, your brain, your muscles. And since oxygen is the main nutrient for our body, our brain can start to relax and start to trust me that I will be able to supply what it needs more than anything. So it starts to take us from a state of fight flight to a state of more safe and secure. We will be able to if concentrate and focus better. Our resources will not be spent so much in looking out for the dangers out there, but to be more grounded and present and able to actually do what we want to do.

Ben Greenfield [00:15:28]: Okay, so, but here's something I don't quite understand and maybe I'm thinking about this incorrectly. When you breathe CO2, isn't there a little bit of a stress response to your body? Like if I were to put just like a CO2 inhaler, like I held up on my face, doesn't the body have a little period of time where it almost feels hypoxic or something like that?

Anders Olsson [00:15:49]: Yes, like with most things, it's all about balance and dosage. So if you look at panic attack, for example, if you have a panic attack and come to the hospital, you will get a bag to breathe in and out through. The same if you're afraid of flying, the flight attendant will give you a bag. And the ones I've asked, I say it always works. And the reason why back breathing works is because you will rebreathe some of the carbon dioxide you just exhale. So typically we exhale 100 times more carbon dioxide than we inhale. So quickly when you do back breathing, you will restore the carbon dioxide levels in your body. And this tells us then that when you have a panic attack, severe, severe stress, you have low levels of CO2.

Anders Olsson [00:16:36]: But then on the other hand, there are studies showing also the complete opposite, that if you inhale, they have done studies where you inhale 35% carbon dioxide, which is like almost thousand times as much as in the atmosphere. So it's a huge increase in the carbon dioxide you inhale. Even there, it can lead to a panic attack. So low levels could lead to stress and panic. High levels of CO2 can lead to stress and panic, which I think goes in most cases. Water is good for us, but so too little is not good, but too much is not good either. It's about the balance about the dosage. So if we understand that, and then we can start to work slowly to increase our tolerance.

Ben Greenfield [00:17:24]: Yeah, I don't know if they put a bag on your face anymore on the airplane. I think they maybe they give you an antidepressant. I'm not sure. I haven't panicked on an airplane, but I don't know if they're using the old school paper bag trick. They're not handing out peanuts anymore either, folks. So the sweet spot, then, is that why, and we're jumping ahead a little bit here, and I want to get into this inhaler later on.

Ben Greenfield [00:17:45]: But just a quick question about it. Is that why you told me when you sent me this unit to try that around, like, 5%-ish CO2 was a good sweet spot. And also if I have the settings incorrectly, which I've done, because I had to go up to like, seven and a half, 8%, and almost immediately I felt a stress response that I didn't feel at 5%.

Anders Olsson [00:18:07]: The nose is in direct contact with. Actually, the nose is very, very important from, not only a breathing perspective, but also from the brain perspective. It's the first developed of our senses when we are newborn. The smell is our predominant sense, more so than our eyes. And the nose is in direct contact with our limbic system, where we have our emotions stored, including the amygdala, our fear center. And a very interesting thing, a study I just read a few weeks ago, is that in the brainstem, we have chemoreceptors checking the levels of CO2 and thereby determining when it's time to take the next breath. But these chemoreceptors, they are also located in the amygdala.

Anders Olsson [00:18:57]: So just as the brainstem checks our breathing, so does the amygdala. So there is a very tight relationship between our breathing and our emotions. And studies confirm that there are different types of breathing when you are afraid, when you are angry, when you are sad. And in one study, they did, and they checked these type of deep breathing patterns for different emotions. And then they took another group and asked them to breathe in a specific way. And what happened was that they were then getting more into that specific emotional state that the breathing habit, that specific way of breathing mimicked. So when we expose the amygdala to higher levels of carbon dioxide, it could lead to a panic attack or to a stress response if the dosage is too high.

Ben Greenfield [00:19:53]: And is there any type of taphophylactic response or some type of resilience that increases such that as you breathe CO2 or use something like a relaxator, you're able to tolerate higher and higher levels of CO2 and. Or breathe a higher percentage of CO2 without becoming as stressed.

Anders Olsson [00:20:16]: Yes.

Ben Greenfield [00:20:17]: So you can train this?

Anders Olsson [00:20:18]: Absolutely. Yeah. Yes. So if a person has 30 breaths a minute, that person has very low tolerance for CO2. Right.

Ben Greenfield [00:20:27]: Right. That's a lot. 30 breaths. Anybody who uses a wearable knows that, you know, it's pretty good if you're hitting, like, what, around, like, the 10 to 15 range, but 30 is really high.

Anders Olsson [00:20:36]: It is, yeah. I agree. So let's say 25 or 20. Whenever I have the habit of counting the number of breaths on people, and I've done it so many times, and every time I come across someone 22, 24, 25, I get so surprised, because you don't really see that when you just look at them first glance, but when you start to count, and that is really a lot. But never mind. If you're taking so much breath, you have a lot lower tolerance for carbon dioxide compared to if you're taking 10 breaths per minute, right. There you have higher tolerance. So if you have low tolerance, that will translate to faster breathing, which is the hallmark of stress. And one way to measure that is the Buteyko test, the control pose, which is also called the Bolt score, developed by Patrick McKeown.

Ben Greenfield [00:21:30]: Yeah. Remind me how the CP, the control pause, or the bolt score goes. It's a great test, by the way.

Anders Olsson [00:21:35]: It's a great test, yes. So basically, you just sit normally, or you can stand normally. And a slow breath in through the nose and a slow breath out. A couple of seconds in, couple of seconds out, just a normal breath. After the out breath, you pinch your nose. If you're sitting down, you're counting the seconds. If you're standing up, you start walking and counting the steps and the number of seconds or the number of steps. That's the control pause or the Bolt score.

Anders Olsson [00:22:07]: And the fewer you can take, the lower tolerance for carbon dioxide you have.

Ben Greenfield [00:22:12]: Yeah. But good Bolt score. Sedentary. In terms of seconds, what do you think? Like, 40 plus seconds?

Anders Olsson [00:22:18]: Yeah, I would say so. And in terms of steps, probably 80 steps.

Ben Greenfield [00:22:24]: Yeah. Yeah. Okay. Okay. So the other interesting thing, by the way, this is a little bit of a rabbit hole that I learned when I was reading Patrick McCown's book about the CP and the bolt score and Buteyko breathing is what you've just described. A variant of that is actually great. And I've used this, and it works fantastically for relieving nasal congestion. Do you know that trick?

Anders Olsson [00:22:52]: To just nod your head like this, or?

Ben Greenfield [00:22:54]: No, you take a, I believe it is, just got to make sure I get this correctly so I explain it to people the right way. You breathe in through your nose, and then relaxed exhale. Plug your nose with your fingers, hold that exhale as long as possible, but you can't hold it anymore. Take a nice long inhale through the nose, and then take kind of three or four relaxed breaths and do that about three or four times, and it relieves nasal congestion. Do you think that's because of the nitric oxide?

Anders Olsson [00:23:25]: I think it's both because of the nitric oxide and carbon dioxide. They work hand in hand. They work in tandem. So one study showed that when the carbon dioxide levels are low, nitric oxide levels are low. So if you are not addressing the carbon dioxide levels, the function of nitric oxide would not be that as it's supposed to be. So they really go hand in hand. So I think it's a combination. So nitric oxide is produced in our nose.

Anders Olsson [00:23:59]: Right. And when we use our nose, the air we inhale will be spiked with nitric oxide. And that's really important gas because it's antiviral, antibacterial, antifungal. And it's surprising that during the pandemic, I didn't hear anyone talk about nasal breathing. And already in 2005, there was a study showing that nitric oxide, which is produced in our nose in large quantities and which then kills virus and bacteria that we inhale by inhibiting the replication cycle. In this study, in 2005, they showed, when you see the pictures in the study, untreated nitric oxide. Sorry, untreated SARS Coronavirus can divide like crazy, but when it's exposed to nitric oxide, there is almost none left. And the Coronavirus was first discovered in 2002 in China, and it was an outbreak there.

Anders Olsson [00:25:05]: And then 10 years later, there was a new outbreak in the Middle East. And then the third outbreak was started in 2019, again in China, the third strain. So it's surprised that it didn't get more attention. Nasal breathing in nitric oxide as a way to help us.

Ben Greenfield [00:25:26]: Paradoxically, it's a real bitch to try to breathe through your nose when you're wearing an N95 face mask or any face mask, because that metal clip makes you breathe through your mouth.

Anders Olsson [00:25:37]: Yeah, that's the thing that's so interesting, and I think it tells us more than anything about the lack of knowledge when it comes to breathing in the medical community. Because typically, a face mask, that's like doing a light paper brag breathing, because some of the carbon dioxide produced in your body will get trapped in the mask, especially N95. And you can have 10 to 15 times as much CO2 that you inhale compared to. Yeah, compared to normal breathing. So no wonder at some point, you need to open your mouth. So, again, when we're talking about CO2 and we're talking about is it good or is it bad? It's about the dosage.

Ben Greenfield [00:26:25]: Right, Right. And so back to this idea of too much or too little CO2. You know, I know I'm asking all these geeky physiology questions, but this is actually really applicable. And eventually we'll bring it full circle through some practical applications here as well. But this whole idea of the. They call it the Bohr curve, B-o-h-r. The idea that the level of carbon dioxide in your bloodstream influences the level of oxygen that's available to tissues. I briefly hinted at that when I said that if you blow off a bunch of carbon dioxide, there's less of a signal for your body to breathe.

Ben Greenfield [00:26:58]: But can you explain exactly how that works, the link between carbon dioxide and oxygen delivery to tissue?

Anders Olsson [00:27:04]: Yeah. So if we take the full circle from the oxygen in the atmosphere to the oxygen region reaching the mitochondria, it turns out that carbon dioxide is crucial in every single step. I look at five steps, and the first is to initiate the breathing. So carbon dioxide makes us take in oxygen in our body, right. And then carbon dioxide, with the help of nitric oxide, they work hand in hand, ensures that the airways are open so that the air can travel down into our airways and lungs, because it has a relaxing and widening effect on the smooth muscles surrounding the airways. And these smooth muscles, they also surround the blood vessels. So when the oxygen is transferred from the lungs over to the blood, again, carbon dioxide and nitric oxide ensures that the blood vessels stay open.

Anders Olsson [00:28:05]: And then finally, when oxygen reaches a place where it is needed, you have to offload it from the oxygen from the hemoglobin in the blood. Right. And there, carbon dioxide is again very important, because when carbon dioxide increases, ph goes down, and when ph goes down, that's the signal to the hemoglobin to change shape and release the oxygen so that the oxygen can enter into the mitochondria and we can produce energy efficiently. But there is also the fifth step, and that is in the mitochondria, because we know that oxygen is a lifesaver but it's also a curse and a blessing in a way that oxygen is very, very reactive. Too much oxygen is toxic for us. That's why one of the reasons why we store so little in our bodies. So in this reaction in the mitochondria, they are called the powerhouses of our cell. They produce almost all our energy.

Anders Olsson [00:29:08]: They're also called the furnaces. And if we have a fire and we put oxygen on that fire, it will almost explode because oxygen is so reactive. So in the mitochondria, we have to make sure that this reaction doesn't go out of hand. And that is where carbon dioxide comes in. So they are like yin and yang, oxygen and carbon dioxide, they need each other. And the reaction in the mitochondria could be likened to a nuclear power plant, where the oxygen would be the nuclear reaction and the carbon dioxide would be the control rods surrounding the nuclear reaction. So that tells us that oxygen the thing we need, but carbon dioxide is crucial for efficient oxygenation.

Ben Greenfield [00:29:58]: Okay, got it. So let me see if I understand this correctly. I'll repeat back to you, and you correct me if I get an F in physiology here. So if the pH is dropping, that means I'm becoming more alkalinic.

Anders Olsson [00:30:11]: No, acidic.

Ben Greenfield [00:30:12]: I'm sorry, Acidic. I already flunked. The pH is dropping, I'm becoming more acidic. And the pH is dropping when CO2 levels are becoming low.

Anders Olsson [00:30:24]: High. High. When CO2 goes up, pH goes down. Yep.

Ben Greenfield [00:30:29]: Okay, so CO2 goes up, ph goes down, and when PH goes down, I've got more oxygen that's being delivered via the hemoglobin into the mitochondria.

Anders Olsson [00:30:41]: Yes. The hemoglobin releases the oxygen.

Ben Greenfield [00:30:43]: Yes.

Anders Olsson [00:30:43]: When pH goes down.

Ben Greenfield [00:30:45]: Right. So high CO2 drop in pH equals acidity. That will then drive more oxygen into tissues. And the problem is that if I drive too much oxygen to tissues, I run the risk of creating excess reactive oxygen species, thus dictating that I need to re-elevate CO2 in order to buffer against that.

Anders Olsson [00:31:08]: Yes, exactly. And the free radicals, the reactive oxygen species, they give rise to inflammations. So when we talk about. We talked earlier about the relaxator and how it reduces the outflow of carbon dioxide because we slow down our breathing. That's one part of the story. The other part is that we reduce the intake of oxygen, which is rarely not talked about.

Ben Greenfield [00:31:37]: So you're simultaneously limiting oxygen availability while raising CO2 levels. But because CO2 levels are going up, even though there's limited oxygen to go around, more of it is getting in the tissues because of that ph drop brought on by the increase in CO2.

Anders Olsson [00:31:56]: Yes. You will become like an efficient car with high gas mileage. So you will be able to perform more in one breath. One molecule of oxygen will get more work done compared to when you are breathing faster, taking in more oxygen, and blowing off more CO2. So you will run your body more efficiently.

Ben Greenfield [00:32:18]: And so if I wanted to simulate this while I were, say, exercising or walking and I didn't have some kind of fancy device, one method I could use would be, for example, to take an inhalation that isn't super deep, that's preferably through the nose, and then to exhale for a longer period of time than I inhale, and to preferably exhale through something like, say, pursed lips.

Anders Olsson [00:32:43]: Pursed lips. Or through the nose as well. You can also just squeeze a little in your throat and.

Ben Greenfield [00:32:48]: Yeah, okay. Okay, got it. You got a pretty good throat control to do that, but, yeah, that makes sense. So let's say I'm doing, I don't know, let's use a really simple example, a pushup. As I drop to the ground, I could take a breath in, but not a super deep one. And then as I push up, I could exhale slowly.

Ben Greenfield [00:33:07]: And so what I'm doing is I'm limiting, flooding my body with oxygen, simultaneously increasing CO2, allowing for better delivery of the oxygen into the muscle, while also giving myself more CO2 to be able to buffer some of the potential negative side effects of that excess oxygen.

Anders Olsson [00:33:25]: Yes.

Ben Greenfield [00:33:26]: Interesting. Okay, so this. This might be the last really deep physiology question I ask you or might get physiological. We'll see. But don't a lot of people say, like, if you were to look it up on the Internet or whatever, that high levels of carbon dioxide are considered to put you into a state of metabolic alkalosis, not acidosis?

Anders Olsson [00:33:51]: Well, I mean, I think it depends on who you ask to start with. But of course, when we do see a therapy, we should be careful. We should listen to our body. So if we use the relaxator, slowing down our breathing, and I'm driving in the car and I'm really pushing it, so I'm slowing down my breathing a lot. I may experience tiredness, for example, because I haven't slept well during the night. And it seems like when you're using this, your body gets more into a state of where it's supposed to be instead of using our mind to run over our body. So when we slow down the activity in our mind and become more clear that could lead to us being tired. So then we should not do it while driving, right?

Anders Olsson [00:34:36]: Or if you are inhaling extra CO2, you should pay attention to how your body reacts, how you respond, and start low and slow and carefully and then build up slowly. But just one example of where at least we can realize that carbon dioxide could not be entirely super dangerous for us is when you do a keyhole surgery in your stomach. And when the surgeon do that, they need to inflate the stomach in order to give room for the surgical knives and to see the organs. So they inflate the stomach. And the gas used is carbon dioxide. And there are huge amounts of carbon dioxide put into your body then. And it's used because it is known that all systems in our body know very well how to get rid of excess carbon dioxide.

Ben Greenfield [00:35:40]: Yeah, you know, renal filtration, et cetera. Yeah. So you would consider carbon dioxide retention or high amounts of carbon dioxide using something like control of breath or carbon dioxide inhaler, to be inducing a state of metabolic acidosis, not alkalosis.

Anders Olsson [00:35:58]: So when we increase CO2, we lower pH, high carbon dioxide, low pH. So that is acidosis. But the thing is, for example, we have this suit you put on. We call it the.

Ben Greenfield [00:36:21]: The Willy Wonka Blueberry suit. Is this the one that does transdermal carbon dioxide delivery if you put on the suit?

Anders Olsson [00:36:27]: Yes.

Ben Greenfield [00:36:28]: Absoluteness. Yeah. Explain this to people.

Anders Olsson [00:36:30]: Yeah. You absorb carbon dioxide through the skin. You put on this suit, it looks like a diving suit, and you fill it up with 100% carbon dioxide. So you look like a Michelin man.

Ben Greenfield [00:36:43]: Or the Blueberry kid from Willy Wonka.

Anders Olsson [00:36:45]: Okay. Yeah. And you will then absorb the carbon dioxide through the skin. And what you would think then is that you will start to breathe faster when you absorb all the CO2, right? To blow off some of the extra CO2 just absorbed. But actually, what happens is that most people start to breathe less. They feel like they're not breathing at all.

Anders Olsson [00:37:11]: Some say they feel, oh, I'm taking two breaths per minute. And the reason for that is probably that we do not have one pH of this amount in our entire body. We will have areas in our body where there are blockages where there may be lower levels of CO2, where there may be an alkaline state. So that means that those areas in our body that needs the extra CO2, there will probably be more CO2 absorbed. And instead of exhaling it, we will let it stay there and be of use so that we can come to a more balanced state of oxygen and carbon dioxide in our body.

Ben Greenfield [00:37:56]: Okay, interesting. So from a practical standpoint, let's say I'm doing breathwork or I have one of these apps that I talk about all the time, like Othership or Breath Source, or you're doing Wim Hof breathwork or whatever. You finish that up. And if you finish it up and just walk away, you're walking away having blown off a bunch of CO2 and potentially even limited the amount of tissue availability of oxygen. Despite having breathed in on oxygen, your CO2 is so low, you're not getting a lot of in the tissue. So you could make a case for finishing a breathwork session with breathing very similarly to how we just described maybe sitting there and doing like two minutes of 4-8 breathing, right? Four count in through the nose, eight count out through the nose, and doing so in a relaxed state, focusing on blowing. Well, I guess. Would you be blowing off CO2 if you're doing like a 4-8 type of breathwork, or would you rather do the opposite and like breathe in for an eight count and out for a four count? How do you look at that?

Anders Olsson [00:38:58]: Well, it really depends on what you want to achieve. So if you look at the breathing, the inhale, that's tied to activation, the pulse goes up, the muscles are active, the diaphragm moves down the ribcage, open up and you move more into a state of sympathetic while the exhale. If I'm exaggerating, that is tied to relaxation, all the stress is over, the danger is over, and we sigh in relief. When you look at the pulse, it goes down on the exhale, the muscle, they just go back to their resting position. There is no, in a normal exhale at rest, there is no real active muscle movement. So inhale is activation, exhale is relaxation. So what we notice is that most people need tools and ways to help them find that relaxing state. And then it's very easy to just prolong the exhale. And I have a really interesting story I heard the other day from a guy. He's a paramedic nurse, and he read my book a couple of months ago and he started to apply the techniques on himself.

Anders Olsson [00:40:14]: He ordered a CarboHaler, he used a relaxator, he taped his mouth shut at night. And he got so much benefit. So he decided to introduce it to his patients in the ambulance. And when he, I talked to him, he said, during the last eight weeks, I've had 150 patients in my ambulance with a heart attack or a suspected heart attack. And normally what happens, he says, when they come to my ambulance, they are in severe stress, of course. And then they get happy when they come into the ambulance, but then they get disappointed again because they realize I'm just not a guy there to take them to the hospital. I'm not even a doctor. And they want to get to the hospital as soon as possible.

Anders Olsson [00:41:00]: And we put on the lights and sirens, and there is a very loud noise inside the ambulance because of that. So they get even more stressed out. So he said, not only in my ambulance, but all my colleagues, we noticed, because we measure all these vital signs, the temperature, the blood pressure, et cetera, we noticed that they are in worse condition when we leave them at the hospital compared to when they come into the ambulance, which is not good, of course. But he said, here is where it becomes interesting. I help them to reduce their stress by just prolonging their exhale. Some of them, they could close their mouth and prolong the exhale through the nose. Some of them had to have their mouth open. And some of them, I had to sit there with them and breathe with them and just help them to prolong the exhale.

Anders Olsson [00:41:55]: And he said, I documented every single case and not one failure. All 150 of them, when they came to the hospital, they were in a better condition than when they got into my ambulance. Such a simple thing in such a severe state of stress. So that tells us if we want to reach relaxation, prolonging the exhale is the best thing.

Ben Greenfield [00:42:20]: So prolonging the exhale is not only going to affect the vagal nerve, innervation of the sympathetic and parasympathetic branches of the nervous system and affect the pacemaker cells of the heart in such a manner that the heart will slow down if you're exhaling slowly or say, exhaling for a longer period of time than you inhale. But, and I think you kind of answered my question. Also, there's a difference with the long exhale that's kind of like inhale 1, 2, 3, 4, and then blowing it all out versus inhale, 2, 3, 4, and exhale slowly in a limited fashion. The former would blow off CO2, the latter would retain CO2. So it kind of depends on how you're approaching that inhalation and exhalation, right?

Anders Olsson [00:43:10]: Yes. It's not only about the breathing frequency, it's also about the breathing volume. So if I slow down my breathing, but at the same time triple my breathing volume, so each breath is three times bigger. Then, of course, the amount of CO2 that we exhale will still be more. So we need to factor that in as well. Right, right.

Ben Greenfield [00:43:33]: Which is kind of like the whole concept behind Buteyko breathing. Right. It's really super smooth, slow, controlled breathing. Not. Not like the deep breaths that many of us sometimes tend to do in breathwork sessions, then carry with us through the rest of the day where we're checking emails and stuff. Breathe deep. Breathe deep. Oxygenate the body.

Ben Greenfield [00:43:51]: And Buteyko is much more the opposite. Breathe in a controlled fashion so that your CO2 levels are high enough to where you don't have to take a bunch of big breaths of oxygen, because oxygen is more readily dissociating from hemoglobin in the cells to be used by the mitochondria.

Anders Olsson [00:44:07]: Yes. So one way of looking at it is that forceful breathing is to push the oxygen into the body, while slow breathing, relaxed breathing, More from the CO2 therapy perspective, is to invite the oxidant into your body and make sure to pave the way for the oxygen.

Ben Greenfield [00:44:26]: Yeah, yeah. Okay. All right, so let's talk about this. This idea of actually inhaling straight up cot. Okay, so now we're going to bring like a device into the mix here. You sent me this device. I started off just hooking up to a SodaStream, but I emptied the SodaStream in like a week. So now I actually have a CO2 canister, like one of those big oxygen tanks, but CO2 on the floor of my office, there's a tube coming out of it.

Ben Greenfield [00:44:50]: It goes into this little controller called the CarboHaler that you sent me, and then it goes into a mask. And I've been breathing about 5, maximum 6% CO2 for around 4 to 6 minutes per day. And the main thing I notice is a decrease in stress and an increase in HRV. Those are the main two things that I've noticed. I know you've got a lot of other things you've looked into with this device, but explain to me how this thing came to be and how it works exactly.

Anders Olsson [00:45:20]: So I think my real epiphany when it comes to CO2 therapy was very soon after I started with when I discovered the power of slow breathing. So I had already started when exercising to do nasal breathing and had started to become accustomed to it. Then I decided to take it to the next level. So I went out for a run for about one hour and I decided to reduce my breathing as much as possible. So I took two or three steps on the inhale and six, seven, eight steps on the exhale. And it was, for me at the time, it was a real challenge. So almost every step, every breath, I felt like.

Ben Greenfield [00:46:03]: Way back in my triathlon days. I read Budd Coates' book. C-o-a-t-e-s. I'll put in the show notes, which are at bengreenfieldlife.com/co2podcast. Bengreenfieldlife.com/co2podcast. Budd Coates wrote this book called Running on Air. And the whole thing is about rhythmic breathing while running in a way that you just described.

Anders Olsson [00:46:26]: Yeah. So for me, the whole hour was really tough. But then I came home and the reward came. I sat down at a kitchen table and I felt super relaxed. Three hours later, I was still sitting there, just like in a complete state of bliss. It was okay, where are the angels kind of experience. I'd never experienced anything like it before.

Ben Greenfield [00:46:51]: You didn't take psilocybin before you ran, did you?

Anders Olsson [00:46:53]: No, just water.

Ben Greenfield [00:46:56]: Okay.

Anders Olsson [00:46:57]: But I've done it a number of times ever since. And you don't need to go for a run. You can go for a walk or Nordic walking, if you know that when you have sticks. It's just to prolong your exhale more, you can get the same effect and it's really, really relaxing. So that's the power of carbon dioxide.

Ben Greenfield [00:47:16]: Yeah. And again, by the way, I'm walking on a treadmill while I'm talking with you. So it would literally be like as I'm walking, here's my cadence. Into out, two, three, four. Into out, two, three million four. Like that. Obviously I'm talking, so I'm not doing it through my nose. But this would be through the nose, for example.

Anders Olsson [00:47:36]: Yeah, but the rhythm in itself is very powerful. That is something, I think we have a tendency to forget how powerful the rhythm is for our well being. So it's not only about the nose and the carbon dioxide. The rhythm is also crucial. So anyway, you asked how did this CarboHaler device came to be? So I don't know exactly to describe it, but I republished a few books on Amazon. One was published in 1794 called Two Cases of Ulcerated Breast Cancer Treated with Carbon Dioxide. And the other one is Carbon Dioxide in Medicine, written by Dr. Achilles Rose, that was published in 1905.

Anders Olsson [00:48:31]: And they played with all kinds of ways to deliver oxygen to the body, rectally, vaginally, through the skin. And they noticed really profound effects.

Ben Greenfield [00:48:46]: Wait, you said to deliver oxygen to the body? You mean carbon dioxide?

Anders Olsson [00:48:49]: Oh, sorry, carbon dioxide. Yeah.

Ben Greenfield [00:48:50]: Okay.

Anders Olsson [00:48:51]: Yes, yeah. Thank you. So then we had a colleague in Sri Lanka, whose brother was. He was electrocuted and he was in a coma and he was in a hospital for three months and then he was moved to his home. And typically they had to clear his throat 35, 40 times per day because a lot of mucus was forming. So our engineer in Sri Lanka, he developed a device so that he could add a little extra carbon dioxide to the air he inhaled. And we noticed that after a month his sleep decreased From I think 18 hours per day to 10 to 12. And his the needing to clear his throat or mucus decreased from 35 to 42, like five times.

Anders Olsson [00:49:54]: And the reason why they could notice when it was time to clear the throat was because he had his oxygen saturation meter. And when it went down to below 94%, then they knew it was time to clear his throat. So that meant that the oxygen saturation was stable when a little extra carbon dioxide was added. So that was the start. And that was a few years ago.

Ben Greenfield [00:50:21]: Okay, so you came across these anecdotal case studies and that's what got you thinking about how you could potentially design something that would allow for at-home inhalation of carbon dioxide with some type of a way to adjust the percentage that you're breathing.

Anders Olsson [00:50:37]: Yeah, and I mean, I mean it wasn't. There were studies already in the 1950s where they inhale extra CO2 and they played with quite high doses of CO2 and they wanted to see if it could help people, there was a stress or if it could alter their state of consciousness. You mentioned LSD earlier. I think maybe CO2 inhalation was something that was used before LSD became popular.

Ben Greenfield [00:51:13]: So if you're saying if I really pump up this CarboHaler sitting next to my desk, I should be careful or ready to see a lot of fractal imagery on the screen.

Anders Olsson [00:51:22]: No, I don't think so. I mean, we tried a lot, we haven't seen any. What can happen is that you can develop some headache, that you can become a little dizzy, or if you have a really compromised health. Like we had one guy, he was a severe alcoholic and he only did three sessions. He did, I think three minutes at 3% and every time he felt lousy. So then get that device out of here. I don't want to see it anymore. I think since he had really poor health because he was really severely alcoholic, he should have started at the lower dosage.

Anders Olsson [00:52:04]: And another woman with long Covid, she started at 4% and she said that was way too much for me. After a few weeks break, I went down to 2% for 30 seconds, and that was the perfect start. And then I gradually increased, and now after a few weeks, I just feel so much better. My lungs has opened up.

Ben Greenfield [00:52:27]: Yeah. So basically we're talking about impacts, and this is all anecdotal. Unless there's been big research studies on this. Am I correct?

Anders Olsson [00:52:35]: Oh, yeah, absolutely. And I should say also when we talk about the his.

Ben Greenfield [00:52:38]: Has been studies done on this?

Anders Olsson [00:52:41]: There has been studies, yes. So just let me. You ask why I came across this. There was a guy in the 1930s in US Yandel Henderson, professor at Yale at that time. He created a device which most fire trucks had installed. Because when you are exposed to a fire, you inhale more carbon monoxide, which displaces oxygen in the hemoglobin, and you may die of lack of oxygen.

Ben Greenfield [00:53:14]: Right. But it doesn't displace it like carbon dioxide. By putting it in the muscle tissue, it keeps the oxygen from attaching the hemoglobin in the first place.

Anders Olsson [00:53:23]: Yes, in the first place.

Ben Greenfield [00:53:24]: It binds to hemoglobin like oxygen would.

Anders Olsson [00:53:26]: Yeah, but much faster. So that's why we die because of lack of oxygen. So what they found was that when you inhale extra CO2, he started with doing studies on pneumonia and saw how it helped people with pneumonia, and then he saw how it helped people with poisoning from carbon monoxide. Because basically, you recruit the lungs. When you inhale extra CO2, you start to breathe a little faster. And since all blood passed through the lungs, you basically recruit the lungs to clean the blood. And they also found then that you will sober up faster if you drink too much alcohol.

Ben Greenfield [00:54:09]: Yeah. Change your whole website, dude, and just market this as a hangover device then.

Anders Olsson [00:54:14]: Well, there was a study done just a few years ago where they inhaled extra carbon dioxide and they noticed that you sobered up three times faster.

Ben Greenfield [00:54:23]: No way. It's useless knowledge for me because I don't get drunk. But it's very interesting to know that. Interesting.

Anders Olsson [00:54:31]: Yeah. Because the liver has only. It can only clean the blood at a certain amount of alcohol. Right. Per minute and per hour. But if you recruit the lungs, if you start to breathe faster, you will exhale more. Because that's the reason why the police can measure the alcohol in your outbreath, because you're exhaling it. So if you speed up your breathing, you will exhale more alcohol, the lungs will clean the blood and you will exhale it. But if you do that with normal hyperventilation, it's not very good.

Anders Olsson [00:55:04]: You may end up having other issues because you lower the levels of CO2. But if you do it with CO2, that's a form of controlled hyperventilation to clean the blood.

Ben Greenfield [00:55:16]: Yeah. Okay, so from a mechanistic standpoint, explain how this CarboHaler works. Explain to me like I'm a sixth grader.

Anders Olsson [00:55:23]: You mentioned earlier you started off with a smaller cylinder. So this is a typical SodaStream cylinder.

Ben Greenfield [00:55:29]: He'S got on the video for those of you watching the video version.

Anders Olsson [00:55:31]: Okay, so a SodaStream, that's a 425 gram cylinder, you can hold it easily in your hand, you screw on a regulator to it and then you connect the regulator to the device so that you can get the CO2 from the CO2 source into the device. And then you start the device and you set it from 1 to 8% and you set the time from 1 to 20 minutes. And then you put the mask, you start the session and you put the mask on. And you can sit down or you can lay down or you can even wear it as when you are walking the treadmill now.

Ben Greenfield [00:56:15]: How long would be kind of like in your opinion, having seen these anecdotes, all the research you've gone through in terms of treatment time, length and also volume, what do you think would be best? Because like I mentioned, I've been just doing about five minutes a day or so average.

Anders Olsson [00:56:31]: Yeah. So we had one guy, he did it for like one week. I think he didn't notice anything. He did four minutes at 4%. So he decided to go really take it to the next level. Seven and a half percent for seven minutes three times per day. And this guy, he's a long distance cyclist. Typically he cycle 100km in one go.

Anders Olsson [00:56:56]: And what he noticed after just two days was that it was completely a game changer for him. He didn't get tired when he was out biking. He said on his ergometer on the bike, his VAT load increased when he did a one hour cycling at the heart rate of 160. Normally he's VAT rate was 280. When he did a CarboHaler before cycling the same one hour, 160 heartbeat. His VAT was 308 and increased by 10%.

Ben Greenfield [00:57:33]: Right. Probably because he had more tissue saturation of oxygen.

Anders Olsson [00:57:37]: Yeah.

Ben Greenfield [00:57:38]: And more nitric oxide. Right?

Anders Olsson [00:57:40]: Yeah. Yes. And what he noticed was also that normally there is a 30 to 45 minute struggle between his mind and his legs. Oh, I just want to hop off my bike and quit this. Why am I doing this? Until he gets into the zone. But he said when he does the carbohydrate, it's like he's almost immediately in the zone. So your question was, what dosage should I use? I think it's very individual. As I mentioned earlier, that person who was a severe alcoholic, three minutes at 3% was too much for him.

Anders Olsson [00:58:17]: The woman with long Covid, four minutes at 4% was too much for her. So she went down to 2% at 30 seconds and slowly started to build up. So I think more than anything, we should try and listen to our body and let it tell us how to do it. But don't be discouraged if you don't notice anything. Probably you haven't found the right dosage then.

Ben Greenfield [00:58:45]: Yeah. I realize this is kind of a potentially dangerous question. Obviously, you know, proceed at your own risk and be responsible. But I'm thinking about moving it from my desk, Anders. To out by my ice bath in the garage. Because I'm now doing a cold plunge every morning. I'm trying to work my way up to four minutes at about 35 degrees.

Ben Greenfield [00:59:06]: I was thinking, based on the mechanism of the nitric oxide release and the near acute increase in stress, resilience and relaxation, I can potentially just breathe CO2 for four minutes while I'm doing an ice bath. I mean, obviously you want to be careful and not do something new that you're going to pass out in the water, you know, and get used to this thing. But am I. Am I on the right track there? You think it would be beneficial?

Anders Olsson [00:59:29]: I would love for you to try and tell me how it goes.

Ben Greenfield [00:59:32]: Yeah, I actually will because I got a pretty good idea of how hard it feels without the CO2. So I may try it with the CO2 and report back.

Anders Olsson [00:59:38]: Yeah. Because if we don't try things, how would we know? Right. I'm just as curious. But of course, not everyone is like that. And we should always be careful and don't push ourselves too hard. But it's definitely an interesting thing. I did the other day, actually, this cardi bath where I immersed my whole body in CO2. And at the same time, I was breathing for 20 minutes, but not maybe at 3% or so not very, very high, but still.

Ben Greenfield [01:00:11]: You mean you. You wore, like, one of the suits that does transdermal delivery and simultaneously breathe CO2? I did. I did that once. But they kept telling me, you don't want too much. You don't want too much. So I think they have the CO2 at like 3%, and I didn't feel a thing. But when I run this CarboHaler, anywhere from 5 to 6%, I noticed almost right away.

Anders Olsson [01:00:30]: But you were asking earlier about studies. So, for example, one study showed that when you inhaled 5% CO2, the delivery of blood to the brain increased by 54% because of the relaxing effects CO2 has on the smooth muscles. So the blood vessels open so you can deliver more blood to your brain. Also interesting in that study was that they saw that the oxygen consumption in the brain decreased by 13%. And at first glance, we may think that that is not good, is it? We want the brain to consume a lot of oxygen. But if we look at today's society and we see how many stressed people there are. One way of interpreting this study is that when you increase the levels of CO2 by inhaling extra, it may induce a state of calmness like when I experienced when I did this one hour run.

Ben Greenfield [01:01:33]: Right, so you're calming neural activity to a certain extent. Unless there's lower oxygen requirements for the brain.

Anders Olsson [01:01:39]: Yeah. And another study along those line was when the had epileptic seizures, and when they inhaled extra CO2, almost immediately, the seizures diminished and stopped.

Ben Greenfield [01:01:53]: Wow, it's fascinating. You sent me some papers and PDFs. Do you mind if I include those in the show notes?

Anders Olsson [01:01:59]: No, no, no, please do.

Ben Greenfield [01:02:01]: Okay, good. I'm going to include those in the show notes and then. And by the way, those are going to be all over at bengreenfieldife.com/co2podcast. Like C. It's an O, folks, not a 0, 2 podcast. Bengreenfieldlife.com/co2podcast and then the CarboHaler. People can buy this now, right?

Anders Olsson [01:02:22]: Yeah, they can. Yeah.

Ben Greenfield [01:02:23]: Okay. All right, well, I'll include a link for people to get. I mean, it's. You get the unit and everything. You still got to go out and hunt down the Soda stream or the CO2. That wasn't hard to find here. It was just at the local medical supply store. And then the SodaStream, you get those at.

Ben Greenfield [01:02:35]: You can get those at like, Target or Walmart or whatever. Yeah. Food grade CO2, right?

Anders Olsson [01:02:40]: Yeah. Food grade or beverage grade?

Ben Greenfield [01:02:41]: Yeah, right. Which if you just Google Namier City plus, Food-Grade CO2 medical Supply stores sell those. Or Target, Walmart, etc. They sell the SodaStream cylinders or canisters that you can use. Well, Anders, this has been fascinating. I've been wanting to pick your brain about this thing ever since I started to look into all the studies and PDFs you've been sending me and ever since I started to use it myself. So thanks for filling me and everybody else in on this. And by the way, if you go to Anders' website and you get a CarboHaler, the cost is pretty incidental on this, but try one of those relaxator things too, to go out on a walk with.

Ben Greenfield [01:03:20]: I still keep one in my family pack for years. And, you know, sometimes if I don't want to work out or, you know, I finish up a phone call, I got 20 minutes to walk home, I still just stick that thing in my mouth. It's incredible. It just basically does exactly what you guys just heard, you know, physiologically, but just while you're out in the walk. So that's a cool device too. Anders, thank you so much, man.

Anders Olsson [01:03:42]: Thank you, Ben. Pleasure to be on your show.

Ben Greenfield [01:03:45]: Yes, sir. Thank you. All right, folks, check out bengreenfieldlife.com/co2podcast for the show notes. Until next time, I'm Ben Greenfield along with Anders Olsson, the author of the Power of Your Breath, the designer of the CarboHaler and the relaxator. Check them out. Signing out from bengreenfieldlife.com. Have an incredible week.

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