February 28, 2019
[0:00:57] Podcast Sponsors
[0:04:29] About This Podcast
[0:05:04] Guest Introduction
[0:08:52] Dr. Dawson “Minimal Talent” in Sports
[0:13:04] Wild Health Beginnings
[0:17:46] Precision Medicine
[0:20:00] Machine Learning Algorithms and Artificial Intelligence Used in Precision Medicine
[0:24:13] Strategies Drs. Mallin and Dawson Recommend in Terms of Athletic Performance Optimization
[0:29:27] Matt's Daily Exercise Regimen
[0:30:42] Events and Podcast Sponsors
[00:35:14] cont. Matt's Daily Exercise Regimen
[0:36:53] Approach on Cognitive Performance, As Well As Dementia and Alzheimer’s
[0:43:26] Approach Longevity and Anti-Aging
[0:50:12] Personal Nutrition Regimen
[0:59:10] Cardiovascular Health
[1:05:18] Identifying the Perfect Diet for People
[1:09:12] About the Kentucky Castle and the Event
[1:12:45] Closing the Podcast
[1:14:10] End of Podcast
Ben: I have a master's degree in physiology, biomechanics, and human nutrition. I've spent the past two decades competing in some of the most masochistic events on the planet from SEALFit Kokoro, Spartan Agoge, and the world's toughest mudder, the 13 Ironman triathlons, brutal bow hunts, adventure races, spearfishing, plant foraging, free diving, bodybuilding and beyond. I combine this intense time in the trenches with a blend of ancestral wisdom and modern science, search the globe for the world's top experts in performance, fat loss, recovery, gut hormones, brain, beauty, and brawn to deliver you this podcast. Everything you need to know to live an adventurous, joyful, and fulfilling life. My name is Ben Greenfield. Enjoy the ride.
Well, howdy, howdy ho. It's Ben Greenfield. I'm sipping a little–did you hear that? Yeah. That was disgusting, wasn't it? I'm sipping some decaffeinated coffee. It's actually–what is this? Blue Bottle Coffee. It's pretty good. No, this isn't Blue Bottle Coffee. This is a pour over from Caffe Luxxe in Brentwood, California where I'm staying right now. So, there, there's your boring fun fact for the day. Decaffeinated coffee actually has all the antioxidants and health benefits of regular coffee with none of the jitters which, considering I'm recording this for you in the evening, is quite convenient.
Speaking of coffee, this podcast is brought to you by my company, Kion, that has the most amazing antioxidant-rich, mold-free coffee on the face of the planet. We tested it against dozens of other healthy coffee brands, or at least so-called healthy coffee brands, and it blew all of them out of the water. And furthermore, the cupping, that's what it's called when you're tasting coffee. The cupping profile also crushed the other coffees. You can get this amazing coffee. You can also get my coconut chocolaty bar, my aminos which is like a shot in the arm pre-workout or for recovery or for staving off appetite cravings, and a whole lot more over at my website, Kion. And to get 10% off of anything, use code BGF10. The website is getkion.com, getK-I-O-N.com.
This podcast is also brought to you by not coffee but water, not just any water though, hydrogen-rich water. I've never actually tried to make coffee with hydrogen-rich water. I would imagine it would probably work pretty well. Hydrogen-rich water is a very special form of water that has hydrogen gases dissolved into it. When you do that, the water has some very interesting properties. It enhances your mitochondrial function, cell signaling. It's an anti-inflammatory. It has what's called selective antioxidant behavior, meaning, you could drink this post-workout and it's not going to blunt your ability to be able to build new mitochondria or proliferate these things called satellite cells. You can build new muscle fibers. H2 Water, hydrogen-rich water is getting very popular now in the NBA, in the NFL, Major League Baseball, CrossFitters, UFC fighters, and even celebrities are using this hydrogen-rich water.
Alright. So, you're about to hear an interview with a couple of my physician buddies who are wicked smart, and they're in the realm of regenerative medicine and doing some pretty good functional medicine and integrative medicine protocols. These cats are located down in Kentucky. We talked towards the end of the show about how you can come hang with us all in Kentucky at this giant castle for this retreat that I'm going to be doing down there. So, stay tuned for the end of the show. And towards the middle of the show, I have an announcement about a couple of other very cool events. So, I'll be back at you here in just a little bit to let you know about those.
There's this quote, it's by Sir William Osler, and it goes like this, “The good physician treats the disease, the great physician treats the patient.” That is the quote on the header of the website of my two physician guests today, Dr. Mike Mallin and Dr. Matt Dawson. They own this company and also a podcast called Wild Health. They're based out of Versailles, Kentucky and Bend, Oregon. These guys reached out to me a few weeks ago to have a little chat about an event that they're having down in Kentucky that we'll talk about later.
But when I dug into what they're doing in the realm of what's called precision and personalized medicine, I was blown away. These dudes are involved in genomics and lab testing and microbiome testing and what they call holistic optimization. They're both guys with a pretty good background themselves in sports and performance. And so, they're men after my own heart, guys who are into health, but also into fitness and performance and striking the balance between that and longevity. So, I thought, “What the heck?” I need to get these guys on the show and delve into some of the cool things they're doing at their clinics.
Dr. Matt Dawson is my first guest. Say hello, Matt.
Matt: Hello. Thanks for having us, Ben. I want to start just by thanking you for your podcast in general. We, Mike and I, have just learned a ton from you over the last few years. I think you realize the impact that you're having with the millions of downloads you have, but what you may not realize is the indirect benefit to people who may not have even heard of you, people like our patients who–I'll be honest with you, when I first are listening to your podcast, I thought you were slightly insane with some of the stuff that you said. But then when I dig into the science, I kept realizing that you were right, and you've really changed my practice. And so, I know it's exhausting sometimes to record these podcasts and your travel schedules got to be crazy but you're making probably an even bigger impact than you think. So, thanks so much for all that great knowledge that you're putting out there.
Ben: Thanks, man. That was a lot more than a hello. I thought you were just going to pull the old “Say hello, Matt,” and you were going say, “Hello, Matt” to me. But for those of you who want to know the voice that you just heard, Dr. Matt Dawson, he played collegiate sports and I'm going to let him fill you in on what he played and how he got by in what he calls minimal talent. But he's a guy who specializes in what's called precision and personalized medicine, and I'm going to define that for you or let him define it for you, but he's the co-host of the Wild Health Podcast. His practice is the one that's based out of Lexington, Kentucky.
My other guest is the branch of Wild Health that's based out of Bend, Oregon, Mike Mallin. Say hello, Mike.
Mike: Hey, Ben. How are you doing?
Ben: Oh, you also did not say “Hello, Mike.” You didn't spring for for that softball I sent you. Mike, you're down in Bend, right?
Ben: Okay. Alright. Cool. Mike, the other voice that you guys just heard, he actually trained in emergency medicine originally and did a ton of ultra-endurance sports like ultra-marathons and hanging out in the mountains and doing a lot of what they do in the hippy state of Oregon. He's also the co-founder of a podcast called the Ultrasound Podcast, which is an educational podcast that trains physicians how to use ultrasound. Geez, you want to talk about a niche podcast. That's about as niche-y as it gets. But anyway, these two guys are partnered up and they run Wild Health. So, before we delve in, I just have a quick question. Matt, I was intrigued by the section of your bio where you say you learned to play two sports in college even with minimal talent. What was your strategy there and what did you play?
Matt: Yeah. In high school, I played most of the sports, but the only ones I was good enough for getting scholarship offers in were tennis and soccer. I mean, I'm not tall, I'm not fast, not a lot of talent but I've been obsessed with performance since I was in high school reading and studying everything I could. And so, I did play a couple of sports in college. I quickly realized that I wasn't really good enough. I was never going to play those professionally, so I just played a couple of years in college and then really changed over to really fully focusing on performance, went to medical school, and I still tried to optimize as much of as I can for my body.
And then now, I'm well out of my prime when it comes to performing. I'm really focusing on helping other people optimize their fitness and achieve their goals, whether it's–and when I say optimizing performance, I mean a 70-year-old that wants to dance at their granddaughter's wedding or an athlete in a contract year. We're really just looking to use every available scientific method we can to help people optimize their health.
Ben: Yeah. We're going to delve into those scientific methods you guys are using over there, but it's kind of funny because I also played tennis in college, and then eventually, branched out and played for the water polo team and played middle for the men's volleyball team at the same time I was kind of prepping for a brief foray in a bodybuilding career. I was the same way. I was not a naturally talented athlete but I studied the heck. Even in high school, I was grabbing physiology textbooks and running up the hills back behind my house and figuring out how to use barbells and dumbbells and began to delve into nutrition in college.
I was the same way. I think that was my first foray into that off overused term now called biohacking where I had to figure out ways to train in a very smart manner that allowed me to get past some of my–some of I guess my lack of talent. I'm not that coordinator or that athletic of a guy but I worked out hard and I studied the heck out of this stuff, and I think it helps out a little bit. And again, I don't want to lead anybody the wrong way. I'm not saying like you get past performance decrements by using supplements or by injecting compounds into your body or getting stem cell or NAD IVs or any of these crazy things folks are doing like you still have to put in the hard work. But where I think the value lies is when you also educate yourself, which it sounds like you did, Matt.
Matt: Yeah, absolutely.
Ben: And study your sport, study sport specificity. I mean, if you feel like you want to succeed in your sport, whether it's Ironman triathlon or Spartan racing or CrossFit or anything else, man, sometimes getting to the library helps. Another one of my buddies, and then I'll shut up here shortly and let you guys delve in, Hunter McIntyre, he's a really good obstacle course racing athlete. He's getting into CrossFit now. And a lot of people think of him as a meathead, right? He's a goofy guy on Instagram. He's big. He's built. He's buff. The thing is when I talked to Hunter, that dude reads a ton, like multiple books a week and he's studying the heck out of this stuff because–and he's also shared this on a podcast that we have called the Obstacle Dominator, he also is not naturally talented. He told me he sucks at ball sports and he's not that coordinated or not naturally coordinated, but the dude has cracked the code on physical performance, and I know he also is a voracious student. The only place you and I split ways, Dr. Dawson, is you went on to medical school. I got accepted to a bunch of medical schools but I went into fitness and physiology and what I'm doing now instead, but ultimately, say, it's a very, very interesting consideration, this idea of educating yourself to be able to overcome minimal talent.
Off my soapbox now. Give me the overview of how you guys partnered up and launched Wild Health.
Mike: Yeah. Matt and I have met about 12 years ago now. We first met in residency in Salt Lake City. We were chief residents and did an ultrasound fellowship together. And then after residency, we started this nonprofit physician education company which focused on ultrasound education for physicians pretty much all around the world, both the developed and the developing world. During that whole time, we were really interested in health and our own personal performance and have always been a bit competitive about it as well. We're always comparing workout times, ketone levels, different diets, sometimes trying new products and devices and basically trying to hack our lives, all while trying to do it a little bit better than the other person.
But what really made us shift I think and become super obsessed with genomics is actually through the process of trying to fix my diet and my cholesterol. So, even though we were ultra-marathoners and living what we thought was an optimal lifestyle, I got some ridiculously scary cholesterol numbers back a few years ago. And I'm not talking like slightly elevated; I'm talking like you're going to die of a heart attack at 50. It's elevated.
Ben: Really? So not to rabbit hole too much but of course, that's a consideration that a lot of people talk about now, how LDL cholesterol is not necessarily reflective of atherosclerosis or cardiovascular disease or risk mortality, but what were you seeing on your lipid panel?
Mike: I was seeing high LDL, extremely high LDL like above 300 high. My triglycerides were pretty good, and I think that's because I was exercising so much, and had a fairly good diet at the time. My HDL, I'm not sure the HDL matters too much but it was appropriate but just really high LDL numbers. When you look at the data, when you get that high, I don't think there's a lot of question that has got to, in some way, increase your cardiovascular disease risk if you also consider the possibility of inflammation or endothelial dysfunction, other things that obviously we can control for in lifestyle, but they were high enough for me that I wasn't personally comfortable with that number.
Matt: Yeah. And I remember when Mike texted me his numbers, I'm not really–I think honestly, we put too much emphasis on cholesterol in general but these numbers were bad, bad enough that we needed to fix. So, what he and I started doing is what we normally do in medicine. We used epidemiology and guess what would work best for Mike because what's worked best in the studies, but the problem we found was he actually got worse. He wasn't in the majority of patients and how they respond and improve lipids. And in the meantime, his doctor put him on a statin, which we were worried about and he had myopathy and muscle breakdown diagnosis. It was a bad situation.
Around that time, we started diving into genomics. We were looking at the science and thinking “Okay, this actually looks like it may be ready for primetime.” So, these two things were happening in conjunction. And about two years into the experiment, his diet–we're really finally getting his numbers better. We looked at all of his snips and about 15 minutes of really looking the snips and correlating with what would be his best diet, we realized that the two years of experimentation, we could have shortcut if we had had this information at the start. And he had a specific snip also that made him really much more likely to get myopathies and have bad problems from statins. And what was just frustrating too is that it angered us that his physician and other physicians were still practicing based on epidemiology and it's trial and error instead of first, really basing therapy on the traditional history, physical lab work, but also adding in genomic and microbiome data. And we really realized that other people could benefit from this, too.
Mike: Yeah. Unfortunately, though, that level of precision is not really something that's regularly offered in the medical community. Matt and I both started reading basically everything we could get our hands on and taking every course we could find and really just immersed ourselves in this topic, trying it out on our friends and family. We've had some pretty amazing results and basically decided that precision medicine is eventually what we wanted to spend our lives practicing.
Ben: Okay. So, you guys launched this clinic together. Do you guys practice distance medicine or do you mostly see patients in your clinic?
Matt: I should say in our clinic. I mean, we can do this distance. I mean, the way that the genomic, the lab tests, microbiome, all that works. Yesterday, I was talking to somebody in Alabama, actually. And so, we're just shipping him all the stuff and we'll have the blood drawn done at his house there. So, we can do it distance, but in general, we really need, at some point especially at the beginning, to see someone because it's not just about the data. We really want to have a conversation, get to know the person and take a holistic point of view. The data is important but really want to start with the person and their individual preferences and what's their lifestyle like.
Ben: Okay. I want to delve into some of the things you guys do that you briefly highlighted like looking into genetics and looking into some quantification, how you actually–kind of what's the path that people follow as they work with you. But my first question I have is precision medicine. That's a term that I think a lot of people might not be familiar with. What exactly is precision medicine?
Matt: Well, I think basically it's not treating the patient like a statistic. Just because a study says that–for example, omega-3 supplements may not show a mortality benefit for a population, or statins are more helpful than harmful, or vitamin D doesn't decrease MR risk. That doesn't mean that the opposite may be true for an individual. So, if we were simply treating populations, that's the kind of data that we would want and we'd recommend. We don't treat populations, we treat individuals.
Just as an example that I had two patients the other day who had low vitamin D levels. One of them ate trash all day, and we're basically just going to get his vitamin D levels up by changing his diet, getting him into the sun, feeding him things like shiitake mushrooms that I grow on my farm. I grow more mushrooms than I can eat, so I am giving him some of those, telling him to lay off the sunscreen a little bit, and then we're going to recheck.
The other patient had a pretty good diet but he had a specific polymorphism that made him unable to make as much vitamin D from the sun, and he had a polymorphism that made him unable or less able to convert the active form of vitamin back to the active form of vitamin D. And I don't think that I can move in [00:19:14] ______ very much for him with lifestyle and diet, so we immediately started him on a vitamin D and K2 supplement. So, it's the same problem, but these were very different people with different genetics, different lifestyles, and it called for different interventions. And we needed to look at them from many different angles to get the precision treatment; their lifestyle, their labs, their genomics, and a lot of times, microbiome as well.
Ben: Mm-hmm. Yeah, it's interesting. I had that same polymorphism as do both of my boys because we've done genetic testing and so we all take vitamin D, vitamin K, but I guess that's a perfect example of precision medicine, right? We went and we got tested rather than simply listening to all of the healthcare advice to take vitamin D. As you guys know, if you take it and you don't need it and you've already got elevated levels, you can increase your risk for things like arterial calcification or just waste money on supplements that you don't need.
The other thing that I think is a big topic now in this idea of this new word in my vernacular now, precision medicine, is the idea of machine learning algorithms and artificial intelligence being used to gather all this data; blood data, urine data, stool data, genetic data, and actually begin to use artificial intelligence or online dashboards or things like that to deliver targeted advice. Are you guys aware of any good movement in that realm or are you using any of that? Are you looking into it or is that just like in its infancy and ineffective right now?
Matt: Yeah. You know, I'm really excited about that. I think there's a lot of potential there. Right now, I think the closest we can come to that is the human brain. I would love for there to be a point where a company can take machine learning, take lab data, genomic data, microbiome data, and spit out the perfect diet for someone or fitness regimen. But it's hard to get the lifestyle factors. “Is the person married? They have kids? What's their job?” All of that. And I think we really do need to have a clinician taking all those things into account right now.
I'm really hopeful that in the future, all of that work that we have to do is done for us and we can get really good recommendations and just talk with the patient and try to implement it. I don't think we're there yet but I'm really hopeful. I know there are some companies like Onegevity and a few others that seem like they're on the right path, and I'm watching those really closely. But right now, I think the human brain is about as close as we can come to that.
Ben: Yeah. I interviewed Dr. Chris Mason and Dr. Joel Dudley from Onegevity Health, and I'll link to that in the shownotes. By the way, the shownotes you guys for everything you're going to hear, they're at BenGreenfieldFitness.com/WildHealth. That's BenGreenfieldFitness.com/WildHealth. And I would say the other folks that I've talked to, the folks at Onegevity are the closest to cracking the code on taking a lot of this data and actually being able to have a computer spit out recommendations for you, which would take a lot of the stress and a lot of the time limitations off of the physician when they can rely upon a smart computer to go through a lot of this data for people.
Kind of related to that, do you guys have specific tests that you rely? Like is there a gold standard range of tests that you tend to run people through when they come in to you?
Matt: We do. We have the genomics and we use different companies actually depending on the individual and how in-depth we need to go, whether or not we need pharmacogenetics or not, and then lab testing. We have a really large panel, all the NMR fraction [00:22:34] ______ lipids, not just the standard stuff. We look at all their hormones, vitamins. We've got a couple big panels that we run on people. And then we also do microbiome assessment. And we're not happy exactly with what the microbiome testing is giving us yet, but we think there is some useful information in there. We have a PhD microbiologist on our team who worked at Mayo on individualized medicine and he helps us interpret some of that data and rolled it into all the other data to come up with optimized plan for somebody.
Mike: And then depending on the patient, there are some patients that we would run through with urinary hormones, and then also serum IgA or IgG sensitivities as well. Some of it is not necessarily every patient gets the same thing, but we do sort of tailor to each patient based on their symptoms, their complaints, and then what we find on their tests.
Ben: Yeah. For that genetics piece, you said that you'll go to a different place to test. You're now saying like you'll go to 23andMe in one case and then look for another service that tests more snips than 23andMe in other cases?
Matt: Exactly. So, if we have someone that's got some big medical problems like I'm seeing somebody who's been–he's been all over the country seeing different places and Mayo and Vanderbilt and all these places around locally and it hasn't gotten a solution, we do a really extensive clinical lab testing, not a direct-to-consumer test, but if I have somebody who's a healthy person in general, they want to dive in and they've already done their 23andMe, then we'll show them how to download the raw data and then we'll upload that raw data into several different programs that give us all those snips to look at. We try to tailor for the individual. A healthy person, we may not need to dive deep and pay the extra money for the pharmacogenetics until there actually a need to take a medication or until they get sick or have a problem that we can't solve with the basic information.
Ben: Okay. Got it. Well, I wanted to dive into some of the different things that you guys do for different folks. The first thing I want to dive into is based on your guys' background in exercise and athletic performance. What kind of things you do for athletic performance optimization? We've talked about a ton of things on this podcast in terms of training and nutrition and biohacks and stuff, but there's a lot of times things folks like you are doing that our audience might be unaware of or that flies under the radar when it comes to strategies that athletes and exercise enthusiasts might be unaware of. What are some of your guides or strategies that you found to be particularly effective for performance optimization?
Mike: Well, I think it's like every answer that we're going to give you, it depends on the person. It's completely personalized. To give you specific examples, just using myself as an example. I think for most people if you tell them to work out more, that's generally good advice for 80% of the population. But for me, I found with my genetics, I don't recover as well as most people. Now in residency when we work in 80-hour weeks, I did two Ironmans during residency and basically crushed myself every day because I loved it. And I didn't realize at the time that it wasn't normal not to be able to bend over and put my socks in in the morning. I just had chronic inflammation, constant pain, and I look like the picture of health, but I have these overuse injuries all the time. And I eventually knew intellectually that I needed to cut back but it really took me seeing those snips and that genomics and understanding that I wasn't designed for that type of volume that I was putting in.
I started to cut back more and more and got from where I was doing two hours a day to, now I limit myself to about 20 minutes per day on average, and I've never really felt better or performed better. So, for somebody like me, we're actually teaching them hacks like, “Yes, I know you're type A. I know you love and want to continually improve yourself but let's figure out some other things that you can do to improve like sauna.” We go over the science on that, cryotherapy, meditation. You're still going to be pushing yourself mentally and physically and you can still pin two hours a day. We want to do something that fits your genetics better. I think everybody when I was talking about the power versus endurance tendency and in developing workout programs according to that–
Ben: What do you mean? Just to clarify for the audience. You're talking about genetic tests to determine whether you're a power responder or an endurance responder and then training if you're a power responder with more power low rep, high weight, short high-intensity interval training, and if you're an endurance responder training with more high rep, low weight, more cardiovascular training.
Matt: Yeah. We're doing some of that. And I think there's some validity there. I've seen the studies in Great Britain and soccer players and some other athletes where it does make a difference. But I think it's important to realize that probably even more important is the individual person on what they enjoy. I think the data is great to have but really, we want to get people in general just moving and into an activity that they love. That's the most important thing. And then sleep. I mean, I think hacking and optimizing the sleep–we're talking about performance, but almost nothing is as important as sleep.
So, all of our patients, for example, get an Oura Ring. We track their sleep. We have an Oura cloud so each morning a health coach can call them and say–for example, yesterday, my resting heart rate normally is in the low 40s. It was mid-50s. I've found for myself if I go ahead do my planned workout, I'm going to get sick. So, I took the day off. I feel great today. I did a good workout today. And that's what we' do for our patients.
Well, if they have a poor night's sleep, not enough RAM, not enough deep sleep, then we'll talk to them, “What did you eat last night? What did you do last night?” And then we can even optimize when they do workouts. You'll hear a general advice to maybe not do workout too close to bedtime. But for some people, it may help them sleep more. So, we'll look at what their daddy is that next morning. We'll do an inner one experiment almost every night on patience changing things up in the evening. When they work out and just over time, try to optimize the performance based on how they respond.
Mike: I think the data that Matt's talking about is extremely important when you're talking about elite athletes or people who just work out a lot and are really, really excited about exercise. Those people, they're probably not going to change the style of working out that they're doing or the exercise that they're doing based on genetic data, but we can really help manage overtraining in those patients by monitoring data like Matt was talking about with HRV from sleep data, or even just fairly regular laboratory testing, looking at hormones; so testosterone, estrogen, sex hormone binding globulin, cortisol, and markers of inflammation.
That data, if you're testing on a regular basis as you're changing your activity level or your specific workout training program, can be extremely beneficial, extremely useful in terms of getting into some serious detail and really dialing in the recovery and optimization. I think that the genetics comes into play a lot more with people who maybe are weekend warriors or are more inactive. In those patients, that's when we could say, “Hey, look. You're a power responder. You're more of an endurance athlete.” And we can say, “Instead of putting you on this 5×5, we're going to put you on a 10×10, or you're going to do the hit training versus–you're going to do more regular cardiovascular activity.” Then we can really dial in the biggest bang for your buck. You've only got 20 minutes a day, how are you going to spend it? This is the best way to spend it based on your genetics and then we'll go back and test that later.
Ben: Now, you were saying, Matt, that you exercise for 20 minutes a day. What's that look like for you?
Matt: Yeah. I'll just tell you what I did this morning, actually. I got in the sauna this morning for the first 20 minutes. I've got an infrared sauna, so I tried to kind of relax, I've meditated some, I've got a near-infrared actually shining through the glass because that does penetrate glass even though far. For the first 20 minutes, relaxing, just do that relaxation first. Maybe there's a little bit more detox benefit. I'm not sure if I believe all of that data but it's not going to hurt to relax–
Ben: You mean activating the parasympathetic nervous system when you're in a sauna rather than say hoisting a kettlebell in the sauna?
Matt: Exactly. I actually do both, but yeah, I do that first. So, I go ahead and get the parasympathetic. Then this morning, I read for 20 minutes after that, and then my last 20 minutes is when I've got a 90-pound kettlebell in there. I did sets of 20 with that where it takes about 35 seconds per set. I do a two-minute rest between and that's about 15 minutes of work and that just crushes me. It's a very short compressed time of working out but I get several benefits from that hour-long and I'm not overtraining quite as much as for me going out for a long run or doing a long set of something else.
Ben: Hey, it's Ben. I want to interrupt today's show because I have two events that I am bringing to you. One is in the Swiss Alps this summer, and the other one is in Napa Valley this fall. The Swiss retreat is with me and my family in the Italian quarter of Switzerland where we are going to be meeting with some of the best doctors in biological medicine, going on these wonderful hikes in the Swiss Alps, eating amazing rich, clean, food. And we just had a couple of spots open up in that retreat. It was sold out and then we had a couple of people who found out they couldn't make it, so we had I believe two rooms just open.
So, if you want to get in on these rooms, head to Switzerland and experience the best of biological medicine while also staying with my family in this wonderful retreat, beautiful place out in the Swiss Alps. You just go to greensmoothiegirl.com/bengreenfield, greensmoothiegirl.com/bengreenfield because my partner on this event is the Green Smoothie Girl, Robyn Openshaw. So, she's an expert in detoxification as well and she's putting this whole event together and I'm going to be there.
You also should know about this Runga event. For that, you go to bengreenfieldfitness.com/runga, R-U-N-G-A. Basically, the way that that works is you come together in this amazing hot spot in Napa Valley located on 70 acres of forest. It's like our own mini-national park. We do mobility, breath works, sauna, cold therapy, personalized small group training. My wife is there. She does cooking demos and cooking classes. We eat these wonderful vibrant organic meals. It is an all-inclusive retreat, extremely high-end and we've got room for a few slots on that, too. So, you go to BenGreenfieldFitness.com/runga for that. And of course, towards the end of this episode, I'm going to tell you about the third event you could go to but you have to tune in to the rest of the episode for that.
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Yeah. And related to that parasympathetic nervous system sauna type of thing, I've also noticed like if I lay on my back in the sauna or meditate in the sauna, the sweat is different. It actually does feel, and I realize this is totally whew, I haven't actually done an analysis in terms of metals in my sweat or composition of toxins and sweat or anything like that but I have indeed noticed that the sweat feels different. It sometimes flows far more easily. It feels as though the pores are more open, which sounds counterintuitive because you'd think you'd get hotter doing exercise in a sauna. And I'm talking about an infrared sauna, by the way, which I think is kind of the best one based on the photonic penetration of the light into the tissue versus a dry sauna or a smoke sauna or wet sauna, but I've definitely noticed a difference with that as well.
It sounds like you guys, you have a multi-modal approach similar to the way I work with my athletes where we're doing HRV data, we're doing sleep data, we're working in things that are passive forms of exercise that avoid the need for beating up the body over and over again like cryotherapy, like sauna, like breath work. I think as much as it gets laughed at still in, especially in pro-sports, which is like a good old boys network where you do the barbell and you drink your Gatorade, I think a lot of smart athletes are beginning to tune in to this concept of not just self-quantification but also some of these alternative ways to improve fitness or improve performance without necessarily exercising in the traditional sense of the word. It sounds like we're on the same page as far as that's concerned.
Another area that I noticed that you guys specialize in is like cognitive performance, brain health, dementia, Alzheimer. Tell me about them and what your approach to that is.
Mike: Our approach, I guess, starts out with like everything else genetic testing, but that's because with Alzheimer's and dementia, knowing your risk is extremely important. Alzheimer's is easier to treat before the symptoms start. So, if you've got an APOE4 gene, that increases your risk of Alzheimer's by 3 to 15 times depending on how many of those genes you have. And it also makes Alzheimer's come on earlier, so sometimes as early as in your 50s. Traditionally, people didn't really recommend testing for APOE because we just thought there's nothing you could do about it, so why would you want to know something bad about your risk factors in life if you couldn't do anything? But we're learning that that thought process is actually wrong and there is such thing as Alzheimer's treatment and prevention.
The good news is that about 80% of that is the things that you talk about on your podcasts all the time and the things that were prescribed for our patients. It's things like healthy diet, sleep, exercise, detoxification. If you can get all those things right, you're 80% of the way there to preventing Alzheimer's in the future.
Matt and I both read and researched the recode protocol, which is described pretty well in the book, “The End of Alzheimer's” by Dale Bredesen. I actually went on and took some classes by Bredesen so that I'm credentialed to actually apply that to patients. But we've also gone a step further and we've recognized that the research in Alzheimer's disease is moving forward in an extremely rapid pace. Like just recently, there were all these studies and all this news about P. gingivalis and its role in Alzheimer's.
Ben: P. gingivalis?
Mike: Yeah, it's the bacteria in your mouth that has been found in the brains of patients with Alzheimer's, and now they think there's a significant link to it. We're trying to partner with people so that we can basically use research like that as soon as possible as opposed to waiting 15 years for randomized controlled trials to take place. We want to use it on our patients who need it now.
Matt: Yeah. One of the first dentists to publish that data, it was quite a while, it was Dr. Pam Stein VanArsdall. We actually had her. She's our director of oral health at Wild Health. So, we take the RICO protocol and then we take Dr. Stein VanArsdall if we have a difficult patient who the RICO protocol is not working on and then surely looking and addressed the oral health, shutting down that fire in your brain and the inflammation from maybe bad oral hygiene. And then we also have Dr. [00:39:22] _______, who's one of the top researchers in the world in Alzheimer's. And specifically, she has great studies on ketogenic diet and really has kind of unpublished literature on just how much of a metabolic disease is it.
We have scientists like those, and Dr. Battaglioli, the microbiologist on our team who, if we have a difficult patient that the RICO protocol is not working on–the RICO protocol is a very personalized in precision approach, but sometimes we need to take it a step further and really involve those scientists in looking at the data and saying, “What are we missing here? How can we really affect this?” Because it's such a horrible disease. We're really trying to throw everything at it that we can.
Ben: Yeah. There's a new documentary root cause that talks a lot about Alzheimer's and the link between that and the mouth and the microbiome. And then I was reading a Fortune magazine article, and I'll link to it in the shownotes, about something called beta-Methylamino-L-alanine, BMAA, and about its role in neurodegenerative conditions. This was fascinating. They actually found this neurotoxin that was present in the food chain of these people. They were like the indigenous population of Guam and they were getting a lot of Alzheimer's and dementia-like symptoms because they were eating, I believe, a diet that included like flying foxes or bats which had very high levels of this BMAA. And it turns out that apparently, BMAA might be something that's also increasingly present based on toxins and bad water and some of the pollution of algae and water, et cetera, that's winding up in food supplies in westernized societies as well. Like even if we're not eating bats per se, especially like seafood, algae, spirulina, shellfish, like a lot of these seem to be turning up with higher levels of BMAA. That's a very recent article but had you guys gotten tuned into that at all?
Matt: Yeah. I read that article. It's really interesting to me. I get a little bit concerned that it's similar to so many other “causes” of Alzheimer's that we found. It's really one thing that maybe causes inflammation and contributes to the disease, but it's such a multi-modal thing. I mean, Dale Bredesen talks about 36 different things and these 36 different holes in your roof and you've got to plug all the holes. I do think that's something that can lead to it and can accelerate it, but we really do think we have to take a really holistic approach and do really extensive testing to identify the root causes for each individual. But yeah, that was a fascinating article. It's really, really cool stuff.
Ben: Yeah, sure. For those of you who may not want to read the entire book by Dale Bredesen called “The End of Alzheimer's,” even though I think it's absolutely fantastic read for anyone who wants to tune into this, there was a recent article called Reversal of Cognitive Decline in 100 Patients in the Journal of Alzheimer's Disease. It lays out like, literally, 100 different case reports from Dale Bredesen. These weren't clinical studies, these were just multiple people that responded to his, I think–what did you say? There are 34 different things that he does?
Mike: Yeah, 36.
Ben: Yeah, it's like hyperbaric oxygen therapy chamber and high levels of DHA and a ketogenic diet and photobiomodulation like these laser lights on the head. A lot of times, allopathic medicine scoffs at these types of approaches because it's very difficult to do like a double-blinded clinical study on 36 different treatments. But the fact is, I mean, he's got the proof in the pudding right there. This stuff is working but it's one of those things that, again, like a lot of doctors aren't putting into practice simply because it's very difficult to say which one thing is working and so it throws some people for a loop.
Matt: Yeah. And [00:42:56] ______ and what works. His approach seems to be working and so we're all for it. And the problem is it's–I don't know if it will ever get really massive NIH funding or other things like that because the money and the research goes into finding the magic pill, the magic bullet and I just don't think we're going to ever have that in Alzheimer's disease. It's going to be something that's going to be more lifestyle and diet and interventions that are going to pay a lot but it works. I mean, he's proving it works and we're trying to practice according to that and just do what works for our patients.
Ben: Yeah. Okay. So, that's your approach to athletic performance and also on a cognitive performance. Now, what about anti-aging and longevity? I mean, this is a huge interest now, and I know a lot of folks, and you kind of have a little snip on your website about how anti-aging medicine is something that you guys do. What kind of things do you do to enhance longevity or to allow people to feel better as they age?
Matt: Well, I mean I think you're the king of that space. I mean, your podcast, you've got a lot of great stuff on there. But for us, the general approach is–I think what people think about anti-age treatments, their mind immediately jumps to compounds and molecules like metformin, resveratrol, rapamycin, nicotinamide riboside, things like that. And don't get me wrong, I'm a fan of some of those for some people, but to me, the ultimate hack is when I can find an ancient practice that's been done for thousands of years that simulates one of these compounds which we've seen the scientifically proven biological mechanism.
For example, rapamycin. We know that rapamycin works because it inhibits mTOR, it induces autophagy, but we also know that fasting does the same thing and every religion in the world does fasting and has done this for thousands of years, and we find it really prevalent in longevity hotspots. So, even if there's great data and safety profile for rapamycin, we still don't have that level of experience with it like we do for fasting, and it's personalized.
My mom and dad, for example, everybody asked us about metformin. Should we all be on metformin? For me, not yet. My mom and dad, absolutely. But I–personally, I'm still young enough that I am concerned about longevity, I've got four kids, but I'm also still pretty concerned with performance. And there seems to be a bit of a trade-off with some of these molecules. So, for me, with metformin, I've decided to revisit the data when I'm 40 and see if my goals have changed just enough that I start taking at that point. So, we really try to make a personalized decision about each of these compounds and molecules for each individual person based on the trade-offs, the risks and benefits, and that person's lifestyles and goals.
Ben: Yeah. That's interesting what you say about rapamycin. You ever heard of spermidine?
Matt: I have, yes.
Ben: Yeah, that's like a polyamine. Well, you find it in semen as you would guess with the name spermidine but you can get it in like old stinky cheese and in fermented soy products like miso and natto. And it appears to work on the same cellular autophagy mechanisms as rapamycin does. So, that's another one that you could throw into the mix along with fasting as eating fermented soy products and aged cheese or good like–I like the European cheeses because they're higher in the protein or they're lower in the A1 protein, which is a protein associated with autoimmune disease that we get with cows bred in America. But if you get your cheeses from Europe, a lot of times it's A2 cheese. You can get like a good aged cheese. And most of the cheese I eat is only like a European cheese, which you can, of course, buy in the U.S. but you can also look into if you're getting a cow cheese, or the goat cheese is not as much of an issue, but spermidine is an interesting one.
Matt: Yeah. A lot of good spermidine jokes I think we'll probably avoid now.
Ben: Yeah, exactly, exactly. Guys, you can tell your women that spermidine is actually a known longevity aid. So, the thing about metformin, you mentioned briefly that it might diminish performance. But have you seen any research? Because the story is that it can inhibit some of the activity of the complex one and the electron transport chain and that that might reduce your ability to produce ATP during exercise. But I'm curious, have you guys actually seen any studies done in athletes who take metformin or anything like that?
Matt: No, I haven't, and it's just what you mentioned, yeah. The mechanism there makes sense that it may have some kind of mitochondrial functions that as someone who's really trying to improve performance that I wouldn't really necessarily want. I don't have any data saying that it actually is going to mess that up. And so, like I said, for me, I'll probably start taking it pretty soon but I'm just not there yet. It's just that hint of potentially some problems is what makes me at least think about it before I just put everybody on it.
Ben: What about stem cells?
Matt: I think that's another one where the jury is out but we are, in certain cases, using exosomes and stem cells for our patients. It's something that–it's a risk-benefit thing. I mean, a normal healthy person like us, I would be a little cautious, but someone who's got some real major health issues, sometimes it's going to be worth it. So, it's something that we're offering but it's a pretty intense discussion with the patient to see if it's right for them and it's a shared decision-making thing. We try to go over what the potential risks could be. And if they want to go for it, then–we're not really paternalistic physicians. We don't really try to push a patient one way or the other. We try to lay out the risks and benefits, and for some patients, it makes sense.
Ben: Now, do you have a specific type of stem cell that you use like amniotic versus umbilical versus placental or fat or bone?
Matt: We're working with an orthopedic surgeon who will do some bone marrow aspirates and we'll spin that down. We also do some PRP, and that's kind of a similar mechanism as well, and then exosomes from chimera. We use those. I think you get a pretty similar effect just with the signaling from the exosomes and simulating your own stem cells as you would from these other types of stem cells. Honestly though too, we love to activate your endogenous stem cells through fasting like we mentioned earlier and other mechanisms where we can do it without as much of the risks.
Ben: What are the mechanisms aside from fasting?
Matt: That's the main one. A lot of things like even dry needling that people will do. A lot of that is similar to PRP. You're causing some damage, you're activating stem cells. So, dry needling, fasting, those are the main two things that I'm thinking–
Ben: A lot of good research on pulsed electromagnetic field therapy for that, like using these PMF devices which are readily available to the general population. There are pockets of stem cells found in bone marrow. And for example, you can take a PMF device like the long bones and the femur and enhance some stem cell production or do that prior to a stem cell procedure to have more available stem cells or increase stem cell mobilization. Again, a lot of people are like, “Oh, I could never do that. Where do you find the time?” Well, I have a PMF device I just slap it on my femur while I'm standing and working during the day. I use kind of a high-intensity one called a Pulse Centers' unit for that, but it does the trick. It just vibrates your legs and you can feel, literally, like as you know, haven't done an ultrasound podcast, Mike, like some of these things you can feel in your bones when those waves hit you.
Mike: Yeah. You can even hear them in your brain sometimes if you ultrasounded your brain. Yeah.
Ben: Yeah, yeah. Okay. So, in terms of any type of–kind of when we're on the realm of anti-aging and longevity and talking about supplements and things like that, do you guys each personally have any kind of supplementation regimen or must-have, go-to nutraceuticals or supplements or even medications that you use on a daily basis?
Mike: Yeah, definitely. Unfortunately, it changes on a weekly basis, but I do have a daily basis of medications that I'm using. The things that I'm really into right now are ashwagandha. I've been taking that fairly regularly due to the reason that–or for the reason that I've got an APOE4 gene. I've sort of bought into the research on that suggesting that there could be some protection for the development of Alzheimer's. And also, the other one I've been playing around with is acetylcholine. I'm trying to use that for liver detoxification, and I've been playing around with that a little bit although I haven't had a chance to recheck labs to see if I've had any improvement in LFTs from that one, but I'm real interested in getting some labs done on Friday to check that out and see how that one worked. But yeah, lots of different supplements. I'm always playing around with something new and then testing to see how my laboratory tests respond to it most significantly with testosterone. actually. It's the one I've been playing around with the most, I think.
Ben: I want to ask you about testosterone here in a second, how you're measuring that and what kind of measurements you do, and how you time those supplement intakes to actually get good information. But with ashwagandha, I'm actually a huge fan of ashwagandha. It's got a lot going forward in terms of reducing blood sugar levels and modulating cortisol and even in some studies increasing testosterone and fertility, but there are different forms.
Probably, the one that I think is the best, and it's important that people understand like not all forms of herbs especially are created equal, and there's one called KSM-66 that a lot of good supplement companies will use, and that's like an ashwagandha extract that's very high concentrated, very bio-absorbable. They use only the roots of the ashwagandha plant for that one. I actually use this supplement. People probably heard me talk about this before called TianChi, and that's just got a ton of this KSM-66 form of ashwagandha in it. That, in my opinion, is the best way to go if you're going to use ashwagandha. Look for supplements that's got KSM-66 in it.
But back to the testing, when you're testing a supplement, do you allow a certain number of days for it to build up in the system before you go and do some kind of a test? And also, kind of a two-part question, you mentioned testosterone. How are you monitoring testosterone in response to some of these supplements that you're using?
Mike: Yeah. Definitely, we want to allow for some time for the supplement to build up in your system. I generally think that it takes about five days of taking a supplement to get it to what we call steady state. So, I don't want to test too early. And then also, you have to account for if there's any response from the body. So, especially with hormonal balances, I think that it does take a decent amount of time to see some response in your hormone imbalance and altercation of your HPA axis and all that. So, I tend to only test about every month, otherwise, I get a little–not only do I get a little too obsessive about things and change too quickly but also, I want to give my body a chance to reset and then reinitiate a production of that testosterone.
I've found that I might not need to wait quite that long, but it seems to be a fairly consistent timeframe to see an appropriate response. For example, regarding the testosterone, for a while there, I got my testosterone first checked a couple of years ago. I noticed that I was low. It was in the 200's range and I was pretty asymptomatic with it but I was like, “That's unacceptable. I definitely want to play with this.” I started doing some self-experimentation and I started off as supplements first because I feel like that was pretty much like the easiest thing to do. And if could find one that worked, then great.
I tried a few things. I tried DHEA, I tried vinegary, I've tried some ashwagandha, lots of different things, and basically found little to no response. And then I tested with basically a month of doing nothing but trying to sleep better, working out less. So, I decreased my endurance from six to seven times a week to three or less. I increased power movements and I increased strength training. I started using a Joovv Light on a daily basis, and I started sleeping and tracking my sleep with an Oura Ring. And within a month, had a doubling of my testosterone, which is way greater than I've got with any other supplementation. I think that's–
Ben: Yeah. So, that's like the Alzheimer's stuff though. It's tough to say which one thing worked but sometimes it doesn't matter, right? It's a multi-modal approach and you can simply–rather than saying the Joovv Light worked, you can say this cluster of strategies works, right?
Mike: Exactly. I think if we can get patients there, then it doesn't really matter how we get there. We just have to find the right combination of things to get the patient to the right place. And I think looking back on it now with a hindsight, I realized like I was working out way too much, I was overtraining, I wasn't sleeping enough. You know what I mean? It's like all the basics were off. So, why try fixing it with supplements when the basics aren't even there in the first place?
Matt: Our current world we live in is basically designed to make our hormones be out of whack. We've got horrible sleep schedules. We have hormones in our meat, all the [00:55:48] _____ compounds that are in our lives, the stress of our busy lives, and we're not thinking about all that. It's honestly surprising to me when someone does have perfectly balanced hormones. The answer though, I think, isn't to start chasing our tails and to put everybody on hormone replacement therapy and slather the body out with testosterone cream. The first step is testing to see if there's an imbalance, and then a conversation and education with the patient because we usually can identify the biggest cause of the disruption just by going over a quick checklist of, “Okay. How do you sleep? We'll look at the sleep with the Oura Ring. What are your dietary habits? What are your normal daily activities? What's your workout regimen like with Mike?” And we know all those hacks to improve testosterone and we've got a lot of things that we can try, but we need to identify the root cause first and then spend some time on lifestyle before we even discuss any sort of hormone supplementation or anything like that.
Ben: How do you measure testosterone?
Mike: A combination of serum and urinary hormone metabolites.
Ben: Okay. Got you. Like a DUTCH test?
Mike: Yeah, we use the DUTCH test. I'm not as sold on the DUTCH test for men. I still think it's beneficial but it's–I mean, I think it's key for women.
Ben: Really? Why is that?
Mike: Because for multiple reasons. So, with women, especially perimenopausal and premenopausal women, there's so much fluctuation of the estrogen and progesterone throughout their cycle that if you just do a single serum test, it really–unless you know exactly what day of their cycle they're on, it's a very little benefit. And you also don't know how they're responding throughout the rest of their cycle.
DUTCH offers a test where you can basically get urine every single day for the entire cycle and you can map out their progesterone and estrogen changes throughout the entire cycle. So, I think it's extremely beneficial and determine if somebody has got estrogen dominance or if their estrogens are getting too low. So, it's just a totally different way than just a single serum test that makes it much more easy to figure out how to intervene.
Ben: Yeah, yeah. I actually like it for guys, too. I mean, for those of you who don't know the DUTCH test is measuring–it's a urine test. I have a whole podcast on it. Go to BenGreenfieldFitness.com/wildhealth and I'll link to–actually, I've got two big podcasts on the DUTCH test, but in a nutshell, it's a urinary measurement. You're peeing multiple times per day then you send it into the lab and what you get back is not just your levels of say testosterone or cortisol or melatonin or estrogens or progesterone or any of these other things that are being produced by your endocrine system, but you'll also get kind of like the upstream metabolites of those and the downstream metabolites of those you could say, “Well, hey. My cortisol is high but my cortisol is high because I got a bunch of cortisol metabolites and it appears that maybe cortisol is–or low cortisol metabolites where cortisol is getting produced, it's hanging around the bloodstream and maybe it's not that I'm producing too much cortisol, it's just not getting broken down in the way that it should, which can indicate things like hypothyroid issue or something else interfering with normal cortisol metabolism.”
So, rather than you just saying, “Oh, I got to figure out a way to lower my cortisol,” well, no. Maybe you need to work on your thyroid or maybe you need to adjust your diet. And so, there are all sorts of very interesting data. You can collect from it, but I'll link to that one in the shownotes if you guys want to learn more about the DUTCH test.
Another one that you guys I know kind of specialize in is cardiovascular health. When it comes to cardiovascular health, what are some of the big things that you do with your patients?
Mike: I mean, so many. In a lot of ways, that's similar to dementia and that it's multifactorial. There are lots of things that are causing cardiovascular disease, and it's also a huge problem, right? Just like dementia affects a huge part of the population, cardiovascular disease is the number one killer. So, it really requires, unfortunately, a very multi-modal approach again where the primary interventions probably account for about 80% of the benefit, and those include things like diet and lifestyle interventions.
But what we try to do is focus on three primary areas, and I think these are the primary factors for cardiovascular disease. And that's inflammation, endothelial dysfunction, and a high LDL particle count. I think those three things are the three things that most people would agree are the cause of most cardiovascular disease. And we want to attack each one of those directly.
Inflammation, for example. A complicated chronic disease process can originate from all kinds of different things from overtraining and running too much, to food sensitivities and a leaky gut. So, really, taking a very broad approach to identify the presence of inflammation and then trying to figure out how to correct it, it's a tough but it's a crucial part of the process.
Endothelial dysfunction. Now, this one's a little bit harder to test for. It requires some sort of hard-to-find lab tests, but it's fairly easily treated and that you can treat people's blood pressure, you can get them to start using the sauna, you can have them eat chocolate, polyphenols, things that can improve your endothelial dysfunction and improve the amount of nitrous oxide in your endothelium.
And then there's cholesterol. So, we mentioned cholesterol earlier. This one is challenging and really has to be personalized to each patient. There are lots of patients out there that absolutely want nothing to do with a statin, and I personally hate putting people on medications, especially if it's going to be for the rest of their life. I understand what kind of burden that is, but sometimes the risk is too great and they really do need to be on some sort of medication to reduce their cholesterol. But if we are going to go down that route, then I want to do that from a very precise way so that we're actually treating the elevated cholesterol based on the reason for it. So, is it because you produce too much? Is it because you absorb too much? Or is it because you don't clear enough? There are specific medications that act on each one of those processes in the body.
So, rather than just throw everybody on a high-dose statin, why don't we figure out why their cholesterol is high in the first place? Try some lifestyle and diet interventions first. And if those don't work, then put them on the medication that actually attacks that specific reason that it's elevated as opposed to just throwing everybody on a statin. It's all very nuanced, unfortunately, and I'm not sure I can give you a specific way that we go about it, but it really does take a holistic approach to try to attack something as huge as cardiovascular disease.
Ben: Are you guys familiar at all with Dr. Thomas Callan? He's been a podcast guest on my show before, and I'll link to a fantastic article that summarizes his approach to heart disease, but he throws in a few things in addition to like the inflammation and the endothelial dysfunction and the cholesterol that you had talked about. Number one is he looks at autonomic nervous system. He does a lot with heart rate variability testing and looking at issues in terms of like sympathetic nervous system versus parasympathetic nervous system balance, and even has a little-known plant extract that he uses. It's called the Insulin of the Heart. It's a seed extract from something called–I think it's pronounced strophanthin, something like that, but I'll link to a picture of it and to what exactly it is in the shownotes for people listening in. But he's actually got a lot of success with using that to balance specifically a decreased parasympathetic tone and excessive sympathetic activity.
He does that and then he also has an entire book that I actually caught a bunch of flak for when I mentioned on a Joe Rogan show because a lot of people came out of the woodwork saying it was woo science, but it's a book about how the heart is not a pump, and how the heart instead relies upon vortices of fluid in the way that those vortices of fluid move through the heart can, depending on the integrity of the fluid, allow the heart to be able to move fluid more easily in and out of it. That's a very basic, basic description. Read the book if you want to really take a deep dive into it, but he based on that, ensures that his patients are using like a really, really good mineral and also really, really good clean water and even water that's like structured or been exposed like infrared light to improve its actual ability to be able to create what's called an exclusion zone, like be able to travel through vessels more readily in the same way that fluids would travel through plants.
And the last thing he tackles is metabolic acidosis, meaning that he's trying to limit the glycolytic shift that would happen when the cells start to build up lactic acid and surrounding tissues. And he gets into how the build-up of lactic acid and myocardial tissues can be one of the things that causes angina or myocardial infarction. For that, he does adjustments, for example to diet. He tries to do things that would limit lactic acidosis. Speaking of metformin, that's one of the issues with metformin. He's also kind of big into this Weston A. Price diet. He's written a lot of books with Sally Fallon who heads up the Weston A. Price Foundation, and that's a diet that he has a lot of success with in his patients. He'd be an interesting guy for you guys to look into.
Mike: That's really interesting. The heart rate variability stuff I find really, really intriguing. I'm interested to see now that we're going to–obviously, these companies are collecting tons of HRV data on people if there's any true correlation between cardiovascular disease and the–because that's a great way of looking at parasympathetic versus sympathetic tone, right? It's your heart rate variability and whether that is increasing or decreasing.
Ben: Yeah. Yeah, exactly. Now, speaking of the Weston A. Price diet, do you guys have a specific diet or nutrition plan that you recommend? It's like one of your go-tos that you find to be successful in a high number of patients. Or do you have a specific way of going about identifying the perfect diet for each patient?
Mike: Yeah. I don't think there's one specific diet that we would recommend. I don't think Matt and our diets could be any more different. I'm basically eating mostly vegan and he's mostly in like ketosis on a fairly regular basis. But what we try to do is use genomics to sort of figure out what your predispositions are so that we can get a leg up and figure out exactly how you're going to respond to certain diets.
For example, we'll look at things like people are Alpha, people are Gamma snips, FTO snips, figure out those patients who have those snips are going to more likely have a negative reactivity to saturated fat diets or high saturated fat diets and probably do better with polyunsaturated fats. So, those patients we're probably not going to put on a high saturated fat diet. We're probably going to choose something that's got higher polyunsaturated fat so that we reduce their likelihood of insulin resistance and inflammation, cholesterol and cardiovascular disease.
Matt: But again, I think it's important to talk to the patient though. I mean, the Weston A. Price, if you had to put a name on a diet, that's probably as good as you get that and the Mediterranean diet. But I'm not going to–even we do the genomic testing, I'm not going to recommend the “perfect diet” for someone even if it is the perfect diet for them if they're not going to adhere to it. So, we start with what the person likes. If we identify 100 foods, for example, that they like then we're probably going to be able to pick 20 to 40 of those that aren't going to be harmful, and then combine the genomic, the microbiome and the lab data to back them into a good diet that they can enjoy their entire life, which to me is better than a perfect diet on paper that they're going to hate [01:07:12] ______ when they're eating it and they're simply going to stop doing. So, I think the Weston A. Price is a great diet, but we do try to drill down a little more and talk about someone's preferences and their genetics and then figure out for them what the best is going to be.
Ben: Mm-hmm. How do you guys eat? What's your diet look like, Matt?
Matt: Yeah. I eat–I'm trying to figure how to summarize it the best. I do eat ketogenic quite a bit. I cycle in and out of ketogenesis. I think there are some big benefits to ketones but at the same time, I'm just a huge fan of plants in general. It's a plant-based diet, but I try to get ketogenic [01:07:44] _______. The way that I do that is I really compressed feeding window. So, each day, I've got a fasting period. As small as I can get that feeding window, the smaller, the better, and then just as nutrient-dense as possible.
I never eat really breakfast. I usually [01:07:59] ______ by around noon. I usually try to break my fast after a workout. And then even my diet, my first meal of the day around noon, it's usually something that's pretty fat-based like some bone broth, maybe some almonds and some walnuts. And in the evening, I eat just a lot of greens, so a lot of crucifers, a lot of greens. Usually, I've got an instapot concoction I have most nights. If I don't have sardines, then I'll just eat this instapot concoction of a lot of wild mushrooms or mushrooms that I grow. I grow about a dozen different varieties of mushrooms on my farm. So, mushrooms, vegetables, bone broth, and then organ meat. I mean organ meat. I try to stay away from muscle meat as much as I can. Just really nutrient-dense food in a compressed time window I think would be the best description of what I eat.
Ben: Okay. Got it. Yeah.
Matt: I think I'm really fortunate where I live. There are a lot of great farmers around who raise their animals in a very humane way. And so, when you combine organ meats of either wild game or these animals with these wild mushrooms that are in season or the mushrooms that I'm growing that I'll dehydrate throughout the year so I have them all year. We're in a really nice environment for producing a lot of our food in a sustainable and nutritious way.
Ben: Now down there in Kentucky, you also, from what I understand, and I mentioned this briefly in the introduction, but you have like a castle that you work out of? Is that correct? Is your medical clinic in this castle? Or what's the deal with the castle?
Matt: Yeah. So, we basically have a castle in Kentucky. It's a boutique hotel and it's a farm-to-table restaurant. It's set on 110-acre organic farm. We've got a working saddlebred horse farm there, a giant organic garden, chickens we get eggs from every day, we've got goats, a culinary mushroom garden in the forest in the back, a truffle orchard where we're producing these European truffles inoculated on oak trees. It's a pretty cool place, and honestly, I'm really pumped to show you. I know you're coming out on April 6th.
Ben: Yeah. I'm bringing my family down on April 6th, but when I'm bringing my family down, this is an actual–like I know both you guys are going to be speaking and talking about a lot of this stuff and walking people through it hands-on. You've been kind enough to bring me down and my family down as well to present to people for like a good, like it's 9:00 a.m. to 1:00 p.m. For those of you in the Kentucky area or want to come check this thing out, a bunch of discussions and presentations and–what else are people going to be able to do there? How is this event going to work on April 6th?
Matt: Yeah. We like to educate people. We like to have a good time, too. It's going to be a great day. So, if you go to WildHealthpodcast.com/events, we got a description there. But really, our goal is to educate people–kind of with two goals. So, we want to get people and the knowledge to apply a lot of this for themselves. So, the things we're talking about now we'll dig deeper into. Have you dropped some of your knowledge on people? And we'll talk a lot about how you can do a lot of this on your own with direct-to-consumer options. Or if somebody really wants to find a clinician to help guide them, we at least want to educate them enough so they know the right questions to ask their physicians, to pick the right person, and then to take some basic steps and not fall into some of the traps of direct-to-consumer testing and a lot of the self-quantifying things that people can do.
So, yeah, we'll go 9:00 to 1:00 with education. And then after that, after the three of us give real-world examples and go deeper into these topics, we're going to take a field trip to what I think is the most beautiful horse racing track in the world, which is less than five minutes from the castle. Then after that, we're going to come back for dinner. We'll probably do a bourbon tasting. We have a bourbon steward and residence at the castle who's the only professor–he's the only professor of bourbon studies in the world, and he'll do some palate training with us. And then after that social lubrication of the bourbon tasting, then we'll do a Q&A where people can ask you their questions or ask their questions and really dive into this even more.
I think it's going to be incredible. I think the thing I'm most excited about is, I don't know how much room we'll have for this, but I think your kids, we're going to go forage in the woods and then your kids are going to teach us how to cook some.
Ben: Yeah. River and Terran are coming down. They're going to teach a cooking class. For people who want to bring their children, this thing's fully open to kids as well, yeah?
Matt: Yeah, for sure. We'll go and forage some. I've got some wooded acreage off side of the castle. My daughters, Madeline and Avery, they're 9 and 7. They love to gather wild food. So, we'll gather some wild foods and then your boys will show us how to cook it deliciously. I think that's going be a lot of fun.
Ben: Amazing. Yeah, I'm looking forward to it. So, for those of you listening in, you could–where would people fly into if they wanted to do it? What city?
Matt: Lexington. So, L-E-X, it's literally three minutes from the castle. So, you land there. You can pretty much see the castle when you land almost. It's really close. Yeah, land. Come have a good time with us and learn some. I think it's going to be a lot of fun.
Ben: Awesome. Very cool. I'll link to that in the shownotes. I know registration is pretty limited but once this podcast comes out, usually folks have about two or three days to act on these things I find before stuff just fills up. But I'll link to that. I'm also going to link to your guys' fantastic website and podcast in the shownotes and everything we talked about from the Alzheimer's research and the book by Dale Bredesen to my podcast with Onegevity Health to the ashwagandha and the DUTCH test and the Dr. Thomas Callan podcast, everything I discussed I'll put a link to in the shownotes. And again, that's going to be at BenGreenfieldFitness.com/wildhealth.
Matt, Mike, this has been very interesting and I think it opened up a lot of people, and hopefully, even inspired some physicians to expand their practices and start to do the kind of all-inclusive approach that you guys do. So, thanks what you're doing and keep up the good work.
Mike: Thanks, Ben.
Matt: Thanks. I've been taking notes. I can't wait for this shownotes because you mentioned several things I want to dig into more. So, thank you.
Ben: Yeah. Well, you guys got my email. You can always pick my brain more if you need to.
So, anyways, I'm Ben Greenfield. Thanks for listening in. This was Dr. Matt Dawson, [01:13:57] ______ talk, Dr. Matt Dawson and Dr. Mike Mallin of Wild Health in Versailles, Kentucky and Bend, Oregon. Look these guys up. Show notes are at BenGreenfieldFitness.com/wildhealth. Have an amazing week.
Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.
“The good physician treats the disease. The great physician treats the patient.”
– Sir William Osler
You deserve better than the broken, assembly-line medical system. The world deserves the optimized version of you. We can get you there.
So claim my guests on today's show, Dr. Matt Dawson and Dr. Mike Mallin of Wild Health, with locations in Versailles, KY, and Bend, OR.
Dr. Matt Dawson is a precision medicine physician in Lexington, KY, co-host of the Wild Health podcast and has been obsessed with performance optimization as long as he can remember. He received scholarships to play two sports in college even with “minimal talent” because of his voracious reading and implementation of any fitness or nutritional techniques that would give him an edge. Dr. Dawson continued that obsession in medical school and, as a physician, he has won national awards for education, innovation, and leadership. He has lectured in over 20 countries and trained thousands of other physicians through live lecture, online education, two textbooks, and an educational app.
Dr. Dawson combines his training in genomics and functional medicine to give personalized, precise medical guidance. His obsession with performance optimization has morphed from initially athletic to now mental performance and longevity. Whether it's a professional athlete or a grandparent optimizing their mental clarity and mobility to keep up with their grandkids, Dr. Dawson is passionate about helping everyone perform at their absolute peak.
Dr. Mike Mallin is a physician in Bend, OR who is obsessed with health performance and precision medicine and is co-founder of the Wild Health podcast. He completed medical school in South Carolina and trained in Emergency Medicine in Salt Lake City, UT where he competed in several ultramarathons and found his love for the mountains and performance.
Mike currently practices in Bend, OR and Lexington, KY in his precision medicine clinics. He is also co-founder of the Ultrasound Podcast, an educational podcast that has taught thousands of physicians all over the world how to use ultrasound, as well as Wild Health, his newest podcast focusing on health performance and longevity.
During our discussion, you'll discover:
-How Dr. Dawson played two sports in college despite possessing “minimal talent”…8:55
- Received two scholarships: tennis and soccer
- Became obsessed with performance; autodidactism
- Focused on helping others optimize their fitness and performance goals
- Ben had to figure out ways to train to overcome physical limitations in college – first foray into biohacking
-The story behind the founding of Wild Health…13:05
- Met 12 years ago, residency in Salt Lake City
- Interested in personal health for performance; competed with each other
- Became interested in genomics trying to fix Dr. Mallin's cholesterol numbers, which were very high
- Extremely high LDL; over 300
- Used epidemiology; lots of guesswork.
- Frustrated with conventional methods
- Saw need for adding genomic and microbiome data into the treatment
- Began studying “precision medicine”
- Treat patients primarily in person, in their respective clinics
- Data is important, but focus on a relationship, know patient's lifestyle, etc.
-What the heck is “precision medicine”…17:45
- First and foremost: not treating a patient as a statistic
- What may be true for a “population” may not necessarily be true for an individual
- Two individuals with the same problem (ex. insufficient Vitamin D) may require completely different treatments
-Machine learning algorithms and artificial intelligence used in precision medicine…20:10
- Closest we can come to that at the moment is the human brain
- Difficulty in obtaining accurate data is in lifestyle factors
- Great potential; Onegevity (listen to my podcast) has great potential but too many variables
- Is there a “gold standard” test that Drs. Mallin and Dawson use on their patients
- Varies with each individual according to their needs and specific situation/lifestyle
-Strategies Drs. Mallin and Dawson recommend in terms of athletic performance optimization…24:15
- Depends on the individual
- Some need more recovery time than others
- Genetic tests to determine power vs. endurance
- Focus on doing what people like to do
- Optimize sleep: Oura ring
- Elite athletes, exercise enthusiasts
- Won't change based on genetic data
- Focus on overtraining by using data to educate them appropriately
- Can better identify a power vs. endurance approach with someone who is more passive in their regimen
- What Matt's daily exercise regimen looks like:
- Sauna: near-infrared light, meditation (20 minutes)
- 90 lb. kettlebell; short sets (20 minutes)
- Reading (20 minutes)
- Short, compressed exercise much more efficacious than a long run, long sets of strenuous activity
- HRV, breath work
-How Drs. Mallin and Dawson approach cognitive performance, as well as dementia and Alzheimers…36:50
- Start with genetic testing
- Alzheimers easier to treat before symptoms start
- If you have apoe4 gene, you're 3-15x more likely to have Alzheimer's; earlier onset
- There are ways to treat Alzheimer's with the right data at hand
- Healthy diet, sleep, detoxification
- Book: The End of Alzheimer's by Dr. Dale Bredesen
- P Gingivalis
- The Fortune magazine article on BMAA
-How Drs. Mallin and Dawson approach longevity and anti-aging…43:30
- Ultimate hack: find an ancient practice (like fasting) that simulates a modern day compound like rapamycin or metformin
- Results from studies on athletes who take compounds like metformin?
- What about stem cells…
- Proceed with caution. Possible if a patient has major health issues.
- Educate them and let them make the decision they believe is best
- PulseCenter PEMF
-Drs. Mallin and Dawson's personal nutrition regimen…50:15
- TianChifor Ashwagandha
- Reduces blood sugar level
- Increasing testosterone and fertility
- KSM 66
- How do you measure for testosterone?
- 5 days of taking a supplement to getting to a “steady state”
- Test once per month
- Joovv Light
- Multi-modal approach
- First step: test for imbalance; then adjust lifestyle before supplementation
- DUTCH test: Key for women, not as much for men
- So much fluctuation of estrogen during the cycle
- More efficacious than single-serum test
- Listen to my podcast on the DUTCH test
-What about cardiovascular health…59:11
- Primary interventions – diet, lifestyle – help with 80% of cure
- 3 areas to focus on:
- Endothelial dysfunction
- High LDL particle count
- Treat based on the reason for the problem; not because there's a problem
- The Insulin Of The Heart: A Little-Known Seed Extract That May Be The Future Panacea For Heart Disease.
-How Drs. Mallin and Dawson go about identifying the perfect diet for people…
- They're both on very different diets
- Use genomics to figure out predispositions
- Weston A. Price
- Start with what the person likes; the “perfect diet” is useless if people don't adhere to it.
-About the Kentucky Castle, an upcoming event where Ben will be speaking…1:09:13
-And much more!
–Kentucky Castle Event: On April 6, 2019, Drs. Dawson and Mallin will show you the science of how to look at your genetics and personalize every life decision to what your body will respond best to. Ben Greenfield will share his vast knowledge of nutrition and exercise science to help you figure out how to hack your biology and get the most out of the genetics you were born with. This will happen at the amazing Kentucky Castle. Interactive discussions and presentations will take place from 9am – 1pm on April 6th. Then everyone will take a field trip to Keeneland to watch the sport of kings, thoroughbred horse racing, at the most beautiful race track in the world.
After the festivities, we'll return to the castle for a feast in the evening and dinner with Ben Greenfield and Drs. Dawson and Mallin. There they'll answer your specific questions about genomics, personalized medicine, the microbiome, or any other questions you have.
Registration is very limited, so click here to register now.
At this 2019 liver detox and R&R at the beautiful Swiss Mountain Clinic (formerly Paracelsus al Ronc) in the Italian quarter of Switzerland, you will stay on-site and receive diagnostics and treatments from the best doctors of biological medicine to detox your liver and your soul.
Plus you're going to have a wonderful time hiking, sightseeing and enjoying one of the most beautiful places in the world. Click here for more information. Spots are extremely limited!
–Runga in Napa Valley: In September and October this year, people from all over the world will come together at a pristine property nestled on the ridge between Napa and Sonoma Valley, for one of the most immersive wellness experiences in the world. Guests spend four days connecting with each other and themselves while learning and applying practices that are at the forefront of wellness and longevity.
This is the RUNGA Immersion. Click here for more information.
To keep up with all of Ben's upcoming public events, just visit the official Ben Greenfield Fitness Calendar.
Resources from this episode:
–TianChi for Ashwagandha
–Kion: The Daily Life Bundle contains Ben and Team Kion's go to, everyday essentials: Kion Bars, Coffee, Aminos and Kion Lean. Use discount code: BGF10 and receive 10% off your order.
–Zip Recruiter: The smartest way to hire. Use my link and try Zip Recruiter for FREE!
–Marc Pro: Helps you recover right and keep your body healthy, so you can do the things you love now without paying for it later. Use discount code: BEN to receive 10% off your order.