Dr. Kay Durairaj 0:15
Well, hello, hello guys. You're listening to Beauty Bites with Dr. K. Secrets of a Plastic Surgeon. Today's podcast, you're going to want to listen if you are an adult who has any adult tiredness. We're talking about the mitochondria, the energy reserves, resilience, and it's Dr. Scott Sher. He's a board-certified internal medicine physician specialist in hyperbaric oxygen therapy and a leader in health optimization medicine. He is chief medical and health education officer of Troescripts, and we're going to learn about troches and how they deliver product into your system fast. And then he is chief medical officer of One Base Health, so he focuses on helping patients with energy resilience, recovery, performance, and just kind of this approach that combines using your labs, using therapies, and targeted supplements, and integrative health strategies. So, so excited to have you on to learn about more. Scott, welcome.

Speaker 1 1:12
I'm happy to be here. Okay. Thank you. It's great to be here.

Dr. Kay Durairaj 1:14
Yeah, so your background was in the hospital doing critical care medicine, right?

Speaker 1 1:19
Well, hospital of medicine. So, I was a hospitalist for many years. I trained as an internal medicine physician at the University of Maryland. I went to medical school there, and then I did my residency, internal medicine. And then from there, I went directly into the hospital, being a hospitalist. And for those who don't know that, who, that, what that is, it's really basically like your primary care doctor in the hospital. So, you see, you see specialists, you see cardiologists, you see pulmonologists, and you have a hospital that's kind of like is the quarterback of your care, and so I did some critical care medicine throughout that time, but I never really thought I would be a full-time forever hospitalist. I actually grew up the son of a slightly crazy chiropractor named Dr. Alan Scher, who's still practicing in New York on Long Island, where I grew up, and, and so my goal was always to find a way to be more integrative in my approach, and I slowly weaned myself off of hospital medicine. It took, it took a while. I, my last shift was a year ago, last month, although I had done much less and created my own integrative practice as that was winding down, as I was having four children, of course, and those were growing, those are growing up, and and now they're they're probably somewhere in my house right now, but I, my, my integrative practice is from my home here outside of Boulder, Colorado, and I help run a couple companies, you said a couple of the names, transcriptions, one base, and we also have a nonprofit called Health Optimization Medicine and Practice, so I do all of these things now, but yes, I worked in acute care medicine for a long time, and I have a lot of respect for it, for what it can do, and I have a lot of respect also what it cannot do, and of course, also from the preventative medicine perspective, what we do in regular conventional care is put band aids on things, mostly, and that can be helpful sometimes, but if there's another philosophy, another way of looking at things, really from the, the sort of foundational aspects of our biology, and that for me is cellular energy metabolism, really, and mitochondrial medicine is kind of where I've been really spending a lot of time lately.

Dr. Kay Durairaj 3:17
I love that. I think that being involved in the inpatient care gives you the perspective to understand why everything we do now is prevention for getting into that emergency dire situation, but yeah, the emergency

Speaker 1 3:30
starts 10 years before, kind of, honestly,

Dr. Kay Durairaj 3:33
does like the moment you feel that adult tiredness is the moment you know your cellular optimization is falling, and we all have that, right? We all reach a day where we feel like, oh my god, I'm getting a little old, I feel it.

Dr. Kay Durairaj 3:46
That's super interesting to me. I also feel like mitochondrial health is going to be discovered to be the driver of most disease. What are things that people can do? Let's start at the beginning. We all know mitochondria are powerhouses of the cell. Yeah, sure. You learned in this past couple years diving into mitochondrial research that maybe people don't know.

Speaker 1 4:06
Yeah, it's good to start at the very beginning for people. And let's go back to eighth or ninth grade biology class, if you all of you remember. Maybe. So, I have a daughter that just finished ninth grade, and she's learning about the cell. You learn about the cell membrane, you learn about the nucleus, the cytoplasm, you learn about the mitochondria being the powerhouse of the cell, and in the picture that they show you of the cell that you're learning, you see one mitochondria and go, "Oh, this cell has one mitochondria, that's how it makes energy. But actually, what's interesting is that we have some cells in our body that have 1000s of mitochondria per cell, and we have other cells in our body that have actually very few, or zero. The red blood cell has zero mitochondria. It did, but then it matured to carry oxygen, so it stops having mitochondria as it matures. But the most mitochondria per cell are in your the types of tissue in your body that have the most needs or the most highest energy demands. Number one place is your reproductive organs, females. Yes, eggs, the oocytes have the most mitochondria per cell of any human cell out there. Sperm is not too far behind, but you're not using your reproductive organs all the time, right? Of course, but obviously making a baby is highly energy demanding, especially for the female. Right behind your reproductive organs, it's your brain, then your heart, your liver, your musculoskeletal tissue, and it goes down from there, and so if you can think about where do people most have symptoms when it comes to energy, it's usually their brain, right? So, brain fog, mood issues, mental health issues, but concentration issues, but also, of course, fertility, right? Fertility is a big deal, and you know, some of you have probably seen these, these popular articles about the last normal birth is going to happen in certain amounts of years, because, because fertility rates are going down so dramatically, right, and so this is because the mitochondria run the eggs, they run the sperm, and they run your brain, and so, and so, that's the overall picture here, and then the other big piece of this to know is that only 6% of the US population has optimized mitochondrial function. This is also known as metabolic health, and a lot of people have heard this term thrown around a lot. Are you metabolically healthy? You're metabolically healthy. What that really means is, can you make energy effectively in these powerhouses of your cell, in the mitochondria, not only making energy, but when we make energy in our cells, it's not free. We are like gasoline-powered cars. We make ATP, which is our energy currency. We make about 150 pounds of ATP every single day. It's a huge amount of energy that we need, but we also make, quote, unquote, waste products of making energy, things like carbon dioxide, which go to our plants and they make more oxygen for us, right? That's the beautiful cycle of life. But then also water and what are called reactive oxygen species, these are free radicals, also known, that are important to let the mitochondria know how much energy to make or to not make, but too many of these, if you don't have enough antioxidants to neutralize these, cause a lot of stress on the system. So, only nine, only 6% of the US population does this effectively on a regular basis. So, 94% of us are not doing it on a regular basis very effectively. So, that's a huge amount of us that are having stress in our mitochondria, and if you're having stress in your mitochondria, then well, this is what's happening, right? The whole system is going to start having challenges, and that's really why mitochondrial function is so important, because if you can't make energy effectively, everything else is not going to work as well. And from there, you know, we can go into the reasons why mitochondria aren't working very well, if you'd like, and there's other aspects of this, of course, that we can dive into.

Dr. Kay Durairaj 7:44
I think that's so critical for people to hear all that background. So, there are some ways to keep your mitochondria healthy. So, one way is to deal with all that reactive oxygen species and byproducts, waste products with antioxidants. Another way is to, like, boost mitophagy, or you know that process where we recycle our broken down mitochondria. Can you talk a little bit about both pathways and what people can do?

Speaker 1 8:09
Yeah, so think about it this way, for those that are listening at home, let's give you a quick science biochemistry lesson. It's going to be super simple, I promise. Okay, you have carbohydrates that you eat, you have fats that you eat, the main reason why we eat carbohydrates and fat is so that we can take electrons from our food, every piece of food, glucose, ketones, fats, these all have a chemical structure. Okay, they have electrons, and we actually take these electrons from our food, we break them down, the food products into the electrons, so these electrons can go into our mitochondria and then run through something called the electron transport chain, which is a chain of proteins in the mitochondria that allows you to pump a gradient against a gradient, so you can make energy when that gradient is released, and that's the ATP. Okay, so when you're looking at thinking, you're thinking about how do you optimize mitochondrial health, you're thinking about everything across that whole, that whole spectrum about the making energy side, and you're thinking about everything across the spectrum of detoxing from the energy that you make, and so there's a lot of factors there. Right, what are your macronutrients, and how optimized are you in that capacity? How well are you doing with your vitamins, minerals, nutrients, and cofactors, so that you can actually create those electrons and flow them into your electron transport chain. Everybody loves NAD right now, for example, right? NAD is like the hot thing, and that's because NAD, what it does, is it picks up electrons from your food and brings them to the electron transport chain, and as a result of that, you get these electrons that flow through. So, when you're thinking about mitochondrial health, what you really want to be thinking about is what's going on there, and then now let's take it a step higher, like the 30,000 foot view is what are the things that are causing mitochondrial dysfunction, right? And so one of the main reasons that people have mitochondrial dysfunction right now is because of insulin resistance, so if your blood sugars are too high, you're getting too much sugar in the body, too much. Glucose, too many of those electrons that we talked about. What happens is that your body can't keep up, your cells, your mitochondria can't keep up, and they create too much of that reactive oxygen species, and they start having like a rusting kind of thing. So the whole system starts breaking down. The other big elephant in the room is stress, and this stress - what I mean by stress is either sympathetic activation, typically, which is when the body is always in like a fight or flight kind of scenario, and if you're always in fight or flight, you're always, you know, running away from the proverbial saber tooth tiger or the bear, or whatever, even if you're this is doom scrolling for a lot of people here, this is a relate, this is a conversation with your spouse that you still are shaking about the next day, like this is stuff that sympathetic activation is the really the scourge of our society, because we are programmed from society to want to hustle, hustle, hustle all the time, you know. In medical school, I had shirts with my friends that said sleep is for quitters, right? You'll sleep when you're dead, kind of deal. And so this is not good for your mitochondria, because if you're always stressing it, you're pumping out things like cortisol, norepinephrine, and epinephrine, your neurotransmitters, and you're just stressing your mitochondria pretty dramatically as well. There's also toxins in our environment, including toxic people, that's more on the stress side, but toxins in our environment, like pollutants and cosmetics, and things like that. There's also infections that cause mitochondrial function. There's there's medications that do it too, things that are common, like metformin and statins and proton pump inhibitors and birth control pills, and the list goes on and on, antibiotics and fluoroquinolones, especially. So, it doesn't mean you want to, you don't want to take those things, or that these things aren't going to happen to you, but knowing that these are the causes of mitochondrial dysfunction, then you can start looking at how to optimize. Now, give your, your, give yourself some support.

Speaker 1 11:43
I know that oftentimes it's, it's not like it's going to happen overnight, because you know, like a lot of my patients, at least, and I'm sure yours too, K, on some level, they, they want to feel better tomorrow, but it took them 50 or 60 years to get to where they are, right? But the human condition is like, I can't wait three months to feel better, I want to feel better tomorrow. I want to feel better now, right. And so, if you have to give people what I do, at least in clinical practice, is a roadmap there, like what can we do now to support mitochondrial function, and then what can we do over the long term as well.

Dr. Kay Durairaj 12:12
I think that's so critical. So, supplement wise, there are obviously diet and exercise are going to give you the healthiest mitochondria, and sure, and in terms of like being adults, being busy, we'll all need some supplements, nutrient depleted. So, where would you start in terms of building a good mitochondrial protection stack?

Speaker 1 12:34
Yeah, so my, my best way, if possible, is to test and not guess, right, because what happens here is that there's so much you can take, what I do with my clients, and so we have a whole nonprofit that trains practitioners called Health Optimization Medicine, and what we do is train practitioners on a foundational framework that looks to optimize foundational biomarkers, optimize health rather than focusing on disease or root causes of disease, and the idea here is much of that is related to energy metabolism. Much of that is related to what are you deficient in, what are you toxic in? If you have heavy metals in the body, if your fatty acid profiles are not optimal, if you have poor B vitamin levels, if you need more minerals, you have more, if you have a lot of oxidative stress, you can measure all these. We use a science called metabolomics, which is the science of small molecules that are happening in real time in the cells, and this is a newer science, in quotes. It's been around for like 30 years, but it's only starting to now hit clinical practice. So, in a perfect world, Kay, I'm getting laboratory testing done, so I know what somebody needs, and when you know what somebody needs, that's fantastic. Maybe they need some Coq 10, maybe they need some glutathione, maybe they need some B vitamins, or whatever it might be. And then that's all going to support mitochondrial function, right? The challenge, though, is that it's not going to happen immediately. If I start somebody on some B vitamins and some antioxidants, it's not going to take them a while, three months or longer, to feel better, and so you mentioned dietary changes, that is huge. Starting to exercise, that's absolutely essential. Getting better sunlight exposure, you know, responsibly getting better hydration, working on stress is absolutely essential. And so, if you're thinking that you can power yourself through with more supplements, but still sleep four hours a night and yell at your husband every evening. Yes, it's.. it's.. there's only so much you can do, because if you're in the sympathetic mode all the time, you can't heal, you can't detox, because it's the other part of the nervous system, the parasympathetic that helps you rest, digest, relax, and detoxify. And so, classic, this happened to me, of course. Gay, I'm sure it's happened to you. Go on vacation, what happens? You get sick, right? Because what happens is right away your body starts relaxing, you start getting like an extra hour of sleep, and all of a sudden the body's like, oh. Is fantastic. I want more of this, so I can finally detox, right? Finally, get rid of some of the garbage that you haven't been able to do, and so that's why being in the parasympathetic mode is important. But I get it, nobody wants to get sick in the process, right? But you're not going to heal and optimize your brain fog or your energy, because, like, once your mitochondria start working better, k, like your brain far gets before your brain brain farts, brain fog gets better, your concentration gets better, your attention gets better, inflammation feels better, your energy throughout the day, your mood throughout the day gets better, so all these things are happening, but and this is the big thing, is that that all can be difficult for some people to do, as you were describing, as you were kind of probably reflecting a little bit there too, and for me too, and so sometimes what I'll do for people is to start giving them some mitochondrial support right away, and I've had a lot of success with a pretty strange and very blue compound called methylene blue in this case, even though it's not from the ground, it's not a natural compound. Again, not everything natural is good for everybody. Arsenic is natural, remember, and not everything synthetic is bad for you. We need synthetic things sometimes, and methane blue falls into that category of things that maybe you need every once in a while to kind of jumpstart, and I've used a lot of that in mitochondrial therapies over the last several years with a huge amount of success,

Dr. Kay Durairaj 16:24
that's so interesting. I definitely feel that phenomenon of your, you know, once your stress breaks, like right after you finish finals or you finish a hard stretch of work, and then your immune system tanks, and why is that? Because then finally you get a little break, and you get to rest, and your parasympathetic can turn on, but why should your immune cells function worse in that setting?

Speaker 1 16:44
Well, it's interesting that what you're, what really, what's happening there is that you're when you're on high stress mode all the time, you're pumping out cortisol, which is your stress hormone. We need cortisol, everybody. Cortisol is not evil, it's just something that should go up when you get up in the morning, up when you have more stressful events like exercise, and then come back down afterwards, but for many of us, we're living in this cortisol, we just kind of go up in the morning and stay up all day, and then maybe it goes up down a little bit at night, so you can sleep, then comes right back up, you know, kind of kind of thing, and so when you have cortisol running all day, it puts a huge amount of stress on your mitochondria, and if you put a huge amount of stress on the mitochondria, well, it stops. They stop making energies effectively. They actually flip over into a response called the cell danger response over time. And the cell danger response - there's three stages of it, but what happens is that the cells are supposed to go through all stages if there's an acute stress, but they can get stuck in some of these stages if there's a more of a chronic stress, and then instead of making energy the regular way, which is by breathing oxygen, you start making it from what's called fermentation or glycolysis, which becomes very much less effective, and when this happens, the immune system starts taking a big hit because immune system cells, they run on mitochondria, right, and so the mitochondria start working less effectively in the in the immune cells, and then the hormones that you have, they start also being affected, because the hormones can't be produced as well from the cells, mitochondria that aren't making enough energy, so you can make hormones or make neurotransmitters, and then this is what happens, you go on vacation, right? You relax your nervous system, finally, right? But then you crash. Why? Because your system didn't have enough energy, and it was so toxic because of being in this stress state for a long period of time. That now the immune system doesn't have enough power to help you mount a good response to help you, so that you don't get sick as a result of it, and so, and it's almost, it's evolutionarily on purpose, on some level, because the body is like, you know what, screw you, now I'm going to get you sick, so that we can finally get you out of these stuck pathways that you've been, because if people don't realize that, you know, this is maybe a little bit sort of a side, but like when I was growing up, the son of a chiropractor, my dad, I would be like, 'Dad, I feel sick. He's like, 'That's amazing. I'd be like, 'Why? He's like, 'Because your body's doing exactly what it needs to do to get healthy, right? And if you think about it that way, it's kind of an interesting one. So, I maybe that's a good reframe sometimes for people you know, because nobody wants

Dr. Kay Durairaj 19:22
to get a reset. Yes, nobody

Speaker 1 19:24
wants to get sick, but sometimes it's like it's forced rest, you know. And that's that's hard for a lot of us that are in the worlds that we are.

Dr. Kay Durairaj 19:31
Yeah, corn, it puts you on quarantine mode, where you have to rest. That's so true. It happens to me all the time when I go lecture at meetings. I'm like pumped, I'm excited, I'm, you know, getting everything coordinated, nervous on stage, and then you, your lectures over, and then you tank. I found the

Speaker 1 19:47
perfect, I have the perfect product at transcriptions for you for that. Oh my

Dr. Kay Durairaj 19:52
gosh, I need it, because then jet lag too, jet lag from my poor mitochondria that fly like all these international flights. What's jet lag is a big

Speaker 1 20:00
one. Yeah, that's

Dr. Kay Durairaj 20:02
a fun because you're on an airplane, right?

Speaker 1 20:04
Yeah, so there's lots of solutions. There's no perfect one, but when it comes to jet lag, the main thing to remember is that when you're on an airplane, you're pressurized to 8000 feet above sea level, right? So if you live most places, United States, I live in Colorado, I'm at 5500 feet here, but most people live at sea level, and so at sea level is about 21% oxygen in the air. By the way, another biochemistry lesson for everybody. Why do we breathe oxygen? Well, we breathe oxygen, which is just 21% of the air at sea level. The rest of it's about nitrogen, unless you live in a polluted area, whether there's more of those fun other chemicals in the air? Oxygen is what's called the final electron acceptor. We talked about those electrons going in the mitochondria, they need a place to go at the end, oxygen picks them up, and then we make water, and so that's why we need to breathe oxygen. So, on at sea level, 21% oxygen, so when you're in an airplane, you're pressurized to 8000 feet above sea level, and that's about, you know, relatively about 18% oxygen compared to the 21% oxygen that you have at sea level, and so, so what can you do in an airplane to help mitigate some of the some of these hypoxic conditions? Well, you can maintain hydration, that's really, really important, because you need hydration, because you get more dehydrated on an airplane, number two is that you really try not to eat very much on an airplane, unless it's like an international travel or trip like that, because when you're under hypoxic conditions, your insulin levels are more sensitive, especially, and so your blood sugar will rise higher if you're on an airplane and eat versus if you're on at sea level and eat, so and then my biggest thing on an airplane these days actually K has been methylene blue, because what methylene blue can do at low doses, like four to 15 or 16 milligrams, is really work on multiple pathways in the mitochondria that protect from a lot of the oxidative stress of being on an airplane, and also work exactly just like oxygen, and can actually pick up electrons just like oxygen would, even if there's less oxygen around, and so it's been a massive benefit. So, anybody traveling, you know, any of my patients always gets methylene blue when they're on their airplane, because that really does seem to make a big difference. There's many other things that you can do, there's light exposure, there's there's circadian rhythm timing, depending on how far away you're going, and things like that, or the best hack of them all I found. Okay, is to live in Colorado, because I live, I'm already at 5500 feet, so for me going on an airplane, it's at 8000 but, but when I get off the plane, it's at sea level, and so my, my sleep score is my ring loves me, because all of a sudden I've, I'm now, you know, hyper oxygenated compared to what I am typically at baseline, so my HRV goes up, my deep sleep goes up, even in, you know, when I'm at, in a, in a hotel room, and no matter where I am around the world, um, usually it's going to do that, so I'm, that's, that's the biggest, I think, benefit that I have now, being in Colorado, is that I live at altitude already, which makes it a lot better, but my mainstays are not eating on a plane, staying well hydrated, trying my best to get methylene blue on board, if I can, even for me, it does seem to help. And then, when you get to your destination, it's so important to work on your circadian rhythms, and so getting good sleep, I use supplementation for this. We have a product at Transcriptions called Troze, which I like a lot, which works on the GABA system and four other sleep systems, including serotonin, melatonin, adenosine, and the endocannabinoids. So it's, it's eight ingredients. It's a really comprehensive formula that works like a charm. And then we have another one called Trommun, which is high-strength extract of the Cordyceps mushroom. It's Cordycepin, which is the most active component of the mushroom.

Speaker 1 23:48
Cordyceps has been around for 1000s of years as a fantastic mushroom for energy, but Cordycepine works on what's called the adenosine pathways, and so it increases deep sleep, and it's also an immune system activator, so blocks RNA replication, so my hack when I travel, K, is I breathe, I bring like a nasal spray with me, so I do the nasal sprays when I get to my destination, so that you kind of clear out your nasal passages, that's typically where we get the viral infections when we travel in our nose, and then, and then, in addition, I take the Troimun every night, and I'm on the road every month, at least once a month, and starting that has been game-changing for me. I used to get sick, I just.. I don't anymore. And even my kids, I have a whole bowl of the Trommun at my house, because I have four of them, and so anytime anybody's got a sniffle, it's like giving them Trommun along the way, and even my wife, who's a physician and listens to zero of what I say, she will take the true immune if she's not feeling well, because she knows it's also going to help if you get it like on the immediate signs of something like you're coming down with something, it is game changing. Absolutely.

Dr. Kay Durairaj 24:53
Wow, I'm gonna have to try that. Yeah, also in the four kid club and the physician husband club. And oh, wow, look at us here forever to get him on like NAD precursors or even anything, and NAD precursors I take too when I travel, I think, Bill, that that helps the whole mitochondrial chain for sure,

Speaker 1 25:12
yeah, yeah, I think that's a good one,

Dr. Kay Durairaj 25:13
yeah, methylene blue, for what kind of dosing should people be doing when they're taking methylene blue, it's been always a little something I wanted to try, but slightly puzzling, as to the dose. What's the duration? What's the frequency of that, and how does it not stain your teeth? Sure, yes, it's it

Speaker 1 25:30
is very blue. It's shockingly blue, and it will make your urine blue. So, people that are taking it need to know that, and it's also important that you get a good source of it. The challenge of methylene blue is that it's made in a lab, and so it's often contaminated with heavy metals, things like lead, mercury, cadmium, and arsenic, which you don't obviously want. And so we've done a lot of testing with a lot of the other companies out there, the ones that direct to consumer on Amazon, and most of them do not meet their label claims for either purity or potency, even though they say they're pharmaceutical grade on the label, they say they're US-made, which is also a bunch of bull. Like, there's a guy that reached out to me a while ago, he's like, "Doc, I bought some methylene blue from Amazon that said it was made in the USA, but it took three weeks to get through customs, you know that kind of deal. So, obviously, you have to be very careful, and so our company, you know, we were the first company to come out with a methylene blue product back in 2020 so we have a long history. So we were the first commercial product using Methylene Blue, basically since the 1950s Really, it was used in early days as an antimicrobial at high doses. It's actually a fantastic antimicrobial at higher doses, around a milligram per kilogram to two milligrams per kilogram, but in general, mitochondrial dosing is much lower than that. It's usually somewhere around eight to 25 milligrams, either daily or BID, or twice daily, depending on the person. But it's not like you need to take it every day, especially pretty well optimized. It's something you can take as needed for more energy, less brain fog, if you're traveling, or somebody's sick at the house or something like that, but in some cases I do recommend taking it more regularly, especially if you have a long way to go with your health. If you've been sick for a while, like I've just seen amazing benefits with people with symptoms for long periods of time, things like for people with that need mitochondrial support with long COVID and fibromyalgia, chronic fatigue, chronic brain fog, chronic mold exposure, Lyme. Like, I'm not saying that methylene blue is treating those per se. What I'm saying is that methylene blue is really working on the mitochondrial side of that and massively improving, improving energy and capacity. And then it's much easier to do some of the more challenging therapeutics and lifestyle things, you know, when you, when you have more energy, right, and I often tell my patients it's like, let's get you more energy, so you can do the lifestyle and diet and supplementation, so that you can feel better along the way, and I think that's that's been like the biggest way I've used it over the years is as a bridge for patients, and so that they can truly start making huger, bigger gains faster, and so that they feel better, and then they're more motivated to do some of the harder things, like changing their diet, or getting out of a bad relationship, or getting out of the bedroom when you're, you have a snoring partner that keeps you waking you up all night, like that's the wonders of a sleep divorce, can go a long way for your health, right? So, so those are that, that's how I think about using it. It's just important to get good quality stuff. I don't recommend buying it directly from Amazon, and the liquids are really not usually very good as well, from the same reasons, and they're super, super messy, because if you get methylene blue on a countertop, it's not something that's going to come out, unless you have the antidote for that, which is buffered vitamin C. So, in my house, I've saved my marriage at least three or four times with buffered vitamin C. I don't have liquid, but I have that. I have that. I have transcriptions. We use what's called a buckle trochee. It's a dissolvable lozenge that typically goes between your upper cheek and gum and dissolves over about 30 to 45 sorry, 15 to 30 minutes. It takes about 30 minutes to work, that kind of thing. It's great. The buccal turkeys are faster acting.

Speaker 1 29:07
The ingredients are typically more bioavailable when you dissolve in the mouth as well. But methylene blue is very, very blue, and so the good news is that you can swallow your methylene blue. You don't have to dissolve in the mouth. Methylene blue swallowed very highly bioavailable, and will work almost as well as dissolving into the mouth, because of the bioavailability being above 70 or 80% which is pretty unusual for most supplements as well. So, swallow your methylene blue on an empty stomach. The beautiful thing about this 2k is it's not like you need to wait 30 days or a month to see if this works for you at one dose. If it doesn't work in three to five days, go up to the next dose, try the next dose, and try to do something the way we typically recommend with our company at transcriptions is that we have the trochees, so they're they're scored, and so you can take a quarter of one, then you can take a half, three quarters full, and then kind of titrate to fine. The right dose, you know, for you, and, and once you find the right dose, you should know it. It should be better energy, less brain fog, a better mood, or in some cases, you know, for me, oftentimes it's just better energy throughout the day. You look at the day after it's over and go, oh, I didn't get tired in the middle of the day, I didn't yell at my son when he was asking about me something in the middle of the afternoon, because I wasn't tired, and I didn't react, you know. Instead of I responded right, and so it becomes something that you know is evident when you find the right dosing for it, and it really can be transformative. And I know that there was a big trend for the last year or so talking about it, and I think that's great, but like any trend, like there's now a little bit of a little bit of a boomerang effect, which is not unusual, but clinically this stuff does work, and I highly recommend people give it a try. I

Dr. Kay Durairaj 30:47
think so, not everyday therapy, but just pulse therapy when you feel you need it, and you're just looking at your own symptoms and tiredness. Or would you recommend some people take it every day because they're always deprived, energy deficient,

Speaker 1 31:01
I think it depends on the person. Oftentimes, what I try to do is over time, if somebody needs it more, is to wean it down, right? Is to have them use it less over time as they, as their system gets more optimized. It's not the only thing that I'm doing, for sure. And it's very safe at these low doses. You can take them at these low doses for long periods of time without any issues, but it's important in my world, at least, is always trying to wean people down off of things that are more sort of, in some ways, temporizing, you know, methylene blue is going to temporize, because it's going to, it's going to support the system, but if you did nothing else and just took methylene blue and then stopped it, very likely your symptoms would come back, because you weren't doing anything else to support the system, so the way I typically use it personally, and the way I recommend, if you're more optimized, optimized is as needed, right? Use it for long days of work, use it when you're on an airplane, use it when somebody's sick at the house, or you didn't get a good night of sleep that night before, you know, that kind of thing, and that's that's been, you know, that's been the way I typically use it for more optimized people, and also on the sort of the athletic side, there is least some evidence that it can improve endurance, specifically. And then your time to what's called your lactate threshold, and so I do have a lot of endurance guys that are using, and gals that are using methylene blue on that side of things, so cycling, endurance races, ultramarathons, those kinds of things, and seeing significant benefit because it increases aerobic capacity. So that's kind of how I think about using it in those capacities too.

Dr. Kay Durairaj 32:30
And should I worry that it's going to dye my entire GI tract blue? If I look inside of you, you're going to be like, no lined blue, no tricked over quickly, and it's, yeah, not really,

Speaker 1 32:42
yeah, unless you're doing super, super high. So, there was a, there was a article written about a year and a half ago talking about blue brains, and these are people that had up to about 300 milligrams of methylene blue IV, because they were dying of something terrible, like caribou arrest, septic shock, and they were giving methylene blue as a last-ditch effort, because at very high doses, methylene blue can improve vaso, can potentially treat vasoplastic shock, so it can basically constrict blood vessels. So that's what they were trying, but all these people died, and in the study, and they biopsied or autopsied their brains within four hours of dying, and their brains were blue, which is not shocking, because that's a huge amount of methylene blue, but my estimation is that if these patients had lived, their brains would not have been blue, because methylene blue recycles itself, it goes back and forth between blue and colorless blue and colorless blue and colorless, depending on its redox state, and fancy words for whether it has electrons or not, and so as it's urinated out, it's urinated blue and colorless together, so I don't have any. I've been doing this a long time, and I haven't seen anybody's organs reported to be blue, and I don't expect that to happen anytime soon. So,

Dr. Kay Durairaj 33:52
interesting. Well, I've heard so many good things about it. I can't wait to try that a little bit more in my regimen. Yeah, I'll send you

Speaker 1 34:00
some.

Dr. Kay Durairaj 34:00
Yeah, I am a big fan of urethane, a yeah, spermidine. Maybe talk a little bit about how those things are good for mitochondrial health and just general autophagy. So, are you using any of those in your own practice or your health?

Speaker 1 34:16
I'm not using them that much yet, but I'm starting to use them more. I would say that the challenge with something like your lithium A is it's difficult to measure, like how it's well, it's working, right? You just kind of like, and then the same thing with spermidine as well, like you guys kind of like understand the research and just kind of pray that it's working, you know, that's kind of the idea. Although I'm seeing more and more stuff about Eurolithin A, and I'm just, it's unfortunately it's very expensive for patients, and that's what is

Dr. Kay Durairaj 34:43
expensive. Yeah,

Speaker 1 34:44
there's only one company that allows anybody to sell it, and so as a result of that, it's very difficult to use in a lot of people, because if you have them on a regimen of other mitochondrial optimization things, you don't know this is gonna be 100 bucks a month for a new supplement, they're like, what, you know, and so. Yeah, I've been having a challenge with that, but, but I think that price will come down, and I'll be using it more, because I have seen some benefit, at least from some of my, some of my colleagues and me, when I've trialed it in the past. Sperm, it means, you know, autophagy and mitophagy are really important, which is the, the when our cells kind of recycle themselves, and mitochondria recycle themselves. So, I think spermidine is great, I think. I think also intermittent fasting can be helpful in this capacity as well, and, and, but I do use spermidine, and I think it's fantastic. I have a friend, a friend's company that does has a spermidine skin as well, like a skincare product that's also very nice that I've used before. And then I think that that's a lot of things are happening in the skincare world, as you likely know, with some of these, some of these products as well, which is interesting.

Dr. Kay Durairaj 35:46
I think it's so interesting. I have found definitely some people respond to the pomegranate, you know, that's an idea for sure. So, but I did find a good one on Amazon, though. Every time I take it, I feel great. So, I mean, I, I'm hesitant on Amazon type drugs, but yeah, but that you can experiment with those, so you have a saying that you say that the sequence matters in healing, so tends to break first. What do you fix versus it sleep, is it mitochondria, is it redox balance, or immune system, nervous system? What does the sequence matter?

Speaker 1 36:22
The sequencing is a big deal, and what I mean by sequencing, of course, is what do you do first, what do you do second, third, and fourth, and a lot of this depends on kind of where you're at with your health overall, but in general, what I would, I always go back to is, if you want to have less anxiety, you need more energy, if you want to have more energy, well, then you need more energy, right, and so the two complaints that we see from patients, at least that I, when I talk to colleagues, and, and my own practice is a reflection of this, is that the two major complaints that people have is that I want more energy and I want to be less anxious, right, those are the main two things, and they go back and forth, sometimes it's anxiety is number one, sometimes it's it's it's energy, but they go back and forth, but, but in essence, these are both energetic problems, energetic problems, because if you have a lot of anxiety and you've been in sympathetic for a long period of time, you've depleted your energy stores, so if you're trying to just take care of your anxiety without working on the energy side first, you can crash, and this is what happens with a lot of people, is that they've been running at such a high level, and they start trying to down regulate their nervous system, and then they crash, right? They crash not only from an energy perspective, they crash from a sickness perspective, like being on vacation times 100 right? It can be pretty nasty for people, and this is this became very evident to me recently, over the last six months, or a year, Kay, because I was talking to a couple of my colleagues that were talking, we're treating patients that were very sick, you know, people that have been, you know, chronic sick for a long period of time, you know, usual kinds of complex medical illnesses with lots of different names, and several of them had gotten and gotten what are called sympathetic ganglion blocks. A sympathetic ganglion block is basically a nerve block of your sympathetic nervous system basically shuts down your sympathetic nervous system, and three or four of these colleagues of mine all describe their patients absolutely crashing and being in bed for weeks afterwards, right? Why? Because you just shut down what was keeping them alive, right? Then now that you shut it down, their cells have no capacity to make energy, and so my sequence for almost everybody these days - anxiety, depression, energy issues - is to work on energy first, and I don't mean this in a woo woo way. I mean this working on the mitochondrial energy side first, and this doesn't have to be for a long period of time, but at least giving people a base of energy support before starting to think about downregulating the stress response, and this is important, because a lot of people don't even realize that they're running at high capacity, like they've done it for such a long period of time that they don't even know where parasympathetic is, you know, and when you're going parasympathetic for the first time, or the first couple times, it could be scary too, knowing that the system's kind of, kind of, kind of coming down, and if you, but if you have more energy available to you, it's a lot more tolerable, a lot easier for people to do this, and then once you give them the experience of having the nervous system calm down with enough energy on board, then you can teach breath work, or you can have them go learn breath work. You can teach yoga, you can teach mindfulness, you can get them to start exercising a little bit again, but and know where that parasympathetic is. You know, I think that's the big thing that I've found over the years is that most people don't even know what that parasympathetic mode is anymore, and but if you get them there too abruptly, then it could be very jarring, and that could be very difficult, and so my sequence oftentimes is energy first, working on mitochondrial side, working on optimizing mitochondrial support energy metabolism, as we were talking about earlier, as we've been speaking, and looking at things that can help.

Speaker 1 39:56
Now I've been using a lot of methylene blue, it's not the only thing I. Use, but certainly diet, lifestyle, sun exposure, mineral, mineral hydration - these are big ones, and, and that's where I typically start with a lot of people, and then from there adding on something like methylene blue, and then down regulating the stress response from there, so the sequence is first energy support, that second, then work on down regulating your stress response. I promise you, all of you listening could do better with your stress response, right? But if I tell you to calm down, that ain't gonna work, right? And so it's sometimes nice to have supplementation that can help you there. And this is, you know, at transcriptions, we have a bunch of products, something like Trocomm and Trozy for anxiety and for sleep, that that are great, because these can really help give you that experience without having you to figure out what that experience is, because you haven't had it in a while. I guess the overarching here, K, is of course sleep as well, right? So, like, in the sense that for some people that's exactly where I'll start, is just on sleep, regulating sleep, even if trying to get instead of four hours, getting them five hours, or whatever it might be, even small amounts of sleep, even 20 or 30 minutes can go a long way, and I know that from my own personal experience, like in the summertime, when my kids aren't going to school in the morning, super early, I get 20 to 30 minutes of sleep more a day, like that's huge for me, right, and I feel it on a daily basis, and so sleep is a big one, and so regulating sleep is absolutely essential. You cannot do any of these things that I just described if you're getting four hours of sleep a night and it's trashed. So, if you're drinking alcohol, probably not going to work either, right? So, there's certain things like that that are really just low hanging, not low hanging fruit, always not easy always to deal with, but certainly some of them can be, and make huge differences. Alcohol being a big one, of course.

Dr. Kay Durairaj 41:46
I think it's so important what you said earlier, too, about getting tested, so you're not just guessing at what to fix, the metabolomics, and then other baseline testing. What do you usually start with for a good overall check, other than you know, when you see your internist, you get your, you're not going to die this year labs, you're like your CBC and your chemistry, and that's about all they care about. And, but what do you recommend as a good testing panel?

Speaker 1 42:14
It's absolutely essential that people get their regular labs done with their conventional doctors, for the reasons that you mentioned, Kay, that the not die panel. I like that, but when you're looking to optimize your health, what I do, at least in my practice, it's based on the framework that we've developed, called Health Optimization Medicine, and this framework looks at metabolomic testing, which is a base assessment of vitamins, minerals, nutrients, cofactors, and energy, heavy metals, fatty acids, lots of different things that are involved in the cell working itself. I also do a gut analysis, looking at poop is very, very helpful. I don't look at it personally, but somebody else in the lab does. And then we look at all the analytes of of what's going on in the poop itself, and and then I typically do a food sensitivity test, although there's controversy around these and how effective they are. I think they could be helpful in the short term, at least to give a sense of what might be happening, but I don't hang my hat on their results. I really do look at this clinically, and so those are my base tests for everybody. And then usually I do hormone testing as well, although that's not done immediately under most circumstances, because when you can nutrient gut optimize people, they're going to feel better, and their hormones are going to also improve. And so, I mean, I've seen this time and time again. Somebody that you think that needs to be on testosterone, for example, then you can optimize their diet, their lifestyle, their supplementation, and their testosterone goes up by 400 points. So, like, well, you don't need to be on testosterone now, you just need to have less stress, a better diet, and optimize your, your energy metabolism, right? So, but hormones are a big part of that too, and and then, of course, you can add on things like peptides, can be helpful, but not too early most of the time, because if you, if you're working on working with peptides, peptides are signals, they're not the main things that change biology, and so they can be helpful, but if you're just using peptides without some of the other basic foundational stuff, you're not going to see the benefit usually for what you're looking for.

Dr. Kay Durairaj 44:10
Interesting, in terms of women and menopause, like with when their hormones are dysregulated, do you feel that you have a harder challenge in fixing energy levels, I mean, of course, you probably do, but where do you start? There

Speaker 1 44:27
it's a challenging time, I know this. Yeah, I have, I have a wife that's going through this, and so, but you know, hormone balancing is, I think, essential. I mean, if it's there's no major contraindications, being on hormone replacement therapy can be really, really helpful for a lot of women, but it's not often the only thing that's going to help, because even if you're hormone balanced, you're still going through transitions, your hormones are still going to be fluctuating, and an estrogen is your one of your best mitochondrial optimizers out there, right? This is why during ovulation, when your estrogen levels are the highest, you feel. All the best, right. And then progesterone is fantastic to help you with relaxation and sleep, and we don't have enough of that around, your sleep gets messed up. And even if having enough of those, having the hormones around is helpful. But what I found over the years is that working on mitochondrial function with women going through this is absolutely game changing, right. So methylene blue has been game changing in these patients, and also the stress response, right, looking at how many women, especially in midlife, are managing a lot of things all at the same time, they have a job, they have kids, they have a spouse that may, it may or may not, you know, help around the house, but a lot of them do, still a lot of them do now, but but I find that they were going at a high level, and then all of a sudden the hormones started shifting, and then things, you know, kind of go down a cliff, and so, and HRT is not often the only answer, right? Optimizing diet, lifestyle, I've had a lot of great success using Methylene Blue, and, and also our, you know, our products specifically that are working on the stress response too, so it's a combination of things, right, but working on mitochondrial function in this, in this, in this group of patients is absolutely game changing outside of HRT.

Dr. Kay Durairaj 46:10
I think that's super important for women, just they have a whole different physiology going on, you know, in terms of the hyperbaric oxygen therapy, that's also super fascinating to me, because I think you know, too much hyperbaric on too much oxygen can give a lot of free radicals and issues and damage, but the maybe perhaps the right amount can stimulate stem cells to be released and repair, and you know, your clarity of thought, what, etc. Why do you like hyperbaric, and how much is the right amount?

Speaker 1 46:40
Have you used it in practice as a plastic surgeon? Okay,

Dr. Kay Durairaj 46:43
I have. Yeah, for wound healing, for vascular occlusion problems. For me personally, I've gotten some, and I love how I feel afterwards.

Speaker 1 46:52
Nice, nice, yeah. And so it's classically a wound healing, wound healing technology, right? Because what it does is it's a fantastic acute wound healing technology, especially because it's going to leverage the body's own natural systems to heal things faster, and you see this time and time again. I see people heal 50% faster in a hyperbaric chamber after an acute event, sometimes even faster than that, and that's because we're leveraging the body's biology by releasing more stem cells, getting more oxygen to tissue, decreasing inflammation, decreasing swelling, so that all can happen very effectively. The challenge, though, is if you have a chronic issue, hyperbaric therapy is going to cause a lot more oxygen in circulation, and you mentioned that case, so that's what hyperbaric therapy does, and so that's good. However, it may not be right, because if you have a lot of oxygen in circulation, that oxygen is going to help you make more energy, but it's also going to cause more reactive oxygen stress, or reductive stress, and as a result of that, does the body have the capacity to be able to manage that stress, and that's having enough antioxidants around, or the machinery to be able to not only make the energy, but also detox from the energy you make, as we talked about earlier, and so in that context it's almost better, almost always better to look at not going into a hyperbaric chamber right away, but optimizing your health foundationally, so that when you go into a chamber, you can leverage the technology to make the changes, because long term, what methyl, excuse me, what hyperbaric therapy will do is change how your DNA expresses itself in various ways, because of the oxidative stress, so you need the oxidative stress for hyperbaric therapy to work most effectively, but if you can't tolerate it, then that's a problem, right? And so, but the oxidative stress itself increases your capacity to make new blood vessels, increases your capacity for stem cells to not only be released but also to mature into the tissues that you want them to mature in, it also downregulates inflammatory pathways, things like interleukins and TNF alpha, and things like that. It also down regulates or optimizes immune system function as well, and improves lymphatic flow, amongst other things. And so it could be a great technology. I think a lot of it depends on just the timing of it, but I use it a lot in acute wound healing, without a doubt, because it's almost always going to be helpful there. If it's more of a chronic issue, then it's about the timing, and it's about the pressure, because the more pressure that the tank is under, the more oxygen is going to get in circulation. So, your milder pressure chambers, soft chambers, things like that, they go to milder pressures. They're typically safer, because less oxygen, less pressure, so you can't really do a lot of harm most of the time, but deeper pressures are more therapeutic, but they also have the potential to cause more oxidative stress, and not the hormetic stress that we're looking for, you know, hormesis being a good type of stress, where you have like sort of distress or not good stress, which happens if you have deeper pressures without the capacity, so I use a lot of hyperbaric therapy in patients, but I use it in the context of kind of where they are in their health journey. I like to say it's not if you need hyperbaric therapy, it's when, like everybody, I think can benefit at some point. The question is just when that's best for you, and I've used it for traumatic brain injury and stroke, and for chronic infection, and cognitive impairment. And regenerative therapies, so combinations with stem cells, PRP, other types of regenerative things. I've, I've used it for lots of different things, and with a lot of benefit over the years when it's in the right context.

Dr. Kay Durairaj 50:13
So, interesting, I think in esthetics and plastic surgery, and the things that we're doing, trying to use bioregenerative therapies to, like, turn on the body's own healing capacity. We, we care about external beauty, but we also care about internal beauty. What for patients who do care about longevity and esthetics, kind of what internal imbalances are quietly sabotaging them that they don't even know? Their results could be better if only

Speaker 1 50:42
I would like everybody to take a second and answer that question that's been listening so far. Right, it's optimizing mitochondrial function. It's optimizing your capacity to make energy in your cells and to detox from them, because guess what? Your skin cells, they're regular cells, they have mitochondria as well, and they turn over much faster. The mitochondria in your skin cells deteriorates faster in some cases, in a lot of cases, compared to internal mitochondria, because of how fast they are producing and dividing all the time, and it's if you have skin issues that is a sign of internal issues too, right? This is your skin is a window into the net

Dr. Kay Durairaj 51:19
subs indicator, totally. Yes,

Speaker 1 51:21
exactly. So, your skin is a window into the rest of your body. Dr. Ted, might one of my colleagues who founded Home Hope, our nonprofit, and transcriptions like to say that your skin is your reverse gut, right? It's basically the outside environment is just being bludgeoned by your skin is being bludgeoned by it, right. And so it's trying to protect itself, it's got UV radiation, it's got, you know, it's got mechanical injury, it's got everything, and so it's a very good window into the rest of your body, and how you're doing, right? And so, yes, you can move to Colorado, and your skin's going to look worse, like mine has, because you're going to be more dehydrated more of the time. Okay, so there's that, right? And all the

Dr. Kay Durairaj 51:57
UV, and all

Speaker 1 51:58
the UV as well, right? Exactly. So, so you know there are environmental things that are very important here, but if you're looking at really optimizing your biology from the inside out, it's really working on cellular function, and it's the basic cell, your regular cell that you learned about in eighth and ninth grade biology class. But how do you optimize that? What's your cell membrane made up of? Made up of good fats, right? What's your cytosol made up? It is made up of water, structured water, like what is, you know, what are your other there? What are the other things made up? They made of proteins, right? So you need proteins, you need, you need precursors for these, you know. And so that's why, like, you need to have the right building blocks, and the mitochondria are really what runs the entire cell, from its capacity to be efficient or not, and so if you focus on mitochondrial function, the issues outside of that will get better most of the time if you're focusing primarily there.

Dr. Kay Durairaj 52:51
Wonderful, that's good. It's a good unifying theme. It's like the, and the more complex we get, the more we go back to the rudimentary things of like sleep, diet, exercise, getting some sun, and like living like a farmer. Yeah, community. I love, I love all of that.

Speaker 1 53:12
Just, it's not easy for everybody to do it. They're easy things to say, right? Easy for us to say, oh, get more sleep, get change your diet, get some more exercise, like. But the challenge again is, if you don't have enough energy to do that,

Speaker 2 53:23
yeah, it's

Speaker 1 53:23
hard, right. And so that's why,

Dr. Kay Durairaj 53:25
yeah,

Speaker 1 53:26
yeah, that's why starting with energy first has been really transformative to my practice, and a lot to a lot of other people. As I've been talking about this for a while, I always get responses from, from people directly, from my colleagues that are starting to think about this more in a sequenced way, and it's they're already thinking about it on some level, they already realize it, but, but they haven't quite put it together until I tell them, and, like, oh yeah, of course, and then, then you start doing it, it's like it's game changing, right, because all of a sudden you got energy to do the things that you didn't have energy to do before, you know, which is nice, like take a walk around the block and get outside for five minutes instead of staring into a screen, like that's these are small things that can go a long way,

Dr. Kay Durairaj 54:03
yeah. And then low energy leads you to eat sugar and eat carbs and bad stuff to get fast energy, and then yeah, in terms of insulin resistance and you know having high level of glucose or glycolation, is there something mitochondrial impact with that?

Speaker 1 54:20
Oh, absolutely. Yeah, I mean, as I mentioned earlier, the number one, or maybe number two, cause of mitochondrial dysfunction is having too much sugar in the body, having insulin resistance, and so regulating your blood sugar is absolutely essential. And this can be hard, especially in midlife, you know, when you have, you know, hormone shifts and things like that. It can be more difficult metabolically, it's just really important to do it right. So, there's there's intermittent fasting, there's getting on better mitochondrial support, there's changing, obviously, your diet. A big thing for a lot of women, especially, is stress. Like, people don't realize that stress itself will increase your blood sugar. Why? Right, because cortisol, which is the. Stress hormone, which we need, as we talked about earlier. If it's elevated all the time, it's going to be pumping in blood sugar into your bloodstream, because it thinks that you are running from a lion, and so, as a result of that, you need all this sugar in circulation to get to your cells, at least the body thinks so. And so that's why I found in a lot of women in midlife there they're their hemoglobin A 1c goes up, and their blood sugar is going up, but they're not even having a lot of carbs, like a lot of these women I know are like they're like either low carb or keto or whatever, they're exercising all the time, but their blood sugars are elevated, it's not because they're having too much blood sugar itself, like they're eating the sugar, they have too much blood sugar because their cortisol levels are so elevated all the time, so it's another main thing that I see, and again, what I won't do is tell my wife to calm down, because that doesn't work right, but I will help in understanding that the stress response is the major driver of a lot of their blood sugar issues, sometimes.

Dr. Kay Durairaj 55:59
Yeah, yeah, it's a challenge, a real challenge. I started wearing a continuous glucose monitor, and that was a very interesting process. But yeah, definitely was my glucose of around 80 when I was on vacation, and now at the office I'm a baseline 100 so I'm like, oh Jesus, am I going to have insulin resistance? So I'm working on that, but it's a real challenge.

Speaker 1 56:24
It is, it is all of us, you know, not just women, but men as well. As our hormones change, although slower, you know, than women, it definitely has an effect as well. So our real goal, as clinicians, I think, Kay, is to give people a roadmap, you know.

Dr. Kay Durairaj 56:39
So I think just this has been so fascinating, and just to summarize, for people who are listening to all this and might feel slightly overwhelmed by all the biohacking, all the supplements, all the advice, what's the best starting point? I know you're going to say energy,

Speaker 1 56:57
yes, yeah, the best, the best starting point is to work on your energy, right, and this is multifactorial, but in essence it's so important to know that if you have better energy, everything is going to get easier. So work on the simple things that you can do to give yourself more energy. If there's a relationship that's sucking you dry, then you got to figure out a way to not have that happen, right? Or if it's you're just not getting enough sleep, like you're getting five or six hours, you can get seven, go for it, right? Or if you're drinking alcohol three days a week, stop, right? If you're having, you know, pharmaceutical drugs, because you're to calm down, that's usually a sign that other things need to change, right? And so look for the things in your life that look that may be in there, you don't even realize they're often habits of mind, they're habits of things that we do that are sucking our energy on some level, and our mitochondrial energy. I'm talking about here, right. And then start working on a process of slowly building that up, right, and knowing that a lot of this is going to have to do with calming down your nervous system too, and looking for ways to do that that you find rewarding, you know, in various ways, whether it's getting sunlight or having a conversation with a friend that you haven't spoken to in a while, like community is a big one. You mentioned that too, Kay. I'm a big fan of looking at supplements to help people, give them the experience, and start getting going, but over the long term, my hope is that you need less of them, because you've found ways to do this in your own natural evolution of being a human and being more optimized in that capacity, so try a little bit of methylene blue, for example, for a couple weeks just to jumpstart you, give it a try and see how you feel, right? And all of a sudden, oh, it's much easier to do xyz now because I have more energy to do that, right? And you know, try to have something to get you some better sleep if you need to, if you're having a hard time, try something for sleep, even if it's a little bit of magnesium, or you can try Trozy from my company, Transcriptions, if you want, or try something else - it doesn't matter, and just try something that's going to really give you a chance at getting a little bit of better sleep. Just, I would just avoid things like melatonin on its own, because melatonin itself is just one signal for sleep, and if it does work, it's probably not going to work forever. So, I like a little bit of melatonin, but not on its own, for example. So, sleep is a very complex process. You need multiple different neurotransmitters working there. So, I would say ideally focus on the basics, but if you have a hard time doing that, give yourself some jumpstarts. Try something for sleep, try something for energy that's supportive, and then from there, see what else you're able to do.

Dr. Kay Durairaj 59:23
I think this has been so motivating. I am so impressed. This is really motivated me to try some methylene blue, so I can't thank you enough for all the knowledge and the mitochondrial supercharging, and hopefully everybody out there is motivated to do that. Where can people find you if they want to contact you directly or try the Trish?

Speaker 1 59:45
Yeah, sure. So, my name is Doctor Scott Sher. My website is my name, it's Doctor Scott sher.com D R S C O T T S H E R R, and that's where I house my clinical consulting, I have my health optimization practice, my hyperbaric medicine. Consulting, I also have links to my companies. The company that has methylene blue products, it's called Just Blue. If you're checking it out, it@troscriptions.com's is the word, the letter T R O, and inscriptions, trascriptions.com And you can find our products like Just Blue, Introcom, and Intro Z. If you are a practitioner, we have our own practitioner ecosystem, which will get set, get you set up with K, that has our own practitioner products that are a little bit higher potency, only for practitioners, and that can use them in office, or they can drop ship directly to their patients if they'd like, and there's a lot of research there, and protocols, and, and, and physician dash references, and things like that, for practitioners, if you're a practitioner, you can check that out at our website, and just click the practitioner button to sign up. And there's also our nonprofit called Health Optimization Medicine and Practice, or HOME Hope for short. You can check it out@homehop.org and we have a whole training program for practitioners. You don't have to be licensed, you can be, but you don't have to be, and you can learn how to do this stuff in clinical practice and learn how to make a very robust foundation in your patients, and then finally, my hyperbaric company is called One Base Health, and you can check that it's a letter O and e1, Base health.com

Dr. Kay Durairaj 1:01:12
Well, there you go, that's a lot of great resources. I know I'm going to check them out, and I hope to be more optimized the next time I talk to you, it's a path.

Speaker 1 1:01:22
Remember, it's a path. There's the only end is when we're not here anymore. So it's all good. Let's stay

Dr. Kay Durairaj 1:01:26
on the path then a little bit longer. I love it. It's been such a great conversation. Thank you, Scott. And don't forget to check out my Instagram. You guys can find me on Instagram, it's Beauty by Dr. K D R K A Y, doing amazing things with people's faces, health, longevity. Our new peptide skincare line just launched, and you can find this on our website. Yeah, Beauty by Doctor k.com I'll send you some. You guys, it's such a great podcast, and I encourage you to go back and listen to more. We do a podcast every Tuesday in a short five minute Friday, and don't forget to listen and tell your friends this is information they need to know for their longevity, their health, their wellness. That's it for now, guys. Stay beautiful,

Unknown Speaker 1:02:10
you.

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