How to Enhance Your Immune System | Dr. Roger Seheult

ruticker 07.03.2025 23:38:53

Recognized text from YouScriptor channel Andrew Huberman

Recognized from a YouTube video by YouScriptor.com, For more details, follow the link How to Enhance Your Immune System | Dr. Roger Seheult

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Roger Schell. Dr. Schell is a board-certified medical doctor in pulmonology, which involves the understanding and treatment of conditions that impact the respiratory system, such as colds, flu, and other viruses, mold infections, asthma, and more. Dr. Schell is also board-certified in sleep medicine. He does his clinical work in the Intensive Care Unit at Loma Linda University and is actively involved in medical and public health education through his terrific online channel. Today, we discuss how to avoid getting colds, flu, and other viruses, and how to treat them to minimize discomfort, accelerate healing, and avoid long-term consequences. During today's episode, we discuss long COVID, as well as the use of sun and red light to stimulate mitochondrial and metabolic health across the entire brain and body. This opens up a broader discussion about phototherapy, which is the use of light to control health and temperature and other levers for improving brain and bodily function. Dr. Schell emphasizes that sun and red light therapy have a long and well-established medical history, and their mechanisms of action are known; therefore, it's not just biohacking, as many people think. We also discuss the sometimes controversial topic of the flu shot and if and when you should get one. Dr. Schell, as you'll see here, is world-class at making medical concepts and the actionable items related to health exceptionally clear. As a consequence, I'm certain that you'll truly appreciate the knowledge that he shares in your efforts to be and stay healthy at any age. In fact, by the end of today's episode, you'll be armed with the real knowledge on how to best get over nasty infections of the sinuses, lungs, and throat faster should you happen to get one, and even better, how to avoid them altogether. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public. In keeping with that theme, this episode does include sponsors. And now, for my discussion with Dr. Roger Schell. **Dr. Roger Schell, welcome!** Thank you so much, Andrew, for having me. I discovered you because you were putting out, and continue to put out, incredible information about how to stay healthy amidst infectious diseases—airborne infectious diseases, skin contact-based infectious diseases, and on and on. Nobody likes to be sick, and you've provided me tremendously valuable information about how to avoid getting sick and, in many cases, how to accelerate the progression from sick to healthy again. It's been tremendously helpful for getting me back into life, as it were. Let's talk about some of the things that one can do to avoid getting sick when in the presence of airborne viruses, in particular colds and flu. If you were to think about the major pillars of remaining healthy, especially when one is exposed to colds and flu from kids, or in your case, also in the Intensive Care Unit where people are coming in specifically because they're sick, often with infections like colds and flu or worse, you need to take specific precautions to avoid getting sick. What do you think of as the fundamental layer of keeping a healthy immune system to avoid getting sick? Then we'll talk about how to get over and move through being sick more quickly. **Yes, well, the question is how do you avoid getting sick in terms of infectious diseases? As it turns out, the answer to that is actually the same in terms of avoiding getting sick for anything, and it sort of goes to the pillars, as you call it. In my mind, there's actually a physician that I know very well just outside of Stanford, actually in a place called Weir University, Dr. Neil Nedley, and he's coined this mnemonic called New Start. Each of those letters, to me, in my mind, is something that I go to when I want to improve health in people in general.** - **N** stands for **Nutrition**. We can talk about nutrition and what that does to the human body. Obviously, as natural as possible, staying away from processed foods is something there. - **E** is for **Exercise**. When I'm talking about exercise, I'm talking about the understanding that we have regarding exercise—not to build muscle necessarily or be stronger, but in terms of health. That has more of a J-hook type of picture. What I mean by J-hook is if you're not doing any exercise, you're going to have higher levels of inflammation. As soon as you start to do some exercise, even mild to moderate exercise, the amount of inflammation in your body starts to come down. But as you start to do more and more exercise, you do have to be careful in terms of your general health. This is exactly what happens with athletes; they have to be very careful that when they're doing that type of elite athletic exercise, they're not sick on the day of performance. So I'm referring to just mild to moderate exercise as good. - The next one would be **W** for **Water**. This is something that's really interesting. Obviously, it seems pretty obvious, but not only the use of internal water but external water. In that area, we can talk about sauna, cold plunge, and things of that nature that can actually help with our immune system. That's a whole interesting area of discussion that involves the innate immune system and interferon. There's a lot of history and data that goes back over a hundred years on how that's been used. - **S** is for **Sunlight**. I've been a real proponent of getting people outside into the sun, and we can talk a lot about that. There's a lot of interesting research not only in terms of sunlight regarding influenza but also COVID and just about any natural disease. A lot of interesting information there. - **T** stands for the old term called **Temperance**, which you may recall is a term that we use to prevent us from taking in toxins into our body. That's a whole other discussion—staying away from things that would make you sick. - **A** is for **Air**. When I talk about air, it's not just what we focus on, which is keeping bad things out of the air, but there's a whole discussion to be had in terms of air that has good qualities in it. There's a whole area of research that looks at, for instance, phytoncides, which are chemicals that come off of trees. You may have heard of forest bathing; they've done a lot of research in Japan on this. Getting out into nature, there are actual chemicals in the air that you can breathe that have an impact on your innate immune system. - Finally, **R** is for **Rest**. This goes without saying, but people who have good sleep habits are going to have much better immune systems. Whether you're talking about the antibody response after a vaccine versus just the number of times per year you're sick, there's very good data that shows that getting seven to eight hours of sleep a night is going to be very beneficial for your immune system. This has to do with cortisol and beta receptors and all sorts of things. - The last **T** is for **Trust**. For some, it is trust in a higher power, trust in God. These are the sorts of things that can help us relieve stress. If someone else is helping you, if someone else is there, trust would also include community—people that are around you. These are some of the less tangible ways of measuring, but when someone asks me a question about what they can do to avoid getting sick, that's where I start out with the pillars of health. **I'd like to take a quick break and thank our sponsor.** Juve makes medical-grade red light therapy devices. Now, if there's one thing that I have consistently emphasized on this podcast, it is the incredible impact that light can have on our biology. In addition to sunlight, red light and near-infrared light sources have been shown to have positive effects on improving numerous aspects of cellular and organ health, including faster muscle recovery, improved skin health and wound healing, improvements in acne, reduced pain and inflammation, even mitochondrial function, and improving vision itself. What sets Juve lights apart and why they're my preferred red light therapy device is that they use clinically proven wavelengths—meaning specific wavelengths of red light and near-infrared light in combination to trigger the optimal cellular adaptations. Personally, I use the Juve whole body panel about three to four times a week, and I use the Juve handheld light both at home and when I travel. If you'd like to try Juve, you can go to juve.com/huberman. Juve is offering an exclusive discount to all Huberman Lab listeners with up to $400 off Juve products. Again, that's juve.com/huberman to get up to $400 off. Today's episode is also brought to us by Eight Sleep. Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity. Now, I've spoken before on this podcast about the critical need for us to get adequate amounts of quality sleep each night. One of the best ways to ensure a good night's sleep is to ensure that the temperature of your sleeping environment is correct. That's because, in order to fall and stay deeply asleep, your body temperature actually has to drop by about 1 to 3 degrees. In order to wake up feeling refreshed and energized, your body temperature actually has to increase by about 1 to 3 degrees. Eight Sleep makes it very easy to control the temperature of your sleeping environment by allowing you to program the temperature of your mattress cover at the beginning, middle, and end of the night. I've been sleeping on an Eight Sleep mattress cover for nearly four years now, and it has completely transformed and improved the quality of my sleep. Eight Sleep recently launched their newest generation of the Pod cover called the Pod 4 Ultra. The Pod 4 Ultra has improved cooling and heating capacity. I find that very useful because I like to make the bed really cool at the beginning of the night, even colder in the middle of the night, and warm as I wake up. That's what gives me the most slow-wave sleep and rapid eye movement sleep. It also has a snoring detection that will automatically lift your head a few degrees to improve your airflow and stop your snoring. If you'd like to try an Eight Sleep mattress cover, go to eightsleep.com/huberman to save up to $350 off their Pod 4 Ultra. Eight Sleep currently ships in the USA, Canada, UK, select countries in the EU, and Australia. Again, that's eightsleep.com/huberman. **Let's start off with one of my favorite topics, which would be the S in New Start. Let's talk about sunlight.** Listeners of this podcast or anyone that's heard me on social media know that I'm as big a proponent of getting morning sunlight in one's eyes as one could possibly be without repeating myself ten million times per year. It's a daily activity that we just know has such an outsized positive effect on the whole setting of the circadian rhythm and thereby improved daytime mood, focus, alertness, and nighttime sleep. But the way you describe sunlight goes beyond just getting morning sunlight in one's eyes. So if we want to parse this S—sunlight—in New Start, how are you thinking about sunlight? Is it sunlight on the skin? Is it also midday light, not just morning sunlight? Is it a certain amount of sunlight? And then maybe we can also talk about some of the underlying mechanisms. **Yeah, exactly. So when you talk about sunlight, and I'm a big believer—I'm board-certified in sleep medicine, and I'm cheering you on when you talk about these things because it's so important that light into the retina does have an effect on the circadian rhythm, the suprachiasmatic nucleus. It does have an effect on mood, going to the periventricular nucleus in the brain, and has an effect there. Those are well-known and very important. What I'm talking about when I'm discussing sunlight is an aspect of light that is not very well known in terms of its visible effects.** We know about the visible effects of light; these are photons that are coming into the eyes that we can see. What I'm discussing is the effect of sunlight on the human body, the skin penetrating into the human body. Now, this at first sounds kind of woo, I guess we could say, but the point that I want to make here is understanding that when we look at the sun, we are seeing about 38% of that energy coming from the sun is in the visible spectrum. There's a whole other 52% of the photons coming from the sun in the infrared spectrum. On the other end, on the ultraviolet side, this is the part we have no problem understanding because we know that ultraviolet B light comes into our skin, and it's high energy, so it's able to actually move the bonds on these cholesterol derivatives in order to make vitamin D. So we know that. So now, what do we say when I say, "Hey, I want to go outside to get some vitamin D?" We know that we're going outside to get this light that we can't see that's very imperative to giving us something called vitamin D, which is a hormone in our body, and it's very, very important. On the infrared side, though, there's something that there's new science, new data that is coming out that is showing that it's actually very, very important. I would point to an article that really changed my thinking on this and really opened my eyes—no pun intended. There was an article published in 2019 in Melatonin Research by Scott Zimmerman and Russell Ryder. The name of that article was "Melatonin Optics of the Human Body." What Scott Zimmerman and Russell Ryder set out to show is that, in fact, infrared light, because of its very long wavelength, can penetrate deep into the skin. We're not talking about how long a path length goes through; you have to remember that this type of long wavelength can scatter, and it can scatter throughout up to, they say, 8 cm. According to this data, a single photon can bounce around. It's a very low-energy photon, but low-energy photons, because they're very long in wavelength, can penetrate very deeply. A good way of thinking about this is, you know, you pull up to a stop sign, and a car pulls up next to you, and they're playing this really loud music, right? What do you hear in your car? It's very low-frequency sound. The reason why that's what you hear is that low-frequency sound is the only kind of sound coming out of that guy's radio that's able to penetrate not only his car but go into your car and shake the steering wheel on your car. It's the same thing. For instance, if you were to go to the Grand Canyon and there's a storm coming from very far away, what's the first thing that you're going to hear? It's low rumbling. It's because that low-frequency energy is able to penetrate very deeply. There's an astrophysicist in Europe, in England, actually, Bob Fosbury. He sent me a photograph of his hand in front of an infrared light source, and it was almost like the first guy who took an X-ray of his hand, Röntgen, I guess his name was. He said he looked at his hand and said, "I almost saw my own death," because he could see the bones in his hand through the X-ray. Well, Bob Fosbury, who's at the European Space Agency and is well-tuned into this type of understanding, put his hand in front of an infrared light sensor or infrared light source and took an infrared light photograph. The light comes through the hand; it illuminates the entire hand. This is, of course, a lot more than a few millimeters. The mind-blowing thing about it was you could not see any bones. It was either penetrating through the bone or it was going around the bone. Very clearly, you could see that infrared light is able to go much more than just skin deep. You can actually test this out on a summer day or even on a winter day if the sun is out. Wear a few layers of clothing, go outside, close your eyes, and move around and see if you can feel where the sun is. You can. The reason is that it's that infrared radiation that's able to penetrate through the clothes, penetrate through your skin, actually activate the heat sensors in your body, and actually go much deeper than that. That's actually in a straight line. After it does that, it hits something and then it bounces around a couple of more times, maybe a few hundred more times. The point of that paper, "The Optics of the Human Body," is that we have this understanding or this idea that light simply hits our skin and that's where it ends, and that's not the case. Why that's important is because of the effect that this type of infrared light has on mitochondria, and that's really the mind-blowing aspect of this. Mitochondria are like engines in your cells, right? They're like engines in your car. The engine in your car burns fuel, makes locomotion, and in the process of making that locomotion, it creates heat. That heat, if not dealt with, can shut down your engine. Well, in the mitochondria, you've got this process occurring, making ATP, which is basically the currency of energy in the cell. In the process of doing this, it makes oxidative stress—reactive oxygen species. If you don't deal with those reactive oxygen species, that could shut down the mitochondria. Quite truly, just about every single chronic disease that we have in this country, whether it's diabetes, hypertension, heart disease, dementia—all of those have at the root of them mitochondrial dysfunction. This goes to a much bigger picture of the mitochondrial theory of aging. We know that after 40 years, the output of mitochondria, which is ATP, drops by about 70%. Can you imagine being in your house and somehow the energy production to your house drops by 70%? Can you imagine what an impact that would have on just about every function that goes on in your house? This is exactly what's happening in the cell. So what does this have to do with sunlight? Well, here's what they've shown: that the mitochondria actually make onsite melatonin in orders of magnitude higher concentration than is made in the pineal gland. **Really? Yes. So they've actually done the work where they have serotonin, and they are actually labeling the carbon in serotonin and showing that that melatonin, in orders of magnitude higher concentration, is being made onsite in the mitochondria.** Okay, I have to ask about this. Most people, including me, are familiar with melatonin secretion from the pineal gland being suppressed by light via some neural circuit pathways that go from the eye to the suprachiasmatic nucleus to there. There's a circuitous loop to the brain stem and then up to the pineal. So light suppresses melatonin release from the pineal, we know that. In that context, melatonin is the hormone of darkness and causes sleepiness, correct? What is the role of melatonin in the context that you are describing? Because if indeed infrared and other long-wavelength light are causing the production of melatonin from the mitochondria in the rest of the body, I'm assuming that's not to increase our levels of sleepiness. **That is correct. And I do know that melatonin is a powerful antioxidant. So I'm guessing that next you're going to tell me that it is combating the reactive oxygen species that are produced as a function of mitochondrial metabolism.** Absolutely. So the mitochondria make melatonin onsite. This is not being secreted into the blood; it's being used onsite. So this is not being used as a secondary messenger to tell the body anything about circadian rhythm. This is an extremely powerful antioxidant, as you know—one of the most powerful antioxidants in the human body. It actually upregulates the glutathione system by regulation. So what this melatonin does is it's able to mop up these reactive oxygen species. Let's back up a little bit there. Reactive oxygen species—what are they? If you burn fuels, you burn carbohydrates, proteins, and fats, and as a result of that, you make these very reduced agents, NADH and FADH2. They go to the electron transport chain, and just as the Colorado River goes down through various different dams and then dumps out into the Gulf of California, the same thing happens with these very highly charged and electronegative electrons. As they start to fall down and get transferred from one enzyme to another, they cause the outproduction or the outtransfer of protons into the intermembrane space. The problem is, though, when you finally get done with these electrons, they've been completely spent. There's nothing else to accept them, and the only thing that can actually do that is something so electronegative that it would actually take these electrons, and that's oxygen. That's the reason why we breathe oxygen—because we need an electron acceptor for these spent electrons. It's very near and dear to my heart as a pulmonologist and critical care specialist. We need to have oxygen; if you don't have oxygen, things shut down very quickly. For those that aren't familiar with these biochemical pathways, maybe one way for them to think about it is that free electrons are not a good thing in this system. You don't want electrons floating around, and in these biochemical steps that convert energy into the stuff that cells can use more readily to move and do everything that we do, right? Electrons are kicked off. is a significant factor in reducing the incidence of influenza. They found that areas with higher solar radiation had lower rates of influenza infection. This suggests that sunlight exposure, particularly during the winter months, may play a crucial role in modulating our immune response and reducing susceptibility to viral infections. In addition to the direct effects of sunlight on our immune system, there are several other mechanisms at play. For instance, sunlight exposure increases the production of vitamin D, which is known to enhance the pathogen-fighting effects of monocytes and macrophages—white blood cells that are essential for our immune defense. Vitamin D also helps regulate the immune response, ensuring that it is robust enough to fight off infections without becoming overly aggressive and causing inflammation. Moreover, the seasonal variation in sunlight exposure can influence our circadian rhythms, which in turn affect our sleep patterns. As we discussed earlier, adequate sleep is vital for maintaining a healthy immune system. Disruptions in sleep can lead to increased inflammation and a higher risk of infections. So, in summary, the interplay between sunlight exposure, vitamin D production, and the regulation of our immune system is a complex but essential aspect of our health, particularly during the winter months when we are more susceptible to infections like the flu. **To wrap up, what are some practical takeaways for our listeners regarding sunlight exposure and immune health?** 1. **Get Outside Daily**: Aim for at least 15-30 minutes of sunlight exposure each day, especially in the morning. This helps regulate your circadian rhythm and boosts mood. 2. **Seek Green Spaces**: Spend time in nature, as being around trees and plants can enhance your exposure to beneficial infrared light. 3. **Consider Clothing**: If you're concerned about UV exposure, wear protective clothing but remember that infrared light can still penetrate through layers. 4. **Monitor UV Index**: Use apps to track the UV index and plan your outdoor activities accordingly to maximize sunlight exposure while minimizing harmful UV exposure. 5. **Supplement Wisely**: If you live in areas with limited sunlight, consider vitamin D supplementation, especially during the winter months, but consult with a healthcare provider for personalized advice. By incorporating these practices into your daily routine, you can help support your immune system and overall health, particularly during the cold and flu season. **Thank you, Dr. Schell, for sharing your insights on this important topic!** to maximize sunlight exposure for patients. Sun decks and open-air wards were common practices in tuberculosis sanitariums, where patients were encouraged to spend time outdoors to harness the healing power of sunlight. **So, to summarize the key takeaways regarding sunlight exposure:** 1. **Sunlight and Immune Health**: Sunlight exposure is strongly correlated with reduced rates of influenza and other respiratory infections. Studies show that as sunlight decreases in the winter months, the incidence of these infections tends to rise. 2. **Optimal Exposure**: Aim for at least **15-30 minutes of sunlight exposure daily**, especially in the morning. This can help regulate circadian rhythms and improve overall health. 3. **Seasonal Considerations**: In winter, when sunlight is limited, make a concerted effort to get outside during the day, even if it's cloudy. The intensity of light is still significant compared to nighttime. 4. **Indoor Light Quality**: Be mindful of the type of artificial light you are exposed to indoors. Traditional incandescent bulbs provide a fuller spectrum of light, including infrared, which is beneficial for health, unlike many modern LED lights that may lack these wavelengths. 5. **Natural Light vs. Artificial Light**: The shift towards spending more time indoors and using artificial lighting has disrupted our natural interactions with sunlight. It's essential to prioritize outdoor time to counteract this trend. 6. **Historical Context**: The benefits of sunlight have been recognized for centuries, with historical figures advocating for its importance in health and recovery. This knowledge should not be overlooked in modern health discussions. 7. **Practical Steps**: If you find it challenging to get outside, consider taking your lunch break outdoors or finding ways to incorporate short walks during the day to increase your exposure to natural light. By integrating these practices into your daily routine, you can significantly enhance your immune function, metabolic health, and overall well-being. **Designed specifically to get people out of the hospital and into the sunlight, you could see the architecture was designed for this. Why don't we do this today? I think we ought to, but I kind of have a sense you asked the question: why don't we do this today? I have patients that I take care of now that I understand this. I have patients that I have in the Intensive Care Unit that I want to get outside in the sunlight. I actually try to get them out; it's difficult to do. These people are critical. The people that we admit to the hospitals today are far sicker than the people that we admitted to sanitariums and hospitals in the 1800s. You have to make sure that they don't desaturate; you've got to take the oxygen tank out there with them. You've got to make sure that they don't have a code. I mean, you're outside, right? You're outside of the bowels of the hospital where your support system is. It's a little bit of a risk to get those patients out there. Nevertheless, I've convinced some of my hospital staff to do that, and I've had a number of success stories where we've had patients that were ready to be intubated, and we got them outside in the sunlight, and they steadily improved dramatically after days of getting worse.** **There was a lady that actually contacted me; her name is Amy Hanm. If you want to look her up, she's on social media. Her son, this is a really amazing story, contracted leukemia at the age of 15 and got put on chemotherapy. This was in Minnesota; fortunately, it was in the summertime. He got admitted to the hospital with what they call neutropenic fever—very high fevers, very low white counts as a result of the chemotherapy, and his immune system was completely shot. Unfortunately, he developed a very severe fungal infection in his lung called mucor, and it just basically eats up the lung and goes right to the blood vessels. He got so bad that there was only one solution that they had at the time, and that was to take out the left lung. So they took out the left lung, and he continued to get worse. The right lung became infected; he started to get worse, had higher fever. They had a meeting with the family—15 years old, completely with it, realizing that he's dying, and they have to tell him that he's dying. So they made him what they call no code or DNR. The staff came to him, and you can imagine, I've been in this position before, trying to do everything you possibly can, and you just can't do anything else. So they came to him, the 15-year-old, and they said, "You know, this is it. Do you have any last wishes?" And you know, Amy, his mom, told me that he'd like to play outside. So he told them, without any knowledge about what we've just been talking about, this is his dying wish: "Take me outside. I just want to go outside."** **And you know that nursing staff will move Heaven and Earth to do something that the patient requests to do, even though it's not going to benefit them. They still want to fulfill this dying wish. They're going to do it. So they hooked up oxygen tanks; they got this 15-year-old boy in a hospital bed outside on BiPAP with oxygen tanks for five hours a day. His mom was telling me they were also using something called a firefly device, where they were just basically shining light onto him to see if it would work. You know how the story ends: he did not die in two days like they told him. He got better; his fever went away, his oxygen requirements came down. And I'm not telling you this as proof that this is what happens, but you have to realize that he was in the hospital for six weeks underneath LED lighting, and as soon as he got outside, the fever went away. Make a long story short, after five days, he came back inside; they repeated the CT scan, and she sent me the CT scans I've seen them. We actually did a little thing on our MEGC channel on it, and the disease was almost gone. There's no explanation to this day; they don't have an explanation. He's still alive today, still getting chemotherapy. He went from basically, and of course, he's missing a lung, but he still has that lung. He's getting the antifungal medication; there's no sign of the fungus anywhere.** **So this is an anecdotal story; it doesn't prove anything. I don't present it as proof. The things that I present as proof are randomized control trials, epidemiological trials with dose-response curves. These are things that we can actually show the science with. The reason why I bring it up is because it shows what is it that we would need to do to get this type of treatment. It's not easy to do, but if there is a will, there's a way to do it.** **I'd like to take a quick break and acknowledge one of our sponsors. Function. Last year, I became a Function member after searching for the most comprehensive approach to lab testing. Function provides over 100 advanced lab tests that give you a key snapshot of your entire bodily health. This snapshot offers you insights on your heart health, hormone health, immune functioning, nutrient levels, and much more. They've also recently added tests for toxins such as BPA exposure from harmful plastics and tests for PFAS or forever chemicals. Function not only provides testing of over 100 biomarkers key to your physical and mental health, but it also analyzes these results and provides insights from top doctors who are experts in the relevant areas. For example, in one of my first tests with Function, I learned that I had elevated levels of mercury in my blood. Function not only helped me detect that but offered insights into how best to reduce my mercury levels, which included limiting my tuna consumption. I've been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with NAC and acetylcysteine, both of which can support glutathione production and detoxification. And I should say, by taking a second Function test, that approach worked. Comprehensive blood testing is vitally important; there are so many things related to your mental and physical health that can only be detected in a blood test. The problem is blood testing has always been very expensive and complicated. In contrast, I've been super impressed by Function's simplicity and affordability. As a consequence, I decided to join their scientific advisory board, and I'm thrilled that they're sponsoring the podcast. If you'd like to try Function, you can go to functionhealth.com/huberman. Function currently has a waitlist of over 250,000 people, but they're offering early access to Huberman podcast listeners. Again, that's functionhealth.com/huberman to get early access to Function.** **It's a spectacular story, by any account. I wanted to just touch on the fact that there's no replacement for sunlight. Getting patients outside is hard. At the same time, most people listening to this, fortunately, are not patients—thank goodness. Many people, however, have relatives or themselves who are elderly. As people get older, they tend to slow down and get outside less. There are fortunate exceptions to this, but one of the setups that I created for myself that I think is certainly feasible for a lot of people is the following: well, first of all, I always make it a point to get outside and get sunlight in my eyes, rain or shine, regardless of where I'm traveling, etc. I do that every single day. If I miss a day, it's only because of something like a flight where I happen to be on a plane at the time of sunrise or something. But I have a setup that I constructed for myself that is basically a 10,000 Lux light. These are available; I don't have any relationship to 10,000 Lux light sources. Those 10,000 Lux light sources tend to be short-wavelength shifted; they tend to be very blue. They're white light, but I don't think they have power across the visible spectrum. I think they're very red light and infrared diminished. They tend to be very blue and green light enriched, and it shows up as very bright white light. So that's what I put in front of me when I first wake up if the sun isn't out yet. But now I've started putting a red light, near-infrared light next to it, and I'll spend the first couple of minutes of my day, usually as I journal or do something like that, or sometimes just with my eyes closed, just pleasantly facing in the direction of the 10,000 Lux white light and the red light, near-infrared light. I must say, this is anecdotal, but the combination of the two not only does it wake you up—the white light will do that alone. We know the biological basis for that. But I have noticed a tremendous improvement in energy, mood, focus, etc., that comes from the addition of this red light, near-infrared light. This is not an advertisement for red light, near-infrared light, I promise. Although, you know, this podcast does have a relationship to medical-grade red light devices. I mention this because what I'm trying to simulate there is sunlight, but I still get outside and get sunlight. So I just mention this setup because it seems to me that hospitals should be able to create this setup. It's for a minimum of cost, certainly less cost than it takes to maintain a patient for one day.** **Exactly. I mean, the cost of maintaining a patient for inpatient care is so high—medical staff, the disposables, the actual disposing of the disposables, the janitorial after the care. Hospital costs are outrageously high. Now, of course, people will hear this and think, "Well, that's exactly what hospitals want, right? They can charge the longer you stay; it's like a hotel. The longer that you stay, the longer they can charge you or your insurance." I'm not a conspiracy theory type, but it is interesting that for many people, they associate going to a hospital with staying a long time and getting sicker. Sometimes they get better and go home, thank goodness. You're certainly a well-meaning doctor; the nursing staff are well-meaning people. Yes, but simply put, why don't hospitals include light therapy given the abundance of data on circadian rhythms and light therapy? And I'll just attach one more thing: my audience always gets upset at the duration of these questions and editorials, but this is my wheelhouse—this whole light thing, so I can't help myself. There's also something known as ICU psychosis, absolutely, which is when people who are perfectly mentally healthy go into a hospital because of the relationship to light and the disruption in circadian rhythm from the overhead lights, the checking of the patient in the middle of the night, the disruption in sleep, etc. People literally develop psychosis that resolves itself the moment they get home and get onto a normal schedule. It's well known that the patients that are in a hospital bed next to a window don't experience this to the same degree, if at all. So it's sort of like I feel like we're sitting under an avalanche, not a waterfall, but an avalanche of data telling us what we need to do. And forgive me, but what the hell is going on?** **Exactly. So I can tell you that not only are you less likely to get this type of ICU psychosis, but the data actually shows that people who are in a two-bed room that are next to the window actually discharge from the hospital faster. And you say, "Ah, well, maybe that's the reason." Well, it's interesting because the financial incentives with hospitals are not monolithic. Some hospitals and their relationship to the insurance companies are at a situation where when a patient comes into the hospital and the physician diagnoses them, the insurance will pay the hospital a certain amount of money for that diagnosis, and that's that. Also, there's something called subcapita arrangements where the hospital has a contract with an insurance company to take care of 30,000 people per member per month. If that patient gets admitted to the hospital, that hospital has to take care of that patient, whatever the costs are. So it basically takes the risk now and puts it from the insurance company onto the healthcare provider. So in those situations, you'll see a hospital having an army of case managers. They come down every day: "What are we doing for this patient? What do we need to do to get this patient out of the hospital?" So they're motivated to get people out. And so when I say that, I'm even more bewildered than when you said at the beginning, "Well, if we have good data that shows that light therapy and light getting people out into the sun actually can improve the discharge." We had that study from Brazil where there was a randomized controlled trial, and they used 15 minutes of—they actually made this jacket that they put on the patients, and they flipped it on with some patients and didn't flip it on with others. The jacket was a light jacket; it was an LED jacket that was giving light out at 940 nm infrared light, so you can't even tell if it's on. And as I said, the mills per square centimeter was like 2.9, so you wouldn't even feel it. But yet these patients, when they were done—seven days, 15 minutes a day—they had better oxygen saturation, they could take deeper breaths, longer breaths, their heart rates, their respiratory rates improved, even their lymphocytes improved—the ones that are very important for fighting off COVID-19. And so at the very end of all of this, the average length of stay in the control group was 12 days; about 12 days in the intervention group, it was eight days. How much does it cost to spend four days in a hospital? It can be outrageous. And it's potentially possible. And this is why I think really people need to understand this—not just people who are wanting for their own care, but people who are in charge of hospitals, people who are in charge of healthcare in this country, is understanding that I believe the lowest hanging fruit, potentially, after you look at that graph of deaths throughout the year, is encouraging sunlight in people, especially in those that are hospitalized and sick. Absolutely. I don't know why, but I think if somebody were to pick up the baton and decide to do a very simple study where you'd have to hire some nurses that would actually—I've actually thought about doing this study myself—having a unit outside in the sun where people go for literally 20 to 30 minutes, and they come back. You have a whole bunch of nurses there with monitoring so that you can make sure the patients are stable, and then you send them right back up. We send people down to the CAT scanner all the time; it takes 15 to 20 minutes. This is not something that we don't do. The difference is you're just sending them outside. Hopefully, it's warm; it's not too cold. You know, there's nothing that bad that happens, and you send them right back up. That would be a very easy study to do. You could randomize them and then see what happens to their length of stay. In my experience—and it's only anecdotal—I have not done the study; it's a world of difference.** **That's for sick people. If we're thinking about health maintenance and health improvement in healthy people who are not in the hospital—which, fortunately, is most people—it's very clear: 15 minutes a day of sunlight exposure. And if you absolutely can't get sunlight exposure, think about some artificial light arrangement that might be beneficial. I want to make sure that we talk about not just sunlight exposure and long-wavelength light exposure from artificial sources, but the flip side of all this, which is the importance of darkness at night. I'm aware of a study published in the Proceedings of the National Academy of Sciences where they basically had kids sleep in either a completely black room or a room that had 100 Lux—this is a very dim light, folks—down in the corner, kind of like a night light, and then looked at morning glucose levels, blood glucose levels. There was a significant difference in the direction of you don't want any light in the room that you're sleeping. Now, that's hard to do, especially if you're traveling or in hotels. But eye masks, in particular, silk or even faux silk eye masks, which are very comfortable, can essentially provide that. It's very clear that it's the light exposure to the eyes. What, if anything, do you recommend for people who are basically living in an environment that's too bright at night? You know, do you yourself use blackout curtains? I mean, how do you—how should we work with these data? What are your thoughts about the importance of getting things really dark at night?** **Yeah, that is the same question and the same problem that I have with people that do night shifts because they go home, and they're supposed to sleep, and it's bright; it's daylight outside. So what do you do? You know, that's where you get the aluminum foil around the windows. That's where you basically have to block out all of that light. And then the eye patch, of course, is a nice thing to do as well. Realizing, though, that even when you close your eyes, if there's a light source in the room, people think, "Well, I'll just close my eyes." Those photons can go through the eyes, just like we talked about with infrared light penetrating the skin. And I don't know if this is true or not, but I've heard even one or two photons of light hitting the back of the retina can cause enough signal to go to the suprachiasmatic nucleus that shuts down melatonin production or at least impairs it in some way.** **In experimental conditions, that's definitely true. I mean, the sensitivity of the human visual system is extraordinary. I mean, your rods—the higher sensitivity photoreceptors in the back of your eye—can detect a single photon. Most people aren't familiar with thinking in photon quantities, so that might not mean anything to them. Put differently, and these are wild data from Chuck Czeisler's lab at Harvard Medical School: light suppresses melatonin. The question is, how much light do you need? Because of the increase in sensitivity of the eye at night, this rod system and these specialized cells that send signals to the circadian clock—15 seconds of artificial light exposure will significantly quash your melatonin. That's a whiz at night—15 seconds! So if you go to the bathroom, then you say, "Well, what am I supposed to do? How do I navigate at night? How do I make sure I'm peeing in the toilet, especially for men? How do I not trip and fall?" This kind of route to the bathroom or getting a glass of water? It's actually, you know, it's funny; the answer turns out to be so logical, but you almost have to hear it before you kind of go, "Oh, that makes sense." So it's perfectly fine to use your phone as a flashlight. And then people say, "Well, flashlights are really bright." But yeah, but you're not shining the light into your eyes. So looking at your screen, dimmed way down in the middle of the night is going to be very detrimental to the melatonin system, right, at the time where you want melatonin high and other things too. But looking at a flashlight shone into the hallway so you can navigate—right?—is a very different scenario than shining directly into your eyes. So you can—and then there are a number of different red light sources that are pretty good, like little red light lamps that are effective. Or you can just turn your phone to red light mode.** **I remember a podcast that you had probably a couple of years ago where you had someone—I forgot his name—but he said his house is very dark at night, and people would be afraid to go over because of tripping. That's my good friend Dr. Samer Hattar. Now keep in mind that Samer is the head of the chronobiology unit at the National Institutes of Mental Health, so he literally lives and breathes this stuff, right? The other thing about Samer, which is interesting, is when I first met Samer, he was very, very overweight. What Samer may have relayed on that podcast, perhaps not, is that by changing his relationship to light—sunlight and getting sunlight during the day and darkness at night—and by the way, he lived in Baltimore at that time, so it's not trivial to do that—and changing his sleep schedule to one of getting into bed around 9 or 10 p.m. and waking up earlier as opposed to staying up late and sleeping the equivalent amount into later in the morning, he lost over 80 pounds.** **interferon. Interferon is a signaling protein that is produced by cells in response to viral infections. It plays a crucial role in the innate immune response by alerting neighboring cells to the presence of a virus, thereby enhancing their antiviral defenses. This is particularly important because the innate immune system acts quickly, often within hours of infection, while the adaptive immune system takes days to mount a specific response.** **Now, how does water relate to this? When you are well-hydrated, your body can maintain optimal temperature regulation and circulation, which are essential for effective immune function. Dehydration can impair the immune response, making it harder for your body to fight off infections. Additionally, external water exposure, such as through saunas or cold plunges, can stimulate the immune system. For example, saunas can induce a mild hyperthermia, which can enhance the production of heat shock proteins and boost the immune response. Cold exposure, on the other hand, can increase the production of norepinephrine, which has been shown to enhance immune function as well.** **In terms of air quality, it’s important to consider both the composition of the air we breathe and the humidity levels. Clean air is essential for optimal lung function, and pollutants can significantly impair respiratory health. High humidity can also help keep the mucous membranes in the respiratory tract moist, which is important for trapping and clearing pathogens. Conversely, low humidity can dry out these membranes, making it easier for viruses to enter the body.** **So, to summarize:** 1. **Hydration**: Ensure adequate water intake to support kidney function and overall immune health. While the "eight glasses a day" rule is a guideline, individual needs may vary based on activity level and environmental conditions. 2. **External Water Use**: Consider incorporating practices like sauna use or cold exposure to stimulate the immune system and enhance overall health. 3. **Air Quality**: Aim to breathe clean air and maintain optimal humidity levels to support respiratory health and immune function. 4. **Environmental Factors**: Be mindful of how temperature and humidity can affect your susceptibility to infections, especially during cold and flu season. **By focusing on these aspects of water and air quality, you can further support your immune system and overall health.** **Interferon** is an extremely important molecule with a wide-ranging ability to combat viruses. It's crucial to understand that with all the variants of COVID and the different strains of influenza, none of that matters with interferon. Interferon has a broad spectrum of action, which is why it's such an important molecule. It has been said that the immune system is so well-designed that there are no viruses that can infect it unless they have countermeasures, and that is absolutely true. This was first observed with SARS-CoV-2. Researchers looked at SARS-CoV-1, the original virus that emerged in 2002, and found that it had a mechanism to neutralize and suppress the secretion of interferon. Upon examining SARS-CoV-2, they discovered that the **M** gene in SARS-CoV-2 is specifically designed to evade interferon. This highlights the importance of interferon in our immune response. Now, let's return to our discussion about water and temperature. Several studies have examined the relationship between temperature and interferon secretion. In one in vitro study, lymphocytes were placed in a medium and exposed to **LPS** (lipopolysaccharide), a molecule that triggers the immune system. As the temperature was gradually increased, researchers measured interferon levels. They found that once the temperature reached **39°C** (approximately **102.2°F**), there was a **10-fold increase** in interferon secretion from the lymphocytes. This indicates that even a slight fever can significantly enhance interferon production. This raises an important philosophical question about fevers: should we block them? In the hospital, I often receive calls about patients with fevers, and the prevailing thought is that the fever is part of the problem and needs to be treated. Interestingly, this was the same mindset during the 1918 Spanish flu pandemic when aspirin was used excessively to reduce fever and alleviate symptoms. Unfortunately, this approach may have contributed to a higher mortality rate. Now, regarding the use of water, external applications can deliver large amounts of energy to elevate body temperature and potentially enhance the innate immune system. Techniques such as hot baths, saunas, and hot showers can be effective. Historically, hydrotherapy, or hot fermentations, was used in sanitariums. This involved soaking towels in hot water, applying them to patients, and covering them until sweating occurred, which indicated an increase in body temperature and immune activation. There are studies showing that administering exogenous interferon to COVID-19 patients reduced hospitalizations by **50%**. This interferon can be given as an infusion, and while it may not be widely available, there are alternative methods to elevate body temperature, such as taking a hot shower and then bundling up under blankets. Historically, sanitariums in the northeastern United States, particularly those run by the Adventist Church, utilized hydrotherapy and sunlight to treat patients during the influenza pandemic. A medical director named **Wells Rubble** compared the outcomes of patients in sanitariums to those in Army hospitals and found that sanitariums had significantly lower rates of pneumonia and mortality. In 1927, **Jules Wagner Jauregg**, an Austrian psychiatrist, won a Nobel Prize for discovering that inducing fever in patients with neurosyphilis through malaria infections improved their symptoms. This highlights the therapeutic potential of fever. When discussing the use of water, it's essential to understand that the goal is to raise core body temperature. For example, Russian banyas often involve alternating between hot and cold exposure. This practice has been used for centuries and is thought to enhance immune function. The physiological mechanisms behind this include vasoconstriction during cold exposure, which can liberate white blood cells into circulation. After a cold shower, while the total number of white blood cells remains the same, more of them are available in circulation, enhancing the body's immune response. In summary, the interplay of heat and cold exposure, hydration, and interferon secretion is a fascinating area of study. These practices, whether termed hydrotherapy or deliberate heat and cold exposure, have been utilized across cultures for centuries, demonstrating a convergence of understanding in health and wellness. about the importance of air quality and how it relates to our immune system. Some people say that indoor air quality is more important than outdoor air quality, while others argue the opposite. What are your thoughts on this? **Air quality is indeed a critical factor in our overall health and immune function.** The air we breathe can significantly impact our respiratory health, and poor air quality can lead to increased susceptibility to infections. Here are some key points to consider: 1. **Indoor vs. Outdoor Air Quality**: Indoor air can often be more polluted than outdoor air due to various sources of pollution, such as cleaning products, cooking fumes, and building materials. Poor ventilation can exacerbate this issue. Therefore, ensuring good indoor air quality is essential, especially for those with respiratory conditions. 2. **Airborne Pathogens**: Viruses and bacteria can be transmitted through the air, particularly in enclosed spaces. Good ventilation and air filtration systems can help reduce the concentration of airborne pathogens, thereby lowering the risk of infections. 3. **Phytoncides and Nature**: As we discussed earlier, spending time in nature can expose us to phytoncides—natural chemicals released by plants that have been shown to enhance immune function. This is one reason why spending time outdoors can be beneficial for our health. 4. **Humidity Levels**: Maintaining optimal humidity levels indoors (ideally between 30-50%) can help keep mucous membranes moist, which is important for trapping and clearing pathogens. Low humidity can dry out these membranes, making it easier for viruses to enter the body. 5. **Air Quality Monitoring**: Using air purifiers with HEPA filters can help reduce indoor pollutants and allergens. Additionally, monitoring indoor air quality with sensors can provide valuable information about the levels of particulate matter, volatile organic compounds (VOCs), and other pollutants. 6. **Breathing Exercises**: Engaging in breathing exercises can help improve lung function and increase oxygen intake. Techniques such as diaphragmatic breathing or pursed-lip breathing can be beneficial, especially for individuals with respiratory issues. In summary, both indoor and outdoor air quality play crucial roles in our health. Prioritizing clean air, whether by improving indoor environments or spending time outdoors, can significantly enhance our immune function and overall well-being. **Thank you for sharing your insights on this topic!** dysfunction. Mitochondria are the powerhouses of our cells, and when they are not functioning properly, it can lead to a variety of symptoms, including fatigue, muscle weakness, and shortness of breath. In fact, studies have shown that individuals with long COVID often exhibit signs of mitochondrial dysfunction, which can be exacerbated by the inflammatory response triggered by the virus. This inflammation can lead to oxidative stress, further impairing mitochondrial function and creating a vicious cycle of symptoms. **What can be done about long COVID?** 1. **Rest and Recovery**: It's crucial for individuals experiencing long COVID to prioritize rest. Overexertion can worsen symptoms, so pacing activities and allowing for adequate recovery time is essential. 2. **Nutrition**: A well-balanced diet rich in antioxidants can help combat oxidative stress. Foods high in vitamins C and E, as well as omega-3 fatty acids, can support mitochondrial health. 3. **Hydration**: Staying well-hydrated is important for overall health and can help support cellular function. 4. **Exercise**: While it may seem counterintuitive, gentle, low-impact exercise can be beneficial for some individuals. Activities like walking, yoga, or tai chi can help improve lung function and overall fitness without overexerting the body. 5. **Breathing Exercises**: Techniques such as diaphragmatic breathing or pursed-lip breathing can help improve lung capacity and reduce feelings of breathlessness. 6. **Medical Support**: Consulting with healthcare professionals who understand long COVID is crucial. They can provide tailored advice and may recommend therapies to address specific symptoms, such as pulmonary rehabilitation for those with respiratory issues. 7. **Mitochondrial Support**: Some studies suggest that supplements like CoQ10, L-carnitine, and alpha-lipoic acid may help support mitochondrial function, but it's important to consult with a healthcare provider before starting any new supplements. 8. **Mental Health Support**: Long COVID can take a toll on mental health, so seeking support from mental health professionals can be beneficial for managing anxiety, depression, or other psychological symptoms. In summary, long COVID is a real and complex condition that can involve a range of symptoms, particularly related to mitochondrial dysfunction. A multifaceted approach that includes rest, nutrition, gentle exercise, and medical support can help individuals navigate their recovery. **Thank you for sharing your insights on long COVID!** a higher power? Those who felt that they had been forgiven by a higher power were much more likely to forgive unconditionally. This suggests that the belief in a higher power and the feeling of being forgiven can significantly impact one's mental and physical health. **In summary, the role of trust—whether in a higher power, community, or oneself—can have profound effects on health outcomes. Here are some key points:** 1. **Community Support**: Individuals with strong social networks tend to recover faster from illness. The emotional support provided by friends and family can alleviate stress and promote healing. 2. **Faith and Spirituality**: Belief in a higher power can foster a sense of hope and purpose, which may enhance resilience during difficult times. Studies have shown that individuals with strong spiritual beliefs often report better health outcomes. 3. **Gratitude and Forgiveness**: Practicing gratitude and forgiveness can lead to improved mental health. Writing letters of thanks or engaging in forgiveness exercises can reduce anxiety and somatic complaints. 4. **Mind-Body Connection**: The connection between mental and physical health is well-documented. Positive emotions and a sense of purpose can lead to better health outcomes, while negative emotions can exacerbate physical symptoms. 5. **Psychological Resilience**: Trust in oneself and one's ability to cope with challenges can enhance resilience. Individuals who believe they can overcome obstacles are more likely to take proactive steps toward recovery. 6. **Holistic Approach**: Integrating mental, emotional, and spiritual health into medical care can lead to more comprehensive treatment plans and better overall health outcomes. **Ultimately, fostering trust and connection—whether through community, spirituality, or personal beliefs—can play a crucial role in health and recovery.** by God, if they felt like they were forgiven by God, they were much more likely to forgive unconditionally. If they had ever felt that they were forgiven by God, yes, for whatever it was that they had done. So this was really interesting to me because oftentimes I will have patients in my Intensive Care Unit who are very anxious. They know that, I mean, anybody who gets admitted to the hospital starts to think about mortality. Just imagine if you get admitted to the Intensive Care Unit. A lot of my patients are not able to communicate; they're mentally out. But there are a few that can, and those you can tell become very anxious. So this is an area that I have to sort of delicately ask about because you don't know people's faith structure; you don't know who they are. I'm a graduate of Loma Linda University, and our motto—it's a Christian institution—is to make man whole. Part of that is not just the physical, not just the mental, but also the spiritual aspect of that. So we make no excuses about that, but it's important to also understand that not everybody wants to have a spiritual component to their care. So you have to approach it in a way that you're almost giving permission to do this, and you have to watch for things. It's not an easy thing to do, but you want to help if someone wants to be helped. So oftentimes I will talk to them about this very issue, and I will say, "You know, is there something on your mind that you need to get off your chest?" You would be surprised about how many times people have this issue. It's because they've done something to somebody in their past, and they don't feel like they're forgiven. If you have the opportunity to do that, to actually give them that ability in their belief structure to tell them that they are forgiven, there's a world of difference. It's quite amazing. It's interesting to me that in all hospitals—not just hospitals with a particular branch of religion—you have chaplains. You have different people associated, often with different religions, that people can call upon, which I find amazing, right? In this "modern" time, I mean, you know, of modern medicine, right? As far as I know, every major hospital has this, doesn't matter how cutting-edge or how small a community hospital, which by the way, many community hospitals are excellent. I should point that out. The words "community hospital" juxtaposed to, you know, "cutting-edge research institution," you know, there's actually a debate as to which one you would prefer to go to, depending on your needs. But they all have, generally as far as I know, access to people with whom patients and family of patients and friends of patients can pray. And that's not a coincidence. I think that there's a deep understanding of some sort of relationship there, and certainly there's good science to support everything you just said. Your clinical experience, in my mind, goes along with that. You know, science, as you said, is very reductionist, right? But people in two groups—one prays, one doesn't. You know, that's sort of the way science is done, of course. But ultimately, the real-world clinical implications are what really resonate. So thank you for that. I have one final question, and it might get you in trouble, okay? But I'm going to ask anyway. Let's say I or someone that I care about is admitted to the hospital. What are the things to do or ask that we're not told that can facilitate better care that are within bounds? Now, I will go on record, since these days I'm in the habit of just kind of saying it all. I'm aware that families of donors to hospitals get special care. This is—I will just tell you—there you go. You go to a hospital; there's a code language. I happen to know it for several hospitals. There's a code language of this is a "special patient." This will anger some listeners, but it's true. This is the way the world works. Not only some listeners, but some physicians too, right? So there's a code language that differs by hospital, and I know it for several hospitals. And I don't want to get into that; it's one of the more complicated aspects of medicine in hospitals as businesses and things like that. The point of asking this is that most people are not donors to hospitals; they're not going to be flagged as a special patient that gets the room with the window that gets sunlight in the morning, that gets the room alone without somebody next to them who's coughing all night, and on and on. So are there specific things that people should mention or ask for in order to get the best possible care when admitted to a hospital? Sorry, I got to put you on the spot. No, this is an excellent question. Some of the things you can control, some of the things you can't control. Getting a bed is just completely out of your control. If you're in the emergency room, you can ask when you're going to go upstairs. You'll get to get—you're going to get a bed when there's going to be a bed. Sometimes I can't even get patients upstairs, so they're triaging, right? This person is at risk of dying; yes, this person is miserable, right? And you're less miserable; you're going to wait. Is that how it works? Okay, potentially. I think in terms of where you are in the hospital and the care that you're going to get, I believe that the number one thing that you can do to make sure that you're getting the appropriate care is to, in as many ways as possible, communicate to the physician—usually not directly—that you are familiar with the disease that the patient is being admitted for, and you're going to ask some tough questions. Yelling at the nurse is not going to help you. Saying insulting things to the nurse or the doctor, the staff, is not going to help you; it's going to make things worse. I think the number one way—and I can tell you that in terms of me as a physician—if I'm speaking to a patient and we have a family member that is asking me intelligent questions about something, that's going to put me up on my game. That's going to make sure that I know I'm going to be ready for rounds because you're not going to be glossing over things. They're going to be asking some tough questions. I got to know what I'm doing. And that's kind of what I've been doing for the last 10 years, 12 years in terms of the teaching that I do. We have a website called MedCram.com where we put up, you know, if you get a—like you go to your doctor and you get a CBC back, right? How do you interpret that? **CBC** is a complete blood count, and it's the blood test that you get back when you get your blood test. There's a metabolic panel that you get back. How do you know what's going on with the things? What about an EKG? You know, you have these smartwatches that can actually measure your heart rate. How can you interpret what's going on there? We've put courses together to educate people. We even have courses on diseases—congestive heart failure. What kind of questions do you need to ask in congestive heart failure? What are the things that you need to watch out for? What are the medicines they're going to put you on? What are the side effects of those medicines? I think if—and you don't have to be that educated actually or even know that much—but if you can show that you're asking the right questions to a physician, they're going to ask you, "Are you in the medical field?" You're like, "No, I just know about this disease, and I have these questions about when are you going to start to do this? When are you going to start to do this? When is this happening? And when's the next step?" I think that more than anything puts those people who are taking care of you on alert to know that you're intelligent, you're going to be asking some questions, and they're going to need to make sure that they focus on and answer those questions effectively. I think that's the number one thing. I love it, and thank you for stepping right in the line of fire with that one, not trying to dodge it. So it speaks to the kind of person you are; it speaks to the spirit behind your work, which is so clearly in service to helping people. You know, it's such a cliché thing we hear, you know, "helping people." I want to help people, but it's very clear that you want to help people. You do this in your social media; you do this through your online teaching. By the way, we'll provide links to all these sources. You're doing this in so many ways, and of course, in your clinical practice. And, you know, for all those reasons, and also for coming here today to take time out of your very busy professional and family schedule—and you have your own self-care, right? If you're not healthy, you can't take care of other people's health, right?—I just want to say, on behalf of myself and everyone listening, thank you so much. I learned a ton, and I know everyone else listening did as well. It's all actionable in service to basic health and improving health and in service to avoiding illness. Those are not the same thing necessarily, although they go hand in hand, and to moving through illness should one contract an infection. And, you know, just a treasure trove of knowledge. So thank you so much. I'd love to have you back again. I would love to come back. I look forward to seeing you online, but even more so in person. So thank you so much, Dr. Schell. You're a real gem. Thank you so much. Thank you once again for joining me for today's discussion with Dr. Roger Schell. To learn more about his work and to find links to him on social media and YouTube, please see the show note captions. If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel. That's a terrific zero-cost way to support us. In addition, please click follow for the podcast on both Spotify and Apple, and on both Spotify and Apple, you can leave us up to a five-star review. If you have questions for me or comments about the podcast or guests or topics you'd like me to consider for the Huberman Lab podcast, please put those in the comment section on YouTube. I do read all the comments. Please also check out the sponsors mentioned at the beginning and throughout today's episode. That's the best way to support this podcast. For those of you that haven't heard, I have a new book coming out. It's my very first book; it's entitled **Protocols: An Operating Manual for the Human Body**. This is a book that I've been working on for more than five years, and that's based on more than 30 years of research and experience. It covers protocols for everything from sleep to exercise to stress control, protocols related to focus and motivation, and of course, I provide the scientific substantiation for the protocols that are included. The book is now available by pre-sale at **protocolsbook.com**. There you can find links to various vendors; you can pick the one that you like best. Again, the book is called **Protocols: An Operating Manual for the Human Body**. If you're not already following me on social media, I am Huberman Lab on all social media platforms—so that's Instagram, X (formerly known as Twitter), Facebook, LinkedIn, and Threads. On all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the content on the Huberman Lab podcast. Again, that's Huberman Lab on all social media platforms. And if you haven't already subscribed to our Neural Network newsletter, the Neural Network newsletter is a zero-cost monthly newsletter that includes podcast summaries as well as what we call protocols in the form of one to three-page PDFs that cover everything from how to optimize your sleep, how to optimize dopamine, deliberate cold exposure. We have a foundational fitness protocol that covers cardiovascular training and resistance training. All of that is available completely zero cost. You simply go to hubermanlab.com, go to the menu tab in the top right corner, scroll down to newsletter, and enter your email. I should emphasize that we do not share your email with anybody. Thank you once again for joining me for today's discussion with Dr. Roger Schell. And last but certainly not least, thank you for your interest in science.

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