2837: The Methylene Blue Masterclass: Cutting-Edge Mitochondrial Support with Dr. Scott Sherr

21:11That's the goal. And we make water, and we also make what are called reactive oxygen species or free radicals. That's great. If we have too many free radicals though, the system starts breaking down. And so metabolic health is, do you have the capacity to make energy effectively throughout that whole process that I just went by very briefly? And then do you have also the capacity to manage the stress of making energy? And 94 % of us don't have that capacity anymore.

21:38Sal Di Stefano:Yeah, so compare the 94 to the top 6 % and compare it from the perspective of somebody, the average person who's like, I want to lose a bunch of body fat. I want to be in shape. Compare those two groups. What is happening on a cellular level as far as their ability to have success? It's their resilience, right? Because everybody's going to have stress. Everybody, even the people that are in the top 6%, of course, they're going to have stress. But what they have is enough capacity to manage both the energy production and the detoxification side of things. And what happens over time is that the detox side of things especially gets really, really clogged up.

22:15And if that happens, the whole system starts breaking down. And the biggest reason for this is actually insulin resistance. So people have high blood sugars. Sugar is one of our substrates. It goes into our mitochondria, helps us make energy. But it also, if there's a shit ton of it, you're also going to make more waste products, right? Make more reactive oxygen species. And then what happens is that the mitochondria get overloaded with these waste products because you don't have enough. What do you need to balance this? You need antioxidants to do this. Things like glutathione and vitamin C and alpha lipoic acid and things like that, which over time get depleted.

22:44And then you get into a place where you can't actually manage the amount of energy that's coming in. And so the mitochondria start actually doing the opposite, actually making less over time. And so you know this, like it's not something that happens overnight for most people, but they're insulin resistant. They're fatigued all the time. They feel like they're inflamed all the time. Like they can't lose weight. Their brain's foggy. They have mental health issues. These are all mitochondrial issues at their base. And the question is just why, right? you have definitely insulin resistance being like one of the major reasons.

23:14The other one is a big one, which is sympathetic activation, always being in fight or flight, always feeling like your brain is on instead of having that parasympathetic side of things. Because if you're always on, you're always releasing neurotransmitters and hormones like cortisol that are stressing the system too.

23:30Sal Di Stefano:So talk about now, this is 94 % of the people and you get news from the doctor, you're not healthy or what about that, or you're recently motivated because you, whatever reason, feel like I need to make a change in my life. And so I cut calories. I start hitting the gym five days a week. I'm pushing sweat my ass off. That person ends up struggling. So explain why that is. And I feel like this aligns so much with the conversations that we have on this podcast all the time. And we get a lot of shit for like telling people to do less. Yeah. Yeah. Yeah. Yeah. Well, I've been calling it the sympathetic spiral of doom for this particular reason because people think they need to do more to get better as opposed to doing less.

24:15And oftentimes it's those people that go to the gym and then they crash for like three or four days after they went, or they go into a sauna and they can't move for five days afterwards because their body's already under such sympathetic dominance. You know, that fight or flight, that running from the saber-toothed tiger thing that we always say in medical school for some reason. I don't know why we always use a saber-toothed tiger. I mean, who thinks about a saber-toothed tiger? but we do. Anyway, but you know, that's what culture rewards, right? We all reward that hustle. I grew up in New York and, you know, the hustle that never stops kind of deal.

24:49And in medical school, we had shirts that said sleep is for quitters, right? Because it was in medical school. I mean, I mean, I told you about my rotation to shock trauma, right? 30 hours every three days. It was intense, right? And so we reward this stuff. But then And what's so interesting is that as a clinician, you think people would realize when they're in this state, but they have no idea, right? They have no clue. They think that, oh, I just need more stimulants or like, oh, I just need to do the gym more. Like I need more coffee, right? Or whatever. But then they realize like they do more and more, but they're not seeing any benefit, right?

25:20And so a big part of this actually is like, you know what? You actually have to calm down your nervous system without telling them to calm down. We talked about this, right? You don't tell somebody to calm down because that doesn't work, right? But if you say, look, if we just down-regulate your nervous system a little bit, throw you back into parasympathetic, everything else is going to get easier. But it's a conversation, and then it's giving them the experience. But the key here, and this is really important, is that when you're trying to down-regulate somebody's nervous system and calm them down, if they don't have enough cellular capacity, they're going to crash.

25:54Because you decrease their nervous system capacity, so you're trying to get them to relax.

25:58Adam Schafer:Which was keeping them just moving. Just getting them, keeping them alive, basically. and being able to function the way they were. I had a lady just a couple of weeks ago, she's like, I was dealing with molds and lime. My doctor gave me some stuff to calm me down and I just went, bam, right? She crashed, right? Because that was keeping her. And so many of us out here, this is the same thing. This is what's happening now, right? Is that we're just able to stay on this sort of train. And then if you start taking the brakes off without giving enough mitochondrial support, this is where the methylene blue actually comes in a lot, right?

26:27Is where, because that's what had been like one of my biggest levers recently is like if you can give them the support while you're starting to put the brakes on, then that's the key.

26:36Sal Di Stefano:We have a term that we call them cortisol junkies. Yeah. And this is really hard to communicate to a person that's in this state because they get this immediate reward from the high stress. Try telling somebody who's here, where you're describing, who just did their circuit training class and they get that rush afterwards of completing it and that adrenaline and they go like, and then try being the person who's trying to tell them that's not good for you. Like you piss off. I know how I felt right afterwards. It's really difficult to communicate that. I'd love for you to get into methylene blue, like the history of it.

27:12We talked about this, you know, tongue in cheek, like where, who was the first person to realize that dye had these types of benefits to it, you know, for the mitochondria. Like, how'd you get, how'd you find your way towards it? So it's a crazy compound. It's very blue. It's been around a long time, but is absolutely a huge bridge in the work that I do because it helps right now with the mitochondrial function that we've been talking about. It helps with energy and detoxification at the same time. So I like to say that our cells are like gasoline-powered cars. We make ATP, but we also make that carbon dioxide.

27:48Not a waste product, I promise, but people will think about it that way. I have friends that get very angry if I call it a waste product. And then water. And then, of course, there's reactive oxygen species, right? That's what our cells are making on a regular basis. But methylene blue comes in. It helps with the energy production side and it helps as detoxifying at the same time. So it works with energy and detox at the same time. It's called a redox cycler in that way. So the history of it in the 1870s, 1870, so a long time ago, it was developed as a textile dye. So if you wore like Levi Strauss jeans, your jeans were dyed with methylene blue.

28:23But at that time, you guys, if you had like a cellulitis, like an infection on your leg, you would die, right? Because there was no antibiotics. There was no antimicrobials available, right? So they were looking for compounds out there that could treat these kinds of infections because nothing existed. And so they realized that methylene blue, it actually got the name of a magic bullet at the time, could treat pathogens, could kill pathogens at high doses, but it would not harm the normal, the human host, right? And that was like the best thing ever that they could find because either they could find compounds that would kill you and kill the pathogen too, which that's not very helpful, or they wouldn't be strong enough to be an antimicrobial, right?

29:04So methylene blue was the first drug registered with the FDA in 1897. Oh, no shit. Yeah. So it was a very nascent FDA and it was the first fully synthetic drug too. So it's not something that comes from nature directly. And that also gives it a little bit of like, you know, some controversy in the world of medicine and alternative medicine, right? even with my dad and he uses it in clinical practice. But I like to remind people that synthetic things are not necessarily bad for you. Just like natural things are not necessarily good for you. Like you can forage for the wrong mushrooms and die. Well,

29:37Adam Schafer:I think the value of natural things is we have, they have a long history of being used. This is a synthetic that's been used for a long time over a hundred years. But didn't like leach into somebody's wound? Like how did this like, so they were doing, they were doing cellular testing on malaria actually. and they found that malaria specifically, you know, us white people going down to Africa and getting malaria, you know, we would die, right? And so this particular compound, methylene blue, could give it very high doses of methylene blue and it would kill malaria. And they saw it in cellular culture.

30:09Oh, wow. And so then they realized, well, what else can it do? So between 1897 and 1950 or so, it was like the premier antimicrobial. And by the way, it still fucking works, but it doesn't, it wasn't as sexy because you had penicillin and other drugs that came out in the 1950s, which is very important. Which by the way, if you go to the hospital now,

30:28Adam Schafer:there's a condition now that they'll give you intravenous. What is it? It's called a met hemoglobinemia. Okay. And this is a, this is a particular condition where your red blood cells can't carry oxygen. Okay. It's typically because you've been, had an overdose or a poisoning. Like you guys know, like the huffer people like huffing glue or huffing paint that has something called sodium nitrite in it. And that is colorless and tasteless, but it actually prevents you from carrying oxygen on your red blood cells. So methylene blue is the antidote for that, for metheglomidemia. And it's also the antidote for cyanide poisoning.

31:01So if you're going to Russia anytime soon, you know, make sure you bring it with you. Because what it does, so cyanide actually destroys part of those electron protein complexes that I was talking about. It destroys complex four. And so if you get methylene blue on board though, So there's all these kind of ninja moves on your electron transport chain to bypass blockages or bypass areas that aren't working. And that's what makes it so powerful is that because so many people are walking around with mitochondria that don't work well, especially complex one and complex two, which are the main complexes that take electrons from your food.

31:34So if you've had a chronic infection, if you're diabetic, if chronic stress, pesticide exposure, so many different things can affect those first couple of complexes and affect the capacity for your energy production to happen. So short story with methylene blue is that between 1897, 1950, fantastic act of antimicrobial. It only had one major side effect, which you guys have all experienced. Blue pee, yes, blue urine. And so there was actually even stories, songs in World War II. If you were World War II and you were shipped off to the Pacific, you were taking methylene blue prophylactically to prevent fungal infections while you were in the jungles of some of the tropical islands in the South Pacific.

32:17And it was calling, they said, going blue in the loo, right? With all the English people going blue in the loo. But in the 1950s, when antimicrobials came around that were prescribed, it became less used in that way, although it works fantastically well as an antimicrobial and still does. And I use it that way now, especially for urinary tract infections, actually, because methane blue makes your urine blue, concentrates in the bladder. It breaks up biofilms. It's an antimicrobial. at high doses, but at lower doses, around like four to about 25 milligrams, it's a fantastic mitochondrial support.

32:51And we know that from the last several decades of research. There's a researcher at the University of Texas, Austin. His name is Francisco Gonzalez Lima. And he's done a lot of work on Alzheimer's models, traumatic brain injury, stroke, and others looking at how methylene blue concentrates in the mitochondria and optimizes mitochondrial function. And it does this very effectively and very, very quickly. It's not like you take methylene blue and you wait a month for it to start working. It starts working. That day. Yeah. It should be within three to five days of taking it. If it doesn't work at that dose, you go up on the dose, right?

33:22And so the higher doses, like a milligram per kilogram, which is like 50 to 70 milligrams or a little bit higher, maybe up to two milligrams per kilogram for an acute infection, like that is a fantastic way to use it. But for the most part, I'm using it at lower doses, four to 25 milligrams on a regular basis for the whole spectrum for people that are super sick and need that bridge, that support, but also on the endurance side, because it increases aerobic capacity. It works, can work just like oxygen in your cells too. So you can maintain aerobic capacity for longer. And the first time I realized this, I was working with a patient, this Southern lady, I can't do her accent, but she's from like Alabama.

33:58And she's like, Dr. Scott, I can't stop working out with this stuff because it's so great. I'm like, well, what's so great about it? She's like, well, I can maintain my heart rate up for longer without having to stop. And I worked with a guy that did the Leadville race, the ultra marathon where I live in Colorado, and he cut three hours off of his time using methylene blue 32 milligrams every four hours.

34:17Sal Di Stefano:So how are we, how are you measuring the success of the dose? Like, so like you decide, how do you figure that out? And then we know like, oh, this is working well, we don't need to go up or like, how do you figure that out? So a lot of it's going to be how you feel, right? But then you can also look at metrics like heart rate capacity, like if you maintain maintenance of heart rate for longer, if you're doing aerobic work, there's some studies that we did on dogs specifically looking at lactate threshold. And so that you reach your lactate threshold later if you have methylene blue on board, because it's able to maintain aerobic capacity for longer.

34:44So a lot of it's gonna be subjective, which means that how do you feel when you're doing certain things and then looking at various markers. But like, what's weird about it is that you can give somebody methylene blue in the morning and they sleep better at night. Well, why, right? It's because they're getting better mitochondrial support during the day. and then you see their hrv go up at night as well when they're sleeping it's the same deal because you can see how when you give more mitochondrial support the system starts being able to calm itself down because it's now like okay now i'm having enough support here it's not trying to

35:12Adam Schafer:fuel with stress uh hormones and stress all the time right exactly and so it's the mitochondria able to relax like the there's this thing called the cell danger response which you guys have probably heard of where where the the whole system goes into this sort of shut down hibernation mode especially the mitochondria if there's too much stress in the system your cortisol people right the what happens instead of the mitochondria making more energy they actually make less but if you can flip it out of the cell danger response then it starts being able to make more and that's why like i was you know i've been shocked over the years like i had a guy a colleague of mine he's like i've had anxiety all my life i took methylene blue and it went away and i was like huh well what's up with that what really because what his anxiety really was a representation of was mitochondrial stress, right?

35:54And when we are giving him more support, then his mitochondria are able to like flip back over into a more healthy way of optimizing energy production.

36:01Sal Di Stefano:Now, there's a lot of things that are marketed to us today about mitochondrial health. An example, red light therapy. Yeah. Is there added benefits of pairing it with this? Like, I mean, and so like, if you were giving me all the things to do that, what would a stack or all the, you know, what you would prescribe to me? Yeah, all the things. There's lots of things that can be there. What I would say is there is a significant synergy between methylene blue and red light. That's been well described because methylene blue can donate electrons, basically help with energy production at all the complexes, but especially complex four, which is called cytochrome oxidase.

36:37And red light therapy, about 680 nanometers, well-established as donating photonic electronic energy to complex four as well. And so that combination is very powerful. So you can take your methylene blue 45 minutes or an hour later, for a minute to an hour later, you go outside in the sun, you know, red lights in the sun, everybody, you don't have to have a panel or you can go in front of your panel. If you have one too, that's a great synergy. Now at higher doses, like you can use that as a compounding for infection as well, for especially for viral infections. So you give your methylene blue higher doses, you go out in the sun.

37:11This is what I was doing four or five years ago without telling anybody that I was doing it and seeing significant benefit. And a lot of my clinician, colleagues were too.

37:19Adam Schafer:So antimicrobial also for viral infections. Yeah, antiviral too. Wow. Now, methylene blue is also an MAO inhibitor. It's actually a quite strong one. So let's talk about that for a second. Yeah. So MAO is a monoamine oxidase inhibition. So what that means is that methylene blue prevents the breakdown of norepinephrine and serotonin and at higher doses dopamine. And so that means there's more of that around, but it's dose dependent. So lower doses of methylene blue are going to do a little bit, higher doses are going to do it more, but it's something you have to be aware of. you have people that are on things like SSRIs and, and, you know, search energy reuptake inhibitors.

37:52These are antidepressants. Yeah.

37:53Adam Schafer:You don't want to combine them. So you don't typically want to do that. The risk is very low to actually do it, but I recommend doing it with a practitioner. Okay. The risk that they talk about all the time, something called serotonin syndrome, which is not something that any doctor has really ever seen in their clinical practice. Happened to me. No. Yeah, that was stupid. I did, I did methylene blue with tesofensin, which is a peptide. well you can buy it as a peptide which is a norepinephrine serotonin dopamine reuptake inhibitor okay and so and i just started sweating like i'm like a maniac okay you started sweating like real bad yeah you went to the hospital like drenching and i so i went to the hospital so i'm like oh is this serotonin syndrome it might be so i went there had the shivers the whole field and then i it was a few hours later i was okay how much methylene blue do you take um i've probably 16 milligrams not a lot but the teslofensin was i don't remember what that must have been a pretty strong SNDR.

38:41Sal Di Stefano:You did a high dose of test of fencing, but you were upset how high of a dose you were. That's right, yeah. That must have been it because usually, the only studies that they've shown causing serotonin syndrome with methylene blue have been IV methylene blue.

38:52Adam Schafer:Oh, wow, which is a high dose. Yeah, which, you know, it doesn't have to be high, but it gets to the body really, really quickly, right? And then when people start taking methylene blue, even at the low doses, one of the things that most people say that they feel like slightly funny, like a little bit off, a little bit different, that's usually because of the norepinephrine and serotonin. But the dopamine doesn't happen until much higher doses of methylene. Yeah, but yeah, that was, again, that combined two things. So this is just the where, because it works. It actually does work. Yeah. And so you want to always be careful with things that work and combining it with other things.

39:23Yeah, but I have integrative psychiatrists that are weaning their patients off of SSRIs of the world, SNRIs, and using methylene blue instead.

39:28Adam Schafer:I was just going to say, because here's one of the other things, and I don't even know if we can necessarily talk about this, but I know a lot of people who use methylene blue as an antidepressant because it lifts their mood. And what is mental health issues like depression really at their core? It's a mitochondrial issue, right? I mean, we know this. It's a gut issue. It's a mitochondrial issue. You have all these books that like fix your gut and your depression goes away, optimize your diet or start exercising and depression goes away, right? So there is a, we know a hundred percent, like when I went to medical school, I learned that if you were depressed, it was a serotonin deficiency.

40:01And that's complete bullshit. There's no evidence at all, but you know, actually there's more evidence that there's a GABAergic aspect to here. So GABA is our primary breaks of the brain and GABA deficiency is associated with depression, but low serotonin levels are not. And so we know that the mitochondria are the big part here. So understanding how you can optimize mitochondrial function is key. Understanding why the mitochondria are under stress is also key. Is it toxic exposure? Is it synthetic dominance? Is it medications people are taking? Is it infections? There's all these other things that it can be.

40:33So you have to think about the roots. We talked about the root causes. But then if you just focus on optimizing mitochondrial function first and the additional benefit with methylene blues, you do have some mild increase in serotonin and norepinephrine as well, right? But it is dose dependent.

40:47Sal Di Stefano:How does it compare if you, and I know like, it sounds like you use this to get the client going, jumpstart it. And then of course, nutrition exercise is key, right? For sure. Now, how does it compare though, head to head with that? Just a better diet and strength training? Cause we know that's obviously incredible for mitochondrial health. So how does it compare? My goal always with people is like, let's get you on some methylene blue if you need it now. And then over time, as you optimize your diet, as you optimize your lifestyle and your exercise, you need it less. You know, I was talking to our mutual friend, Thomas DeLauer, just a couple weeks, a couple days ago.

41:20And I was like, he takes it two or three times a week, right? When he has like a bigger day, more stress, you're traveling. That's what I do. Like if you're well optimized, you don't need to take it every day. But if you're traveling, like let's talk about an airplane, right? Yeah. airplane, you're pressurized on a plane to 8 ,000 feet above sea level. So as soon as that cabin door closes, you get tired. You want to take a nap, right? Because you just became hypoxic all of a sudden. And I'm, you know, for me, when I live in Colorado, it's glorious getting on an airplane and coming to the other places that I go because it's mostly sea level.

41:48So my, or my, you know, my ring loves me, right? Because I'm always, you know, at sea level and I have 21 % oxygen in the air. Where I live, it's about 17 % oxygen in the air. When you're on an airplane, you're about that too, about seven or eight, 17, 18%. And so that's a hypoxic stress almost right away. So taking methylene blue before you got an airplane is like transformative for people, right? Because even if you're mitochondrally healthy, right, that's still significant stress. So you use it as like a pre travel stack that you can use. It is transformative. So all of my patients, it's a great hack.

42:19Adam Schafer:That's so great. I'm going to use that. Cause I travel, uh, we all fly a lot for the company and I always don't feel good from on a plane. And so, and I've never thought to use methylene blue beforehand. Yeah, before and during, depending how long the flight's going to be. So I have people dose every, it's the half-life is about four hours. So if you have a flight that's 10 hours, you're dosing every four hours while you're on the plane. You just want to modulate your dose depending on sleep, right? And then you also want to try to, you know, meet the time zone that you're going to go to. But then you can also use GABAergic things.

42:47You know, we have other things that we use to help people.

42:49Adam Schafer:What you're saying about mitochondria, I think that now lots of data supporting this. So people might not even be aware, but there's all these studies now that are coming out like creatine they're showing has got antidepressant effects. Why? Because it helps with ATP production. Uh, we know a ketogenic diet sometimes has this effect, not because there's magic in the diet, but because producing ketones is just the cleaner, I guess, for lack of a better term way of producing energy. So if you've got kind of dysfunctional mitochondria, suddenly you feel like, Oh wow, it feels so much better. Well, it's because you just switched energy sources and you have something different.

43:23Adam Schafer:so um yeah mitochondria this is this is like it looks like medicine is kind of moving in this direction yeah where they're all looking okay what's what's going on with the mitochondria it's it's you know it's called cellular medicine sometimes it's called mitochondrial medicine but it's absolutely happening because we used to think you know these mitochondria you know when i was just my daughter was 15 she just took science and she learned about the cell and then you have a nucleus and you have the mitochondria you have the gold you bodies there's just one mitochondria in that cell that you learn about then you learn that there's some cells like we were talking about eggs and sperm that have thousands, neurons, thousands of mitochondria per cell.

43:56And they're not just making energy. There's a whole new world of talking about like mitocentric medicine you're gonna be hearing. And it's gonna be all about the mitochondria are these gating and sensing organs in your cells. Your nucleus, yeah, they're kind of important, but they're not as important than mitochondria is what we're actually, I mean, obviously it's where all your DNA and everything. But then also, as Dr. Ted likes to always remind me, like where is the brain of your cell? It's not your nucleus. It's actually the cell membrane itself. The cell membrane itself is sensing everything.

44:26It has to decide what to let in, what not to let in. Exactly. So the cell membrane. So that's why we're talking about phospholipids. We're talking about oxidative stress. You can see all signs of this in the lipid membranes as well. Of course, the trans fat arguments and all that. Thankfully, those are gone for the most part now.

44:40Adam Schafer:What's the role of mitochondria dysfunction in cancer? It's a big one, right? Because if you think about cancer, cancer is an end-stage process. that's happened because of poor terrain or poor foundational health, right? If your immune system optimized, like we're making cancer cells right now, all of us, every second of every day. But our immune system knows most of the time, amazingly, to get rid of those cells, right? But cancer cells are just trying to protect themselves. This is a crazy thing. There's all these ideas of, have you guys sort of like the mean gene, like Richard Dawkins stuff, but like the idea is that all of our cells are really just trying to protect themselves and do what they're supposed to do.

45:17And if they need to protect themselves because there's toxic exposure, because there's sympathetic activation, they're gonna do what they need to do to try to survive, right? And that's what cancer cells are doing, right? And a big part of that is the mitochondrial aspect of this, right? Because mitochondrial function, if that starts going down, the whole cell starts going down too. Because if you can't sense how much energy needs to be made, you can't sense what you need from a resources perspective, you can overcompensate or you can undercompensate, right? And this is the thing about what mitochondria do is that you make new ones all the time, but you're not making them like de novo.

45:50They're actually being mitochondrial efficient. So you're actually making new ones out of the ones that you already have. And so, yeah.

45:55Adam Schafer:So it's like making a photocopy of a photocopy. Exactly. And they start to get worse over time. Yes, exactly. Wow, wow. Did your work with hyperbaric chambers start your kind of fascination with mitochondrial health? It did actually, yeah, 100%. Because I realized what you're doing in a hyperbaric environment is you're flooding body with a huge amount more oxygen, right? And that sounds great in principle, right? But what that does is revs up your capacity to make energy, if you can, and also revs up your capacity to need to detox because of the way hyperbaric therapy works is by creating a huge amount of oxidative load, huge amount of reactive oxygen species in the system.

46:29But what if you can't tolerate all that, right? The idea with all that ROS is that you're creating an impetus for stem cells to get released, the immune system to get activated, to kill bugs, to do all these good things, to decrease inflammation. But if your system can't tolerate that, then you're gonna be in a world of hurt or you might get some benefit, but you're going to go back to the same way you felt before. This is what I kept seeing in hyperbaric medicine. Like I actually got disinvited from a conference back in the day because the title of my talk was going to be, please don't put them in the chamber.

46:59And I love hyperbaric medicine. I think it's fantastic. Yeah, because sometimes it doesn't.

47:02Sal Di Stefano:But it sounds like it's far more beneficial for somebody who's metabolic healthy than it is for somebody who's not. Right, or to at least try to optimize for like three or six months to get the foundation on board. And that's where that health optimization medicine became a huge piece for me because I was seeing people and they weren't getting better. Like I'm like, you should get better. Like you have an infection. I'm treating it with hyperbaric therapy. Like this should get better, but it wasn't. Like, or they were getting a little bit better, but then they just get worse again, relapse. And I was like, well, this came down to understanding cellular metabolism, understanding energy production, detoxification.

47:31And then how could I help them? Well, I could use this foundational framework called health optimization medicine that takes three or six months to get them better, work on that, then get them on some methylene blue, which would be really great as a support. and then also working on optimizing their nervous systems or down-regulating their stress response. Because this is the other thing, right? I was actually just learning about this a couple of days ago where there's some of the antidepressants actually are mitochondrally dysfunction. They make the mitochondrial dysfunction more. As I found out like early on in my career and using hyperbaric therapy, that some people on certain antidepressants just would not get better.

48:04Yeah. Just would not. And I was like, why is it on Cymbalta you won't get better on using hyperbaric therapy? It was because it was destroying mitochondrial function, right? And so I found out over the years that if you can really focus on helping people now, you know, and then giving them a ground game, that I often say, get 60 or 70 % better first, and then let's get you into the chamber to get you that next 30 % more. There's other reasons. If you're doing performance or recovery, there's other reasons too. Like you can just go into the chamber tomorrow. Or if you have an acute issue. But in essence, my practice has kind of developed like, okay, hyperbolic therapy is great.

48:40But if you want to see long-term benefit, you need to get 60 or 70 % of the way there anyway, right? And then if we do that, do you really need to be in the chamber? And then we can have that conversation, right? I use hypobaric therapy all the time still. But what I'm using on my ground game for people is like, okay, let's optimize - Much more complete picture.

48:57Adam Schafer:Yeah, yeah, yeah. Were you guys one of the first ones at Troscriptions to use Methylen Blue or to work with Methylen Blue? We were the first company to make a commercial product with Methylen Blue back in February of 2020. So just about six years ago. Wow. And it exploded. Yeah. And exploded. You know, what's so interesting about it is that before us, you had to go to like a chemistry company or somewhere, you know, to get it. And it was very difficult to find good quality stuff. So we were the first, and it took us about a year longer to launch the company in 2020 than we anticipated. It took us that long to find a good source of it.

49:31Adam Schafer:Really? The problem with methylene blue is that when you make it, it's often, it's made in a lab and it can be contaminated with heavy metals like lead, mercury, cadmium, and arsenic. Is that often the case? Unfortunately, yes. So if you look online now, you can find it everywhere. We were the first company, the only one in 2020. There was like six companies in 2024. Now there's over 100 companies that are making it now. But the problem is that the quality is all over the map and it's not very good. And so there's something called USP grade. So if you go online now, you go online to Amazon, I don't recommend you buy any supplements on Amazon, but especially methylene blue.

50:08Adam Schafer:There's a lot of counterfeits. So much counterfeit stuff. Which is crazy. Yeah, it's crazy. Like millions of dollars worth. So I always tell my patients, do not buy your supplements on Amazon. But anyway, so methylene blue specifically, this USP grading it's called. Like that's supposed to be pharmaceutical grade. But the problem with that is that people don't eat, they just put that on the label. And then we've tested a lot of this stuff as well. It doesn't meet USP grading. And that means it's more contaminated with heavy metals. and the liquids out there are probably the worst offenders because their potency is nowhere near what it says on the label.

50:39Like one of my biggest pet peeves is that, if I say, Dr. Scott, I've been taking methylene blue 10 drops a day for a week or whatever. And I feel like shit. I'm like, well, how much you've been taking? I'm 10 drops a day. I'm like, well, how much is that? Like, I don't know, 10 drops. I'm like, what are you telling me it doesn't work? What are you telling me it's making you, and then what are you taking, right? And then, so liquids are really difficult because it's like a milligram per like dropper. You don't know exactly how much it is. And then it gets on your countertop and you almost have your wife try to divorce you.

51:04And so the key, this is a good trick. If you get methylene blue on a countertop, it does stain buffered vitamin C. Oh, wow. This has saved my marriage at least three times in my laundry, in my sink. So it does work. But the challenge is like finding good stuff is really difficult. Sal and I found, we've tested a bunch of stuff across Amazon stuff, pharmaceutical stuff that you can prescribe.

51:30Adam Schafer:Scott, I'm not just saying this because we work with you guys. Actually, this is one of the reasons why we work with you guys. I've tried three different, separate from Troscriptions, so three other methylene blue providers. And yours was the best, has been the most consistent best experience. So it's gotta be that. It's gotta be that I wasn't getting either the right dose or there was some other stuff in there. Yeah, one of my favorite stories is a guy a couple of weeks ago, actually a couple of months ago now. He's like, yeah, doc, I bought this methylene blue from a source that says it was made in the United States and it took three weeks to get through customs, you know, at times.

52:04And this is the thing, if you're buying it on Amazon, it's so funny how things come back like full circle, right? Because early in the pandemic, about six months in, there was this article from the New York Post. It said, biohackers drinking fish tank cleaner to reverse their age. That's because - Great clickbait. Well, because methyl and blue were killed. You get methyl and blues and fish tank cleaner. Yeah. You don't want to drink fish tank cleaner. Please don't win a Darwin award, everybody. That's very highly contaminated with heavy metals. But it was a great clickbait headline. that same paper eight months ago did a whole article just espousing the beauty of methylene blue and had an affiliate relationship with one of the shittier ones on amazon i was like of course that's how it's gonna go right it's and is it anti-parasitic as well yeah anti-parasitic um it's antimicrobial in general so we use it for people that have parasites that have dysbiosis in their gut that have you know overgrowth of bacteria how does it kill and how is it

52:51Adam Schafer:anti-parasitic and anti-parasitic do they just not survive the electron transport like what's No, it's actually a little bit different. So you guys know hydrogen peroxide? Yes. So we can buy it at the store, but our cells make it as an antiseptic. It's housed in a part of our cell called the lysosome. Okay. And when we have an infection or the cell is trying to kill itself because it's under stress and it's better to sometimes die than to try to survive, it'll release hydrogen peroxide. So methane blue releases hydrogen peroxide to help kill these kinds of things. And what's cool about it actually is that it doesn't work like a nuclear bomb as an antibiotic would or an antimicrobial.

53:26Like if you take, you know, amoxicillin or Augmentin or something else, like these are nuclear bombs to your gut. They kill everything. Yeah, yeah. And what methylene is more selective than that. It doesn't do it. It really does have a more selective capacity. So you can give it in the acute setting and not worry about causing that nuclear bomb kind of picture in the gut. But, you know, for the most part, we're using it lower doses. Like using it at 4, 8, 16 milligrams.

53:51Adam Schafer:8 is for me the sweet spot. That's where I find where I feel the best with it. So, so I was just going to say like, so you use your fish cleaner and then your horse dewormer. It was, it was that time. It was a time guys. Yeah. But so what we do with, with quality is that we get our methylene blue from a manufacturer in Japan or Korea, South Korea. For those of you who are wondering, um, I'm not North Korea. Um, I have my, our CEO boomer. He's, he's married to somebody from South Korea, but they just say they're from Korea. And I was like, wouldn't they say South Korea? I'm like, no, it wouldn't be obvious that they're from South Korea.

54:23Like I didn't really think about that. Anyway, so we get it from Korea and Japan, and then when it comes in, we get it with a certificate of analysis. It has USB grading, but then we test it again. So the problem in the supplement industry in general is that they're trusting. You talked about creatine earlier. Did you hear about that creatine scandal? No. Creatine gummy scandal? Oh, yeah. Zero creatine. Oh, yeah, nothing. They just eat candy. Yeah. It came with a C of A from the manufacturer, certificate of analysis, that said creatine in the gummies, right? So you have these companies, because we have to regulate ourselves in this world, as you guys know, nobody else is doing it, that they just take that C of A from that other company from another country.

55:04I don't care if it's China. I mean, things getting from China is fine if you have a C of A that is optimal and you test it again. So with all of our products, we take it that next level and we really say, look, yes, this is a trusted manufacturer, but we trust and we verify. And we've had to even throw out thousands of dollars worth of stuff from our trusted manufacturer over the years.

55:23Adam Schafer:Do you need to take a break on methylene blue or is it something you take daily or take it every other day? Like what's the best way to use it? It depends on where you're using it, right? If you're using it for a bridge because you have chronic fatigue and you're, you know, you have autoimmune conditions and you have severe mitochondrial dysfunction, you have long COVID or other kinds of conditions where you have, you're in a pretty bad place or you're in a pretty significantly compromised place. Then taking it every day for a little while or maybe even for months can be okay. as long as you're keeping the dose if you're taking about 30 milligrams or less i usually say you don't have to take a break because it's super low doses okay if you're taking over 30 milligrams a day you just take at least one day off if you're taking over 70 milligrams a day two days off a week but it's pretty rare to have people on those how would someone know when they're taking the dose that they took too much like what do they feel with like okay i gotta back off it's so person dependent what i find is that what i like to do is titrate people so like with the just blue that we have at your prescriptions.

56:17It's in a trochee form, which is like this dissolvable lozenge, which classically could be dissolved in the mouth, but it can also just be swallowed. And methylene blue is very highly bioavailable, which means that you can take it in the mouth, you can swallow it, you can use it in the IV, and almost all of it's gonna get in the body. Of course, this is an IV. There's very few compounds that are like that, actually. But so with methylene blue, the way we developed in these trochee forms, you can take a quarter, which is four milligrams, and then you try that for a couple of days. Try it in the morning on an empty stomach.

56:44See how you feel. you don't feel much then go up to go after about three days if you don't feel much go up to eight see how you feel you're like oh so you can what's your experience so how do you feel when you take

56:53Adam Schafer:oh uh sharper i just have a little bit more energy uh you know verbal fluency is better i use it before uh big interviews typically yeah right and so in your case i would be okay you tried eight let's try 12 any any difference you're like you know what at eight a little bit jitterier didn't feel as as i felt like it was a little bit too much you know and then usually it's like usually it's an extension of how you felt when you felt good, but maybe just a little bit less good. And so oftentimes it's not like a more is better kind of thing. Oftentimes I find between eight and 16 is the dose for most people.

57:25Adam Schafer:Yeah. If I go up to 16, it's a little edgy is how I would describe it. Yeah. And that's common. And that's what I feel like. I'm usually around four or eight milligrams actually. When I get above that, I get on the edgier side. But sometimes what I'll do if it's a long day is I'll combine it with something that's going to take off the edge at the same time. Like what? Theanine? I use one of our other products. I use, I use like our GABAergic stuff. Okay. Um, I use our Trocom actually, because that one has, it gives you some anxiolytic effects of anxiety decreasing, takes off the edge at the same time.

57:53It also doesn't make you feel tired. So I like that combination.

57:57Sal Di Stefano:What's in that? Cause I saw you, you brought that today. What's a, what is in the calming one? So GABA, what else? So Trocom has something called B3 GABA. Okay. Um, it has Kava CBD and CBG. Now the thing about GABA, you guys probably know this, but GABA is our primary relaxing, the breaks of our brain, right? It calms things down. It's always in balance with another neurotransmitter in the brain called glutamate. Glutamate is our excitatory neurotransmitter and glutamate actually gets converted into GABA in the brain. So that's 80 % of your neurotransmission, just those two. So you heard about serotonin, norepinephrine, dopamine.

58:31That's like the minority of what's going on. Yeah. And the, the classic glutamate overload situation is like when you go to a Chinese restaurant and have MSG in your food. And so you have, what do you feel? You have headaches, tremors, you're irritable. The problem is that most people are, what's that? Then you're hungry again. Yeah, exactly. Yeah. That's the worst. Um, the, the problem is that most people are walking around with those things, irritable, you know, you know, mood, mood instability, because most people are walking around GABA deficient, you know, GABA deficiency is associated with anxiety, associated with depression.

59:04We were talking about that earlier. It's associated with insomnia, mental health issues. But if you go to a doctor, like a conventional doctor, like one of my colleagues, and you say, I feel depressed or anxious, they're gonna give you an SSRI, right? But we talked about how serotonin is not related to depression, right? But GABA is. But the thing about just, well, could you just take a GABA supplement, right? GABA itself is too big of a molecule to get into the brain. So if you take GABA on its own and you feel great, you have a leaky brain. Wow. So your blood brain barrier - Isn't that great.

59:36Isn't doing what it's supposed to do. And this correlates very dramatically with a leaky gut. So I've had patients that I've worked with over the years. They're like, hey, doc, I'm taking GABA. I feel great. I'm like, okay, let's do something about that. And because it's diagnostic, basically, if you have, but you optimize their gut, they seal it up and the GABA supplements stop working. Now B3 GABA is a smaller - B3 GABA is different. So B3 has a vitamin B3 attached to the GABA itself. And B3 has a transporter. So B3 - So it hitches a ride. Hitches a ride, right? And then in the brain, it hydrolyzes, it breaks apart.

1:00:07So you have mild amounts of B3, which is niacin and NAD, and you have GABA, okay? So that combination is great because now you have the GABA, which is relaxing you, but you also have mild activation, so you don't feel tired at the same time. And so you get that combination is great. And then we have kava in there too. And so the cool thing about how we developed this is Dr. Ted, he's the founder of the company, this brilliant pharmacologist dude. Well, what if we created a way to enhance the GABA system in the most comprehensive way possible? So when you think about the GABA receptor, small biochemistry lesson, I promise.

1:00:41It's a cool one though. So GABA itself, the receptor has places where things bind. It has where GABA binds, that's where GABA would bind, right? But it also has other places where things bind, like alcohol, for example, or benzodiazepines, like Ativan and Xanax, or sleep drugs. The problem with these separate sites where GABA binds, the GABA receptor to where GABA binds, is that they can bind very tightly and enhance GABA to bind very, very tightly and then deplete GABA in the process. So you drink alcohol, you wake up two hours later feeling like shit. That's because all that GABA was depleted very quickly.

1:01:12Benzos, Xanax, all these things, they do the same thing. And so you don't want to give something that just increases the amount of GABA to bind without giving a source of GABA at the same time. So he created something called an obligate pair system or an oblipair where you bind something to a separate site on the GABA receptor and at the same time give something that works just like GABA or GABA itself. So in the case of Trocom, you have vitamin B3 GABA and you have kava. And kava binds to a separate site on the receptor. It makes you feel drunk. You guys have had kava before. But kava itself is also something that can cause tolerance and addiction, just like alcohol, just like benzos, just like sleep drugs, because it depletes GABA in the process.

1:01:52And so instead, what we do is you have a combination of the B3 GABA and the CABA together. So the CABA binds and you have the B3 GABA going in. So you have the GABA there too. And so you have this nice combination where you get no tolerance, no dependence, no withdrawal and you can take it as needed and you don't feel tired at the same time.

1:02:09Sal Di Stefano:What's the dosage look like for somebody? So the Trocom dosing is the B3 GABA, I believe is 50 milligrams, five zero. And then you have CABA, which is a hundred milligrams. Yeah. And you have, then we have CBD and CBG in there as well. Yeah. So just a small amount of CBD and CBG and that works on the endocannabinoid system, the body's own internal cannabis system.

1:02:29Adam Schafer:And there's a Garin in there. What is that? Oh, so agarins and it's in our sleep, it's on our sleep formula. Okay. So what is that? So agarin is from the fly Garic mushroom. Do you guys know the Amanita muscaria mushroom? I know Justin did, by the way, off air, Justin like named it right out the gates. I know he doesn't. Yeah. Well, Well, what's his name? Paul Stamets. I've listened to quite a few of his podcasts, but yeah, he talks about the association there with Santa Claus. Yeah, it is. Yeah. Yeah. There's a great, if people are listening, they can look up there. There's a New York time piece on the idea that this particular mushroom, the Amanita muscari mushroom is the reason why we have Santa Claus.

1:03:08because as the stories go, in Siberia, this mushroom would grow wild and the reindeer would eat the mushroom because they liked it and it also made them trip balls. And then people are like, oh, what's going on here? And then they realized that eating the mushroom itself is toxic. It's neurotoxic. But if they dried it, it would become less toxic. One of the ingredients in the mushroom is called ibotenic acid. That's neurotoxic, excuse me. The other ingredient is called agron. And agarin is a long-acting on the GABA receptor. Binds to where GABA would bind. And so we combine that with another modulator of the GABA receptor called hanokial, which comes from magnolia bark.

1:03:50And that combination of hanokial plus agarins in our formula called Trozy, along with six other ingredients that are working on sleep. But working on the GABA system is really, really important because again, most of us are deficient. And if we can put the brakes on for people, they start calming down their nervous system. And we talked about mitochondrial function. The combination of supporting mitochondria with something like methylene blue short-term and then less long-term if you get more optimized and then using something that puts the brakes on, like your calm and your Z here for me, then suddenly people can feel like, oh, that's what it felt like to not always be in stress mode, right?

1:04:25And doing it in like a very intentional, you know, safe space, if you want to call it that. Because when people have like, their nervous system calmed down for the first time, they actually get reactive anxiety. to not being stressed. You guys have probably seen this, right? Somebody's like, so like working at such a high level stress-wise and then you bring them down, they're like, holy shit, I'm supposed to be stressed and they get very anxious about it. So it's nice to have this like, more of like, now here, Trocom, just take it in front of me. 15 minutes later, you're feeling better. This is what it feels like to not be in stress mode, right?

1:04:54Because it works that quickly because that's better used in the mouth, the Trocom, because it's going to work in about five to 15 minutes. Oh, wow. And there's a little bit of tingling. You'll know it's working because the kava from the trocom is, is kava is a little bit numbing. Oh yeah. And so you get a little bit of a numbing in your mouth while it's happening. And then you feel like you're just go down. You know, it's, I love it because I'm, I tend to be on the stress side of things more too. And, and like, if you have like a lot of meetings, like a lot of shit, like, you know, you just bring it down, you know, and it sounds like an awesome way.

1:05:23Sal Di Stefano:I mean, we're always trying to teach people. I think this is actually one of, one of the missing links to, for a lot of people with tech today and the amount of stuff, social media, all the things that we're on late at night, like getting people to have like a bedtime routine. It sounds like this would be like an awesome supplement to take post dinner. So much better than winding down. Yeah. Take that. We're talking about it as a replacement for alcohol. Right. And like, and I talk about it as the parasympathetic edge, really. And this is something that Thomas and I were talking about on stage once, Thomas DeLauer.

1:05:51It's like, if you can give people, especially in the performance world, Like, let's give you an edge. It's called the parasympathetic edge, right? Because if you have this edge, you're gonna perform better with your workouts, with your training, with your recovery, everything, right? And then like, well, what does that mean? Like, well, it's dropping down your nervous system. Well, how do I do that? Well, let me show you what it feels like. Give me some calm. Let me give you some Z. And then, oh, this is what it feels like. And then, oh, I don't need to train as much because I can recover better, right?

1:06:20I see the benefit. My sleep gets better. And I talk about this a lot with my athletes. It's like, well, and as soon as you finish your workout, what are you doing? What are you doing? You're going to, you're going to go run and go to all your meetings. You're going to go bang things out, you know, or are you going to like give yourself 10 or 15 minutes just to calm down, right? Because that's going to be a huge difference on how you're going to recover and see the gains, right? Because you guys know, you don't make your gains in the gym. No, it's after. Well, we say the best athletes, right, have figured that out, how to be able to get into that calm, parasympathetic state the quickest and most effectively.

1:06:51And while they're actually doing the work, Right. So I have a friend of mine. He's like the only guy that was a professional running back. He was on the Eagles and he was also professional. He was Olympic skier. Only got to do both. And he told me when he first was doing skiing, he listened to like Metallica and like, you know, hardcore shit. And by the end of it, he was listening to Beethoven, Beethoven, right? Beethoven, Chopin, like things that were relaxing because you don't need like, we don't need to be more stressed. We need to be, this is not only for working out. This is for like, if you want to perform better at your job, right?

1:07:20Like you need to drop down. You can get too amped even for athletic performance.

1:07:24Adam Schafer:This has happened to me competing in the past where I was so psyched that I would just gas out so much faster than I did in practice.

1:07:30Sal Di Stefano:Well, they've done cool studies. I've shared it on the podcast before that Justin's referring to, where they compare a Steph Curry with some other random people. And there's a game winner free throw he has to hit. And they measure his heart rate. And his heart rate is like resting heart rate for the average person. In the middle of a game where he's been running up and down a court, it's like that ability to be able to do that is so unique. And that's cool. I just call it, I call it with my patients, I call it a superpower. Like, and I remind myself this on a regular basis because if you can just, if you're so sympathetically dominant, what you don't have is a lot of what's called sympathetic reserve, right?

1:08:02So if you're already going in like this, you don't have a lot more you can do, right? But if you're coming down, if you're coming from a very low place, the amount of tension you can put on a muscle, amount of stress you can put on the system, that's where the change is going to happen. That's where you're going to see the major like long-term benefit, right?

1:08:18Adam Schafer:One of your products has something called cordycepin. Is that from cordyceps? Yeah. Okay. So what's the benefit of that? Yeah. So you know the cordyceps mushroom, right? I do, yeah. Cordyceps has been known for a long time in Chinese medicine as something that helps with energy, helping with detoxification. There's a lot of different compounds in the mushroom. There's one particular compound in there that is my favorite compound other than methylene blue at this point. And it's called cordyceps. And cordyceps is the most active portion of the cordyceps mushroom, but it's only 0.03 % of the mushroom by weight.

1:08:48So a very small amount. and what's very, very cool about it is that it's about 100 times more potent as an antioxidant, anti-inflammatory, antiviral, and it increases deep sleep. And you take it at night typically and it has transformed my personal health. I'll say that because I'm traveling a lot like you guys, right? And whenever you're traveling a lot, you're at high risk of getting sick and I just don't anymore, knock on whatever would I have here, but I don't. And my kids, I have a little bowl of it at my house. They call it the green stuff. It's green colored. and anytime anybody's feeling like they're getting sick, they take it.

1:09:20So you can take it prophylactically. We have something called True Immune, for example. That's one of our products that I take prophylactically if I'm a place that, you know, I have a higher risk of getting sick at a lower dose. And then if you feel like you're coming down with something, you take it immediately. Like the soon as you start feeling like you get something, like you take your rest of your stack of store. It's not the only thing you take, but you will see a shift in that whole progression. Like my wife who listens to zero of what I say, she's also a physician. she's one of those people that gets a cold you know she gets the usual cold then she gets a cough it doesn't go away for like a month yeah and i can't sleep in the same bed as her and like it's the you know it's the whole thing but if i can get her to take the true immune right when she's starting to feel sick she doesn't get that whole thing like she doesn't get that cough and like it's better for our relationship right um and better for my sleep scores too and so that's such a cool thing about it and it works like adenosine in the body so adenosine yeah adenosine has a lot of different functions.

1:10:16It's an adenosine. The main people, the way people think about adenosine oftentimes is related to blocking the adenosine receptor. You guys are drinking something on a regular basis. Coffee. Most of us, yes. Caffeine does that. Caffeine does that. Coffee blocks the adenosine receptor in the brain and makes us feel more wakeful, right? And so what cordycephrine does is it works just like adenosine. So it gives you sleep pressure. So it increases your deep sleep too. So you take it at night. It increases your deep sleep. You will see this if you measure your scores as well. And at the same time, it's giving you antiviral, anti-inflammatory, and can you take it at the same time as the z and the call yeah i want give me okay so this is like

1:10:50Sal Di Stefano:the last three months i'm on this like mission to i'm oring tracking and like trying to i'm shooting for i haven't seen a 90 score ever i got my i got one today okay okay so give me c level give me the the whole stack uh of what i should take in a day to try and optimize this i want to know what's meth one blue i mean it's so variable right because everybody's going to be different but what I would say is that you need to have a good enough support from mitochondrial support during the day. You have to make sure that you're having times when you're parasympathetic during the day too. So you're going, so the most beautiful nervous system is one that dynamically oscillates between sympathetic and parasympathetic throughout the day.

1:11:30But the majority of your time is in parasympathetic, right? The majority of your time should be in chill mode. This is why you see like older, you know, tribal cultures that hang around most of the day doing nothing, right? And then we're just relaxing and then they, you know, then they're hunting, like then they're fishing, like then they're having sex or whatever it is. Like, but like they're doing things periodically and sympathetic. So the best way to get the best sleep is have the most regulated nervous system and have the most mitochondrial support. But then you're thinking about, okay, three hours before bed, I'm not going to have any more food.

1:12:02Typically you don't want to have a lot of food before you go to bed.

1:12:04Sal Di Stefano:Good three, two, one rule. Right. You got that. Right. And then you want to be winding down your nervous system within those three hours. Right. And so how are you getting more parasympathetic? What are you doing? Are you no TV? Yeah. No TV, no phone. Yeah. Or if you're doing it, I mean, you know, most people are going to do some of that. At least you're wearing protection, right? You know, not condoms for your face. Like

1:12:23we should call them a condoms for your face. I haven't thought about that. That's good. Um, I should tell my friends that have those companies. Um, anyway, so yes, you're, you're protecting your face. You know, there's also the idea that you have photoreceptors in your skin. so in general it's about trying to keep the lights dimmer you know um and then trying not to be too activated before bed you don't want to do too much heavy exercise before bed if you can like i'm not a big fan of people doing like cold plunges and shit before bed people do this like they go back and forth from hot to cold at night i don't think it's great for most people i think if you're pretty well optimized you can do it but if you're not it's probably gonna be too stressful yeah to release all those neurotransmitters and then you're thinking okay now 30 minutes before bed what am I doing?

1:13:04So I, you guys remember Pavlov and the dog and things. I taught, I talked to my patients about salivating for sleep, right? Which is like, you do the same thing every single day, no matter where you are, no matter what time zone for at least five to 10 minutes before you go to bed every single time and try to go to bed at the same time every single time. And then if you're stacking in the products, which I do, I'm thinking about our trozy, um, a half of that and a half of our tromune combined together. Okay. Because, and that's typically about 30 minutes to an hour before you go to bed. Yeah. You can use them as a trochee.

1:13:37You can put them up in the mouth and let them dissolve or you can swallow them, you know. Obviously it's an empty stomach, so it's pretty well absorbed both ways. Yeah, yeah. And then, you know, you go to bed and you go to bed the same way every night.

1:13:49Sal Di Stefano:Yeah. The same sleeping position, the same cover, the same sound machine, the same eye mask. Like it sounds like a lot, but in the end it's like - No, no, no. And I appreciate you framing it this way because this is what we talk about on the show all the time. And this is even what I've communicated. I was just yesterday, we were talking about this. And there is nothing that had so far that I've been able to do supplement wise or anything else than the things that you listed first. Like that is getting my good exercise in, making sure that I calm down for, shutting all this stuff down, being consistent.

1:14:17Sal Di Stefano:I can go four days in a row of that. Like you just said, perfect consistency. And I'm scoring in the eighties. As soon as I stay up an extra two hours later, just like that, it doesn't even matter if I had the supplement stack that disrupts the most. So I, so I'm doing those things. Yeah. Now I want to know what the, yeah. I mean, one of the things that we also like to do, and this is helpful, maybe not for you, but for those that are listening is that Dr. Ted is, you know, again, the guy that I get a lot of my sayings from these days, um, likes to say that your day starts when you go to sleep, not when you wake up.

1:14:43So make it the priority. Yeah. Instead of it being the last thing you do every single day, make it the first thing you do.

1:14:49Sal Di Stefano:Isn't it ironic that we, we talk about this too all the time on the show is that we've put so much, there's so many books about morning routines and stuff like that. But yet I would argue that your night routine is far more important, way more important than your morning. But we just don't talk about that. Don't talk about it, right? Because sleep is the afterthought, right? And then it's been a big deal for me. I mean, I was in the hospital working for years and getting called at home. And I just wasn't getting... The thing about it is if you're relatively healthy, you can tolerate this for a while until you can't.

1:15:20Right. And then you start falling off that cliff. Like, why can't I recover as well? Why is my mood all over the place? Why am I tired but wired all the time? I'm like, well, because your nervous system is shot and your mitochondria need more support and you can't just think you're gonna take a supplement and that's gonna be the end all be, right? That could help you and it could be a good start or it could be something that, in addition, you add to the other stuff. Most people are gonna go the other way around, which is like, they're gonna want a pill first, right? They're gonna want a supplement.

1:15:44And that's what I tell my patients all the time. It's like, look, I hope over time you don't need as much of this, but let's get your nervous system working well or better. Like, let's get your mitochondria more supported. And then over time, as you're getting your diet better optimized, lifestyle better optimized getting out of a shitty relationship like you know getting a sleep divorce you know you guys know sleep divorce right half of u.s couples i think live in different sleep in different rooms now is it half about half are you serious wow it's like back in the 40s they have like one bed for sex or they change beds i don't know how it all goes you know but there's uh there's also just another hack for people is just getting a separate set of covers

1:16:19Sal Di Stefano:you guys we have sleep eight so my wife which blows my mind is at 90 degrees i'm over here at 55. That's crazy. Yeah. So you have different, different covers, different mattresses. You're not like, you know, trying to steal the covers from your spouse or partner. That's another way to do it. But like, they've actually done studies. Like if your partner is snoring next to you, your cortisol rises every time they snore, even if you think you're sleeping all night.

1:16:40Adam Schafer:Wow. Yeah. So you're not getting good rest. And so you have to start off with the basics. And so when I work with patients, it's like, well, what, what, what are the basics for them? It's either sleep, stress, mitochondrial function. That's all happening at the same time. The question is where you start, but almost always, if sleep is the issue, you start with sleep. Because if you can get them to sleep better, everything else is going to get better.

1:16:59Sal Di Stefano:This is why I love these tools that we have now, like Oura Ring, is because I think for years as a trainer, over 25 years now for us, you were playing that guessing game so much. And I'm sure there's a major individual variance of what each person feels like with a score of an 80 or whatever, but at least gives you a metric that you can go. and it's very clear to me, there is a clear difference between, you know, two, three days in a row of 80 scores versus a 67 and it is, you can feel you can. And so I can see that now. And then I can see as I apply these habits and routines, like what a difference that makes.

1:17:35Sal Di Stefano:Yeah. Trozi has been great because it has eight different ingredients in there. And the problem with most sleep aids out there is that they're just going to trash your architecture, you know? So your sleep architecture is the idea that you have to go through various cycles while you're sleeping. You have four stages of deep sleep. You have REM sleep. You're supposed to do this every 90 minutes. And then in the beginning of your night, you have more deep sleep. In the end of night, you have more REM sleep. This is typically how you guys, if you're looking at your ring, you'll see this. But if you take something like THC, if you're taking like that trashes your deep sleep, alcohol trashes all of your sleep.

1:18:01Right. And then, you know, Benadryl or other, even melatonin, they're going to give you some, Benadryl is going to do nothing good for you, but melatonin will give you like a little bit of help. It's not going to do the whole thing. So people tell me like melatonin doesn't work for me. I'm like, yeah, because you were just taking melatonin. That's one of like six different sleep signals. Like what about GABA? What about adenosine? Like what about serotonin or melatonin together? Like you combine these things together. That's why Trozy is so powerful because it has that comprehensive support. And I always tell my patients, like, look, I want you to, if you're not sleeping, that's the first thing we got to figure out because if that doesn't get better, nothing's going to get better.

1:18:35And this is something I've learned over the years, right? Like you can give people expensive therapies and like go in a hyperbaric chamber. But if they have sleep apnea, like doesn't fucking matter. Like, or if like, if they have terrible stress, it doesn't matter. Right. And so like, don't waste your money. And like, I tell, and that's why I got disinvited. Like, don't waste your money on this great technology. If it's, if you're just going to be doing the same thing that got you where you are.

1:18:58Adam Schafer:Well, Scott, I appreciate what you guys do. Cause I'm pretty hyper aware of how sharp I can be because of what we do. So, you know, if I didn't, you know, have conversations with people or do a show with my partners every single day. I mean, it wouldn't make that big of a difference, but I need to be sharp. And so the Methyl and Blue product you guys make, that's like one of my favorite things. And it definitely improves my ability to just do this.

1:19:21Sal Di Stefano:So I can't wait to mess with the sleep stack because I'm like so into this right now. I've been tracking. So it'll be a fun thing to tell me how it goes. Yeah, I told you. I've never scored in a 90. So it's yeah. Well, I only get 90s when I come back down to sea level. You know, I gotta be saying when I'm in Colorado and I come down and I sleep in a hotel room, even if it's all like shit, I still get a 90 because my HRV goes up because I have more oxygen around. So that's how it typically goes. But yeah, I mean, I love our products because they really do serve a purpose, which is they help you now while you're on your path.

1:19:49And hopefully over the long-term, you need them less because you're more optimized and doing the things, but we're all getting older too. And we all have more stress on us at times, sleep stress because you have a bad night of sleep, right? Or you're going traveling or whatever it might be. And so what I love about our company is that I'm a physician. I do this shit for a living. Like I'm, I'm working with patients. I work with lots of my colleagues that do this all the time. I see what's working. And, you know, my colleague, Dr. Ted and I, we've seen what's working for over 20 years. And we know that one sleep stack is not going to work for somebody else and somebody else.

1:20:21And then we have these trochees that you can titrate. So you can take a quarter, you can take a half. You're not like relegated to a capsule and have to figure out how to take out like half the stuff and figure out if it works for you. And so trochees are great. They're fast. They're bioavailable. and we have a whole nonprofit organization that trains practitioners on a different way of doing all this. That's cool. So you don't have to be in, if you're a physician and you're listening and you're a conventional doc and you want different training, like we have that for you. Like it's, and that's why I feel comfortable talking about the products.

1:20:49It's like, because we have a whole ecosystem for people to educate them. And then I say this with absolute truth. Like if you don't need my supplements, our products going forward, great. That means you've been well optimized and you don't need them as much. Awesome. Well said, Scott. Thank you so much for coming on the show.

1:21:04Adam Schafer:This has been awesome, man. Appreciate you. Thank you, guys. It's been fun. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Super Bundle at mindpumpmedia.com. The RGB Super Bundle includes MAPS Anabolic, MAPS Performance, and MAPS Aesthetic. Nine months of phased expert exercise programming designed by Sal, Adam, and Justin to systematically transform the way your body looks, feels, and performs. With detailed workout blueprints and over 200 videos, the RGB Super Bundle is like having Sal, Adam, and Justin as your own personal trainers, but at a fraction of the price.

1:21:49The RGB Super Bundle has a full 30-day money-back guarantee, and you can get it now, plus other valuable free resources, at mindpumpmedia.com. If you enjoy this show, please share the love by leaving us a 5-star rating and review on iTunes and by introducing Mind Pump to your friends and family. We thank you for your support, and until next time, this is Mind Pump. Hey, it's Cole Swindell, and when I spend 200 days a year rolling down the highway, the bus can start to feel smaller than a guitar case. Everyone wonders how I stay chill while the hours crawl by. truth is one good luck spent on chumba and suddenly the trip feels a whole lot shorter finding your space even when there isn't much to spare need some chill let's chumba no purchase necessary vgw group void were prohibited by law 21 plus tnc supply sponsored by chumba casino