What's the deal with colostrum?

13:33Perry Wilson:Be careful, but don't panic.

13:35Emily Oster:Yep.

13:36Perry Wilson:All right. That's it for the health news of the week. After the break, what's the deal with colostrum?

13:43Emily Oster:A doubly certified OBGYN and endocrinologist doctor, a naturopathic doctor, and a certified health coach walk into a room. What do they talk about? GLP-1, of course. But more specifically, the difference between the synthetic version of your body's own hormone that are prescribed by doctors nationwide versus Metabolism Ignite product, which naturally increases your body's GLP-1 by 61%. GLP-1 side effects can lead to nausea, fatigue, and muscle loss, whereas Metabolism Ignite is powered by plants, and there are no side effects. Some long-term results of GLP-1 links to weight gain after stopping the synthetic drug, which has been proven in multiple studies, in comparison to Metabolism Ignite.

14:23Emily Oster:There is no weight regain, and this product supports metabolic health. Join the 50 ,000 customers by skipping the needles and taking two capsules of Metabolism Ignite a day for sustained weight loss with plant-based therapy. Visit V-E-R-A-C-I-T-Y health.co. Promo code IHEART for up to 65 % off your order today.

14:46Emily Oster:This is raw colostrum. So powerful. It's actually banned in NCAA. Yes, college sports banned colostrum because it contains IGF-1, insulin-like growth factor 1. It's associated with increased muscle growth and vitality, increased levels of HDL in humans. Colostrum also contains a ton of different immunoglobulins, which support the health of the gut. Also, proline-rich peptides like colostrinin that support the immune system and the thymus. This stuff is liquid gold. It's the first milk cows give to their calves, and it helps program their gut. And across species, mammalian milk is very healthy for humans.

15:18Emily Oster:So if you can find somewhere to get a colostrum, preferably a raw colostrum, this stuff is incredible for your gut, for your immune system, incredible for muscle growth and recovery. I love this stuff. However you can get it, colostrum is a superfood, banned by the NCAA. Good for me, good for you. This stuff is amazing. I'm going to go home and drink a bunch of colostrum right now.

15:34Perry Wilson:I love that clip, Perry, because I think it illustrates a very common wellness influencer talking point, which is, you know, this is like, why would they ban this if it wasn't great?

15:45Emily Oster:I mean, we've made that talking point several times.

15:48Perry Wilson:Yes, I'm always making that point. Like, you know, this must be good for performance if they ban it in professional cycling. So I'm convinced. But before we talk about how we should all be consuming the milk of that is intended for baby cows, I think we should talk about what this is and and why it might be helpful. So let me start with the what it is, and then I'm going to pass to you for like what might possibly be going on, which is, you know, so bovine colostrum is the colostrum from cows, literally. So it's the first milk that is produced by the female lady cow after she calves. And it has, like human colostrum, has a different composition than more mature human breast milk.

16:31Perry Wilson:Bovine colostrum has a different concentration of various features than mature milk. And the idea is that somehow this would be helpful for something. And actually, relative to some of the things we talk about, those fill-ins are, to me, very vague. This is – a lot of it feels like that influencer clip where it's just a list of things that one might be interested in and how they might be good here but with no real connection.

17:02Emily Oster:Yeah.

17:02Perry Wilson:So is there something biologically behind anything here? Yeah.

17:07Emily Oster:It's always so complicated when we're talking about like a natural substance instead of a chemical or a single chemical, right? Even when we talk about something as simple as coffee and like, oh, this study showed that coffee was beneficial for X, Y, or Z. It's like, okay, well, coffee is 8 million different things, right? Yes, there's caffeine, but there's also all this other stuff and it's very hard to untangle. Colostrum is no different. It is clearly a biologically very important substance. All mammals produce colostrum before they produce milk. As you pointed out, it is quite a bit different from the milk that comes in later.

17:43Emily Oster:And animals that don't get colostrum from their mother early certainly do worse in a variety of ways. So it is something important. I think when I was kind of listening to what influencers are talking about and people who support colostrum a lot, there's a few substances in there that kind of keep getting mentioned. And I think we'll probably want to focus on those as like the biologically relevant ones. The first is probably IGF-1 or insulin-like growth factor one. There are anywhere between 50 and 2 ,000 micrograms per liter of IGF-1 in cow colostrum compared to like less than 10 micrograms, basically undetectable in mature cow milk.

18:28Emily Oster:This is from the Bulgarian Journal of Veterinary Science, you know, not maybe the number one veterinary journal in the world.

18:35Perry Wilson:Not a very high impact factor, but okay.

18:37Emily Oster:But actually the best study on like the content, the actual measurements of what's in this stuff that I could find. So and I think let's can we talk about IGF-1 as like because I think this will give a framework for how to think about stuff that you eat. So what IGF-1 is, is the molecule that mediates the effects of growth hormone. So your pituitary gland releases growth hormone, particularly when you're growing. and downstream that tells your body to grow, tells your bones and your muscles to grow. And for you to get taller, that's what growth hormone does, but it doesn't do it itself. It doesn't act itself.

19:11Emily Oster:It acts on the liver to release IGF-1. And then IGF-1 is the thing that tells your muscles and stuff to grow. So it's just a two-step process. Okay. That's IGF-1. Kids who are born with like genetic deficiencies of IGF-1 or growth hormone have congenital short stature syndromes. So, you know, little people types of syndromes. IGF-1 is banned by the NCAA and the World Anti-Doping Association. You can inject IGF-1 because it does grow muscles. It is a growth factor. In fact, there was concern about – some people who are concerned about our intake of dairy point to IGF-1 and they're like, dairy causes cancer because of IGF-1, right?

19:53Emily Oster:Because of the growth signals from IGF-1. So you always get these millions of sides. But there's a couple of things we need to think about when it comes to a cow product. Number one, are we pasteurizing it? If we're pasteurizing it, some proteins lose their functionality. Some don't. Number two, can it get absorbed intact through your GI tract?

20:12Perry Wilson:And this is the big one where kind of a lot of the biological plausibility falls apart.

20:20Emily Oster:When it comes to IGF-1, and this will be the case for multiple things that's in cow colostrum, you can give it to people. In fact, it's heat stable IGF-1. So you can even pasteurize this stuff and it still has IGF-1 in it, but it does not get into the blood. Some studies that suggest it does get into the blood see fragments of IGF-1, but that's just digested stuff. It's not the actual molecule.

20:41Perry Wilson:Yeah, I think this point comes up actually a lot in this space of linking, you know, this is a substance in this food to this is going to have this impact where we know the substance is something where like if you injected it in mice, right? Really what you're saying here is like if you take IGF-1 and you inject it in a mouse or even in a person, like that's good. You know, that's why they don't let you.

21:04Emily Oster:It's not necessarily good for you, but it'll make your muscles grow a bit.

21:08Perry Wilson:It'll make your muscles grow. And so you can get a super muscular mouse by injecting them with IGF-1. But our digestive system is not the same as injecting things. Not at all. Right? Like when you consume something, it goes through your stomach and your stomach is full of acids and other stuff and it breaks it down in all kinds of ways. And so there are many things, for example, even GLP-1s where there is a reason it's taken a long time to get to an oral GLP-1 because the injected version is just so much more accessible to our body. And so I actually believe if we looked into it, there's many things in this space where that is the link that kind of breaks when people go from here is something where we know if we inject it in a mouse, it would matter to here is something you can take by mouth because the amount that you have accessible after you consume it through your stomach is like nothing.

22:00Yeah.

22:01Emily Oster:Yeah. It's really hard. And pharmacologists spend a lot of time trying to figure out how to get your body to absorb something without digesting it. It's just a tricky problem and it's not solved in colostrum. So I'm actually, I think that like a colostrum, if you dig into the NCAA rules on this, the reason they ban colostrum is actually they say that it's risky because potentially of false positives in your blood. It's like similar to how like you might not want to eat a lot of poppy seeds if you're getting like an opioid test, right? It's not because the poppy seeds make you high. It's because they have kind of similar chemical structure.

22:36Emily Oster:Maybe you get little pieces of IGF-1 in your bloodstream after it's digested, but then the test that they give you is like, oh, he's using IGF-1.

22:43Perry Wilson:Fun fact, Perry, a lot of people, when they get popped for doping, the excuse is I ate a food where the animal was fed growth hormone.

22:53Emily Oster:Okay. There you go. Yes. That is why I exclusively drink milk that has been extensively treated with bovine growth hormone.

23:04Perry Wilson:When they test you at the end of the 5K. I'm not getting tested.

23:08Emily Oster:I'm just trying to hit the golf ball further. That's all I care about.

23:11Perry Wilson:Just trying. Okay. So when we look at the particular items in colostrum, and I think this is important to set the stage for looking at the data on it, there's the growth hormones. There are a bunch of other things, immunoglobulins. Yeah, we should definitely talk about that. I will say we should talk about all these things, but big picture, one of the issues with biological plausibility for this substance at all is that almost all of these things are not really available once you eat them.

23:42Emily Oster:Yes, that's correct. Most things are digested. I'm going to put one coin on the other side of the scale though. Let's give colostrum its due. Not everything that affects your body has to get into your body. And so for example, immunoglobulins. Immunoglobulins are little, those are antibodies and your body makes them against certain antigens like bacteria, viruses, stuff like that. The antibodies stick, they're each specific to one of those antigens. They stick to it and it's sort of a signal to your body like this is a bad thing. It's marked for death. Take care of it. And the whole immune cascade follows.

24:22Emily Oster:There are different types of immunoglobulins, but one that's very relevant here is called IgA, immunoglobulin A, which is the immunoglobulin that lives in your mucosal system. So in your nose, mouth, throat, and GI tract. This is the frontline immunoglobulin. It's actually secreted into the mucosa by your body. And it's directed against antigens, the many different bacteria and pathogens and stuff that you will get, you know, just by breathing air in a non-sterile environment, by eating food that hasn't been sterilized like we always do and et cetera. And colostrum contains IgA. And so that IgA can actually stick and mark some of those antigens potentially while they're sitting there in the GI tract.

25:06Emily Oster:And it's conceivable that that would promote an immune response to some antigens. Some scientists also point out that some of these molecules, including even things like IGF-1, yes, they don't get into the blood, but they can potentially signal to the gut epithelium because those are cells, right? Like they're just half of them are sitting out there, you know, in the lumen of the GI tract and the IGF-1 can kind of float by and at least act on them. and you get people saying like this promotes gut health and stuff like that. So yeah, the idea that you're getting like, you know, a secret way to take anabolic steroids by drinking this stuff, definitely not true, but there may well be some physiologic effects here.

25:50Perry Wilson:Okay. So I think that that is a good place to turn to the question of what we see in the data, because I mean, always with stuff like this, you can sort of start with like, Like, is there a biological plausibility? I think in this case, it's like a little bit, maybe. But then the question is, when you look into people, are we actually seeing any impacts? And the outcomes here that there are actually two groups we can talk about them in turn. The first is there's actually a lot of work on this in athletes. Yay, my favorite. I want to hear about it. And then there's work on people.

26:29Emily Oster:Actual people. Okay. I like that. There's athletes and then people.

26:32Perry Wilson:Well, not elite male cyclists. And then, and sort of, we're looking at like something about inflammation, the gut, maybe performance, maybe respiratory viruses. Part of what's hard here is the range of outcomes that we're looking at are so broad that it feels like, ah, what, like, how could it possibly, how could this thing possibly matter for all of these?

26:54Emily Oster:Yeah, it's a problem. And of course, because there's so much stuff in colostrum, there's always going to be a biologically plausible route, right? Like you're given all these Lego pieces and you can be like, oh, I can make a car and I can make a boat and so on and so forth.

27:07Perry Wilson:It's always a just so story. You can sort of say, okay, I'm going to look for this in the data. Maybe I'm going to like p-hat a little bit through a bunch of different outcomes. And then I'm going to make up a story for why the particular peptide that's in this matters for that. So I think that is a caution with everything we will say here.

27:23Emily Oster:Absolutely. But as I was looking through this, I definitely saw a number of trials in these athletes. And all I could think reading them was like, I've got to get Emily's take on this. So can you walk me through how you as an athlete can talk to me as a human about the data here?

27:43Perry Wilson:So what I really like about studying athletes and what I think researchers like is that you know the outcome you are looking for, and it's very easy to measure. So like an example of a study. It's a pretty old study from the British Journal of Sports Medicine, but it's very consistent with this whole research space. And we love the British Journal of Sports

28:05Emily Oster:Medicine. That's actually a very good journal. Yes, it is.

28:07Perry Wilson:So this is like, they take 29 highly trained male road cyclists. That's everybody's favorite. Everybody loves a highly trained male road cyclist. And then you stick them on the bike and you have them do time trials and then you give them some colostrum and some not colostrum. And, and, or in this case, I think it was some of the time they had the colostrum and some time they, they didn't, there's all kinds of like detailed ways you can control this. And then they look at whether their time trial VO2 max performs. It's just like, there's a lot of outcomes you can very clearly measure. And so in a set of studies like this, you do see, you know, some impacts on performance, maybe even some impacts on respiratory illness in some of this.

28:53Perry Wilson:We see a little bit in like recovery for runners. You know, a lot of, it's a lot of cyclists.

29:02Emily Oster:Yeah. I want to put numbers on this and I can't, I don't know how good this is, but I'm hoping you do. So I'm looking at the British Journal of Sports Medicine study. They did a 40 kilometer time trial, either on colostrum or on like whey protein was the control, I think, and their performance improved by 2 % versus baseline. Like to me as a human that is not an athlete, 2%, I'm like, that doesn't sound like great at all. But is that actually something where it's like, dude, like if you're an elite male cyclist, this is the difference between first and second place? Like, like, what are we talking about here?

29:39Perry Wilson:Yeah, I mean, so look, 2 % is two ways to think about 2%. One is to say, like, if you're at the end of the Tour de France and you're trying, you're like Jonas Vingigo and you're trying to get Tadej Pogacar at the top of the, you know, call the blah, blah, blah. Like you would take a point. Those are people. Jonas Vingigo and Tadej Pogacar are people. I don't know which call the call is it, you know? Okay. Anyway, you would take like a half. I mean, that's, that's the difference. These guys are, are biking for hundreds and hundreds of miles and winning by four seconds. for more regular people. I think 2 % is pretty good.

30:20Perry Wilson:It's like not as good as it's not as much as the benefit you'd get from really like ramping up your fueling, which is like a sort of core element of improving your, your performance. But it's like, that's like a solid, like people would take people who love people who are highly trained male roads, Nicholas, would definitely take 2%. Okay.

30:39Emily Oster:So that sort of confirms my impression, which there are several studies like this where you see relatively small studies, relatively small effect sizes. And I think we do need to say to people that that raises your eyebrows a little bit from a data science perspective. In part, that's because of publication bias. So just as worth saying that if you conduct to study in 20 people and the results are negative, it's just hard to get it published. Like I've been there by the way. Um, and you submit it to a journal and they're like this, like why we don't care. Like nothing happened. You only enrolled 20 people.

31:20Emily Oster:Like if you enrolled a thousand and nothing happened, then, you know, sure. We'll publish that because that's a big study, but for 20, no, not really. But if you enroll 20 people and you do see a modest effect or even a tiny effect, but you know, that passes statistical significance threshold, you're much more likely to get it published. So we do kind of one of the meta analytic things we think about here is like, if we're seeing all, if we're seeing several studies, but they're all very small, we worry a little bit about this, about this issue of publication bias. But, you know, hey, if you're an elite male cyclist, and this is how you make your living, you know, seems like you can give it a shot, I suppose.

32:00Perry Wilson:Yeah. I mean, I find, yeah, maybe. I mean, I think the publication bias piece here is pretty important. Yeah.

32:10Emily Oster:Yeah. You got to say it, right? The literature is not perfect.

32:14Perry Wilson:This is a place where, you know, I think the really great next step, if one was really interested in this, is to say, okay, let's take these theories. Like, we've got a bunch of data that would suggest particular outcomes that have been seen before. Let's redo with a larger sample looking at those outcomes, which would get away from p-hacking, like you're just choosing your outcomes based on which ones work and would get away from some of the publication bias if you could kind of pre-register. But I don't know. I think we can get into the people thing. What's hard here is like, I have no idea why this would matter.

32:45Perry Wilson:Like nothing in the biology of this substance would suggest that it connects to, it's not like protein or creatine or something where you could say, okay, I can see mechanistically why this matters for performance. It's just sort of like, it's just like a really good protein shake. Yeah.

33:03Emily Oster:Yeah. There's just kind of like good humors in it. And, and, you know, these studies were controlled for protein intake by giving whey protein. So, so yeah, we like some, some plausibility. And I think actually the, the place that has more plausibility is in the data looking at like respiratory infection.

33:21Perry Wilson:Yeah.

33:21Emily Oster:rates. So this is a place where we actually have some larger trials, also kind of relatively on the old side. But the reason I think there's some biologic plausibility goes back to that immunoglobulin A phenomenon. So again, if you're putting something in your GI tract that has a lot of immunoglobulin A in it, and presumably these cows are making immunoglobulins against at least some of the same pathogens that humans are exposed to, maybe that can rev up your immune system. So I'll highlight one study because it was relatively large from the European Journal of Nutrition, also old, 2003. They took 174 adult men.

34:11Emily Oster:This actually was a little bit of a weird design, they created this study out of other randomized trials of colostrum versus whey and just looked to see who reported as an adverse effect upper respiratory symptoms. So this wasn't the primary outcome. So it is randomized, but they're like convenience looking at the outcome. And over the seven weeks that they looked at, 32 % of the colostrum subjects reported some upper respiratory tract symptoms, could be anything from a runny nose to a sore throat, versus 48 % in those who are getting whey protein. And that was a significant decline. And there are sort of other studies that go along this line.

35:00Emily Oster:There's even been some studies in medical people who are exposed, presumably exposed to pathogens.

35:08Perry Wilson:There's a study in preschool children who are exposed to pathogens even more. Even more.

35:12Emily Oster:Oh, my God. Yeah, yeah, yeah. Yeah.

35:14Perry Wilson:So there is a like six-week long study of colostrum in preschool children. It's relatively small. It's like 60 kids, 57 kids. And they randomized kids into colostrum versus not. And there was a reduction in days with upper respiratory symptoms, 31%, which is large. Yeah, that's not nothing. I'll take a 31%. Parents would definitely take that when they are parenting preschool children. So, yeah, we do see this in a number of different settings. I will say I am still worried about the p-hacking and the small samples and the publication bias. I think I just I'm still worried about that here.

36:01Emily Oster:It's always going to be the case when we have multiple small studies. That preschool study also had parental reported outcomes, which I don't know. you're not going to ask the kids, obviously, but that does open the door. You know, this isn't like they were tested in some way for, you know, viral carriage in their nose or something that was objective. This is a subjective perception of if the kid is doing better. And if blinding is inadequate, like if there's, if the parents had any way to tell like, oh, this is my kid's getting colostrum versus my kid's getting whey protein, then that can kind of bias the results.

36:32Emily Oster:So there's just, you know, this is, this is medium to low to medium quality data pointing in a direction. And there is some biologic plausibility here, but we do have to be really careful in interpretation.

36:43Perry Wilson:Well, can I ask you, before we get to the second piece of this, which is the gut health, leaky gut, my favorite topic. Leaky gut. Why do you think we do not have larger scale trials here? I mean, I understand why maybe we don't have larger scale trials in sports because people don't care that much. But let's say there was something that you could give your kid that would cause a 31 % decrease in upper respiratory infections. Like, that seems pretty important. And so I'm a little bit confused. And it's not like these studies were published in 2025. And it's like, oh, somebody's doing that. Like, what do you think is in the way of what we'd really want here?

37:20Perry Wilson:Large scale randomized controlled trial, really evaluating this?

37:24Emily Oster:Yeah, money is the answer. So, you know, colostrum is recognized by the FDA as a dietary supplement. So that has two implications. Number one, it doesn't have to be vetted. They have to adhere to certain good manufacturing practices, but it's not like tested by the FDA. There's no they don't need to prove that it's efficacious or that it is safe. It's generally recognized as safe. It's like a food product, which means there's really no moat like anyone can sell colostrum. And so, you know, in theory, if you, you know, if you're a big pharmaceutical company, that's going to fund a multimillion dollar trial, you want to be able to sell your thing for more money, at least until your patent runs out.

38:06Emily Oster:And that's not possible here. What can happen and the way this often works when there are signals from natural substances is that pharmaceutical companies will go in and like try to pull out what molecules might be meeting this effect. and then patent and do a trial on that molecule. That often doesn't work. Because, you know, and it's not because there's like a magical combination of things and you need the magical combination to work like a la original Michael Keaton Batman. Hello, Gen X. How are you today? Good, good. It's that you are often wrong about the substance that you've like put your nickel down on.

38:47Emily Oster:So I think that's the main problem.

38:49Perry Wilson:Yeah, I mean, I think I totally agree that's the main problem. This is one of my frustrations with like the NIH and other like government funders, because I feel like they could do this. They could do this. They could just be like, you know what? Pharma is not going to do this. You know, pharma is it's not a pill to make your penis grow faster or whatever, which presumably pharma is into. It is something that could potentially improve a lot of people's lives. And we could we the NIH could fund someone to run this trial, which wouldn't actually, by the way, be that expensive. It's like how I feel about breast milk storage.

39:21Perry Wilson:And I have a lot of feelings about the things.

39:23Emily Oster:And this actually feels kind of aligned with the Maha agenda, right? It's like, this is a natural thing. And you could even imagine a whole NIH institute who's like, okay, we're going to test the stuff that like no one else, you know, that's cheap, that's widely available, that's not patented. And if it doesn't work, fine. Great. We learned something. And if it does work, we have this great new public health intervention that is widely accessible to everyone. I totally agree. Seems like a great use of funds. I agree.

39:48Perry Wilson:Jay Bhattacharya. Jay, if you're still talking to me after the interview I did with you last week, I have some, this is my suggestion.

39:57Emily Oster:Make it happen, Jay. Dr. Jay, do it.

40:00Perry Wilson:Let's do it. Okay. All right. So let's talk about the last sort of set of big things that come up in colostrum, which is leaky gut, intestinal permeability. Leaky gut, it's so popular with the wellness influencers. Nobody wants it. Where is it leaking to, Perry?

40:17Emily Oster:Where's it going? God, the wellness influencer marketing is so much better than like everyone else. Leaky gut sounds terrible. Talked about glucose spikes before. Like it's really good. No one wants a leaky gut. Okay. First of all, it's very important that your gut is leaky because if nothing got through your gut, you would die. So let's set the table here. Intestinal permeability is the medical term for what's going on. And your intestine is supposed to be permeable to a wide variety of things, amino acids, proteins, glucose, other substances, et cetera. That's what your gut is for.

40:59Perry Wilson:This is because as the food moves through your small intestine, that's when the stuff comes out of it. It goes through your small intestine and stuff comes out and goes into your bloodstream, and that's how you get nutrients.

41:07Emily Oster:That's correct. And you want that. Now, you can measure intestinal permeability in the lab. What you do is you give someone a dose of some substance that should not be absorbed very well, like something like mannitol, for example. It's like a poorly absorbed sugar type of thing. And then you measure it in their blood. And you can certainly show that there's variation across people. Like some people, they take the mannitol and like there's more in their blood and some people there's less. And scientists have shown that people with comorbid conditions, like people who are sicker, often have a leakier gut by that definition.

41:41Perry Wilson:Which means more stuff that should not be getting through is getting through.

41:45Emily Oster:It's not even necessarily that should not be getting through. It's just like that usually doesn't get through if you appreciate sort of where I'm going with that. But there's this real causality problem here, right? Like a lot of wellness people would be like, oh, no, it's your leaky gut that causes the diabetes or the cancer or the dementia or like whatever it is, as opposed to it's the diabetes or the cancer or the dementia that causes the leaky gut. And we don't know the difference there yet.

42:18Perry Wilson:I mean, another way to say this is like even if colostrum were to fix your leaky gut, it isn't really obvious that the leaky gut itself is really a particular issue. It is just a thing we see rising that is higher among people with certain conditions, but also in other – this is like a problem that athletes have. Like when you stress your body, stuff gets –

42:40Emily Oster:Absolutely. Now, in the medical space, there is this phenomenon called bacterial translocation where someone comes in with a bloodstream infection with bacteria. This is bad. You don't want this. This is – Sepsis. Sepsis. And when someone comes in with that, we zoom around and we look for what the source of the infection is. And we identify the infection. We're like, okay, is there a skin lesion that spread to the blood? Do they have pneumonia that spread to the blood? Like, where did it come from? And every once in a while, you cannot find the source. And if it's a gut organism, like E. coli, that's in the blood, all you're left with is like, did the E.

43:16Emily Oster:coli like escape from the gut? And, you know, bacteria are a lot bigger than glucose molecules, right? So like they should, bacteria should not be translocating the gut, but in very stressful situations, it can. And the reason I'm mentioning this is because of one study looking at this phenomenon, actually in 62 children who had newly diagnosed leukemia, ALL leukemia. And one of the problems when you're getting chemotherapy, you know, pretty intense chemotherapy like this is that you can affect the intestinal lining and you can get bacterial translocation. And if these kids get sepsis, they're in big trouble.

43:58Emily Oster:We don't want that to happen. So anything you could put in there to like prevent bacteria from getting out would be great. So they randomized these kids to oral bovine colostrum while they were getting that induction chemotherapy versus a control. And they were looking at fever as well as bacteremia. And there was no difference in fever or infection rates. They look at fever, by the way, as a marker of like, maybe the bacteria got in, but then you fought it off before we detected it and like caused a fever response. So no difference in fever or infection rates. But there was a secondary outcome that was positive here, something called mucositis, which are like these ulcers that develop in the mouth with intensive chemotherapy.

44:40Emily Oster:It's incredible, painful. That was improved by the colostrum. And so I'm setting this in terms of like, this is the leakiest gut you can have where you're actually worried about bacterial translocation causing sepsis and death. Colostrum is not preventing that phenomenon. That's our starting point. Now we can kind of walk this back to maybe your average everyday person who's worried about their own gut health.

45:08Perry Wilson:And when we walk it back there, I would say there is a bit of evidence. Again, the evidence probably stronger in sports than in non-sports. You know, to the extent that the stress of like intense exercise increases the permeability of the gut, which we know that it does, this seems to to some extent truncate that that rise. And so kind of, I don't know, seal off the gut a little bit, I guess, which is interesting and I guess is potentially some of the mechanism for some of the performance effects, although I'm not sure why that would be.

45:48Emily Oster:I don't either. I just I don't know why leaky gut is bad.

45:53Perry Wilson:Right. I mean, I think there's a fundamental thing, which is outside of this kind of setting that you're talking about with kids who are very sick, where this could potentially lead. Like it's not really clear why you would care about fixing this, why you would care if you had it, why you would care about fixing it if you were an otherwise healthy person. So observing that this fixes that, OK.

46:11Emily Oster:It's not enough. You've got it. You've gone from A to B. That's great. Now go from B to C. Now show me that you have improved exercise performance. And hey, there's a little bit of that. This is a potential mechanism. But again, small effect sizes in small studies.

46:28Perry Wilson:They do, you know, they look at like diarrhea in some ill patients, which were kind of interesting. And they saw some reduction, actually quite a large, a small study of quite a large reduction in diarrheal events among HIV patients in Uganda. So there's a few pieces here of kind of potentially interesting outcomes, but it's, I wouldn't say it's overwhelming.

46:56Emily Oster:Yeah, it's definitely not. And there are studies that don't show improvements in diarrhea. They did a study of kids with Shigella infection, which is an unpleasant bacterial diarrhea illness and no difference with the colostrum. Um, we need to talk about safety because up front that guy was holding, if you're, if you're watching this on a video, this big jar of bovine colostrum, raw and unpasteurized.

47:25Perry Wilson:And I will say the reason the influencers like the unpasteurized colostrum is that there are some elements of colostrum that would be killed by pasteurization. Is it like some of these elements that might be killed by pasteurization? So if you're a true wellness influencer here, you are into the raw colostrum. Although I will say all of these studies would be using pasteurized colostrum powder, which is in the study. Okay.

47:48Emily Oster:Correct. And moreover, even the things that are hurt by pasteurization, even the things that are inactivated by pasteurization still don't make it into your blood in the raw form. So we're already over that. Okay. And Emily, what else is killed by pasteurization?

48:08Perry Wilson:Yeah, it's E. coli and other bacteria that make you really sick. And the reason that we don't recommend people drink raw milk or raw colostrum is that it can be and often is tremendously full of bacteria that will make you very sick. And if you are taking this colostrum so you don't have a lot of diarrhea, you are also putting yourself at risk for quite a lot of diarrhea from the E. coli that may be lurking in your colostrum. And also other things, not just E. coli, other things.

48:38Emily Oster:Yep. I'll put some numbers on it for you. Journal of Dairy Science 2021, they looked at 1 ,241 colostrum samples from 39 Czech dairy farms. The average count of bacteria per plate that they put the colostrum on was 408 ,000 colony forming units per milliliter, and only 28.4 % met the recommended threshold for bacteria levels, which is less than 100 ,000 colony-forming units per milliliter. A study in Northern Ireland a few years earlier than that found that 81 % of raw colostrum samples exceeded industry bacterial contamination guidelines. So chances are there's quite a bit of E. coli and other nasties in the colostrum if it hasn't been pasteurized.

49:30Perry Wilson:Yeah, there's some evidence. And so we also have some of these in the dried commercial products as well. So it's not only the raw milk colostrums that are impacted. Anyway, this is you should be careful about your colostrum.

49:44Emily Oster:Definitely. Do you want to touch briefly, Emily, on like, this might be the bleeding heart in me here, but like, what about these baby cows? Like, isn't it for them?

49:57Perry Wilson:It is for them. I mean, I think what the people who produce bovine colostrum will say is that an individual cow produces far more colostrum than a calf needs. I think the counterpoint is like, but why? That's not how evolution works. You know, why are they producing all this extra colostrum? So this definitely comes up in people's concerns. Again, I think you make the same complaint about milk.

50:26Emily Oster:I wouldn't though, because milk, as long as you keep milking a cow, they'll keep making milk even after the calf doesn't drink milk anymore. The colostrum is more limited, right? Yeah, colostrum is like time limited. Yeah. And think of how cute the baby cows are. Are you considering that aspect from a data point of view?

50:43Perry Wilson:I'm considering it, but I'm also thinking the same people, probably the people eating the raw colostrum are also eating veal. You think so?

50:51Emily Oster:I feel like that Venn diagram does not overlap very much.

50:54Perry Wilson:No, I think you're wrong. I think you are wrong. But I guess we could look at the data.

50:58Emily Oster:Listeners, are you both veal and raw colostrum?

51:03Perry Wilson:Okay. All right, Perry. Smash or pass on colostrum?

51:09Emily Oster:I am a pass on colostrum. I think, you know, if this is not the way I want to spend my 50 bucks a month and what I want to be, you know, mixing into my shakes in the morning, there's other better stuff. I'm a pass. How about you, Emily? Smash or pass?

51:25Perry Wilson:Okay. I am actually a soft smash and I will say I do have this. I do have calls.

51:31Emily Oster:After all of this.

51:33Perry Wilson:After all of this. This is an example of something where I think if you are an athlete who has GI problems, I believe this might be worth a self-experimentation. Okay. Because I think some of the evidence is a little suggestive. I wouldn't recommend it as a general rule, but I guess I'm soft smash.

52:00Emily Oster:Okay. I'll give it to you. Are you an athlete with GI problems, and do you feel like it's helped your athleticism or GI problem?

52:08Perry Wilson:Yes, I am an athlete with GI problems, and no, I don't think that it helped me, but I am not sorry that I tried it. Okay. It turns out what helps is not eating too much salad for dinner. We can get into that at another time or perhaps never. Perhaps we can never get into that.

52:28Emily Oster:Well, not eating salad is cheaper than buying colostrum.

52:33Perry Wilson:Totally. Totally. Salad has too much fiber. That's the problem. Anyway, there we go. All right. That is it for colostrum. Your mailbag question of the week after the break.

52:47Emily Oster:A doubly certified OBGYN and endocrinologist doctor, a naturopathic doctor, and a certified health coach walk into a room. What do they talk about? GLP-1, of course. But more specifically, the difference between the synthetic version of your body's own hormone that are prescribed by doctors nationwide versus Metabolism Ignite product, which naturally increases your body's GLP-1 by 61%. GLP-1 side effects can lead to nausea, fatigue, and muscle loss, whereas Metabolism Ignite is powered by plants, and there are no side effects. Some long-term results of GLP-1 links to weight gain after stopping the synthetic drug, which has been proven in multiple studies, in comparison to Metabolism Ignite.

53:26Emily Oster:There is no weight regain, and this product supports metabolic health. Join the 50 ,000 customers by skipping the needles and taking two capsules of Metabolism Ignite a day for sustained weight loss with plant-based therapy. Visit veracityhealth.co, promo code iHeart, for up to 65 % off your order today.

53:50Emily Oster:Hi, Dad et al. This is Aliyah. Why do people sneeze when they look at the sun? This is a question from my own home. That's my daughter writing the question. This happens to her. Emily, are you a photic sneezer, which is the term? No, I'm not a photic sneezer. Are you? Is it genetic? I am not, but my wife is. And there is, in fact, a genetic condition called autosomal dominant compelling heliophthalmic outburst, or the Achoo syndrome, which... You made that up. I did not. I mean, it is a real genetic syndrome, maybe a bit more dramatic than what people are thinking about, these are people who will have a series of like 10 sneezes in response to bright light, which is not what like my daughter or my wife has.

54:43Emily Oster:I, you know, what most people have experienced is going into bright light and you have like a sneeze or two. This has been recognized for centuries and centuries. I think like, I think like Aristotle or something like this wrote about it. And it's not fully understood. People think that it is a little crosstalk between your optic nerve and your ophthalmic nerve. So the nerves from your eyes and the nerve coming from your nose and like the bright light kind of like goes your optic nerve a little bit and that kind of jazzes your ophthalmic nerve in some people and you just like sneeze out of confusion.

55:20Perry Wilson:That is totally fascinating. And so it's autosomal dominant, which means that it is strong. That would be a strong genetic link.

55:27Emily Oster:Yeah, it would mean that if one of your parents has it, that you have a 50 % chance of inheriting it.

55:34Perry Wilson:That is totally fascinating and I had no idea. The only thing that makes me sneeze is pollen.

55:38Emily Oster:Oh, well, it's been rough this year. Hope you're doing okay.

55:41Perry Wilson:It's been a bad year for sneezing. Achoo syndrome, fantastic. All right, that is it for us today. Stick with us next week when we will ask, what's the deal with psychedelics? I'm excited, but I will say I don't have these in my cabinet, Perry. So I won't have as much personal experience.

56:05Perry Wilson:Wellness Actually is produced in association with iHeart Media. Our senior producer is Tamar Avishai. Our executive producer at iHeart is Jennifer Bassett. Our theme music is by Eric Deutsch. And our content is for educational purposes only.

56:20Emily Oster:If you like the show, help other people find us. Leave a rating and review on Apple Podcasts or your podcatcher of choice. and help us spread the word about the show, you can follow us on Instagram at wellnessactuallypod. And don't forget, we want to hear from you. Head over to wellnessactually.fm and leave us a question for our mailbag or suggest a topic for a future show.

56:41Perry Wilson:We'll let the influencers have the last word. How to know if you have a leaky gut. There's no such thing.

56:46Emily Oster:One, chronic fatigue. I have chronic fatigue. Frequent headaches and brain fog. I have frequent headaches and brain fog. Armour Colossum is a pure... Oh, come on, man. Strengthens your gut barrier. Oh, no. Replenishes your microbiome. Come back.

57:07Emily Oster:A doubly certified OBGYN and endocrinologist doctor, a naturopathic doctor, and a certified health coach walk into a room. What do they talk about? GLP-1, of course. But more specifically, the difference between the synthetic version of your body's own hormone that are prescribed by doctors nationwide versus Metabolism Ignite product, which naturally increases your body's GLP-1 by 61%. GLP-1 side effects can lead to nausea, fatigue, and muscle loss, whereas Metabolism Ignite is powered by plants, and there are no side effects. Some long-term results of GLP-1 links to weight gain after stopping the synthetic drug, which has been proven in multiple studies, in comparison to Metabolism Ignite.

57:47Emily Oster:There is no weight regain, and this product supports metabolic health. Join the 50 ,000 customers by skipping the needles and taking two capsules of Metabolism Ignite a day for sustained weight loss with plant-based therapy. Visit veracityhealth.co, promo code iHeart, for up to 65 % off your order today. This is an iHeart Podcast. Guaranteed human.