What About Ketamine?

Join us on a mind-bending exploration of the human brain, aging, and the untapped potential of psychedelics with our guest, Dr. Jeffrey Becker. As a psychiatrist with a keen interest in natural molecules and their effects on our minds, Dr. Becker brings to the table a fresh perspective on mental health. His insight on the brain as a metabolic organ, the positive impacts of the ketogenic diet, as well as the intriguing world of psychedelics promises to transform the way we think about our mental wellbeing. Ready for a trip into the unknown?

Peeling back the layers of conventional wisdom, we venture into the profound impacts of aging and longevity on our minds. Dr. Becker highlights the GABAergic Inner Neuron Net and unravels how low doses of ketamine can facilitate greater integration within the brain. Moreover, he paints a vivid picture of the convergence of effects between psychedelics and ketamine, bringing to light the importance of consciousness as a target for treatment. We also open up a thought-provoking discussion around how psychedelics can enhance not just our mental health, but also our overall brain health and aging.

Finally, we dive into a fascinating conversation about the role of genetics and nutrition in mental health. Dr. Becker's approach to functional workups, the potential advantages of the ketogenic diet, and the intriguing comparison between a diesel car and our mind's engine are sure to stir your curiosity. So, are you ready to rethink mental health, psychedelics, and the aging brain? We would love to hear your reviews and suggestions for future topics and guests. Remember, this journey is just as much yours as it is ours.

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Transcript

Speaker 1: 0:01

Welcome to the Health Longevity Secret Show and I'm your host, dr Robert Lufkin, for today's episode. Steve and I are excited to take you on a thought-provoking journey through the captivating world of aging, longevity, brain health and, yes, ketamine. Our conversation takes us into the incredible work of psychiatrist Dr Jeffrey Becker. With his passion for biochemistry, pathophysiology and the power of natural molecules, he provides intriguing insights into the potential for psychedelics and transcendence. We also delve into the role of ketamine in enhancing brain flexibility, the power of breaking patterns and shutting down that default-load network, and the journey to self-discovery. As we dig deeper into the fascinating realm of mental health, we highlight the significance of considering the brain as a metabolic organ. We discuss the potential benefits of the ketogenic diet, the importance of comprehensive physical and genetic considerations and the exciting impact of psychedelics. So get ready for a thought-provoking conversation that takes you beyond the realm of brain health, aging and into the world of psychedelics and beyond. And now please enjoy this conversation with Dr Jeffrey Becker.

Speaker 2: 1:36

And I'm very pleased today in this session to have with us Dr Jeffrey Becker. He's known for his focus on whole health integration and he's been a leader in developing protocols and methodology in the world. He's a leader in developing the methodology in both functional psychiatry and consciousness medicine and is known also for his neurobiology of ketamine and psychedelic transcendence and I'm looking forward to getting into all of these concepts. Jeff, it's a pleasure to have you here.

Speaker 3: 2:11

Thank you, Steven. Thank you for the invitation. It's a pleasure.

Speaker 2: 2:16

Great, and to get started, I would love to get a sense of what got you into this area. What inspired you to go into this area?

Speaker 3: 2:28

When I look back, I was quite naive when I was in medical school. I thought that if I went into psychiatry and I learned how to use all of these medicines that touch these receptors, that I would be somewhat of a shaman and I'd be able to heal people by giving the right amount of medicine, give them a little bit of this and a little bit of that. At the beginning of kind of it was that kind of expansion of polypharmacy. When I was in my training I had studied in undergrad. I'd studied biology, of course, or pre-med and biology, but also I'd studied mysticism and had felt that transcendence and kind of spontaneous religious experience was quite healing. I found the psychedelics very healing to myself personally and I thought, okay, well, here's this space in the middle, this is amazing, we can play. And then I found out in medical school residency, but really in private practice, really working with people, how underwhelming the results were with medications that we could help people feel less bad. But we didn't necessarily help people feel good. We didn't help them feel well, we didn't necessarily make them well. With the medication we could resolve acute, extreme suffering, I think, a lot of times, but what we didn't know how to do was help people expand and become who they are with the kind of medical toolbox. I think that the psychological toolbox, the therapy toolbox, in some sense some of the spiritual concepts I'd learned in undergrad. I think there are a lot of tools out there, but the medical toolbox seemed to be again underwhelming, and that's when I really dived into the functional world.

Speaker 3: 4:30

I loved biochemistry, I loved pathophysiology and the combination of the two. For some reason I've always had an ability to see as above so below, kind of thinking. The fractal nature of microscopic patterning all the way to macroscopic patterning has always been just something kind of intuitive to me, and so I just a lot of basic principles regarding fundamental molecules in health really got plugged in in medical school and I got to. I think I had the benefit of having that understanding all the way through my training, so that when I learned about the breakdown product of dopamine being peroxide, which turns very commonly into hydroxyl in the presence of iron, then the next step is well, maybe it would be good if we didn't break down dopamine as much with MAO MAOB to be specific and that caused me to look that up and this was we barely had the internet was running, but it was not. It wasn't full blown.

Speaker 3: 5:47

But then I found the papers on seledylene and all of the kind of animal data showing improved lifespan and a kind of anti-aging effect from seledylene, and so I dive deeper into that way. What are the mechanisms? Well, it turns out it's not just that, it's also that it seems to increase catalase levels, you know, and endogenous and antioxidant. These are the. It was just, it was so fun, it was so much fun.

Speaker 3: 6:17

And then it was a lot of fun to start to put these, put these principles into play in medical care, in psychiatry, because in some ways, again, another aspect of this that I think was interesting was that the brain is really in very much I mean the metaphor of it being a black box.

Speaker 3: 6:39

It still is, really. I mean, we really have very little way of robing the brain in terms of its metabolic state, especially in patient care. In patient care, maybe university labs and things like that. But we have to use extrapolation, we have to use intuition and we have to use patterning. Now we can use genetics, actually, which are just the pricing of genetics. That's come down to where it's just astounding what you can get for $99 now. So it allowed me to play with natural molecules. I always felt like, if you really can be pretty sure you're not gonna hurt somebody and you think you might be able to help and you're actively engaged and you are engaged in clinical correlation, you've identified signs and symptoms and a reasonable guess at pathophysiology and there's literature to support it do something about it and then check up with the patient, see if they get better and over time you really learn what works and what doesn't.

Speaker 2: 7:44

That's great and I can really resonate with what you said really at the beginning, which is how there's a leap between just trying to get people okay versus really feeling well, because my experience is that most people, if we break the whole range of experience, most people are typically living in the bottom half and their goal each day is I wanna make sure nothing bad happens today. Let's hope everything is okay at the end of the day so it fits with exactly what you're saying. What would you say is your perspective on aging and longevity?

Speaker 3: 8:28

It's a really it's a complex question because you've got a lot of different layers to what that means. If you look at what Eric Erickson was getting at in the eight stages of man non-inclusive language, but eight stages of the human being a lot of what that middle stage of life is about is basically solving a specific problem, the kind of maintaining creativity versus despair, being able to stay engaged and repeatedly reinvent oneself and reinvent the sources of meaning. When we find that things have changed or we've graduated. We've actually developed a past where that particular form of meaning was sustainable, was nourishing. Now it might, and when you, if you do this properly, you move up a layer that's still there, but you want more, right, you're looking for more. So I think this is the kind of spiritual aspect of development and I think this is why it's been so exciting to see the acceptance of psychedelics in terms of kind of care of the soul and staying kind of open-hearted.

Speaker 3: 9:41

I think that it's very easy to get smaller as we get older, more fearful, more rigid, more constrained, less comfortable with being uncomfortable, and so these things can help to kind of push those boundaries open and hopefully open ourselves up.

Speaker 3: 10:00

But also on the molecular side, I mean, if you are getting older and you're, deep sleep is harder and harder to get as we get older, as the cholinergic tone in our brain goes downhill and you don't get that growth hormone pulse and that kind of nice clean hypothalamic pituitary axis kind of symphony tuning up that is occurring during deep sleep, in the first phase of sleep at night.

Speaker 3: 10:30

It's no wonder we don't feel so as well in the morning or we don't recover, and so that's maybe at the lowest level. So, addressing again, I think that we have to think in terms of body, mind and soul or spirit and really be thinking about all these things. If we're talking about what is anti-aging, take care of the molecular, it's really the foundation. If you don't do that, it's kind of it's a bit silly in a sense to think that just expanding the mind is gonna fix everything. If the metabolism and the tissue and the brain, which burns 20 to 25% of our calories every single day, in a very small space that tissue can't support an expanded consciousness, then we're not doing our patients a proper in that sense.

Speaker 2: 11:20

Right, and what I appreciate in what you just said is you're really talking about the quality of aging, the quality of life in the process of aging, which ties into the next question, Jeff, which is how does the mind and mental health conditions impact aging and longevity?

Speaker 3: 11:43

Well, we see this in so many ways. It's almost you might ask, how does it not? We constrictive beliefs can constrict behavior and can constrict opportunity or recognition of opportunity. And so that kind of inquisitiveness that we see in the young, where they explore their environment right and they discover new things and there's no things lead to excitement and a kind of leaning into life. And all of that, if there's a use it or lose it kind of quality, both to the body and to the neurons and the brain and the mind. That process, I think, is very important. And I have been deeply fascinated by a particular set of, a particular aspect of control over consciousness Actually, which is the GABAergic Inner Neuron Net that actually both constricts and stereotypes the way that we think and comes on substantially in the tween years and kind of is mostly finished with its pruning and kind of conducting of the kind of ego, the everyday perception of ourselves internally, by the time we're about 30. And we know this from-.

Speaker 2: 13:14

That's a neurotransmitter system you're referring to.

Speaker 3: 13:16

Yeah, it's called the GABAergic Inner Neuron Net and it's not a tract like everybody else about the way that we think of the catecholamines. It's not like the dopamine tract that starts one place and projects out and does certain things. It's kind of like a plastic, almost a plastic matrix, kind of controlling our thinking, and it's very specific in this sense. There's a cell called the chandelier cell that actually has a chokehold on pyramidal cell activity. It's got its axon, which is inhibitory, around the axon of a pyramidal cell. It is literally the arbiter of whether a pyramidal cell can fire or not. And interestingly, these are the cells that ketamine preferentially gets onto in low doses and inhibits. So ketamine inhibits that inhibitor. And what you see is this blooming of interactions across neurons. These neurons are allowed to share information with each other where normally they would be shut down. It would be. You know that chandelier cell says nope, you know you don't share information with that neuron. You share information with this set of neurons. You know the default mode network and executive network and salience networks.

Speaker 3: 14:31

We know, that there is a stereotyping of interaction and so breaking that up, kind of dissembling that, I think can be very helpful for people to kind of crack out of, you know, the kind of straight jacket of their own conception of who they are. It can lead to kind of deep creativity that leads to, you know, entire new chapters. I've watched it. I've done 20 years of using ketamine in clinical practice in mental health applications and it's just been astounding to see what it can do for people.

Speaker 2: 15:05

So are you suggesting that the use of low doses of ketamine creates greater integration in the brain? Would you characterize it that way?

Speaker 3: 15:17

That's almost perfectly said and this isn't, you know, really up for debate. We see this in functional imaging. We see that when a depressed subject, or even a subject that's not depressed, is under kind of subanesthetic ketamine doses the kind of 0.5 milligram per kilogram dosing that we use so much in training, mental health disorders, ptsd treatment, resistance, depression what we see in the brain is that the nodes that normally are interacting with each other, with stereotyped kind of relationships, like the default mode network as an example those relationships fall away, that those areas are talking less to each other. But we also see weirdly and really I think it explains a lot we see the areas that are anti-correlated to those nodes. Now, speaking with those nodes, it's as if every area of the brain has all of a sudden allowed to talk with other areas of the brain more easily. That the rule set of like you, only you and you get to share information and then we make a decision based on that. All of a sudden there's all kinds of information coming in.

Speaker 3: 16:34

That leads to a sense of something, and if you work with people with ketamine, what's very interesting is how deeply symbolic and meaningful the experience is that they will, they'll use these words of like. There's this wholeness to it, there's this integration. It's so large, it's so meaningful, it's so beautiful, and a lot of what I think they're getting at is that there's a wholeness to what they've experienced, what they're experiencing, some aspect of who they are. It's pulling from memory, from intellect and the conceptual, from the emotional and even, a lot of times, even with eyes closed, from the kind of visual cortex. I think we store a lot of information in memory and pictures as well. So the evocative nature of that all kind of comes together and people feel like they've rediscovered themselves. Maybe it's the deep self, I think, in a sense.

Speaker 2: 17:39

That's amazing.

Speaker 3: 17:41

It's amazing to watch. It's so fun.

Speaker 2: 17:44

I can imagine. Yes, would you also say that it's increasing like the flexibility of the brain, like it's taking the brain out of its rut, because a lot of emotional disability is really part of it is that the brain is just kind of stuck in a pattern. Would you say that it's kind of freeing the brain from that stuckness?

Speaker 3: 18:11

Absolutely, absolutely. We know that complex systems tend to fall into patterning and that patterning ends up in some ways creating its own grooves that repeat that patterning more easily over time. We just see this all over the place.

Speaker 3: 18:30

So finding a way to break, to crack through that actually is really well A it's very heartening to the patients when they rediscover aspects of themselves or rediscover aspects or discover aspects that they didn't even know were there, and there's this kind of recruitment of old forms of joy and meaning that feels particularly holistic for patients. I mean, I'll give you just really easy, quick example as a young woman, kind of inner 30s, who, feeling that estrangement, inner 30s that a lot of people feel like, is this it I used to feel like life, there was adventure, there was something, there was something I was looking towards or I was going towards, and then now it just feels like each day it's a day and it ends and then it's the next day is the same. And she found, you know, she remembered just very simple, but it just is such a big thing how much she loved the violin. She used to be an incredible violin player and one day in her late 20s she put the violin in the closet and forgot about it. That weird, it's very weird. Actually. We become so driven towards goals or towards kind of proxy markers for goals or for where we wanna get or who we wanna be that we forget about what we are actually, that she's a beautiful violinist and that's something that gave her joy and meaning and also helped her escape from. You know, music is so transcendent for people. It helps us. I think it helps elevate as well. So I've seen so many amazing transformations like that that I don't even know where to start. I mean, I could give you another one, if I can give you another quick story just to explain. Okay, this was an amazing story.

Speaker 3: 20:37

I was working with a woman. She was about 50 and she had a deep, deep kind of kind of almost a character traits like a sorrow, just a deep sorrow, and I have a lot. I can go there really too, as well. I grew up with a lot of kind of achy pain that I really, when I studied Mrs and really realized that a lot of it was a gapé, just kind of maybe CS Lewis's concept that a gapé is pain per se, that if you really are in touch with it it's hard to be here, it's hard to just see the suffering, and you know we connected on that and but what's interesting about her is that she ran away from this in particular. As you know, it was very scary how intense it was, how much that pain was so intense. And she would describe to me that she ended up in graphic arts, which was interesting to go into the visual and the artistic world.

Speaker 3: 21:39

But she found that repeatedly she would be at people's beds and she would be the one that would be there when they would die. And you know, maybe the family's gone down to dinner and you know she decides to stay and that's the moment the person in the hospital bed decides I'm out of here, you know, and she's holding the hand. I took note of this and anyway we moved into her using a ketamine and it was almost like a triptych for her. The first time she came out she was just really gloriously, just expressing how she felt like she'd been held by God, like she'd finally really returned to a state. So it's kind of resolution of estrangement.

Speaker 3: 22:24

Right, like, why this question of like, why did you put me here? Why did you put me here to be in so much pain for a whole lifetime? Right, I mean, what is this about? Right? The second session she actually came. She was crying and it was, you know, I was kind of quietly quiet but you know, hoping to understand what was going on. And she really expressed that. She really realized that she did not, had not known what she was, and I had a hint of what was going on here. But the third time she comes out and she says I know what I need to do, I mean it's just like could you ask her any more of like these things fall so nicely into?

Speaker 4: 23:09

these kind of spiritual.

Speaker 2: 23:10

It's a beautiful journey.

Speaker 3: 23:11

Yes, it's just amazing. And she said I should have been a nurse.

Speaker 2: 23:17

And then, you know, mine is she's 50.

Speaker 3: 23:19

She didn't do any hard science in her undergrad. She went back to undergrad to city college and she took core science. She got a scholarship to a nursing program. She ended up going into hospice and into nursing leadership and her life is, you know. She still feels the pain but now she's using it. She's you know this is her gift, right.

Speaker 2: 23:45

Yes.

Speaker 3: 23:46

And it's been. It's just these, these are it's. I'm so excited that we're in a new era where we can talk about this in medicine, that this is these. These are very, very real. You know aspects of healing that if we don't address as doctors, you know we're going to get left behind.

Speaker 2: 24:05

Yeah, you know, some of the research shows that what makes a difference in these journeys or these experiences is whether the person going through it has a spiritual experience. Is that what you find also?

Speaker 3: 24:23

Definitely. In fact there's even specific research. It's not, they're not as. I wish there were more, but there is a. There are good studies, two of them that I can think of offhand, that have shown that the response to the drug is correlated to the, basically the spiritual quality of the experience. You know the magnitude and the quality of the experience and that's why, that's why the people that know really know what they're doing in the field. We dose to effect, you know, properly, properly delivered for a patient. It's not, there's no fixed dose. You start with basic principles but you do need to move the dose up until a patient kind of experiences that expanded state, I think, for them to have the full, receive the full potential healing that ketamine can offer for sure.

Speaker 2: 25:13

Right, right, so you use the term consciousness medicine. Jeff, can you explain what you are referring to with that term?

Speaker 3: 25:23

Well, you know this is a messy field and nobody likes. No, there are a bunch of words out there for the psychedelics and for ketamine. And then there's this debate is ketamine a psychedelic and are psychedelics, you know, fundamentally different? Well, they're absolutely fundamentally different in mechanism of action, but there's a convergence of effect and what I'm getting at with this in terms of consciousness medicine, is that consciousness per se you know it's size, it's scope, it's quality, the stereotype, the stereotypies that are involved, you know, is a potential target for treatment and that understanding what it is and having you know working paradigms and knowing how to apply you know the psychedelics, ketamine, other molecules that actually have consciousness expanding effects for even for tonic daily use, is a very important aspect, I think, of what psychiatrists should be thinking about.

Speaker 3: 26:27

I think this is, and they are, and that's again why it's been such a wonderful decade here, I think, the reemergence of this interest. But again, I will always say, and this is one of the things you know, don't forget, if you're a doctor, to do your labs and remember that if somebody has a low B12 level or they have low glutathione levels, or their magnesium is in the lowest 5th percentile because they're a drinker. You know they're not gonna feel well if you put, if you have a psychedelic experience, they're gonna. They will often feel quite racked afterward actually and this happens out there a lot and doctors, therapists and underground you know practitioners kind of rude around thing. You know what is this and I will say it's something that you can probably figure out. You need to do your labs and your genetics.

Speaker 2: 27:23

Can you give us a little bit of your thought process as you do a workup on one of these complex cases?

Speaker 3: 27:32

I think at the so at the base level. If you think of kind of brain, if it's mental health or brain and body, they're in typical psychiatry. Often actually it's not on. It's not atypical in psychiatry that there are zero labs drawn. A lot of times labs are thought of as the internist job or the internist has done enough labs and the psychiatrist looks at them and says, okay, there's nothing going on. You know, at a metabolic level, internist is signed off.

Speaker 3: 28:10

Now it's time for me to do, to apply my behavioral patterning, signs and symptoms right and and define the disease, just to find the disorder and then offer a treatment. I think that this is this is a mistake in psychiatry, because my psychiatrist should think of it as tertiary care and should remember that the internists often did not get very much training in terms of the brain as an actual organ, as a metabolic organ, like how it works and remembering the biochemistry of the brain. I mean again, I would just point out that it burns 20 to 25% of the calories in a given day. That's, that's a big deal. You know. It's similar to the heart in that sense that that it's metabolic requirements are both quite demanding and also create a burden, a substantial burden of oxidative molecules, of, you know, reactive oxygen species and basically just garbage that needs to be processed properly, and if people don't have the basic molecules they need to do that, their brain is not going to function very well as an organ. So so I do, I do a deep my functional work up.

Speaker 3: 29:24

It starts with a lab review and I ask patients to get every single lab they can get their hands on. I tell them I, if you can find childhood labs, I want to see them. I ask them to put them in in temporal order, save them as one single document so that I can spin through and it's and it works as a you know, it's a timeline and now I have a bit, and a lot of people have a lot of labs and you know, if you do this a lot as a doctor, you can spin through them pretty quickly and what you're seeing is a movie play out. You're not seeing a single snapshot in time. Then I, and then I also have my, their questionnaire, which is fairly granular. My questionnaire, I think, is probably a lot more specific and granular than the average psychiatric intake, partly because I'm really looking for signs and symptoms of specific nutrient deficiencies B12, zinc, magnesium, copper zinc you know ratio high, high copper zinc ratio and I work a lot at syndromes like polycystic ovarian syndrome, small intestinal bacterial overgrowth that can really really these kinds of things that can affect the brain very specifically.

Speaker 3: 30:39

Yes, technically it's a GI syndrome but it, you know, s IBO just ravages the brain. Small so does a polycystic ovarian syndrome gets very commonly misdiagnosed as depression, atypical depression and ADD, when in reality it's really in some ways it's a, it's an insulin, it's an insulin insensitivity, kind of a type 2 diabetes light. So gathering signs and symptoms, gathering labs and then also doing genetics and, truth be told, I just use the 23 and me panel. It's $99, you get 650,000 snips for $99 and I've had my own reader programmed. I got the snips that I'm interested in. I follow about 300 of them, but there are a lot in there that are that are really worth. You don't have to follow 300. I mean I think if you follow, even if you just only follow like 15 to 20 on a given patient, you can you can really discern a lot about what might be going on with them.

Speaker 3: 31:42

Some of these snips are so specific. I mean one of the like methionine synthase reductase snip. There's a, there's a version of it, very, very common, very common in Caucasian, in Caucasian Americans, and if you have two copies of it you're four times more likely to have a child with cleft palate or spina bifida. And what we're, what we're getting at here is really this is a very clear clinical sign that that this, this enzyme, doesn't work that well in the process of reducing cobalt amine, the cobalt on B 12, after it becomes oxidized. It becomes oxidized after about 20, after about 1000 to 2000 reactions, bringing homocysteine back to methionine, and some people have a version of that that it doesn't. It doesn't bring the cobalt back into the proper valence and that's a person that really probably can benefit from high dose methylcobalamine to support their, their metabolism. But you won't find it without the genetics and you can find it for $99. I mean, it's just astounding.

Speaker 2: 32:51

Yeah. What are your thoughts on the ketogenic revolution in mental health, and some are saying that it can reverse some mental health conditions. Chris Palmer has a new book out on this.

Speaker 3: 33:05

Yes, absolutely there's. I mean there's, I think they're too. There's two really easy thing, easy aspects of leverage to point to as to why it could be so helpful. And the point is simply that you know if you think about I don't know if you've ever driven a diesel car, but you know when you once you drive a diesel car, you don't go back to gasoline.

Speaker 3: 33:29

They're so, they're so stable, you know they're just, they just go forever and they get a lot of mileage out of a gallon of a gallon of diesel. Compared to, compared to gas, gas is like it's just on off. On off, yes, it helps you jump off the line and to go to the gas station all the time. Right, it's just fast fuel, fast fuel. So I kind of think of it similarly in that way and that that's so many of us are get used to with the three meal a day kind of model.

Speaker 3: 33:59

You know we get used to that fast fuel, that it's off fast fuel, and it's often that just creates well, it runs the insulin system ragged. But the brain doesn't like that either. It doesn't like the ups and the downs, and so you know, training the body to live on ketones and using fatty acids and even you know I actually believe I'm less specific about having patients do keto than I am that they do intermittent fasting, because I believe that if you intermittent fast properly, what you end up doing is really turning up the architecture that produces this type of fuel for the brain anyway, it can take a couple of weeks for the brain to kinda and the brain and the body to kinda get used to it, and then you find people will say, yeah, it was really hard in the beginning.

Speaker 3: 34:50

Now I don't even notice it, I don't feel that feeling of like I'm hungry, and their energy is a lot more stable. That said some people, that's not the proper path and actually more of a ketogenic diet and the C8 and C10 fats and things like that, mct oils and stuff like that can be nicely supportive. But a perfect example of what I was just getting at polycystic ovarian syndrome. One in eight women really looks at some core level like it has a lot to do with insulin resistance, and you will see a lot of carbohydrate craving in these individuals and if you can get them to change their diet and move over and get on to a longer slow burn fuel, they just do so much better. Sometimes.

Speaker 3: 35:39

Again, though, to remind again check your chromium levels, because a lot of them are low in chromium and they don't. That's glucose tolerance factor. That's the metal in the middle of glucose tolerance factor. If you don't have your chromium, trivillain chromium, you're gonna have insulin issues and chromium's gone down in our diets by about 30% over since 1950. So anyway, I'm again saying don't ever forget the labs and all that, but I think it can be very helpful that way. And of course, for aging it's not good for us to blow our insulin system out, and if we're not careful it happens. Sugar is pretty toxic.

Speaker 2: 36:19

Right, so you mentioned intermittent fasting. What is the schedule that you recommend the most?

Speaker 3: 36:29

It depends on the person. Some people never like breakfast. It's just not natural for them. I'm one of those folks. If I eat breakfast, I'm tired by noon and I eat more and I don't feel as well. It's weird, I don't know why. I've thought that I could figure out what's going on, what kind of patterning or something, and I just kind of gave up a long time ago and just said whatever a person's natural patterning is, just let's work with it.

Speaker 3: 36:57

Some people, really, breakfast is very important, in which case you try to bring eat all of your food within an eight hour period. Essentially, this is what it means. I don't care what eight hours. It's not ideal to go to bed on a full stomach, of course. So there's other principles to kind of include in that, but I don't feel you know ideologic about. It has to be breakfast or it has to be, you know, the other way around. There is some, there has been some data that says that it's not good to not eat in the morning, and then there's some data that says that it's okay and sometimes it says you shouldn't have coffee and you should. I just say, do what feels right at a certain level, but give your bowel some rest from feeding all that bacteria in your small bowel. You know it's the best way to get rid of SIBO you know I think it's kind of it may be the only way, honestly, so small intestinal

Speaker 2: 37:54

bacterial overgrowth excuse me, Psychedelics have been referred to as neuroplastic. Could you elaborate on that?

Speaker 3: 38:05

So what they mean by neuroplastic is that there's, you know, there's this kind of window of potential for learning and for kind of learning, you know, new connectivity, increases in dendritic densities and it's not a surprise that, if you know how they work I was talking about ketamine before that ketamine inhibits the inhibitor. It inhibits the chandelier cell, primarily at the kind of low doses that we use, partly because those cells are slightly excited and that means the magnesium isn't in an NMDA receptor and the ketamine can get on them preferentially, turn them off, and then all the cells are allowed to talk to each other. The pyramidal cells, psychedelics, work differently. They attach to the cell body and the proximal dendrite coming in, and when that 5HT2A serotonin receptor is activated, what it does is it increases the chances that any given cell is going to fire based on a given amount of stimulus. So it's kind of like a global stimulant in a sense for pyramidal cells, but not in the way that we normally think of stimulants being norepinephrine driven and maybe some dopamine, neither of those catecholamines. It just increases the ability of that neuron to fire.

Speaker 3: 39:27

Remember that inhibitory neuron, the chandelier cell I was talking about. It's still trying to stop that firing maybe, but it gets overwhelmed and now there's new connectivity Cells have been able to overwhelm the inhibitory tone and the dose matters. Obviously you take a lot and you get a lot of increased catalysm, catalyst effect in terms of firing, and a little bit and maybe a little bit. I think this is where the micro dosing model comes in and has been quite interesting to watch that grow, the idea of using a very small amount every two or three days just to kind of help keep an expansive state and also why a whole lot in some people, where control over control over thought and all that may be actually pretty important and kind of breaking that down isn't always a good thing for some people. I mean you can have post psychedelic psychosis, of course, and some individuals. So these are all you know, solid considerations about whether somebody is a proper candidate and dosing and what drug and all of that and support you know, before and after.

Speaker 2: 40:43

But, based on the mechanisms that you're discussing, it seems to me that what what you're suggesting is these are substances that not only can be beneficial to people with mental illness problems, depression, anxiety, but also for the average person they could increase their brain health.

Speaker 3: 41:08

Yes, I would say that, you know, we always have to be careful as doctors when we start applying something to somebody that doesn't have a disease or a disorder exactly.

Speaker 3: 41:19

But you know, aging and dying and memory loss is all you know, these are, you know, is that a disease? Fda doesn't feel that aging is a disease, but I mean, in some ways, I mean it's a, it's a process of the question of whether it needs to occur, at least at the rate that it does. I think it's a very legitimate one and in that kind of use it or lose it model in, you know, increasing connectivity and increasing creativity and, you know, maybe you know, dusting off sources of meaning and kind of integrated sense of self, these are all. These are all aspects of consciousness that I think are it's not hard to understand why that might improve both health span and life span even. I think we tend to make better choices when we feel better and we tend to take better care of ourselves and there's an orientation towards the world is often more healthy. The food that we choose to put in our body tends to improve and, you know, it all kind of adds up.

Speaker 2: 42:27

Yeah, well, this is a such a fascinating subject and a mushrooming subject.

Speaker 3: 42:34

Yes.

Speaker 2: 42:35

As well, no pun intended there. Can you briefly describe the differences between the most common psychedelics in use right now?

Speaker 3: 42:48

Yeah, absolutely yeah, I mean that's a lot of fun there's. So I mean I think that the most common thing for any given person, I mean if you just queried a hundred people in a room, you know I think mushrooms are probably the most commonly experienced and you know they've been around a long, long time. Of course. You know Gordon Walson discovered, you know, discovered that those were not, those were not balik. You know stones, you know down in Mexico, but mushroom god stones and all of that.

Speaker 3: 43:17

And we discovered this, the psilocybin class, and that psilocybin is a prodrug and it turns into psilocin. It's got a phosphate I'm gonna just cleaved off by a phosphatase and that's psilocin is basically called four hydroxy DMT. That DMT part is kind of important. Four hydroxy means that DMT has got a little substitution on there. It lasts about, you know, anywhere from four and a half, five hours to maybe eight, depending on the dose, and it tends to have a quality. That's very generally it can be it's very spiritual, it's less intellectual, it's less kind of people in the field will say it's got a, it's less clear headspace. But also I think a lot of people feel it can be the deepest of the spiritual experience, depending on the person. It can be quite punishing as well. Sometimes it can be. You know, the Jungian concept of the tree that has its leaves in heaven has its roots in hell.

Speaker 3: 44:23

I think is very pertinent in this when one moves into the psychedelic arena. You know this is a very, very, very real considerations. I mean, you do it enough and it's very you will. You will have a dark experience at some point. So being prepared for that and understanding it, I think, is important.

Speaker 3: 44:42

Lsd, of course you know, discovered from the ericot fungus by Albert Hoffman the 25th compound that they had isolated from that, claviceps, perporea and, and there are LSD analogs or close, close molecules and morning glory and and rosewood and things like that. But LSD very, very potent and kind of a cleaner, cleaner kind of experience, a little bit more intellectual. I think that that is often where people turn when they're looking at micro dosing and they want to be able to kind of work and and kind of grind out. You know more maybe tedious stuff and you know, whereas mushrooms you might micro dose mushrooms and be like, well, I'd really rather be out, like you know, walking through those oak trees and you know getting the slide deck done kind of thing. So lasts a long time, a lot longer than than I've often enjoyed, but it's, you know, is what it is. These things have their own own pharmacokinetics on that 5he2a receptor.

Speaker 3: 45:56

They all attached to that receptor at least partially, and then they have these other flavors by probably how they bind to the receptor we're finding out, and then also probably other receptor binding profiles that kind of create flavor. And then there's there's mescaline, of course, from the peyote cactus and that's actually a phenylethylamine. And lice the LSD is a lice surgeon, me that's a different, it's a different scaffold. And then we've we have phenylethylamine looks not that far off from norepinephrine and dopamine really, whereas the psilocybin and it looks more like serotonin, but mescaline very non potent, you know, it's more like 300 milligrams, but that was the original.

Speaker 3: 46:40

A lot in many ways one of the most important molecules in our history, with Aldous Huxley having, you know, his two really major and important experiences with mescaline, leading to doors of perception and heaven and hell, as these kind of short, very, very powerful and very, very deeply felt and meaningful kind of extended essays about what the experience is like.

Speaker 3: 47:05

If anybody has not read those, those are very pertinent still today.

Speaker 3: 47:11

And then, finally, you know, we have the rise of ayahuasca, which is really kind of amazing, and DMT, of course, which the MT, dimethyl tryptamine it's so simple that our body breaks it down quickly if you take it orally.

Speaker 3: 47:26

So ayahuasca uses DMT from one plant and an MAO inhibitor from another in order to decrease the ability to break down the DMT. So the DMT gets into the body. It's broken down by an enzyme called monoamine oxidase. If you take a mono aminoxidase inhibitor, then that means that the DMT can get into our blood stream and kind of come on slowly and powerfully and kind of stay up for a while and then slowly it gets broken down and so there's kind of a there's a rise and a fall. That's much over a much longer arc, you know, eight hours, even ten hours depending. Whereas DMT that's inhaled is like a rocket ship straight into the space because it goes right into the brain and very, very rapid onset and can be very, quite scary for people but but also can be quite profound yeah, yeah, this is a fascinating subject with a lot of implications.

Speaker 2: 48:26

I, jeffrey, I'm I'm so pleased that we had the opportunity to have this conversation. If people wanted to reach you or learn more about what you are doing, how can they do that? And would you have something that weak people, like an ebook or pamphlet on some of this that people can reach out to you for?

Speaker 3: 48:49

yes, you know we talked about this before and I definitely have a few things that I think I'll pull together and and offer here at the end of this. For me, I, you know, I do have my own, my own personal website that's that's associated with my practice as a doctor. I'm also the science director of an early startup pharma company that is developing ketamine subcutaneous, a subcutaneous form of ketamine with a patch pump, a wearable, simple to use patch pump. Take off a sticker, put it on for pain management, actually in post-operative pain, as a flagship. But that will be, you know that that's our starting point and then we will branch into mental health and we're looking at other indications as well. We need a an effective, an effective, you know, convenient way of delivering ketamine in a parenteral fashion.

Speaker 3: 49:45

To get this back into the psychiatrist's office, I have lots and lots of anesthesia all just friends who have anesthesia clinics and I'm on the board of ASKP American Society of Ketamine providers are very much believed in their good work. But I do also feel that it's it's a, it's a shame and it's really not acceptable that the psychiatrist have not had access to this powerful medication in a way that works. We, we have to deliver this in a parenteral, in a, in this subcutaneous fashion, so that we can get people into the space properly in dosa tunes. So that's been my mission for the last five years and that's bexon biomedical BEXSON you can follow us there great well again, jeff, thank you so much.

Speaker 2: 50:30

We really appreciate it, and good luck in what you're doing with that company thank you both.

Speaker 3: 50:37

Yeah, thank you, thank you, stephen, and really appreciate what you are both doing. It's feel feel privileged to be invited thank you.

Speaker 1: 50:47

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Speaker 4: 51:00

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