In this episode, I’m sharing a special rebroadcast of my chat with Dr. Mikki Williden all about physiologic flexibility, including how to train your body to handle stress and adapt better. We cover metabolic flexibility, heat and cold exposure, sauna and cold therapy, lactate and buffering systems, plus CO₂ and O₂ tolerance. You’ll learn how these systems connect to boost performance, recovery, and body composition in a healthy, sustainable way. Sponsor: Physiologic Flexibility Certification Course open Monday, Oct. 13 to Monday, Oct. 20: https://miketnelsons.samcart.com/products/physflex/
In this episode, I’m sharing a special rebroadcast of my chat with Dr. Mikki Williden all about physiologic flexibility, including how to train your body to handle stress and adapt better. We cover metabolic flexibility, heat and cold exposure, sauna and cold therapy, lactate and buffering systems, plus CO₂ and O₂ tolerance. You’ll learn how these systems connect to boost performance, recovery, and body composition in a healthy, sustainable way.
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Speaker: [00:00:00] Welcome back to the Flex Diet Podcast. I'm your host, Dr. Mike T. Nelson. On this podcast, we talk about all things too. Increase performance, increase muscle, improve body composition, and do all of it within a flexible framework without destroying your health. Today on the podcast, I've got a special, , rebroadcast of an interview that Dr.
Mickey Den did from Wikipedia, all on physiologic flexibility. So she interviewed me and put this out on her wonderful podcast, which I'd highly recommend you check out. We'll put links to everything down below. And she quizzed me all about physiologic flexibility, and I wanted to., Put this out also on my channel so you guys can [00:01:00] listen to it.
And in here we talk everything about metabolic flexibility to physiologic flexibility, cold exposure, heat exposure,, some of the psychological and physical benefits of cold, the role of lactate and exercise, different buffering systems such as beta-alanine, uh, how your body is buffering, CO2 and O2.
Altitude training, CO2 tolerance, and much, much more. So without further ado, enjoy this podcast with Dr. Mickey.
I
Dr Mikki: hey everyone, it's Mickey here. You are listening to Wikipedia, and this week on the podcast I speak to returning guest, Dr. Mike T. Nelson, about physiological flexibility and the four physiological intervention points. Mike is an OG in the exercise [00:02:00] physiology and nutrition space, and previously we talked all about metabolic flexibility.
This time on the podcast, Mike comes back and expands that idea of being flexible and resilient across other domains. So in addition to fuel substrate use and sort of a recap on metabolic flexibility, we talk about temperature regulation, our pH buffer and lactic acid tolerance and breath work to enhance our ability to deal with stress and become less.
Antifragile. For those of you unfamiliar with Mike, I'll put a link to our previous podcast that was recorded almost two years ago in November, 2023. Dr. Mike T. Nelson is a research field, fitness and nutrition educator. He has spent over 20 years of his life learning how the human body works, specifically focusing on how to properly condition it to burn fat and become stronger, more flexible and [00:03:00] healthier, enhancing longevity.
Mike is a go-to in the industry for his knowledge and has been called in to share his techniques with top government agencies, universities and colleges, fitness organizations, and fanatics. The techniques he's developed and the results Mike gets for his clients have been featured in international magazines, in scientific publications, and on websites across the globe.
His podcast, flex Diet Podcast is a wealth of information on all of these topics and more so you can find out more about mike@miketnelson.com. His Flex Diet podcast is on all of your favorite podcast listening platforms. I've got a link to it in the show notes in addition to the wait list for his physiologic flexibility course, which is coming out in a week or so.
So this is a perfect opportunity to enhance your understanding and learning from one of the best there is [00:04:00] in our industry. All of that said, I think you're gonna really love this conversation. Before you crack on and a listen though, I would like to remind you of two things. One, the best way to support this podcast is to hit the subscribe button on your favorite podcast listening platform.
That increases the visibility of Wikipedia in amongst literally thousands of other podcasts out there, so more people get to hear from guests. I have on the show, like Dr. Mike and two, my Mondays Matter accelerated 2.0 program is on sale now. We are selling through to the end of Sunday, the 12th of October to kickstart this 21 day reset.
On Monday, 13th of October, and this is where I coach you for 21 days through implementing those protein sparing modified fast days, which are so effective for you to lose body fat and keep it off. This is for anyone who has felt a little bit overwhelmed the idea of [00:05:00] joining an entire plan, but really wants to understand more about how they can effectively implement this fat loss plan into their lifestyle.
So this is such low hanging fruit for anyone wanting to get a handle on this fat loss technique and see some real results in a short amount of time. So that is Monday's matter accelerated. I'll pop a link in the show notes as well. For now though, please listen to this interview that I had with Dr. Mike T.
Nelson
Follow, and then I, then I just go off on a tangent, but that's all right. Um, Mike T. Nelson, so great to see you. It looks like you've had a busy summer. Like I, I all I see. Yeah. Is you traveling at concerts and the rowing machine? Actually,
Dr MIke T Nelson: yeah. Yeah. Doing a fair amount of rowing again and uh, recently, the last seven days I went to three concerts, so.
Dr Mikki: Oh, amazing.
Dr MIke T Nelson: Yeah, I was good. I saw Bruce Dickinson solo stuff one night [00:06:00] and then saw Apocalyptica with Lindsay Sterling and Hailstorm, which is amazing. And then one of my favorite bands of all time is a band called Demon Hunter. They're a Christian metal band. So I did the, uh, VIP, got to meet them, got my picture taken, went to the show, and yeah, it was awesome.
Dr Mikki: That is awesome. Nice one. And, uh, are you settling in for like a season of work now?
Dr MIke T Nelson: Um, kind of. We're gonna be back down in South Padre in a couple weeks, so we'll be down there, you know, for probably about five and a half weeks just hanging out, working and doing some kite boarding. So I try to. Not do as many podcasts, not do as many meetings.
Usually just project, like writing work. I've got a lot of writing I need to get done and try to have a little bit more open schedule so that if it's windy, we can go kiteboard and hang out and move stuff around as needed.
Dr Mikki: Yeah. Nice one. Uh, so last time we spoke on the podcast and something, which I hear you, or particularly [00:07:00] over the last few years, you've, you've, or, or actually 10 years, probably longer.
We've talked a lot about metabolic flexibility and it's, and I, I feel like that's actually gained a, like you were one of the OGs talking about Yeah. Flexibility and, and, but now it's a term that people are really familiar with and, or at least people in sort of my circles. But of course of late, I've heard you talk much more about physiological flexibility and just the idea that it, you know, this which sort of extends beyond metabolic flexibility or is a little bit bigger.
So can you chat first about how you came to sort of expand the idea of of yeah. To expand to this metabolic flexibility idea.
Dr MIke T Nelson: Yeah. So I started working on metabolic flexibility as part of my PhD dissertation. I started that work in, I wanna say 2008, I believe. Cool. Um, yeah, I know, which is wild. Um, the term metabolic flexibility was coined [00:08:00] by David Kelly in around 2000.
And so it was around three, four years after that, I started thinking, I'm like, okay, that, that's a cool theory. It applies to metabolism. There's a lot of useful stuff there. But how do we take that concept and we expand it to all of our physiology? So for metabolic flexibility, you've got carbohydrates on one end, fats, fats on the other end, and then how well can you transition back and forth?
And it's kind of the. Dynamic nature of transitioning from one thing to the opposite thing I've been kind of infatuated with. So if we look at even biomechanics, right? Most of the muscles in the body are arranged in pairs. You have your bicep and your tricep and they do kind of opposite things. You've got your quadriceps and your hamstrings and they do opposite things, et cetera.
And a lot of systems in the body are, are paired systems, like sort of a push pull. It's not always that simple, but I started thinking, okay, so if someone has, we'll give them a B [00:09:00] and basic exercise, you know, pretty good nutrition and sleep. Like those are kind of obviously the three pillars of basics you wanna start with.
And obviously you've got a ton of great stuff in that area too. But once we're done with that, like how do we know what's next? Like how would we, is there any framework, are there any kind of rules of thumb we can figure out where we should focus our time next? Because there's a never ending list of.
Biohacking, you know, red light to grounding to hydrogen water, to, you know, cold water and sauna. And it is a never ending list of things people could do, which gets a little bit overwhelming. So I thought, okay, so we're on physiologic flexibility and how do we figure out what system to look at? And so my bias was what are the systems that the body absolutely a hundred percent has to hold within a very, very tight range or stuff goes really awry because I think if you want better performance, you just need to train your body to survive.
Um, better originally got that concept from DR [00:10:00] at ZHealth back in the day, and I came up with, uh, the four main pillars, which would be temperature, pH, expanded fuels, and then air, which is just CO2 and O2, that all of those have very tight ranges of which your body has to operate. However we can put it in more extreme environments.
So temperature 98.6, it's actually probably 97.7. Um, but we can do sauna, we can do cold water immersion. We can put ourselves in these extremes of temperature. You know, we're not really trying to change that core value, but we're trying to run, you know, some of these like, um, just more adaptive processes and other benefits from exposing ourselves to methodical way of increasing those extremes on the end.
Dr Mikki: Yeah, and I've read articles that you've written on physiological flexibility, and you've talked about it like it's training for chaos. Yeah. Which is almost, which is actually like one of the, like, I often [00:11:00] joke about that my strength training is often like chaos training, which, which is, you know, you don't wanna do, if you want to actually seriously progress with like, you know, muscle building or whatnot.
But, you know, in evolutionary terms. How much of this flexibility, and I think about this with metabolic flexibility, but ex expanded to, to this term. Like, how much of this do we naturally have and how much of it is sort of dampened down or suppressed by modern environment, do you think?
Dr MIke T Nelson: Yeah, it's a great question.
I, I think inherently we have a high capacity in each one of those areas, although I would agree that because primarily of our modern environment and modern living, we're just not exposed to it at all. Right? So I think that you can't really ever stop adaptation, and the question is, okay, what is the signal or the stimulus you want to adapt to?
So again, like temperature, um, I live in Minnesota and it's hilarious that people in Arizona yell at me. They're like, oh, how do you survive the [00:12:00] cold winters? It's horrible there. I'm like, you just run from one air conditioned unit to the next air conditioned unit in Arizona when it's super hot. Which I understand it's ungodly hot down there.
Um, but I think. We don't expose ourselves to any temperature range, and over time we, we lose that, um, capacity. So the extreme example, I think if you've ever been, uh, I remember visiting my grandma, she was over a hundred in the nursing home and she was alive and it's like 800 degrees in there. And we're in a room and I literally would check the temperatures, 76 degrees Fahrenheit, and she has a, a, a sweatshirt on and a blanket, and she's like, oh, I'm so cold.
You know, because it, she's losing the ability to regulate heat and she can't tolerate very much of an extreme in the environment. And granted, unfortunately towards the end, she was basically stuck in the exact same environment all the time with even little movement or no way to, to raise, you know, core temperature or anything like that.
So I do think a lot of it is [00:13:00] the environment of which we're in. We've adapted to a very kind of fine range of, of thermal neutrality. And again, it doesn't mean to be that oh, you've gotta have no heating in your house and sleep with stone pillows and you know, do all these extreme things. I love air conditioning 'cause the Minnesota does get pretty hot in the, in the summer.
I love having heat in the winter. It's freaking amazing. But I think you then have to pick some type of stimulation, even on a small amount to compensate for that. And just like exercise, like think of all the benefits we can get from as little as 5, 10, 20 minutes of exercise a day. Right? More is usually, generally a little bit better, but you, you know, the curve tends to, to drop off.
You don't have to exercise eight hours a day to see benefits. So I think it's very similar to that. You don't have to live in as sauna. You don't have to buy a cold plunge and be in there four times a day. But you probably do need to apply some of that stimulus [00:14:00] at some point throughout your week or throughout your day.
Dr Mikki: So Michael Esther has his book, the Comfort Crisis. Yes. Love that
Dr MIke T Nelson: book.
Dr Mikki: Yeah. Yeah. And it's, it's exactly the same concept, right? Like, like we just, all of us have seen to be sort of within this small range of where we are comfortable. Seldom is zero an opportunity to put ourselves out there unless we do it purposefully.
Dr MIke T Nelson: Mm-hmm. Yeah, I agree. Yeah. And it, again, I, I love all the things with, with modern life, but I do think you're going to adapt to wherever you're at. And so you probably should think strategically about doing a few of these things. And that doesn't need to take any hercule effort. Like most people could take a cold shower or get exposure to cold.
If you're in a warm environment, you could shocker exercise outside, right? You don't have to go to an air conditioned gym all the time. You can go for a walk. You could go for a run. Uh, like where I live, a lot of times I'll take my rower out and stick it in the middle of the street. I'm like, we live on a dead end, so there's not [00:15:00] a lot of traffic or anything like that, but there's ways you can get around doing it without having to spend a, a ton of money or a lot of cases, any extra money.
Dr Mikki: Yeah. So you personally work to become more resilient in the areas that we are going to discuss, Mike?
Dr MIke T Nelson: Yeah, so I started, uh, playing with these experiments probably going back eight years ago, and then, you know, stuff that does take a little bit more technology to play with. I got a big freezer right before COVID happened, so at the end of 2019 and stuck in my garage, sealed it with silicone, and then used that for my coal plunge.
Again, I'm not recommending that. Make sure you're, it's unplugged, make sure you're safe, all that kind of stuff. But I'm like, yeah, if I'm the guy out here saying all this stuff, like I probably should practice it again. I didn't know COVID was gonna happen, but. It kinda gave me about a two year period where I could literally do a cold plunge every day, probably six, seven days a week for like two years in a row.
And, [00:16:00] you know, I, I still do it most of the time now and not quite as much as I did then. Um, but yeah, just to see what happens because I didn't want to be the person who's saying, Hey, look at all this research, look at all this literature. And yeah, I've, I've had clients and we've kind of put it into their training, but I also wanted to, you know, personally experience it of what's going on.
Run the experiments of sitting in a cold plunge maybe too long and poking your finger, looking at glucose and all that kind of fun stuff.
Dr Mikki: Yeah, interesting. 'cause particularly now, look, there's so much hype around both sauna and cold plunge. Probably more hype run cold plunge actually. Yeah, yeah. And, and of course now you're getting a lot of pushback from factions like sports scientists and saying, you know, coal plunge isn't the be all or end all, but of course I think you are coming at it from a different perspective actually.
And so can, like, is that, am I right in thinking that?
Dr MIke T Nelson: Yeah, so when I, so when I looked at it, coal plunge was very much a very [00:17:00] niche thing. Like I had seen some of Wim h stuff, um, shout out to Brian McKenzie. He had a few things on it, you know, with working with Larry Hamilton and those guys, XVT had just started, so there was a few crazy people out there doing it, but it wasn't like mainstream.
But I never. If you would've asked me at that point, even six years ago, like, oh, is cold plunging gonna be a mainstream thing? I'm like, what? Are you crazy? This is stupid. It sucks. Like no one's gonna wanna do this. This is dumb. There's not gonna be companies making cold plunges. I think like, uh, Morocco, I think Dr.
Tom was like the only guy making one at that point. Um, and now it's like, oh my God. There's like, I dunno how many different cold plunge companies, people doing it. And if we look at the research on it, my initial thought was I, I was hoping for these magical body comp effects because I read the, um, Ray Corona published some stuff years ago about Michael Phelps and that he did these calculations of why he could burn [00:18:00] so many calories is because of the temperature of the water.
And you know, to his credit, I guess he had a metabolic heart and was doing a bunch of measurements. And this is maybe 10, 15 years ago, quite a while ago. So in my head I was like, okay, how do I test cold plunge? And at some point I need to figure out how to buy a metabolic cart outta my house. Yeah. Um, so now I do have a metabolic cart in my house, so shout out to pin noi.
Um, I was disappointed though because the math just doesn't work out. Like in theory, if you can be in water that's just a little bit cold and you can be in there for many, many hours, maybe it doesn't work out perfectly. But I would say in that case, maybe, um, but the fact that you're in cold water, you're in there for very limited time.
You know, if we're talking 2, 3, 4, 5 minutes, even eight minutes, there's, there is a huge thermal drain, but you just don't accumulate enough [00:19:00] calories for it to make any difference. So I went back and pulled all the literature I could find on body com stuff, you know, all the way back to some studies published in like 1934 or 1968.
And there was, I think only two studies I could find. And one of 'em was literally they put people in their shorts in a freezer that they had made that they monitored. I wanna say the air temp was like, I could get this wrong, but I wanna say it was like 42 degrees and they were in there for hours. And in that case they did show that, yeah, you did burn a fair amount of calories, but if you read the study, people were shivering, they hated it, every single one of the subjects.
And you could argue this was done so long ago, IRB was highly questionable and those types of things too. Um, and yeah, so basically body comp, I would say is kind of a, a bust in terms of. Massive effects because you will even now still see some, some people's names who rhymes with breca that look like, oh, it's the most amazing thing you've ever [00:20:00] seen in your life.
It rips fat off your body. And I, no, no, like the only way that I've seen, if you run the calculations with cold water immersion, maybe if you push yourself to the point where you're constantly shivering for hours afterwards and you include that in part of the calculation, maybe, but if anyone's done that, which again, I would not recommend people do that, it is absolutely miserable.
Um, you can end up with some aftershock effects. You can end up with pressure drops. Again, it's not anything, anyone I would recommend do, let's say. I may have done it a few times to see what happens and. It is absolutely miserable for hours.
Dr Mikki: And, and I think there's a potential to eat back those calories because you're quite hungry.
You know, like I've seen PE people argue that point as well. I think Eric Trickler, I think did a, a good article on it for mass, and he, he was like, you know what, yeah, you might burn a few more calories, but you're going to eat [00:21:00] a lot more calories just by way of, you know, the fact that it makes you hungrier.
Dr MIke T Nelson: Yeah. And what I've seen with that in the literature is, you know, I would say that's probably a true effect. I love Eric's stuff. He is awesome. Great dude. Um, in practice, I've noticed the variability of that is super high. Like some people doesn't affect their, their calorie intake at all. Other people it's, it's, it's horrible.
They're like, oh my God, I'm so hungry. Um, I, I see the same thing with the high intensity inter uh, exercise, like high intensity intervals. Most people, like an hour or two after, won't be hungry. And then some people go back to just normal baseline, even if they put out a really high output. They did true high intensity interval training.
Other people are just ridiculously hungry. Um, so I I, I do think there's a fair amount of variability there, but I agree a hundred percent with your point that yeah, in and of itself, you would want something that's gonna burn a ton of calories and in theory, just blunt your appetite for 24 hours, you know, other than drugs.
Those, those things don't really seem to [00:22:00] exist. Don't exist. Yeah.
Dr Mikki: So, Mike, what are we training then when we, when we are looking at cold and, and hot? We haven't really talked about the sauna, but what is it that we're actually training for and what's, what's happening? What are we doing this for?
Dr MIke T Nelson: Yeah, I, I think it's as simple as expanding what I would call like your HDR or human dynamic range.
We know, for example, heart rate, the lower your heart rate goes and the higher you can get to a max, the bigger that range is, is probably a good marker of health. Um, we know that same thing with lung volumes, whether you're looking at minute ventilation or whatever markers you're looking for, pulmonary measures.
We know that faster transitions are also better, right? For both sports performance, both metabolic flexibility, et cetera. So I think being able to tolerate a higher high and a lower low just expands, you know, some people have called it like a, a physiologic headroom, um, that allows you to just be more adaptable.
And what's super interesting in the literature is [00:23:00] that would apply to temperature. But there's, there's only a handful of studies even looked at this, but there's something called a cross adaptation effect where you train one thing, but you get better at something else. So like in the lifting world, this would be like, I don't want to get better at deadlifts.
Okay, well, everybody knows that. Shocker, you should probably deadlift, but I can't deadlift heavy every single day. So is there something else I could do that would transfer to my deadlift? If you talk to, you know, people who do kettlebells, like Pablo Satlin or people like that, they would say, well do kettlebell swings.
Oh wow. I deadlift twice a week. I added two days of kettlebell swings and my deadlift went up more than just deadlifting. Cool. So that means the kettlebell swing transferred a two year deadlift doesn't look like a deadlift, but you saw an increase in your deadlift performance. And so there is some of these cross adaptations effects that again, are not real well studied.
The main one is, uh, tolerance to hypoxic events. So [00:24:00] hypoxic events are low oxygen. So they did this really cool study in humans like many years ago where they said, okay, one group you get exposure to cold water immersion. The other group you do not. And we're gonna expose both groups to a hypoxic condition.
So low oxygen, which for humans is very threatening. And they rated like kind of self-report of like how threatening they felt it would be. And the group that had cold water immersion before reported that the hypoxic environment wasn't not nearly as bad. And it was a pretty big difference. There, there's some background mechanisms that tend to cross over and things like that.
So I think there's more of these crossover effects that we'll find that these systems are kind of overlapping in the background. So I do think there's probably a lot of transfer that we just haven't figured out yet. Again, it's anecdotal, but I can say that if people have worked on these four areas, like their HRV scores tend to be better, their ability to [00:25:00] handle stress in other forms, even psychological stress sometimes, which is self-report training, stress, other stressors seems to be a lot better.
Um, and so the thought being that maybe systematically putting yourself under these small amounts of stress is increasing your body's resilience and allowing you to get back to baseline faster via some mechanisms that we probably haven't really a hundred percent figured out yet.
Dr Mikki: Yeah, interesting. Uh, we did some sauna work, um, in the lead up to a run that we just did in the Grand Canyon.
Oh, cool.
Dr MIke T Nelson: Yeah. Oh, yeah, yeah,
Dr Mikki: yeah. And it was, it was really great. And particularly ster. He, he's not very tolerant of the heat, and so for him, he got a real, he really handled the temperature a lot better, um, than he would've otherwise because we just knew from, from previous events, I didn't get into the sauna quite so much.
But equally, when we are both in the sauna, I, I tend to take longer to, to heat up and longer to sweat, [00:26:00] uh, than he does. And, and is this a known difference, uh, sex difference, Mike, in your experience?
Dr MIke T Nelson: I haven't seen it be a sex difference, but I definitely have seen it be an individual difference. Um, yeah, like some people, and you can see this in the literature, right, some people are what they call heavy sweaters.
Some people aren't, some people lose more sodium, other people don't. So there seems to be a lot of variability with that and it does change, right? So a lot of that might be some genetic stuff. We do know that adaptation does change that, and like you said, if you know you've got some competition or some event that's gonna be in a hot environment, like even just two weeks of, of sauna or heat work, like, makes a huge difference in terms of the, the acclimation to that stressor for sure.
Dr Mikki: Yeah. Interesting. And to your point about the cold exposure and hypoxic environment, can we, um, from that, is that translatable to, if you're not, you are going to, I don't know, climb Mount Kilimanjaro for [00:27:00] example, then actually doing some cold exposure work before you go may help you tolerate the, the shift in, in, um, percent oxygen?
Dr MIke T Nelson: My argument would be yes, but I don't know if that's actually been formally studied yet. Um, but my argument would be yes, and as long as it's monitored, it's probably not much of a, a downside. I mean, you could extrapolate even further and say, well, maybe that would transfer to high intensity exercise. Um, again, I haven't seen that study that's been done either, but it would be super interesting because I think one of the limbs, especially on, you know, like you're doing a max 2K on the rower, something like that is definitely your ability to get oxygen in, carbon dioxide out, all that kinda stuff.
But I, I do think there is something perceptually there too, because like, if you've ever done like a hard aerobic event and you know, cardiovascular wise, you, you feel pretty good if you [00:28:00] haven't done it in a while. There's this weird sort of, not dread, but just like, it feels like I'm, I'm mentally not prepared for this to suck.
You know what I mean? Like I'm just, yeah. Yeah. I feel like I'm gonna ws out earlier than what I would normally do, where if I'm acclimated to it, I've been doing 'em a couple times a week, I kind of, okay, I know this is gonna suck, but. I don't know. There's just something that feels like I can't push myself nearly as hard, but it, it, it feels like it's more of a, you know, Tim Noakes would say like the central governor, you know, more of that type of thing.
Dr Mikki: Yeah. Yeah. No, that makes sense. And have you bred into, she hasn't done a lot, but she went on Huberman once, Susanna Berg or something? She has like, yeah. Protocols for, I think she only did one study, I'm not sure. Correct. Like, do you have, do you, okay. Do you have thoughts on her, like pro saying you only need like 11 minutes of this cold or 20 minutes or so?
I can't actually remember the numbers. Like how much do we [00:29:00] need and does it compare to what she found or is she just one person of many?
Dr MIke T Nelson: As far as I know, she's the only one that's looked at it in terms of quantifying sort of a total time. And then the protocols that have been used for sports performance are all across the.
Like most of them tend to be relatively cold, like 50 degrees or colder, and they tend to be long like 5, 10, 15 minutes. So they do tend to be on the longer side. So outside of those protocols, which tend to be acute, and again they're looking at, you know, vertical jump performance or there has been some look at body comp and you know, muscle mass and muscle protein synthesis and that type of thing.
Um, I don't know of any other good data. 'cause that's one of the things when I did the course, I was trying to figure out like how much we recommend for how long, and, you know, her study is the only one that's tried to kind of put some time recommendations around it.
Dr Mikki: We'll be right back with the [00:30:00] conversation after I give a shout out to sponsors of Wikipedia.
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Grab yours today, guys, with a sweet 20% discount for being a listener of the show with the code Wikipedia over at their website, and we will pop a link in the show notes for you to be able to do that. All right, now back to the show. People often think about the metabolic benefits, which to your point, they aren't necessarily, they're not robust really, but the psychological benefit of going into cold, um, I, I at least notice it.
Like you get, just get sort of feel invigorated, feel rejuvenated, and I do think there's research around that. Um, like improving psychological sort of, um, aspect.
Dr MIke T Nelson: Yeah, the dopamine [00:32:00] release, the norepinephrine release. Granted, these were acute studies, you know, and this was a novel stimulus, but now those studies are pretty robust.
Like that's a pretty legit thing. Uh, my friend Dr. Rhonda Patrick's talked a lot about that. Um, and you definitely do, do feel it, like you get done and you're like, oh, like I know the rest of my day usually goes a little bit better. I feel like I have a little bit more energy. I tend to drink a little bit less coffee.
And then to the, the psychological side too. The surprising thing for me, but especially after doing in the COVID times, I thought, okay, like any other adaptation, like, eh, you know, I've been doing this most days for, at that point, two years. Uh, my expectation was it would be pretty easy at the end of the two years or even after one year, that, okay, I just go out and get in.
No big deal. But the, even to this day, like five plus years later. That little hesitation, like right before you get in, like never goes away. Like even a couple weeks ago, I'm standing there [00:33:00] going, this is stupid. What am I doing? This is dumb. Yeah. Like this is sucks. I don't want to, and there's always that, that hesitation even done it, you know, how many, hundreds of times.
And I would've thought that would've went away or been very minimal. But it, it's always there and it, it feels like you can't ever get it to zero. But I do think that might be the benefit. Right. So you're, you know, psychologically saying, okay, yep, this sucks, but I'm still gonna do it anyway. You know, like, heart exercise still sucks.
I know there's some benefit. I'm gonna feel better once I'm done. It's only a few minutes, it's gonna be okay. I'm in a safe environment. You know, you still kind. Talk your way into it. I think Huberman has a term which I actually like, called limbic friction. You know, I, I think of it as like the, the professor cortex part of the brain, and then the, the lizard limbic system are like arguing with each other, you know, the lizard limbic system's.
Like, no, this is stupid. You're gonna kill us. We could [00:34:00] die in here. And the professor part's like, no, it's only for a couple minutes. It'll be okay. Shut up you pussy. You know?
Dr Mikki: Yeah. I often think, you know, I often say this to myself when I'm like, out in a long run, or, or, or similar, like, just about to head in the cold.
Like, sucks, but feelings change and I'm not always gonna feel this way, and, and I'm gonna feel differently and for when it's time, you know, like I sort of, I bargain myself with myself with all of these sort of like, um, uh, things that go through my head with it. Mike, you mentioned that you sort of have moved from daily exposure to, to cold.
We haven't really discussed heat, but just on, on, on the whole sort of temperature regulation thing. And also we are not sure of the dose really. But do like, do you have any idea of, you know, like if someone were to say, Mike, what's your recommendation with cold and hot exposure? What are you gonna say?
Dr MIke T Nelson: So with cold, what I came up with is, I like the, the eustress [00:35:00] model.
So EU stress. So stress you can more readily adapt to. And my, I'm very much biased more towards frequency if people can, so this the same thing with training, same thing with nutrition. You know, same thing with most things. There is definitely the distress end of the spectrum where it's gonna take you, it's gonna be much more difficult, but the stressors are also gonna be a lot higher, you know, so in the cold plunge world, like, you know, Joe Rogan is a very big fan of the distress method of cold plunge.
And you could argue that maybe that's better for him because he is been doing it so long, he has different adaptations. But I think people see his video and think, oh my God, day one I gotta go to 35 degrees and get out there and get all the, the ice out of the cold plunge and do five minutes. And it's like, no, you don't need to do that.
And you probably don't want to do that. Like, you don't need that much of an extreme stimulus to get the adaptation. So in general, I tell people, just start where it feels cold. But you could stay in initially for 60 seconds. Like for most people, I would say [00:36:00] 50 degrees Fahrenheit is plenty cold to start.
Like some people have had start at 60 degrees Fahrenheit. And then what I do is I like people to slowly build up time. But when you get in, you know, get your breath, like, you know, calm your breath down, be calm, and then you'll feel like these sort of, it sounds crazy, but you'll feel like these waves of how it gets harder and then easier.
So the first wave is usually like right after you get in, everything is cold and just kind of get yourself and you get through that. Okay. And now I just kind of get out before that first wave starts coming up, which for a lot of people is like 60 seconds. And then your goal is over time, the limit. I use this kind of five minutes.
Once you can pretty easily do five minutes at 50 degrees, then, you know, drop it to 49, drop it to 48, go back down to 30 seconds, kind of start over. That's kind of my bias because I don't, I don't think you need to go super cold. Most people will still even have a gas reflex at 50 degrees. Right. So it, it, [00:37:00] that's one way of your body.
I got that from Dr. Tom Seger of telling your body, telling you that it is fucking cold, it's cold in here, you know, you're, you're applying plenty of stimulus. And then, you know, once you get down to, you know, it took me probably two years to slowly walk myself down to the coldest I've ever done is 38, 39, 40.
Oh wow. For a couple minutes, you know, two, three minutes. It's relatively easy to do now, but it's still hard at first. Um, and then related to heat. I know that contrast therapy is all like a, a big thing and there's some interesting data on it. It might be beneficial, but if someone starts with contrast doing both cold and hot, it is literally impossible to troubleshoot because you don't know how cold was the cold, how long were you in the cold?
How hot was it hot? How long were you in there? What was the humidity? How long were you in for each one? What did you do? Did you transfer? Did you like run outta the cold plunge? And then in the sauna, did you go directly from [00:38:00] the sauna into the cold plunge? Like, so, the more you push the extremes, the higher the stress is gonna be, right?
So the faster your transitions are, you're gonna just accumulate more stress. And again, more stress doesn't necessarily mean that it's bad, but it, it is virtually impossible to figure out. So the only time I will let sort of athletes or clients do that is. If you do that on a Sunday and you don't have a cold plunger sauna, you go somewhere to do some recovery work.
Great. Do the set protocol. We'll monitor your HRV on Monday. If it's showing that it's always better, just just do it and we won't worry much about it. But if you have access to 'em, much like training, like if you wanna maximize training, you would maximize strength training and you would do some cardio, but you would not try to maximize cardiovascular stuff at the exact same time and you wouldn't squish both those sessions next to each other if you could.
Again, if you want the absolute maximum adaptation. So usually I would tell people do [00:39:00] cold first or do hot first. Get to a pretty good level, get some adaptation going, you know, six, eight weeks or whatever. Then add the other modality in on a separate day, bring that up. So I'm gonna put cold on kind of maintenance.
I'm gonna do sauna maybe 4, 5, 6 days a week now. Then once you get pretty good with that, then you can kind of play with, with contrast, because now you're more adapted to both of 'em. And now you're working on the, the transitions back and forth. So just like metabolic flexibility, like you work on carbohydrates for a while first, then work on fats, then work on your transition.
Like work on cold for a little while, work on hot for a little while. Okay. Now play with your transitions.
Dr Mikki: No, that makes so much sense. And people who, and, and people will be well familiar with sort of, uh, sauna cold plunge. 'cause they're very much in that sort of public sphere. Mm-hmm. Um, but your sort of, when I think about another pillar that you talk about the pH balance and acid [00:40:00] tolerance, like this isn't.
Almost ever talked about in the, in the information that I consume. And I'm very interested in the whole sort of metabolic physiology space. So, you know, you described lactate and hydrogen iron as the body's acid bath, if you like. Um, can you just sort of chat about both lactate and hydrogen and, and what's going on at that buffering level that, that, um, that is relevant to our understanding of how people tolerate stress, I guess?
Dr MIke T Nelson: Yeah. So pH your body has to hold pH very, very tightly. If it goes up a little too much or a little bit too low, you're, you're in an absolute world of hurt. So we have all these systems in that will buffer that system, which is, okay, great. So how would I put more acid into the system if I want to test the buffering system, right?
Just like if I want a bigger bicep, I probably have to find some way of stressing the [00:41:00] bicep. Same idea, uh, turns out that by doing high intensity interval training, you actually literally dump acid into the muscle. So if you look at, you know, for the fancy term as glycolysis, we're just running a bunch of carbohydrates through the system.
We're using mainly carbohydrates because we need to produce a TP at a very, very fast rate. The side effect of that is a production of what probably doesn't exist, but is air quotes called lactic acid. So everyone's heard lactic acid is this thing that makes your muscles sore and has all these bad things associated with it, and turns out almost none of that is true.
So lactic acid, if it does exist, immediately dissociates into lactate, and then these little pesky hydrogen ions. So hydrogen ions are literally the definition of an acid. So the hydrogen ions get dumped into the muscle and so does lactate. Lactate gets a sort of bad view because, you know, if you've ever done lactate testing, it's usually some type of ramp test.
It's some sort of hideous [00:42:00] test, and they're like, Ooh, your lactate was 11 millimolar. You poor bastard. This sucks. Um, but even during that test, they're really using lactate as a proxy for hydrogen ions because it's just not that easy to measure pH directly without fancier equipment. Um, and it turns out lactate in and of itself, it is a really high energy fuel that's used by the body.
Like the brain loves lactate, the heart loves lactate, your muscles love lactate, especially the slow twitch fibers. The bugger is, it's just not produced a lot without concomitant increases in hydrogen ions. That
Dr Mikki: requires high intensity exercise or similar.
Dr MIke T Nelson: Yep, yep. The only way to get there is by basically running glycolysis really, really hard so that the byproduct is lactate and hydrogen ions.
Um, what that allows you to do is it allows you to get to these higher level outputs, but if anyone's ever done that, or even just doing, you know, 15, 20 reps of a leg extension on the leg extension machine, you literally feel like your muscle is [00:43:00] burning. And it's literally because there's acid being dumped into the muscle.
Dr Mikki: But it's not lactate.
Dr MIke T Nelson: It does not lactate, right? Yeah. Yeah. And lactate doesn't even hang around very long at all. It doesn't do anything with muscle soreness. Um, they're not massaging, lactate outta your system, all other kind of stuff. It still persists. Um, but the body does have buffering system. So the main intramuscular, so inside the muscle system is a molecule called carnasine.
So carnasine, you can increase levels of it. So originally. The studies did ingestion of Carine itself, and they did find, oh, this does help buffer some of the hydrogen ions. And then later they realized the rate limiter on that is an amino acid called beta alanine. But beta alanine combines with l histamine to form intramuscular carine.
And we, the rate limiter is betaine. So if we just give Betaine as a supplement, probably need to accumulate up to 180 grams over 30 days, so about six grams per [00:44:00] day for 30 days. That'll increase, uh, intramuscular levels of, uh, carnasine. And that is, uh, a buffer that then allows you to do a little bit more high energy output.
Most of the research would say between 120 to 240 seconds of continuous output. That's kind of the sweet spot. We do have some other buffering like, um, baking soda can be used, right? So bicarbonate can be used in the blood, so you can ingest that as a supplement. It does have some efficacious effects. The two big side effects are it can really mess with your GI system and it can feel like you want to crap yourself during the middle of your exercise, which is not good for performance.
Um, and the, just what I've noticed is a variability per individual is pretty high, so you kinda have to start low. You probably have to use multiple dosings. It's kind of a pain. Some people really respond well to it, some people don't. In all honesty, I don't use it a ton just because of the variability [00:45:00] of it.
But you know, it is something to consider. And there is some pretty, uh, efficacious data with it
Dr Mikki: because there are some sports supplements now. Morine, I think have sodium bicarb is part of, yeah, so a formulation.
Dr MIke T Nelson: They put it in a gel. And so they're trying to get a much, uh, slower release. Um, again, data I've heard from athletes, like some athletes said it was like the greatest thing they ever did.
There was one study that was published as a poster session that the International Society of Sports Nutrition with that product and did not show any effect. So it's super interesting. I like the, the, the concept. Um, people kind of have to play it around with it themselves and see what they find, but it does reduce a fair amount of the GI issues.
Dr Mikki: Yeah. Okay. And then with better alanine then, do you feel like that's a safer bet?
Dr MIke T Nelson: If I had a choice, I always start with Betaine because the only negative effect is kind of the, the tingling effect. The beta alanine can interact with something called the [00:46:00] DRG, the dorsal root ganglia, and it can just make you feel kind of weird and kind of itchy.
There's no real negatives other than that. It just, it doesn't quite feel like you took too much niacin, but it kind of, sort of feels like that. Some people like the feeling. I, I personally just don't like that feeling at all, but I don't,
Dr Mikki: I don't mind it at all. I'm like, that people, me, I'm like, yeah. I'm like, oh, this is working.
And my, because it's in a pre energy drink that I sometimes take. Yeah.
Dr MIke T Nelson: Yeah. So I've had an idea for years. Someone will probably do this. If you talk to like, uh, Roger Harris, rest in peace, like he was a godfather of kind of creatine and beta alanine. Super, super nice dude. It does not appear to be rate limited.
Meaning in theory, if you could take a high, high dose of beta alanine, you might be able to load it in a very short period of time. Now, again, I'm not recommending somebody do this, but the itchy sensation just is [00:47:00] absolutely horrible for most people. Um, but if you could come up with a compound that maybe blocks the interaction at the DRG or slows it down long enough to allow it to be absorbed, to get under that threshold, which might be really tricky.
I do think the use of beta-alanine would go up dramatically because the biggest issue I find is especially if they get itchy, oh crap. Like you might be dosing it like four times a day now to get under the itchy sort of threshold and get like 1.5 grams four times a day. And this is a pain in the butt to do.
Um, so someone will probably figure out that problem if they do, please remember me and I don't know, send me something cool in the mail. That sounds great.
Dr Mikki: My, all I would say is like, it's almost your scientific duty to trial just six grams of beta alanine before you go on the rower like that. I mean, that would give you a good, uh, indication of whether or not that high dose and you're only itchy for a short amount of time.
Right? Like surely you can set aside your. Your individual sort of tolerance for it. [00:48:00]
Dr MIke T Nelson: Yeah. The other issue is you probably have to load six grams a day for 30 days to see an effect. Ah, of course, because it is stored in the muscle,
Dr Mikki: of course. Okay. Yeah. There
Dr MIke T Nelson: isn't much of an acute effect, which on one hand, once you're loaded, like you don't need much to like creatine, like you don't need much once you're loaded to stay there on the washout period is pretty long.
It's just the, the bugger of getting to that loaded stay to get all of it basically in, in the muscle. The main reason it's in most pre-workouts is because people want to feel it working and so that was when the price dropped in Betaine and that was the main reason. It's in a lot of pre-workouts.
Dr Mikki: Yeah.
Okay. And that is me to a tea, you know, when I have my energy drink and it's got better, Alan, I'm like, oh yeah, I totally noticed this. And, and then potentially that does make me work a bit harder, albeit from a placebo effect. 'cause I'm having, I'm having an energy drink once every couple of weeks. I'm not having one like daily.
So I'm not really getting this like, um, sort of like dosing effect.
Dr MIke T Nelson: [00:49:00] Yeah. And it is not bad to do it before, like there's no neural negative to it. Um, it's just, it's one of those things you probably to see the full effect, you'd have to be, you know, pretty what they call saturated on it.
Dr Mikki: Yeah. Nice one. So Mike, on with regards to sort of pH balance and acid tolerance, how best are we, are you, uh, in sort of, uh, guiding people as to how to work on this and, and work this sort of pillar?
Dr MIke T Nelson: The best way is what I call, like shit training are super high intensity interval training.
Dr Mikki: Oh, that's good. I like it.
Dr MIke T Nelson: Yeah. So most people who do interval training. I would say have the best intentions and probably do something that's difficult, but I'd say a lot of it's pretty ineffective. So if you, so just say we will rip on the, the 30 30 protocol, right?
So get on a rower, salt bike, do 30 seconds all out, and then take 30 seconds to rest and then do it for like 10 rounds or something crazy that someone just pulled out of their butt. [00:50:00] If you watch most people's power output on that, let's say your first one's at 300 watts, I would bet by round three I've seen people as low as 200.
I've seen 'em drop off all the way to like one 50. So your, your power output is dropping really hard. You could do that protocol, but you would have to drop your power output a lot to start. But my bias is keep the power output high and then just open your rest period. So instead of making a mandatory one-to-one work to rest ratio, which is actually very difficult for most people to do, even high level athletes, um.
Just go until you feel you're ready or below like a hundred, and then go again. And then once you can't keep within five to 10% of that output, you're done. So you know, if you dropped at two 50 and you can't recover, maybe if you're new, I'll let you go one more round. But if you get like 2 45 the next round and your goal is 300, you're done.
Like you could do more work, but now you're so sub-threshold, [00:51:00] I think you're just adding more fatigue at a high cost. So my bias is keep the output high, allow rest periods to be more open. And then once you auto-regulate, once you can't do that, then you're done for that day. And then your goal is to get to maybe 10 or 12 rounds of open rest period.
Great. Now we can go back and start to shorten the rest periods again. And then once we do that, once we get down to 30, then we will maybe up the output to like 320 watts. Repeat again. So my bias is I like keeping the output high, adjusting the other parameters around that because it's that high output that really is one that leads to performance gains.
And two is where you're actually are producing the most amount of hydrogen ions.
Dr Mikki: Okay. And then with that in the rest period is like, is it Sam doing it on a bike? Could I light cycle in that rest period? Like, just like turn the legs over. Is it a complete rest?
Dr MIke T Nelson: You can do either one. Like I have some [00:52:00] people who will just do light rest if you're doing a rower.
Most people I tell 'em, just get off the rower, walk around, do whatever. Like I don't really find it matters that much. Like if, if they're on a bike and they're doing some easy pedaling, just make sure it's easy pedaling. Um, I mean, the other way around it is you can go the other extreme and do like blood flow restriction or you're putting on a cough or something like that.
That's limiting, uh, venous flow, not necessarily arterial flow. So we're trying to do is allow blood to come in and not allow a lot of it to go out. And what you'll find there is because you are trapping a lot more of the blood, you will accumulate more, uh, hydrogen ions and metabolites, uh, from doing that.
And you can go as low as, uh, 30% of water m so you can use really light loads and still get that high acid environment. So that would be another way to do it more with a lifting modality.
Dr Mikki: Yeah. And outside of exercise, is there any way that someone can do this or is it literally about [00:53:00] training?
Dr MIke T Nelson: There are some ways you can get at it with breath, with breathing techniques.
So if you look at, uh, like, so Wim Hof technique is, uh, actually a tumor or what I call like a super ventilation method, especially where you're breathing in and out really fast. So when you're doing that, you're not actually hyper oxygenating the tissue, which you can't do without pressure. Um, but what you are doing is you are actually off-gassing more CO2.
And it is true that higher levels of CO2 via different reactions become carbon acid, which do dump acid into the bloodstream. So by doing the opposite, by actually off-gassing and getting rid of more CO2, especially at rest, or you're not building up any, any extra from exercise, you do temporarily make the blood more alkaline.
So that part is actually true. Now it doesn't stay for very long again because you can't really tolerate big changes in pH. Um, and by contrast, if you do a lot of breath holding [00:54:00] now because you don't have any airflow coming in or out and metabolism is still running, uh, that will push you more to the acidic side a little bit.
Dr Mikki: Yeah, that's super interesting. And then before we move on, 'cause that's, I, I definitely wanna, um, chat about more about the oxygen CO2 very briefly, but how often should someone do the, the ship training?
Dr MIke T Nelson: My opinion is, most people, if you're really doing high, true high intensity, probably once a week. Like some people can get by twice a week.
But with rare exception, other than some elite freaks, like yeah, once or twice a week I think is, is plenty. Even once a week is plenty for people to start.
Dr Mikki: Yeah, okay. No, that makes perfect sense. So on oxygen and CO2 tolerance, um, is that why CO2 tolerance matters a lot more maybe than even oxygen delivery?
It's just its ability to [00:55:00] increase, to increase alkaline? Like, is that what you said?
Dr MIke T Nelson: Yeah. So if you look at how your body is regulating, so most people are like, oh, we know oxygen's like super important, so we must be regulating oxygen super tightly. And the answer is not really. Oxygen is kind of the backup system to CO2, and it's the CO2 sensors in the body, in the brainstem, these little chemo receptors all out the body that your brain and body are most sensitive to.
So for example, if you just are doing a breath hold, people are like, oh, it's because I'm running out of oxygen. That is happening, but it's actually the buildup of CO2 that is triggering the need to breathe over the dropping amount of oxygen. So oxygen is kind of like this backup system. Now this, I don't remember the exact stat, but I think there's something like eight or 10% of the people where CO2 is not the main driver.
They think that oxygen is kind of the, the main driver. Um, so there are a few of those people around. [00:56:00] But the way you can show this to yourself is at rest. Again, if you hyperventilate or you breathe in and out really, really fast, you're offgassing more CO2. And what that does is that allows you to do a much longer breath hold, right?
Because you've gotten rid of more CO2, it's gonna take longer for it to build up now, which is allowing you to hold your breath longer. Again, you would never wanna do that near water or your face under water. 'cause you can have what's called shallow water blackouts, where you literally go from feeling fine to just like what?
Like, um, I've heard Larry calls it the dead fish that they have to take you. Oh, I guy got a little floppy, like, take him out of the pool. And you know, obviously they're there in a completely monitored environment doing that. Yeah. But um, but yeah, you, there unfortunately have been people who have drowned by doing the hyperventilation technique and doing a breath hold, you know, in a pool.
They can pass out and then, you know, then that's it. But as long as you're on dry land, you know, make sure you do it lying down. 'cause [00:57:00] you, you can fall over all that kind of stuff. Um, but it is a way to show you that CO2 is the main regulating system within the body and oxygen is kind of the backup system.
Dr Mikki: Yeah. Interesting. And so from a practical perspective then, like, how do we take this information and implement it in a way to help improve our physiologic flexibility?
Dr MIke T Nelson: Yeah, this is probably the hardest section it took for me to do because the, the regulation of O2 and CO2 is very tightly held in the body, but it's also very redundant.
And there's also different systems responsible and there's like a ton of, uh, just myths everywhere. So for example, uh, you see people inhaling oxygen to help with athletic performance. All literature I've reviewed on that so far says it's probably not doing anything. If you could pressurize it, then in theory you [00:58:00] might see a benefit.
There was a very old study where they, they took like what looked like a big iron lung and they stuck a bike in it and they did hyperoxic experiments where they, they did pressurized oxygen and they had people exercise. Again, very risky, would not recommend people do this on their own, but controlled settings, et cetera.
What they did see is that their output in the chamber was actually better, but what was cool is they then tested them in normal oxygen conditions. Again, this was just one acute thing. This was not a training study, no transfer at all. So even though they got a little bit better exercising with oxygen, once you took that pressure oxygen away, there was no conferred benefit.
Um, so a lot of the things with, uh, altitude training, so the altitude training over the years has actually kind of flipped. So now you would actually train low and sleep high. So the theory is when you train, you want the highest level of oxygen because you want the biggest [00:59:00] performance output because everybody knows if you go to altitude, especially if you're not accustomed to it, your performance just just tanks.
Um, but we want to try to get more red blood cell mass, some of these positive changes in EPO by sleeping high. Um, the data on that is even mixed, like the amount of randomized control trials with altitude changes for performance at sea level, not at altitude is really mixed and kind of non impressive.
The, uh, hematologic changes you'll see when you do it probably disappear within one to two weeks. So they're very short-lived. Um, but again, if you are competing at altitude, then yes, it is a, a huge advantage to do that type of training. So I even then looked up, I'm like, well, what about all these like sports teams that perform at altitude, like the Denver Broncos in the us, the Utah Jazz.
And it does turn out that there is statistics on that showing that [01:00:00] they do have a significant home field advantage in theory, because of the altitude, because everyone else has to come into play at that altitude. It's not big. It was definitely still in the single digits, but you know that that does add up over time.
Dr Mikki: Does any of the studies, like, I wonder about how they created that train, low sleep, high environment and whether or not any of the, like if they use tents and maybe the tents aren't actually great at creating that sort of hypoxic environment? I don't know. I, I, I don't know because I haven't actually looked, but
Dr MIke T Nelson: yeah, the.
They're mixed. There's only a handful of actual chronic training studies that have even ever looked at it. There's a, a great review in Med Sci, I think like five years ago now that detailed them. And I think there's only like six studies. Um, and one of the issues is for what's your placebo, right? If you're doing it in the mountain, like you probably know if you're at a lower [01:01:00] altitude or a higher altitude, right?
So the, the best way to do it would be to stick people in pressurized chambers and not tell 'em when it's pressurized. Okay? How many labs are gonna do that? How many athletes and labs are gonna let 'em run that for weeks on end? Like almost none. So it, it gets hard and in theory you're like, oh, this is great.
And then you start thinking about the mechanics of how to do it, and it becomes very difficult. And then obviously athletes have placebo and variability. Like I know some athletes who swear that altitude training was like the best thing they ever did, and their results got better. I don't know if that's placebo.
I don't know if they're a hyper responder. I, I don't know, but they seem to swear by and they were better. So great. Like, like kind of run with it. So it's kind of a, it's, it's a mixed bag right now, I would say. If you have to perform or you're at the normal IC environment you're at, not performing at altitude.
Dr Mikki: Okay. And then, so all of that said, Mike, [01:02:00] what am I gonna do to help improve my, uh, CO2 and O2 tolerance? So what am I gonna do?
Dr MIke T Nelson: Yeah, so what you end up with is you've got basically four conditions and only two of them really matter. So I, I could go hyperoxic, right? So I could go high oxygen, I could go low oxygen pressure, or I can just go normal IC and change the pressure or the concentration amount.
I can do the same thing with CO2. Um, so in practice, what it comes down to is. The best bang for your buck to probably play with is something called CO2 tolerance. So, CO2 tolerance has been around for quite a while. If you talk to hardcore physiologists like Dempsey from Wisconsin, they'd be like, I don't even know what you're saying.
Right? And the guy's published like, you know, respiratory stuff and, and exercise performance and muscle training, all this stuff for frigging decades. So there is no 100% agreement on what it [01:03:00] actually is, but yet everyone can kind of feel a difference. And so I think the best way to test it is probably the nasal exhale test, which is from Brian McKenzie at, at Shift to dap.
Uh, I believe they did published on this. I think it is published now. I'd have to go double check. But in essence, what you would do is you would, you'd sit quietly, take a few big inhales, exhale, and then you're gonna exhale as long as you can through your nose without swallowing or pausing. And what you get on that test will give you a rough idea of one, your diaphragm's ability to do an eccentric contraction and your CO2 tolerance.
If you're really low, like under 15, 20 seconds, you probably need to work on that. And if you're like 30 to 50, I'd say you still probably need to work on it, but it's not, at least in my book, uh, a, a dead stop. If you're, you know, 50 or 60 seconds and above, you're probably fine. And what I've noticed with a lot of people is that sometimes that can be a, a [01:04:00] huge rate limiter that they've just never looked at.
Um, the other way to get at it now is like if you're using aura, like aura for respiratory rates, pretty darn accurate. The new whoop is pretty accurate within one breath per minute. Um, Garmin is like really hit or miss. Um, but respiratory rate can be useful. So I just did a talk for the F1 racing teams on respiratory rate and, uh, HRV and how to use all these metrics and what do they mean?
So if your respiratory rate is 17 or higher or even 16 or higher at night, I can guarantee your CO2 tolerance is dog crap because what are you doing? So at night you're unloaded, you're not exercising, you are basically off gassing too much CO2 because your respiratory rate's too high. So that means that little chemo receptor in your brainstem is like the temperature in your, your house.
It likes this little happy medium, but over time we wanna kind of work that down. So for those [01:05:00] people I would definitely have 'em do some hypoxic work. Usually low intensity stuff. Go for a walk with a long exhale, try to do things to do mostly nasal breathing. Um, do a longer exhale doing your zone two, maybe even zone three stuff.
But what we're trying to do is get a little bit higher levels of CO2. We're trying to accumulate enough time there that that chemoreceptor over time will reset and what you'll see is that the respiratory rate will start walking itself down. Um, the good part is once it gets lower, you don't have to keep doing that work a lot.
It'll tend to stick there, it tends to hit these kind, you know, tractor points or whatever math you want to use to associate with it. Um, so I'd say respiratory rate, nasal XL test for CO2 tolerance is probably by far the, the biggest low hanging fruit in that area.
Dr Mikki: Yeah, that makes sense. And um, I mean, this is a random question, but you know, those nose things people wear
Dr MIke T Nelson: Yeah.
Dr Mikki: Is that to do with this at all? Not at all.
Dr MIke T Nelson: It's supposedly more of an airflow issue. [01:06:00] I played around with a bunch of 'em. The only ones I think that are worth a crap are the newer ones that have little magnets you just put on the nose and they actually do pull your nose apart. Um, there's been some anecdotal stuff.
I think supposedly there's one study published on it. I would have to look. So those might be beneficial. I've used 'em with a few clients. They seem to be beneficial. The, the breathing strips and all the other stuff, the data on that's just so mixed. Um, but again, some people swear by 'em. I'm like, yeah, you're not doing yourself any worse.
So bro, if you like it, like you wear 'em all day, I don't care, you know?
Dr Mikki: Yeah, yeah, yeah. Totally. And in, I wanna be mindful of your time, but the, the last one I wanna just double check with you is that we spoke a lot about metabolic flexibility the last time that you were on Wikipedia. Have any of your thoughts changed on, um, how to get there?
Its importance. I, I don't think the importance has changed because obviously this is one of the pillars, but any sort of additional thoughts you might have on metabolic flexibility that would be of interest [01:07:00] to, to the listeners?
Dr MIke T Nelson: Yeah. I am in the process of looking at a bunch of literature from, um, my buddy Dr.
Andrew Knick was just on my podcast. It's not out yet, but you probably saw the paper that he did and. One of their big consensus from the paper was that maybe carbohydrates are playing a role to help high intensity exercise, but maybe more from a stabilization of blood glucose than anything else, which is super interesting.
And they did a really cool study, uh, with some data. They've done two studies looking at that. Um, so I'm in the process of going back through all that data, rereading their study again. Um, yeah, because it's super interesting. So it's not to say that carbohydrates don't have a role, but if that's true, maybe their role is a lot less than what we think.
And maybe there is an area where we could push fat oxidation up even higher. That could be an argument more for a ketogenic type diet to [01:08:00] be used for that again. Um, yeah. So I would say that's something I'm trying to rethink again. I don't know if it would. Currently, I don't think it's gonna change anything drastically, but I think maybe that higher fat oxidation is more useful than we thought.
And the other part that makes it interesting is if that's true, we know that exogenous ketones as terms of a supplement, do appear to stabilize blood glucose and allow for bigger drops in blood glucose. So if blood glucose stabilization is the main issue, maybe that would make an argument for exogenous ketones might be more genic than what we've seen play out in the studies.
The, the data on them is, I'd say very mixed. Right now, I would argue the, the best data for exogenous ketones is cognitive function or high levels of fatigue. Uh, like Dr. Brand, Negan's done a lot of that work. Even that data is still a little bit split. Like what did you [01:09:00] use to fatigue him? Like what cognitive measures are you doing?
Full disclosure, I, I do some work for Teton Ketone EERs, so take that for however you want. But yeah, so I don't know, that's the end of the spectrum and kind of playing around with and looking at stuff more, I dunno if you have any thoughts on that area.
Dr Mikki: Yeah, and it's interesting, like I, um, we use ketones, but the kind of running that we've been doing lately is like hours and hours and hours of running.
Sure. Um, into the night in, in, in this one particular case. And our use of ketones has been more of a supplemental sort of energy source, but that attention and focus and, and I spoke to Brendan Egan on my podcast as well about the use of ketones and Ed said, you know, anecdotally, which he hasn't published on obviously, but a lot of his athletes do actually use them as a performance enhance as well.
And, and for what it's worth, anytime I've taken ketones for performance placebo or not, I, I've had a lift in performance, so I'm super [01:10:00] interesting in that, in that space for sure.
Dr MIke T Nelson: Yeah, I, again, this may be because of my bias, but I do think it's confounded by what type of Esther you're using. And I don't think the one three Butane Diol is effective for performance.
And I think it might actually be a negative, um, because it does partially get converted to ketones, which is true, but it also does get converted to an alcohol pathway. So if you've ever taken one three butane dial just in and of itself, like at a small dose, I'm like, okay, yeah, I think this feels good.
And if you cross that threshold, it definitely feels to me like I've been at the bar. Like I can guarantee you that my cognitive performance and everything else is going down. For sure.
Dr Mikki: Is that the Keto iq? Does that, did they use uiq? Currently is
Dr MIke T Nelson: one three Butanediol. It was the same formula as Vita's Lab initially.
Um. They didn't pay for the license.
Dr Mikki: Wow. [01:11:00] That's, yeah. More fool them. I, um, I use Audacious Nutrition actually. Like, it's, oh,
Dr MIke T Nelson: which one is that? I'm not familiar with that. Oh,
Dr Mikki: that's, uh, um, keto start, uh, Dom's wife Dom. Oh, ke wife. Oh, star. Yeah. Yeah. Silly. Yeah, yeah. Yeah. So that's the one that, that, that we've been using.
And, um,
Dr MIke T Nelson: and that's salt, correct?
Dr Mikki: It is Salt, yeah. Yeah. And I think, and with my conversations with Dom have sort of, he's sort of talked about a, if there is a performance benefit for ketones, it's sort of, if you're able to lift your ketones not that high actually. Like it might only be, you know, lifting them up by a milli mole rather than what you get with an Easter, which is like pushes them quite high.
But I mean, again, a lot of it is, is it's not published, sort of, it's more observational, I suppose.
Dr MIke T Nelson: Yeah, I don't think we know blood levels, what the ideal level of ketones are. Um, the salts are interesting. You can't get high levels with the salts. And I love Dom and Hiss wife. They're, they're both amazing, like super, super awesome people.
Um, and I also wonder what the salts are these people just [01:12:00] getting more electrolytes, which I know sounds really simple. Yeah, yeah. Yeah. Because I've seen that happen a lot. And I, you know, again, anecdotal I'd be like, Hey, well what do you use for electrolytes for long racist? Like, what are you talking about?
I'm like, oh, well maybe it's just because you're getting a lot of the electrolytes in there, especially if you're using the quad salt, which I think they use. Um, yeah. So I'd say there's still a lot more interesting work to be done, for sure. And then last part is even if we just use a blood mark or measurement, that doesn't tell us really anything about rate of appearance and rate of disappearance.
So I do think there is an argument to be made that if you're hitting four or five, six millimolar like super high to me, I wonder is everything backing up in the bloodstream and not being used? Because if it's being used, I would not expect these astronomical high amounts of ketones in the blood. I would expect them to be a little bit lower.
But again, you'd have to do [01:13:00] again, a tracer study to figure out, you know, where all everything's going.
Dr Mikki: Yeah, no, I agree. And, and when we first started playing around with a ketogenic diet, I had a colleague whose wife, her, her ketones were consistently above five for weeks and weeks when she started. Wow. I know.
It was crazy. And then they dropped and then she started getting weight loss and started getting benefits from, so it was almost like her system was unable to use what was. What was there And then, I don't know, once things changed metabolically for her, she's seeing some, some benefits. But I agree there's so much, like, it's such an interesting space and um, the work of like Andrew Knik and, and the Prince group and stuff is, is really interesting to watch for sure.
'cause it does challenge notions of carbohydrate in the sports nutrition literature and that's, it's a highly contentious area.
Dr MIke T Nelson: Oh yeah. Yeah. And even to me, like, I remember talking to Don and God years ago when he was doing the contracts of the military [01:14:00] and Patrick Arnold was making ketones for him and stuff.
My first question was, I'm like, you can give these to people and they can still use and burn ketones. He's like, yeah, they appear so, and I'm like, to me, it's crazy that Bob whose butt may look like a couch cushion, has never been in a state of ketosis for 47 years of his entire life. That pathway is so conserved, you could give him an exogenous ketone and his body would use it for fuel.
Like that to me is just fascinating because that's the backup fuel source. If there was, you know, starvation or very low energy intakes and all that kind of stuff.
Dr Mikki: Yeah, yeah. No, I know. It's, it's, uh, super interesting. So, um, just to sort of finish up then, yeah. Mike, like in this area, this whole space of physiologic flexibility, like, it, it makes sense, right?
Because not everything, nothing happens in isolation. So you're looking at a much more sort of global pictures. So are you writing a book? Like what's the story? Have you written a book that I've ignored? I don't know. No. [01:15:00]
Dr MIke T Nelson: I'm behind on writing books. I'm working on one now on a, a high flux rate, uh, with my buddies, uh, Dean and job.
So the theory being for most people, I think you do better having more calories come in and more calories go out, right? If someone is weight neutral on 1200 calories. Oh man, what are you gonna white knuckle your way to like a thousand calories a day? Like where are you gonna go? But if you're weight neutral at 2,500 calories per day.
Right. Okay. That's a lot easier. Now you have, you can cut a little bit and be in a deficit and you're fine. And our argument is that the best way to get there is just by doing more walking. Like you do, burn a fair amount of calories. It's easy to do, most people have access to it, most people don't do it enough, et cetera.
Um, the other book I'm working on is a book on metabolic flexibility through human kinetics. So still working on that. I might be working on a book on protein, but that one's kind of third behind that. And so for right now, the, the physiologic flexibility stuff is in the physiologic flexibility [01:16:00] certification.
Which will open October 13th through the 20th for seven days.
Dr Mikki: Oh, amazing. Well this is perfect timing then. Yeah,
Dr MIke T Nelson: perfect timing. Yeah, great stuff
Dr Mikki: Mike. Um, and of course you're a wealth of information. You talk about this all the time on social, obviously in your um, podcast as well. Can you just remind the listeners Weda connect with you?
Dr MIke T Nelson: Oh yeah, yeah. Best Place is probably just the newsletter, so probably like 90% of my content goes out to the newsletter. So go to mike t nelson.com. There'll be a little button for newsletter. Uh, I do have some stuff on Instagram, which is Dr. Mike T. Nelson. And then the main website is mike t nelson.com.
Again, if you have any questions or certifications or anything like that, um, yeah, let us know.
Dr Mikki: Amazing. Thanks Mike so much for your time. Really appreciate it.
Dr MIke T Nelson: Yeah, thank you so much. I really appreciate all the wonderful, really highly intelligent questions and thank you so much for all your time. I really appreciate it.[01:17:00]
Dr Mikki: All right, team. Hopefully you enjoyed that as much as I enjoyed bringing it to you and of course chatting to Mike such a wealth of information. So again, I have links to how to find him, his Flex Diet podcast and his physiologic flexibility course in the show notes. And don't forget to sign up for Monday's matter accelerated 2.0 if you are looking for a primer as we head into the season of festivities Until next week, you can find me over on Instagram threads and X at Mickey Willin Facebook at Mickey Willin Nutrition, or head to my website mickey willin.com and book a one-on-one call with me.
Alright, team, you have the best week. See you [01:18:00] later.
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