New Series here on occasion - "Only for the Hardcore" Let me know what you think. This one is all on breathing, respiratory physiology during rest and exercise for performance and health.
Learn more in pillar 4 of the Physiologic Flexibility Cert HERE.
The main questions are
- What do we mean by oxygen delivery and oxygen saturation, and what is the relationship?
- Do we actually need to bring in MORE oxygen during exercise via respiration? What does efficiency of breathing look like?
- What happens to CO2 levels during exercise, are we offloading too much?
- What does “increased oxygen delivery” actually look like compared to sub-optimal oxygen delivery? Aerobic vs. anaerobic.
- Do we have any way to quantify CO2 tolerance right now? If so, normative values?
- Are people with hyperactive nervous system (anxiety, panic disorder, etc.) more likely to rely on anaerobic pathways quicker? (Low CO2 tolerance -> overbreathe -> low O2 delivery -> anaerobic?)
If you want a useable framework for these concepts, check out Pilar 4 in the Physiologic Flexibility Cert HERE as it is all on air- O2 and CO2.
Also check out these podcasts I've done in the past:
Interview with James Nestor, author of “Breath: The New Science of a Lost Art
Q_A_breathing_hardcore
[00:00:00] Dr Mike T Nelson: . Hey there, what's going on everyone? This is a sort of bonus podcast series. I'm gonna play around with doing here on the Flex Diet podcast. And since I enjoy metal music and hardcore music, I'm gonna call it only for the hardcore. So if you want some hardcore physiology and go super deep down the rabbit.
[00:00:21] These episodes will probably be a little bit shorter and they'll generally just be based on questions that I get from people. Sometimes I can't get back to everybody's question but if it's a referral from someone I know or from the newsletter, I try to do the best I can to get back to people.
[00:00:35] And instead of just having some of this information just hang out on a hard drive somewhere else, I thought, Hey, other people will probably have very similar question. and I will publish it here as a podcast. This one is all about some really great breathing questions from a student. And I can't say I have all the answers here, but this is some stuff I've been looking into pretty heavily for man, coming up on seven years now.
[00:01:03] So everything. What is really a CO2 tolerance? The role of aerobic training supply and demand information or blood flow oxygen, depending on what paradigm you want to look at it from. I tried to give credit to as many people as I could on this material since I've learned a lot.
[00:01:25] Other people also wanna shout out James Zerbe and his oxygen course. Learned a lot from him in this process too, about nears technology. Moxi if you are interested in a Moxi device or a metabolic cart. So for example, I use a P and OE device. Feel free to email me more than happy to help you out with anything on that.
[00:01:45] I do have an affiliate relationship with p and oe, so I do make some money Yeah, if you do purchase one from them. But drop me a note. That's all the disclosures I've got. And then the book that I was stumbling on from Alex Hutchinson is called Endure. If you haven't read it and you really want to go deep down the face fatigue science area, highly recommend it.
[00:02:08] Really great book the Oxygen Advantage but Patrick McEwen is also very good. Breathe is also very good. I've got a podcast you can find with James Nester that I've done. And then if you really want to go hard down this whole area and the Physiologic flexibility certification. The fourth component is air, so CO2 and oh two, and that took me the longest to my arms around and make something useful out of it. Because these are not easy concepts per se, but they are super helpful. Cause at the end of the day, our bodies are running on oxygen and how we manage that and how we manage byproducts such as CO2 makes a huge difference for health and performance.
[00:02:54] So it is definitely worth knowing. Unfortunately, there's a lot of misinformation out there. So the fourth pillar and the phs Flexer is. Oxygen and co2. I did my best to break that down into, I think the technical videos for that ended up being only about two hours. And then I broke it down into 10 plus specific action items.
[00:03:15] So if you want more information on that, go to physiologic flexibility.com. Yes, I did create the chorus. Yes, I do make some money if you purchase from that, but it was also for me to try to make sure I really understood it and trying to convey, inform. That people can hopefully understand and also use.
[00:03:35] So depend on when you're listening to this. The physical X course is open again through March 27th, 2023. Go to physiologic flexibility.com for all the information. If it's after that date, you can still go there. Get on the wait list onto the newsletter with all the information. So here you go. Here's your hardcore dive into all things breathing, exercise fizz and respiratory physiology.
[00:03:58] Enjoy.
[00:04:00] Question number one, what do you mean by oxygen delivering oxygen saturation? What is the relationship? I do cover that in the course to me.
[00:04:11] I think a better way of thinking about it is oxygen delivery and oxygen. I think just changing that paradigm makes it easier to figure out. From there you can go down the rabbit hole of sticking to Moxi sensors, so near infrared on the muscle. That'll tell you basically oh two usage. So that really tripped me out, God, probably seven or eight years ago now.
[00:04:37] I don't know if it was Aaron Davis or who I saw that put a moxy sensors on a muscle. Had someone get on a ROI machine, went balls out for 30 seconds and you're looking at the sensor and we've always been taught, oh, that's like a Windgate type thing, that's anaerobic work that doesn't use oxygen. And what is the oxygen level in that quad muscle just goes down and at the end of that 30 seconds, it's like around 15%.
[00:05:08] You're like, oh crap. So we are using oxygen immediately during exercise, and that gets into the rate at which you use oxygen is different. So that really spun me out for a whole bunch of years. And even now I have a frigging metabolic card in my place. I've got a three sensor Moxi set up, et cetera, because I couldn't get that thing out of my head.
[00:05:38] if you look at it as rate of oxygen use I think that helps quite a bit. More what do we actually need to bring in more oxygen during exercise, via respiration? Long story short, that gets into, can you hyper oxygen? More or not you can, but you need a driving factor to quote unquote force it in, and that's gonna be pressure.
[00:06:07] So if you hyperoxygenate someone in an environment, so hyperoxic and high pressure, so higher percentage of oxygen and high. Acutely you do see an increase in exercise performance. Now, I haven't been able to track down a lot of these studies that have been done. There's one or two older ones. However, when they had those people exercise at C level, again, the effect did not transfer.
[00:06:38] So at some point, do we need to bring in more oxygen via respiration? Yes. Oxygen is being used up. So we do need to replete it. Now, how much more do we have to bring in as up for a debate that has to also do with the byproduct, not necessarily a waste product of respiration, which is co2. So to me, a simple way to look at efficacy of breathing, if you do have a metabolic heart I'll let you think on this.
[00:07:09] You can look at all those parameters on a metabolic heart. I can see different ventilatory capacities. I can see breathing frequency, and since mine has dual gas, I can look at CO2 and oh two. So I'll let you think a little bit about what you think is useful for that what happens at CO2 levels during exercise.
[00:07:31] Are we off floating too? . So CO2 exercise, obviously it's gonna go up. Can you offload too much? Ooh, maybe. Now that gets into a huge debate about, are you looking centrally or systematic wide? I e metabolic art or are you looking locally? I e using AM MOXY strapped to the VMO on the quad. To me, those are two completely different.
[00:08:00] Yes. Now it is true that if you could get rid of more CO2 locally because of something called the bore effect, which you're probably familiar with, that may not be the best thing in the world. But again, you have to look at what is happening systemically, what is happening locally. So that's gonna be the big difference there.
[00:08:24] I'll let you think a little bit more on that, but that should get you pointed in the right direction. What does increased oxygen delivery actually look like compared to suboxin delivery? , this gets into the debate about are you working with some athletes that are what they call delivery limited?
[00:08:39] This would be from my buddy Evan is now at, did a bunch of moxie stuff, used to work at a training thing tank for quite a while. He's at a new nears company. I'll think of it. But you can just look him up just to look up Evan. And nears moxie, you'll find him. So some of the Moxie people that do a lot of this testing, I've done some of it.
[00:09:00] Buddy Aaron Davis has done a lot of itTrain Adapt Evolve shout out to him. Evan's in a lot of it when he was that training thing taken and still. . There's some debate about if you stick Moxi censors on people. Let's say we stick one on your right quad, and then we stick one on your left quad and you're doing a row or a bike, and then we stick one on your left deltoid.
[00:09:22] If we're looking at flow, the working muscles in this case is gonna be the quad muscles, those we would expect to see. So SMO two dropping, right? It's using oxygen on at those. . Now, the theory is that once we see a drop in the deltoid, that the body is stealing blood flow from the deltoid. And then that may indicate that after is what they call delivery limited.
[00:09:50] Maybe they need to do more cardiovascular work. So that's some of the theory around there. Cause if you think. You've only got so much blood volume, which during exercise is relatively fixed, which is why dehydration can be such an issue. Cause your plasma volume's gonna drop, mean systemic filling pressure temps are gonna go down and then that's limited.
[00:10:10] So if you have the medium, which is blood and red blood cells that are doing your transfer of O two and co2, or at some point you just need to get more blood flow there as one of the parameters to make that. . Now again, is this aerobic versus anaerobic? That's like probably a whole lecture . My bias is most of what we're talking about is actually aerobic.
[00:10:36] That doesn't mean glycolysis and all that kind of stuff doesn't exist. It clearly exists. Yeah, I'll leave that one open-ended for now. Do we have any way to quantify CO2 tolerance right now? If so, what are normative? Man, the short answer is hella I note. Now have you talked to like hardcore, like respiratory researchers?
[00:10:57] My main go-to there is, you can look up Dempsey. He's from University of Wisconsin Madison, I think. He's done work on that for frigging three decades. If you ask him outright, Hey, what is a CO2 tolerance? He'll look at you and be like, I don't even know what you're. . However, I think there probably is something to that.
[00:11:17] What it is, you're probably gonna need a known gas as of CO2 injected into the system. There's been some research done on this. You can look at the book, breathe. He talks a little bit about that research. I have seen some athletes where their CO2 levels get a little bit higher. Everything else looks fine, and they just seem to tank.
[00:11:36] Maybe they're not used to. Who knows? I think part of it is a plastic part of the brain, which gets into no's central governor theory that if you've ever done like a two K row or some heinous thing, and even if your performance you feel like is pretty good back to where it was before, but you haven't done it in a while, just that ability to go through that suck.
[00:12:01] It just seems like that's plastic. I think it can be changed more than what we realize. A great book on that is gonna be Alex Hutchinson's book on fatigue, which I am completely blanking right now. I'm staring at my bookshelf cause I got way too many freaking books and I know it's on there somewhere.
[00:12:20] But anyway, look up Alex Hutchinson, you'll be able to find him. He goes into all the really great detail on that. So I think there is something to CO2 tolerance. What I do in. I do use Brian Mackenzie's stuff. I have taken his course, Rob Wilson, art of Breath. Love those guys. If you talk to him, please tell him I said hi.
[00:12:37] I do work with Dr. Andy Galpin and Dan Garner and those guys over at Rapid Health. I do help with some of the visible assessments with those guys there. I do use the exhale test that Brian has on their Shift to Adapt website. I switched over to using that probably two and a half, three years ago.
[00:12:55] I do think it's better than some of the botte stuff that what I was using before which is Patrick McEwens stuff. It just seems to be more reproducible and I find it useful. Having looked at shit, probably hundreds of athletes now using that, it does seem to correlate to a huge component of their performance.
[00:13:13] So if they're real low, I think getting that higher and if we use that nasal exhale test as a co2, . I do think it helps. You can look on their website for what they have for normative data on that. So it's their database. And I believe Andy and those guys did finally get their abstract on that published.
[00:13:32] Are people hyperactive, nervous system anxiety, panic disorder, more likely to be rely on anaerobic pathways quicker? My bias from working with a lot of those people would be, yes. If I were to go back in time and add another assessment sooner than to something that I didn't add, as soon as I probably could have, it would be on aerobic training.
[00:13:54] So I got this from my buddy, Dr. Kenneth J. Now shout out to him. You can look up his cardio code. He's got lots of great stuff. He helped with the KE Human Performance Program that I was a part of. I was doing the nutrition and metabolism portion. You can do a two K on a rower warm. Set it for exactly 2000 meters.
[00:14:09] Go balls out as hard as you can. Just look up online on the concept two site. You can translate that into a VO two max. For most people it's relatively accurate. I've compared it to the metabolic cart I have here. You generally gonna be in the ballpark. Some people are gonna be outliers on it, but it's gonna get you pretty close.
[00:14:26] You can look up the literature on the 12 minute Cooper Run test would be the other one I do if they're a running athlete. Anyway, that's gonna give you a VO two. . So that's what I generally will use for a lot of athletes. If they are a strengthened power athlete and their VO two max is low, I do find that they do tend to be more on the anxiety almost a d type symptoms.
[00:14:48] If you wanna go super far down that pathway, you can look up some of the stuff related to, Brian's talked about this too, a facial structure and especially. . A guy that I know in Chicago, God I first met him seven years ago he does dental and palate procedures on kids who they've imaged and find that their airway is really small.
[00:15:10] He said almost all the kids present with a D H D like symptoms. They do the procedure on them, they open their airway, basically, and he said in almost all cases, their ADHD symptoms go. If you think about what's going on, if their brain is limited for oxygen and airflow, it's going to go very sympathetic, which is going to mimic what in those disorders.
[00:15:33] As a long story short, yes, I do see that have even done some stuff with lactate testing. You will find resting lactate levels and those people tend to be a little bit higher. Shout out to my buddy Luke Lehman from Muscle Nerds. He's done some of that stuff. if I stick 'em on a metabolic heart under just very light exercise.
[00:15:51] I do find that they tend to be much more on the glucose carbohydrate side. So in my biased opinion, they're also metabolically in flexible, so they need to change the fuel system that they're using better, and engine on their car is just too tiny for what they're trying to do now, again, as a low CO2 tolerance.
[00:16:12] Related to that, I think. . So in Patrick McEwen stuff, are you really over breathing during this? Maybe you can try to get at this by looking at loop data or aura data. Look at the respiratory rate overnight. If the respiratory rate is high overnight and their VO two max is okay, i e 50% of a population, again, for some athletes are always gonna want it to be.
[00:16:41] then I'm thinking they might be over breathing. Paradoxically sometimes that can give them even a clean sleep study. Again, you have to talk to your sleep experts on that. But always look at respiratory rate, breathing frequency, that type of thing when you're looking at sleep studies. So yes, I do think there is something to that.
[00:16:58] What would I do to fix it? One, I'd look at their breathing mechanics. Anything I can do to get their breathing mechanics better. I a 360 degree expansion of the ribcage area is primarily what I'm gonna be looking at. My biased opinion for that is gonna be Be Activated training just from Doug Hill.
[00:17:15] The version for coaches and practitioners is RPR reflexive performance Reset. I am biased cause I did do teach for RPR level one, level two used it for quite a while. I think it can be extremely helpful in those cases. So that's gonna help their breathing efficiency. A lot of times their respiratory rate will then drop.
[00:17:33] The other thing I'm gonna do is nasal breathing for aerobic work. I find that seems to help quite a bit in dropping that. Now again, is that bumping up the aerobic capacity? Is it changing the pathways? Is it nasal breathing? Probably all the above. . Yeah, . But I really appreciate the great questions.
[00:17:54] Thank you so much. If you made it this far, all the way to the end, really appreciate it. Yeah. Lemme know what you think of this series. Is it useful, is it not useful? Obviously it's gonna take some time to get these put on the podcast, even though they are in a pretty raw format and get them out there.
[00:18:11] But if you find it's useful, I will definitely keep doing it because I like getting solid, actionable information to all of. If you want more information on this you can look up all the people I referenced above. I'll put a few links to some of the podcasts down below here that I've done also, and physiologic flexibility course is still open as of this recording until March 27th at midnight 2023.
[00:18:38] So if you really wanna understand the homeostatic regulators to become more resilient, anti-fragile, recover faster. and just be much harder to kill. Check out physiologic flexibility.com. The four pillars are one temperature both hot and cold, two pH changes such as doing maybe some below intensity of work to ultra high intensity intervals.
[00:19:03] Three is gonna be fuel systems, so an expansion of carbohydrate loading and lactate. and all the way down to using ketones as a fuel. And number four is, as I mentioned at the intro, oxygen and carbon dioxide. How do we regulate those for performance and health? So go to physiologic flexibility.com for all of the info there.
[00:19:25] Let me know what you think of this extra kind of bonus series here on the podcast. As always, thank you so much for listening. I really appreciate it. Have a great day.