Dr. Mercola on Oxygen for Healthy Mitochondria, Ketones, Insulin Resistance, Fasting, and More

Content By: Ari Whitten

In this episode, I am speaking with Dr. Joseph Mercola—a certified family physician and a pioneer in the natural medicine realm. We will talk about the biggest problems with health today, the role of oxygen in mitochondrial health, ketones, insulin resistance, fasting, and more.

Table of Contents

In this podcast, Dr. Mercola and I will discuss:

  • The importance of fasting for optimal health and energy
  • The critical role of oxygen for healthy mitochondria
  • How to utilize ketones to increase your health and energy
  • The prevalence of insulin resistance (and why it should matter to you!)
  • The most efficient way to reduce all-cause mortality
  • The power of blood-flow restricted training

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Dr. Mercola: Hey, thanks for having me on. And it’s great to have inspired and been a part of your journey in understanding health. I know you’ve had many influences, but I’m glad I was part of it. So you’re doing a good job out there, leading not only with information but by example, which is really important. You do not want to be a hypocrite in this field. A lot of people are.

Ari: I am with you 100%. There’s a line Paul Chek used to say many years ago. He said, if your health guru is not comfortable teaching in front of you in their underwear and showing the results of their work, then you probably shouldn’t be listening to them.                  

Dr. Mercola: That’s right.

The big picture paradigm of human health

Ari: Yeah. So talk to me about — you’ve been doing this a very long time at this point. You’ve been a major leader in the natural health movement for a very long time. You’ve seen it all. You’ve tried it all. You’ve been a bio-hacker. With everything that you’ve seen and done, what is your big picture paradigm of human health and human energy optimization? What’s the big picture look like?

Dr. Mercola: Well, that could be a three-hour answer, but I haven’t seen it all and done it all for sure. And I’ve got a lot more to learn. Life is a journey, but there are a large number of people who’ve influenced me on my health journey. One of them was Ron Rosedale, who is still out there. Unfortunately, he’s gone off with some tangents now. 

And he’s like villainizing or demonizing mTOR unfairly, I think. And he got me off in that direction, and I actually suffered some health problems as a result because I believed him because previously in the mid-nineties, he helped me understand the importance of insulin resistance. And I think insulin resistance is key metabolic flexibility. The ability to burn seamlessly fat or sugar for fuel and be able to switch back and forth with those. And what percentage of the population do you think can do that?

Ari: Oh, well, I think I’m privy to some recent data that we were discussing and that I saw talked about in a recent article. So I think I know the answer. I would guess just by —

Dr. Mercola: I want you to guess before. That’d be more fair.

Ari: Well, I think something like 75% of the population in the US is either overweight or obese. So just that factor alone is a major predisposing factor to insulin resistance and poor metabolic health, higher inflammation, and so on. So I would say in the neighborhood — I would have said probably in the neighborhood of 75%.

Dr. Mercola: Yeah, that’s pretty darn close and probably closer than most people would have guessed, but it’s probably a neighborhood of 90%, which is another term you can apply to this. And frequently, as in the people who use this term, have no clue typically of what the prevalence is, but it’s about 90%. And this was the Haynes data that was analyzed from 2010 to 2016. It’s four years old now. So it was actually 88%. So I’m sure it’s well over 90%. And they included in that people with metabolic dysfunction, including high triglycerides, high blood pressure, or taking medicines for cholesterol. So if you fall into any of those categories, that’s 90% of the population.

Once you correct insulin resistance, lots of things improve, including mitochondria. I want to talk about the COVID-19 because that’s a central — in fact, it’s our lead article today as we’re talking of that. It’s not really a pandemic of SARS-CoV-2. It’s a pandemic of insulin resistance because almost everyone who’s passing away or suffering serious complications has insulin resistance. So the key is to address it at a fundamental level, and you’re doing so brilliantly with your work.

And I didn’t really — I mean, I learned about mitochondria in high school, 40, 50 years ago, but I didn’t really understand the clinical importance like many people did until maybe four or five years ago, but it is so crucial, and it’s intimately connected with insulin resistance because if you’re insulin resistant, it’s really difficult to have optimal functioning mitochondria. So I think those are the broad strokes, and there’s so many variables that contribute to optimizing that function. And we could talk a lot about them, but one of the things that isn’t typically appreciated, and I don’t know that I’ve heard you speak about it, but I have invested in it. I don’t watch all your podcasts, but I’ve been watching a lot of them recently.

Ari: You got to get on them, Dr. Mercola. You got to watch everything.

Dr. Mercola: I know. My podcast viewing has increased by at least 200% to 300%. And the only way I’ve been able to do that is I listen to it at double speed. And you got to be focused. Sometimes I’m even reading articles while I’m listening. It’s crazy.

Ari: I think I started speaking faster as I have been listening now to podcasts on double speed.

Dr. Mercola: Yeah, it’s the only way. Unfortunately, it’s starting to plateau and feel this pressure to digest all this information, understand what’s going on. But one variable that I think is crucial to all of these things, and as I mentioned, I don’t think I’ve heard you discuss, is oxygen. Now, oxygen is critical for mitochondria. The reason why mitochondria exist is they are, of course, the organelles that allowed us to use oxygen as a fuel substrate. And essentially, the oxygen serves as the final electron acceptor as the electrons are being passed from the fuel sources that we’re eating.

So if you don’t have mitochondria, there’s very little use for oxygen. In fact, it turns to be quite toxic. So the challenge becomes, and this is so important for the COVID-19 is because we know it’s becoming really clear that putting patients on ventilators is not a good strategy. It’s killing most of them. So actually, I’ve known and speculated for months now that hyperbaric oxygen be the treatment of choice for these individuals, but I didn’t have any data on it.

Well, just this morning, I listened to a presentation from a group of physicians in a Louisiana hospital. They have a chamber that’s integrated with the hospital. They have six hyperbaric chambers. These are hospital grade chambers, sea crest, the acrylic tubes that are clear, and the full-blown 100% oxygen.

And their small community, they didn’t have — well, it was becoming prevalent and, in their hospital, they hadn’t yet found the need to put any patients on ventilators until like literally five or six weeks ago. And their first patients, they used this as a legal way to allow them to do it. And essentially, they’ve treated 11 patients now 100% successfully—no need for ventilators. So none of the patients went on ventilators, and 100% of them came off it. Actually, all of those patients because they reviewed all the patients, all of them had the comorbidities you would expect. They were overweight, had high blood pressure.

The role of vitamin D levels in disease prevention

Most of them were aged, and a large fair share of them were African American. And the reason that being African American is a risk factor is not because of their ancestry, but because the color of their skin is so dark and deeply pigmented, they can’t get enough vitamin D from the sun. So normally there’s a strong correlation with low vitamin D levels.

Ari: There was just a study that came out. I’m sure you saw it. The one linking low vitamin D status with —

Dr. Mercola: Oh, yes.

Ari: And massively elevated risk of dying.

Dr. Mercola: Yeah, and we work with Grassrootshealth.org for like the last 13 years, and we help fund them, and they have a preprint-out. They looked at 212 patients that they reviewed their charts from Southeast Asia. And they found that of those who had a mild illness — all of them had COVID-19, and they looked at their blood vitamin D levels. Those with mild illness, 96% had normal vitamin D levels, which they quantified as over 30 nanograms, which I would say is not normal. It’s okay, but it’s certainly not optimal. Closer to 60 would be better or even 80. And then the ones who were serious or critical, the two most severe categories, only 4% of them had the normal vitamin D level. So, I mean, obviously, it’s a correlation study, and correlation does not prove causation, but it’s a pretty strong suggestion that vitamin D has something serious to do with this illness. I mean, your immune system.

Ari: The magnitude of the effect was it was something like to go from vitamin D sufficiency to deficiency. It was like, I think, a 19-fold greater risk of having severe symptoms and dying.

Dr. Mercola: It’s just crazy. One of the values of this pandemic — or plandemic would be more accurate — is that it’s showing us the importance of really optimizing our health and the consequences — the really severe significant consequences of not doing that. Now, no one gets a free ticket out of here alive. We’re all going to pass at some point, but the key is to be resilient and enjoy your health and have all the vitality and function, which you really promote with your focus on energy and energy blueprint. So it’s a big part of it. If you’re not optimizing that, you’re not going to be able to create energy.

Ari: Yeah. You said something earlier that some people might interpret as controversial, but I think, in my view, such an important point that I want to emphasize it, which is, you said, it’s not really an epidemic of COVID-19, it’s an epidemic of insulin resistance. And so, the data is something like, from what I’ve seen, about 86% of people in the US — may be that’s specifically in New York — who died had either insulin resistance, cardiovascular disease, or hypertension, or obesity, which overlaps with those. 

And then I think it was like 99% of the people who died from Italy had at least one of those conditions. So if you consider that and obviously, it’s unlikely, in my opinion, given that we know the mechanisms. It’s very unlikely that this is just a confusing correlation with causation. We know that obesity and insulin resistance, diabetes causes immune senescence and leads to poor immune function. So there’s a very clear mechanism that could explain this.

And given that if we were instead of to just say, just ignore those things and just try to look for a drug to fix it. If we were instead to try to fix metabolic health in individuals, we could not only prevent a massive amount of death from COVID-19, but you’d also simultaneously prevent a massive amount of deaths from cardiovascular disease, obesity, neurological disease, and so much more.

Dr. Mercola: Yeah, absolutely. Yeah, so it’s not that we’d be — I’m not claiming that there’s not an epidemic out there, and people aren’t dying from this infection. Yes, I do believe it’s an infection, unlike some people, but they’re dying because their immune system is not optimized because of this insulin resistance. And if we didn’t have this epidemic of insulin resistance, we would not have these people dying. This would be a non-issue. This would be less than the flu.

And the other variable, which you didn’t mention, was age. And age is going to get all of us eventually. But this is the immuno-senescence that you’ve referred to that occurs. And your immune system deteriorates with age. So the older you get, the more susceptible you are. Now, the other thing that occurs with age ties into the oxygen. There’s a number of two important things that occur that many people don’t recognize. One is that your levels of NAD+ and NADPH radically decrease. And I mean, radically. We’re talking 90%, 99%, and beyond once you get over 65, 70. So the other thing that decreases is — and I don’t think it’s related to this, but it occurs simultaneously — is a decrease in your microvasculature. What in the heck is microvasculature? Well, that’s your capillaries.

And the importance of that is when you have a decrease in the microvasculature, you’re not going to be able to deliver oxygen like you need to or should. And you won’t be able to provide that oxygen as a fuel substrate to your mitochondria. So one of the missing parts of the equation, which actually obviously ties into insulin resistance, is exercise and very specific types of exercise, not long-distance running or aerobic or cardio, but more of the resistance training, especially under certain conditions, which you’re very familiar with. And you’ve adopted for many years since you were a teenager, I believe. And you get that benefit.

Because when you increase muscle mass, you’re going to increase the GLUT4 receptors on the wall, and so it will help bring the sugar into the cell, so you don’t get the insulin resistance, but it also increases the microcirculation through a number of myokines that get established through the exercise. So exercise is another really crucial part of the equation to optimize your health, not a doubt in my mind. Of course, there’s a lot of diet and nutritional components, but exercise is key that is frequently, in my experience, the back burner.

How to optimize mitochondrial health and oxygen levels

Ari: I want to dig into some of the specifics on exercise with you, but I want to come back to oxygen. So you talked a bit about ventilators. You talked about hyperbaric. Is there a way that people can optimize the amount of oxygen coming into the system beyond just say, hey, go use a hyperbaric chamber or an oxygen concentrator? What can we do with that information to optimize oxygen delivery to ourselves?

Dr. Mercola: Well, hyperbaric oxygen is unbelievable as a tool, especially if you have not only COVID-19, and you’re going to die soon, but if you’ve had a stroke or any other ischemic event, like a heart attack or even traumatic brain injury, and that can be unbelievably useful in that recovery. But outside of that, what I found to be enormously useful and comparable in many ways to the benefits of hyperbaric oxygen is something called blood flow restriction training, which for someone like you would have a minimal benefit because you are like the classic person. You’re young; you’re credibly fit, and your microvasculature, I’m sure, is optimized. I don’t know that you can get much better, but for someone who’s elderly, at least 50, certainly over 60 and beyond, the microvasculature is going to be compromised. And that’s when you’re going to benefit from optimizing these hormonal myokines signals or cytokines.

So blood flow restriction therapy allows you to create this hypoxic environment and a rigorously exercise muscle. And when it’s hypoxic, your fuel sources to the point where you’re increasing lactate rather than using glucose. And it’s not in a hypoxic environment. So you generate these signals, specifically a real powerful cytokine called HIF-1-alpha, which is hypoxicinducible factor -1-alpha, which is actually the same signal that is generated with hyperbaric, which causes your microvascular to grow and expand.

So it’s a powerful tool, and the benefit in the elderly is that it radically addresses sarcopenia because it’s able to increase the blood flow to the muscle stem cells. And as a result of that, you can do the extra because you can deadlift just without this blood pressure therapy, but when you’re seven years old, if you have a compromised microvasculature, there’s not going to be enough blood flow to the stem cells for it to really make a difference and you can see muscle hypertrophy. But if you do it in combination with like blood flow restriction therapy, you can get that increased microvascular growth.

Ari: So for people unfamiliar with blood flow restriction therapy, what does that actually look like in practice for someone to actually do that? How do you do it?

Dr. Mercola: Well, it was developed in Japan almost 50 years ago by a guy named Sato, Professor Sato, S-A-T-O. And it’s a totally Japanese component. It was copied by the Americans about maybe 15 years ago. Big time maybe 12 years ago. And the original version by Sato and others is they have this really mechanical device that when it was first introduced, it cost about $20,000 or so, and essentially it is a compressor that puts air into these expandable bands that you put around your arms that are really pretty sophisticated devices that blow up and then inflate and deflate on a regular cycle, and then they can maintain their inflation. So the physical therapist in this country kind of weren’t too interested in paying that type of money. I don’t blame them. It’s a lot of money. So they did knock-offs, and there was a device that seemed like it was similar, but in reality, it really wasn’t.

It was a surgical tourniquet that already had FDA approval, and it costs a lot less. So they just knock that off and use that as a tourniquet, not as a smaller band because it’s a surgical tourniquet. It’s like a blood pressure cuff. It’s about four or five inches while these Kaatsu bands are maybe two inches, so literally less than half the size. So the difference is that it allows the blood to go into the muscle. 

You can actually get a more optimized training effect, but they still work. But so that you can use the constitute type equipment or even physical therapy equipment, there’s a number of them out there. Or you can get the really inexpensive knock-offs that will work, but they don’t have a cycling book component. And that is just a simple band that has a Velcro strap on it so you can wrap up. Not wrapped so tight that it’s a tourniquet. You still want some blood flow going through.

You only want to restrict the blood by about 50%, at least the arterial. You want to completely obstruct the venous return, but not the arterial flow. And then you get the best of both worlds, and you can get the training effect. And I’ve got a whole — I mean, the purpose of this interaction is not — we could spend two, three hours on blood flow. I put together a series of videos and a 25-page PDF on my site, and it’s bfr.mercola.com, where you can learn more, and we don’t sell it. We don’t sell this equipment. It’s just pre-information because I’m such a strong believer, and it’s literally changed my life specifically. My parents would still be alive if I knew about this ten years ago. And I didn’t because they died of frailty, sarcopenia, and complications of it.

I mean, when people die — typically when you’re elderly, you die of normal or natural causes. It’s usually frailty and sarcopenia. Typically, it’s what the end result is. Not all the time, but more often than not.

Ari: Yeah, interesting. So I’m just curious. Do you personally use one of the more sophisticated machines?

Dr. Mercola: Yeah, I do. I use the Kaatsu version. Well, when I first bought it last year — I saw it at the bio-hacking event in LA — it was like $2,500, but now they’re down to under $1000, which is good. And the newer one is even much better, which is under $1000. It’s this smaller size of a deck of cards. I use it every day for probably an hour and a half. I do it on my beach walk because you can put the bands on your legs, and you can just walk. And I walk on the beach for an hour a day.

Ari: Oh, really? It’s a portable —

Dr. Mercola: A little portable device, the size of a pack of cigarettes. And you just put on your belt. It’s got little tubes, pneumatic tubes that come out, and go into the bands. If you have a shirt — I walk the beach without a shirt, but if you had a shirt on, the shirt would cover it, so you don’t look like a wacko nut job walking down the beach.

Ari: But you look like a wacko nut?

Dr. Mercola: I do. I don’t care less what people think, even my neighbors.

Ari: Yeah. So for people who may be can’t afford that, is there a way to — is this accessible at all?

Dr. Mercola: Yeah, you can get the $15 bands at Amazon to just put your toe in the water. You don’t have to get the $1000 one. It’s just that if you’re really — I mean, people have no second thought about spending $1000 or $2000 or $5,000 for treadmill or something, and this like blows away a treadmill. There’s no comparison or even — but it is not cheap. That’s for sure. But it’s, I think, a powerful device, probably one of the best pieces of exercise equipment I own. But you have to use it with resistance. So you have to have weights with it or bands. You could use resistance bands too. So that’s another option.

Ari: You use it while walking down the beach, correct?

Dr. Mercola: Yeah. You can use it when you’re doing normal exercises, but you can also want to do it with resistance training. So like dumbbells typically or barbell. Like when you’re doing like a — I don’t know. You could probably bench press 300. I’m lucky if I can hit like 160, 170, or maybe 175, but when I’m doing the bench press with the bands on, I’ll only go like 55, 60 pounds, that’s it.

Ari: Yeah. It’s interesting. So for people listening, one of the unique things about this kind of training is you use much lighter weights than you would for normal resistance exercise, but it’s still quite intense.

Dr. Mercola: Just as intense, if not more. And in general, it is about a third of your one-rep max, and you do more repetitions. So usually it’s three sets of like 40, 30, and 30. So it’s 100 reps. That’s a lot of reps, but it’s a relatively lightweight, but you’re just struggling for those last few. It’s really good.

Ari: I’ve never heard of somebody using it while walking. So how does that work? Does it go around your muscles or your calves or?

Dr. Mercola: Yeah, you can put them on your arms; you can put them on your legs. And on your legs, you put it like right where you would have a bikini, and it’s using a cycling mode. So it compresses and inflates and holds it there for maybe 20 seconds, 30 seconds. And then it deflates, and then it repeats the cycle with higher pressure. It does it eight different times, going progressively higher each time. And then it takes about eight or nine minutes, and then you just — it finishes, and then you can repeat the cycle. So I usually do, might be, five, six, seven cycles on my walk.

Ari: Wow. And so, you get a nice burning in lactate buildup your legs when you use it while just walking?

Dr. Mercola: You could. My leg muscles are relatively strong — much stronger than my chest muscles. I mean, I’m 66, and I could deadlift like 350, which is decent for me.

Ari: That’s great.

Dr. Mercola: Yeah. So I have strong leg muscles. I’m not doing that to practice, so I don’t get the benefits because the device won’t inflate hard enough where I could do it. Now, if I did aggressive exercises, if I actually did deadlifts, then I would get it, but I don’t get it with walking.

The biggest needle movers for improving health

Ari: Got you. So you’ve written about — you’ve been aware of a whole lot of things, not just exercise. You’ve done deep dives, obviously, into nutrition for over 20 years now. You have talked about the benefits of sunlight. You’ve delved into red and near-infrared light exposure. You’ve delved into hormesis and sauna exposure and many different things. What is your perception of the top two or three biggest needle movers for people to optimize their health and energy levels?

Dr. Mercola: Well, maybe going back to the insulin resistance, which really is the key, is one that you didn’t mention, which is time-restricted eating. Basically, limiting the number of hours, the window, which you’re eating to at least eight hours. There’s about 90% of the people — this is clearly documented evidence. I think Satya — Yeah, the head of the UCLA lab.

Ari: There’s another guy named Satya Patel and then —

Dr. Mercola: Satyananda Panda is the guy.

Ari: Yeah, Satyananda Panda.

Dr. Mercola: Yeah, he did the surveys and found 90% of the people eat more than 12 hours a day. That’s crazy. And probably 50% eat 16 hours a day or more. And essentially the only time they’re not eating is when they’re sleeping. So there’s a lot of room for improvement out there. And interesting, 90% eat more than 12 hours a day. Ninety percent of people are metabolically resistant, insufficient, inflexible. So there’s probably a strong correlation to this. 

So if you can just decrease the — not even addressing the food rating, which of course, is nuts, it’s just as crazy not to, but just doing that — And they’ve done studies with animals where they’re still eating crappy diets, and they radically improved their health just restricting that because you activate autophagy; you decrease insulin resistance, and you get just overall better metabolic health.

So probably the most powerful strategy I know after just drinking water as your primary autophagy, which most people get. Now, when I first started mentioning that in the nineties, there was an epidemic of people drinking soda or juice and thinking it was healthy. Now, more people understand that. It’s kind of like they woke up from cigarettes, and they woke up from soda. Now they’re drinking water, so that’s good. They get that. But the next step is to compress the eating window or teary or time-restricted eating, which I think is probably the single biggest lever that you could use to improve your health.

Ari: Yeah. That’s a big one. So you mentioned at most eight hours is what the feeding window should be.

Dr. Mercola: Yeah, for most people. Even I suspect if you’re pregnant. I don’t know that there’s many conditions where that wouldn’t be true, or there probably isn’t. I’m not thinking of it, but as far as I can recall, there’s really no limitations on it. Like for regular fasting, there are limitations. You do not want to fast if you’re pregnant or if you’re underweight or have an eating disorder, but for time-restricted eating, I don’t think there’s any limitations or restrictions.

Ari: Do you think there’s a sweet spot? So is more restriction, more compressing that feeding window always better, or is there a sweet spot of where you could force it too much?

Dr. Mercola: Listen to your body. It probably needs to be cycled. I would think. So I kind of like four hours. I know a number of people who do two hours. It’s kind of hard to eat all your calories, especially if you’re like close to 4,000 calories or more in two hours. People can do it. It’s just hard. So I go for four hours personally, but I think there’s probably benefits once or twice a week going to six to eight hours, maybe even a little bit more. The caution with that is that it’s important to eat too soon before you go to bed, which I think most people understand because you are going to impair rest and recovery, and digestion is going to be active, and you don’t want to do that.

So at least three hours, preferably five hours before you go to bed as your last time you eat. And I know a lot of smart people in the health world who violate this just on social principles, and that’s their choice. They’re healthy, otherwise. I can think of two people like Peter T and Mark Sisson, who eat all the time. And they understand the principle, and they’re just making a choice, and everyone gets a choice. So I just don’t think it’s ideal.

Ari: There’s some research showing early time-restricted feeding is superior to late. So like all things being equal, same time-restricted feeding window of however many hours. If you shift that feeding window earlier in the day, so let’s say starting at 8:00 a.m., to 4:00 p.m. or something like that as opposed to 4:00 p.m. to 9:00 p.m., the earlier window is better, and there’s also research showing that stacking more calories earlier in the day was superior to stacking calories later in the day. Are you —

Dr. Mercola: I couldn’t agree more. Yeah, that’s absolutely aligned with keeping your calories away from bedtime as far as possible. I typically stop eating at about two o’clock in the afternoon. So I’ve got seven hours before I go to sleep.

Ari: I’m a big advocate like you of time-restricted feeding. My general recommendation on the sweet spot is like usually six to 10 hours. Because I find so many people who try to go down below eight, especially below six, start to — they have periods of the day where they’re really fatigued, or they’re hypoglycemic. Do you have any recommendations on how people —

Dr. Mercola: No, it absolutely needs to be individualized. I’m pretty healthy, and I don’t really have a social life. I live alone. So that’s not an issue. Social interactions are really important to your health, of course. And if you have a family, that’s important. So, of course, we can get them on board with the TRE, and that’d be good too. But usually, people are going to work and that so much nowadays, and they come home and meet with their families. So that’s an issue. So you have to listen to your body. Absolutely, that’s the number one rule. And I think I could clearly see where if you already had a health challenge, as many of you do, then you want to be especially careful.

Ari: Yeah. And this is, I mean, the way I frame it, and I’m curious if you agree, the way I frame it is just like exercise, you’ve got to build up. If you’re currently set —

Dr. Mercola: Yes, you don’t jump down. Absolutely, I’m sorry I didn’t mention that, of course.

Ari: Yeah. So I mean, somebody who’s currently eating a 15 or 16-hour feeding window, if they try and jump straight into a six-hour feeding window, they’re probably going to feel like garbage.

Dr. Mercola: Yeah, and it brings up an important point. The reason they feel like garbage is they don’t have the ability to access the fat as fuel so that when their glucose stores, their glucagon stores, and their liver get depleted, they have nothing to burn for energy. Of course, they’re going to feel like crap. They have got to optimize those pathways. So you can do that in a number of ways. Certainly, gradually is one way to do that, but you can start restricting the carbs. You can also take MCT oils. I like C8 being a little bit better because that converts to ketones a little bit more efficiently.

So that’s another good, powerful strategy. Hopefully, we can talk about some of the benefits of ketones, too. I love molecular biology, and there’s just not a lot of people talking about molecular biology and the COVID-19. And once you understand it, there’s some simple strategies that you can do to optimize a bit, but well, our previous discussion is so important because you got to essentially overcome that insulin resistance. Everything we’ve been talking about is insulin resistance. So you’ve got to do that first, and then you can start playing with how to optimize your body’s ketone productions.

Ari: Got it. So we’ve mentioned a few key things so far. So blood flow restriction, exercise therapy, time-restricted feeding.

Dr. Mercola: I like time-restricted eating, typically. That’s what (inaudible 32:10).

How EMF’s may affect health

Ari: Yeah. I guess because you’re controlling what they’re feeding. Got it. So okay. And then you mentioned also vitamin D in passing. We’ve talked about metabolic flexibility and insulin resistance being a key sort of measure of overall metabolic health. Your last book was on EMFs. I’m curious to sort of gauge your perception of the role of EMFs in the overall sort of as you said about 90% of people have poor metabolic health. What percentage of that do you think is accountable — is caused by the role of EMFs?

Dr. Mercola: Yeah. You cannot say there’s no studies that have been done. And I think anyone that claims to have an answer to that question would be foolish because we just don’t know. We cannot help you. So it’s only going to make things worse. How much worse really depends upon your personal health. So I think it’s wise to limit this just like it’s wise we know that eating organic is great primarily because you want to avoid things like glyphosate and all the hormones and chemicals they put in the foods, but glyphosate is particularly pernicious.

So how much of an impact does it have? We don’t know, but it’s not good. I have the same view for vaccines. I mean, for most of us, it can only cause problems. So we just got to be careful. So I limit my exposure to EMFs. I really do. And I’m really assiduous with it because actually, that was a result of my journey to understand mitochondrial health. And I dived deep in my book on how EMFs, and I think we — did we have a podcast on that too? I think we did, didn’t we?

Ari: We actually didn’t talk really about EMFs at all in that.

Dr. Mercola: Oh, I thought we did. Okay, I’m sorry. I think I confused it. There’s so many of them.

Ari: I think you’ve probably done a big book tour after your book came out, and you did confuse on the EMFs.

Dr. Mercola: Yeah, but it is a big factor, and it’s into the oxidative stress especially if you’re susceptible and the EMFs, they trigger certain receptors in your cell that cause the release of intracellular nitrogen — that immediately combines to form this really pernicious molecule called peroxynitrite, which sucks out — which damages your cells. It causes oxidative stress; the damage causes DNA breaks. So the peroxynitrite causes your body to consume something called PARP, which is a DNA repair enzyme, which creates the matrix where the enzymes can work. And this PARP is probably your body’s biggest consumer of NAD+. So a nice way to increase NAD, and I think your audience is quite familiar with NAD, is to limit the unnecessary consumption. And one of the ways you do that is by limiting your exposure to EMFs. So it’s just a simple, inexpensive way. Well, you don’t have to take a supplement to increase your NAD. Stop using so much needlessly.

Ari: Thank you for that super quick summary of what EMFs are doing. I know you’ve written an entire book on it. You managed to summarize it — Dr. Mercola: The graphs and illustrations and figures and everything.

Ari: Yeah. Quick question on 5G. This is something I haven’t really done a deep dive in. All I know is there are some people who are under the impression that it’s really dangerous and really harmful to human health. And then I’ve also listened to podcasts. One podcast I like listening to — though sometimes they have perspectives that I really don’t agree with — is Science Vs. It’s really kind of fun podcast to listen to. And they did one recently on 5G and basically the way they presented it was like yes, there’ll be more towers. Yes, there’ll be sort of more EMFs around, but they don’t penetrate deeply into our bodies. They stay very much on the surface and, therefore, can’t really have any effect on us by virtue of not sort of penetrating into our body. What is your perception?

Dr. Mercola: I think there’s some partial truth to that, that the 5G does not penetrate as deeply. That is correct. I mean, it’s still cumulatively and additionally an EMF burden, though, and because of the increased exposure, I would say, admittedly, I admit to, cumulatively, it’s going to be a problem so especially if it’s coming from space. 

You’ve got Space X that is going to be launching — which has permission for 42,000 satellites; Amazon has another 10,000 or 8,000. So the whole planet is being blanketed this from above and horizontally. So it’s a problem. It really is. I don’t think personally 5G is any more pernicious. In fact, I think it’s a lot less dangerous than the initial — the old cordless portable cellphone — the portable phones that we have — cordless phones. So that was a 900 megahertz and 5G is at least 17, 20, 30 up to 60 gigahertz.

So it’s quite 60 times higher frequency. And because it’s a higher frequency, it doesn’t penetrate as deeply. It’s kind of similar to the UV, which you’re used or infrared, I think, which you’ve written a whole book on. Whereas the farinfrared, the higher frequency does not penetrate as deeply, but this partially because it’s being absorbed by the water molecule. So it’s not quite a really good analogy, but there’s the lower frequencies, which bounce like about 660, which is not near-infrared, but 800, 850 around there it gets absorbed right through it because water doesn’t suck it up.

Ari: Yeah. You mentioned UV. I mean, that’s interesting in this context because UV also doesn’t penetrate deeply into our bodies. It stays very much on the skin, but the idea that that’s an argument for why it’s not very bioactive is not a very good one, in my opinion. We know UV is incredibly bioactive with vitamin D3, obviously, and cholesterol sulfate and nitric oxide, and many other mechanisms of how something that sort of “doesn’t penetrate deeper than the skin” can absolutely have widespread systemic effects.

Dr. Mercola: Yeah, it absolutely does. And so that’s a really good example to illustrate that. So thanks for sharing that.

Ketones and how they affect health

Ari: So you mentioned ketones. What are the role of ketones, whether exogenous ketones or ketogenic diets in the context of NAD+, in the context of insulin resistance, immune function, COVID-19? What’s sort of your picture of the role of ketones in overall human health?

Dr. Mercola: Well, if we didn’t have the ability to generate ketones usually through not eating for a while, typically for a day or two for most people, if we did not have that ability, anyone would not be here. We would not be on the planet. Our ancestors would have never survived. So it’s incumbent upon — it’s a capacity that our species is essentially developed over — has always had.

And the problem is we lose that capacity as we ignore basic ancestral, nutritional common sense. Essentially violating the time-restricted eating guidelines, and then by choosing poor food. So the ketones are essentially water-soluble fats. They’re very short molecules, usually two, three, or four carbons. And the benefit of them being so small is they easily penetrate through pretty much all the cell membranes, including your blood-brain barrier, and they can be metabolized quite readily as an alternative source of fuel, as an alternative to glucose.

Now, in the context of COVID-19, it’s particularly important to understand that — I think everyone’s heard the term cytokine storm, and the cytokines are signaling molecules that get generated usually under episodes of acute inflammation. So one of the consequences of cytokine storm is that it shuts down your body’s ability to make a really important bio-molecule, which is called NADPH. And I’ve watched as for you, I’m sure, maybe hundreds or many hundreds of podcasts now in the last few weeks or months on this topic.

And I really haven’t heard anyone addressing this, even though there’s a number of people talking about the oxidative stressors. And that’s all. There is relatively small. They’re usually talking about other topics, and this is an important component because NADPH is essentially your body’s battery. And it serves as a reservoir of electrons. And what this reservoir does, is it recharges your endogenous antioxidants, things like glutathione and vitamin C and vitamin E. So once those molecules get used once, and they donate their electrons, then they’re useless. And sometimes even worse than useless. They’re actually dangerous until they get recharged, and NADPH does the recharging.

Ari: Real quick, what’s the distinction between NADPH and NAD+, which may be a lot of people have heard of as people are talking about nicotinamide riboside and —

Dr. Mercola: Yeah, there’s a kinase. I think it’s NADP kinase. I forget the exact enzyme, but a kinase is an enzyme that essentially attaches to phosphate. And the only difference is that there’s a phosphate attached to the NAD. So you have NADP. And then the H means that also, it’s reduced already. So it’s a source of electrons. So they’re cousins. They’re in the same family. They’re great controlling nucleotides, which are four: NADPH, NADH, NAD+, and NADH. And then you’ve got coenzyme A, acetyl coenzyme A, which is the other. There’s five controlling nucleotides, and the guy that has done most of the work on this is actually Richard Veech, who passed away earlier this year. He is really the major pioneer on this.

He was an NIH fellow, and after he got his MD from Harvard, he went out to Oxford to train with Richard Krebs, who they named the Krebs cycle after — the Krebs tricarboxylic acid cycle, which is how energy is generated in the mitochondria. And Krebs got his training from Warburg. He was really considered the greatest biochemist of the 20th century. So there’s an interesting lineage there.

Now, Veech wasn’t really good at communicating to the mere mortals. I mean, he was a really smart guy, but he had a colleague who’s still alive. And who actually has Parkinson’s disease. His name is William Curtis. And Will’s a really great guy. I talked to him for hours at times. He’s just this reservoir of knowledge. And he helps me understand a lot of Veech’s ideas. And I actually just shared a recent presentation we put together, which is where I’m gathering this information because this information is not only important for preventing COVID-19 or treating COVID-19, but it’s also important for scenarios where you’re going to encounter regularly in normal life.

What are those scenarios? Well, you’re flying in a plane. Most of us aren’t flying now. I know I certainly am not, but most of us do fly. So when you’re flying, you’re in the air, 35,000 feet or so, and you’re exposing yourself to ionizing radiation, and there’s definitely massive oxidative stress on your DNA, and there’s — understanding what I’m going to talk about in the next few minutes is really important because if you do understand that, you can eliminate the vast majority of that damage. And the other area that you’re going to electively be exposed to ionizing radiation is in a medical procedure.

What is that procedure? A CAT scan, which is one of the most dangerous medical procedures you could ever go under — at least diagnostic procedures, and there’s more. Well, one of the most dangerous routine procedures because there’s certainly more dangerous ones than the CAT scan, but the ionizing radiation exposure is quite traumatic. Now, there’s an interesting CT scan. So you don’t want a CT scan unless your life depends on it. Look for an MRI as an alternative.

If you get an MRI, you don’t want one with contrast, with gadolinium, that’s for sure. That has its own intrinsic problems. So the interesting CT scan that most people should consider — I don’t know if you’re aware of this already, but for dental imaging, there’s something called 3D cone beam CT scan, and it is the most unbelievable tools now for about ten years, but it can image your teeth and your sinuses and your airway and any lesions you have or infections. It’s just unbelievable.

I think it’s an image study that almost everyone would benefit from. I know it helped me quite a bit, and I’ve just had my first one recently, and I was very impressed with it, but if you have those —

Ari: How did it help you?

Dr. Mercola: You could see your teeth. I mean, it’s almost like medical negligence and almost irresponsible for a dentist not to be using this tool because it’s like trying to run a race with your legs tied, and you’re tied back together. It’s like you’re so handicapped. You can’t really see the details. You can turn this around. I mean, you could be a grade school child and with literally a few minutes could learn how to diagnose almost all these infections, and you don’t have to be an expert at all in terms of interpreting shadow differentiations.

It’s just plain as it can be. It’s just easy for everyone to see. So it’s just radically transformed diagnostics in my view. So it’s something that — especially as you get older and there’s a tendency to develop dental infections because your dental health is really important to your health. And it’s an area where most people don’t really fully appreciate it, but it is massively important. It could take you out prematurely if you have dental infections that aren’t addressed.

Ari: I went to the dentist a few months ago, and they found some, I forget the proper dental term for it, but some kind of little tunnel kind of between or under one of my teeth that’s sort of an abnormal formation just as far as how my mouth is structured or my gums are structured.

Dr. Mercola: Your personal anatomy, right.

Ari: Yeah. And actually, my dentist referred me to someone else who’s a specialist who does that 3D cone beam scan. And I was actually not — I didn’t get it because I don’t like so much x-ray exposure, but now I’m like, okay, if Dr. Mercola says it’s okay, then I’ll go with it.

Dr. Mercola: I’m telling you. Once you see it — they can take that image. They can rotate it; they could turn it around. It’s like a hologram. You could see the entire area of the two — front, back, side, up, down, bottom, turn it upside down. It’ll blow your mind when you see it. It’s just crazy good. So definitely get it. No question. So that the reason I preface that is because I want to explain some complex molecular biology, and what the hell is he going on about this for?

Well, there’s the practical importance of it because, like I said, the COVID-19 — well, I didn’t say this. This COVID-19 when you have the cytokine storm, it’s suppresses, but let me just preface this early. When you are eating food, typically, the primary sources of calories are either carbohydrates or fat that you’re going to burn as fuel in your mitochondria. You don’t burn those directly. They’re broken down to their constituent molecules, and what are those constituent molecules? In the case of glucose, it’s pyruvate. Pyruvate is a three-molecule, carbon molecule rather, that essentially gets further metabolized to carbon dioxide and Acetyl-CoA. Then it gets shuttled into the mitochondria, into the electron transport chain. Similarly, the fatty acids get broken down to Acetyl-CoA, and they get shuttled in there.

Most people are relying on glucose, especially those with comorbidities that are COVID-19. There are really insulin resistant. These people cannot metabolize fat. They are not generating ketones. That’s one of the reasons they’re so sick. So their primary and almost only source of fuel is glucose. So what that means they have to use pyruvate. If they can’t break down pyruvate, they’re in bad shape. And that’s exactly what’s happening because these cytokines inhibit the enzyme that is responsible for metabolizing the pyruvate. This pyruvate hydrogen is complex, and then they get backed up.

And when that gets backed up, they cannot make this molecule, NADPH, which essentially is the antidote for all the inflammation that’s being generated from this virus. It’s no surprise that they’re dropping like flies from this. It’s exactly what you would predict. It’s really is a perfect prescription for metabolic disaster with this COVID-19. But if you understand the basics, you can bypass it. And so how do you bypass this thing? Well, hyperbaric oxygen does it in space, but not everyone’s going to have access to that, and certainly, you not going to have access if they want to do a CT scan.

Ari: And it also, just to tie things back in, relates to exercise and blood flow restriction training hence cultivating metabolic flexibility. It also relates in a massive way to time-restricted eating. So just connecting the dots for people listening.

Dr. Mercola: Yeah. So, but acutely, ionizing radiation exposure, acute ischemic stresses such as stroke, TBI, heart attack, the same intervention I’m going to describe can be used in all those situations with incredible benefits because what you have in these ischemic scenarios is this massive oxidative stress that’s causing the damage. And you need an antidote at a biochemical, molecular level to compensate for that stress, and NADPH is how to do it. 

So you want to have your body make it. And if you’re impaired because of this inflammation, which is similar in many of these other conditions, not so much systemically unless it’s in COVID, but certainly at a local level, then the way to bypass that is by providing ketones to your body. And ketones bypasses this. Essentially shuttles into the next step where the acetyl CoA enters the Kreb cycle from the pyruvate.

And the ketones go indirectly and can generate the NADPH and, as a result, bypass that temporary metabolic dysfunction that the COVID-19 and these other scenarios are generating on the body. So it’s a marvelous solution. And one of the ways you can do it is the things we were talking about before is to do it endogenously through your body’s efforts. So that clearly is ideal, but you can also take — there’s another strategy. Something called an exogenous, which means it’s outside your body ketone. 

And the exogenous ketones consist of two types. There’s salts or esters. The salts are somewhat problematic because they have a really high solute load, which would be sodium, magnesium, or other ions, which can be problematic. So the esters are clearly the best and most efficient way to do that. And the only problem with them is they’re a little bit pricey. They’re about $1 a gram, and you might need — a gram is about an ML. So you might need 25, 30, 50 grams of this for a therapeutic dose.

Ari: Per dose is that one dose per day, or how many doses per day?

Dr. Mercola: Well, you sense this is not something you would be taking in all the time. You take in those scenarios where like for you — like when I had my CT cone scan — First of all, carbohydrates will limit your body’s ability to make ketones nutritionally. So you want to limit your carb to usually below 50 grams a day for a while, and then you’ll be making more of your own. The other thing you can do is use things like medium-chain triglycerides, or specifically even better CA, which is even shorter, and that will help convert to ketones even better.

So I typically have about six ounces of CA today and a relatively low carbohydrate diet. So when I have had that as a base, and I take these esters like before my CT scan, I took about, I think, 30 CCs of the esters. And I got my ketones up to five. Have you ever measured your ketones, Ari?

Ari: I haven’t, no. And in fact, I just had several homemade blueberry muffins right before we started. I am not in ketosis right now.

Dr. Mercola: I can guarantee you. Don’t waste the money (inaudible 53:40). But if you’re going to measure ketones, the best most accurate way is with your blood. And there’s a really interesting test that is called KetoCoach, all one-word x.com, or you can go to Amazon and find them. I think it’s like only $0.50 a strip because most of the — these strips first came out they were like $4 or $5 a strip for every test, and that gets kind of pricy. So it is a lot better when it’s under $1. So if you want to know what they are, it’s really interesting. But most people like — you are under 0.5, I can guarantee it. You’re just probably undetectable at this point.

Ari: Right now, post blueberry muffin binge?

Dr. Mercola: Yeah, it’s not that they’re bad. It’s not like being in ketosis isn’t healthy. Absolutely not. You should not be in ketosis continuously, but when you want to have the therapeutic benefits and get that NADPH up to counteract this oxidative stress, that’s when you want to just kind of modulate things in that direction.

Ari: Got it. There’s a lot of complex biochemistry that you went into there. I want to try to see if we can simplify it. So basically, in a state where somebody is a carb burner, and they have no metabolic flexibility, the typical person who’s eating tons of refined and processed carbs and way too many carbs. And for way too long, during each day, they’re time-restricted. They don’t have a time-restricted feeding window. They might be feeding 12 to 16 hours a day.

Dr. Mercola: Yeah, like most people.

Ari: These people are going to be likely metabolically inflexible, not having an ability to tap into stored fat for fuel and insulin resistance. And that’s going to lead to what at the biochemistry level? That increases their likelihood of severe symptoms or death. It’s decreased NAD —

Dr. Mercola: Well, because their glucose levels is high, and they’re relatively insulin resistance. Those are two prescriptions that inhibit your body’s ability to create ketones. So just that very nature. Now, additionally, when you’re burning carbohydrates as your primary field, there’s an additional artifact of that process that I neglected dimension. And that is that very process of brain glucose as opposed to ketones, is metabolically inefficient. 

So it intrinsically is 30% more inefficient. By inefficient, I mean, there’s an excess. There’s a surplus of leakage of electrons out of the normal sequence of events that actually contributes to more reactive oxygen species, more oxidative stress because you’re burning fuel inefficiently. It’s dirty fuel essentially. Now, it’s not bad fuel, and you need to be able to use it. I mean, you’d be very impaired if you could not burn glucose. You have to have it, but when you’re burning it continuously, that is not a good strategy.

Ari: Got it. So in the case of somebody who is a carb burner, maybe they are metabolically inflexible, can they just take these exogenous ketone esters with a lot of these benefits?

Dr. Mercola: It would work, yeah. It’s not ideal. And you won’t get a level of five. You might go up to one, maybe one and a half. Because if you have the metabolic machinery already in place where your body knows what to do with these molecules and augment it naturally, you’ll get a better effect, and the higher level of ketones, the better you’re going to be able to counteract this oxidative stress, which is intermittent, and especially — how many 3D cone beams CT scan are you going to have in your life? Not many. So this is not a strategy you’re doing every day, certainly or even a few times a year maybe. That’s it. But anytime you’re flying would be another time to consider it. Or if you had an elective CT scan, which could be — The CT cone beam is not that — I mean, it’s definitely a lot, but it’s not anywhere like a regular CT, which clearly increases your cancer risk. No question.

Ari: Got you. So just to connect the dots again with COVID-19, you’re saying this would likely decrease the likelihood of high oxidative stress and the likelihood of a cytokine storm happening?

Dr. Mercola: Yeah. Interestingly, I could send you a video if you want. A person who makes Ketone Aid sent me this video. A COVID-19 patient who is having great shortness of breath and difficulties, and I think she is clearly metabolically inflexible. She was overweight and insulin resistant and having great difficulty talking, thinking, speaking. She takes the ketone esters and bang, she like wakes up before your very eyes, like in two minutes. It’s like crazy. So it’s a band-aid. It’s not treating the foundational cause, but it’s the difference between life and death many times, so it can have a radical benefit for you.


Ari: Got you. Related to this is NAD+. I know that in your EMF book, you talked about NAD+, and you mentioned also niacin, which I found interesting because most people who are talking about NAD+ are talking specifically about nicotinamide riboside and nicotine mononucleotide, NR, NMN as being sort of the things you need to boost NAD+. 

And much less known is that there’s already quite a bit of research showing that plain old niacin, cheap niacin, and niacinamide also boost levels of NAD+ very significantly. I’m just curious. What’s your thoughts on that landscape? Why aren’t you pushing NR and NMN harder, and why are you saying niacin also works or works just as well if that’s accurate to say?

Dr. Mercola: Well, not quite accurate, but I’m happy to go there. So it’s a complex discussion. NAD+ is mentioned as a really important bio-molecule. It’s crucial for energy production and as a signaling molecule between the mitochondria and nucleus. And if your levels go off, which you tend to as you age, that’s one of the signals that you’re going to age prematurely, and maybe not be with us for much longer. So increasing your NAD+ levels is really important. Interestingly, the benefit of the ketones I just mentioned works independently of NAD. So just by increasing NAD doesn’t mean you’re going to increase ketones. They’re two separate mechanisms. Although NAD will help NADPH through a different mechanism, but it actually — I think it inhibits —

This molecular hydrogen inhibits NADPH oxidase, which consumes the NADPH. So to answer your question, the NAD+, we use about nine grams a day, 9,000 milligrams, all of which about 99% get recycled.

Now, if you have a lot of EMF exposure and stress, you’re going to use more and not going to be able to recycle as much. So your need becomes more. So when you consume NAD, it’s breakdown product is niacinamide. So you need some niacin. In fact, there’s a disease — I’m sure you’ve heard of pellagra before. A disease pretty much in the 20th century. And you get dermatitis, dementia, diarrhea, and then the fourth, which is death. It has killed a lot of people, and usually, it’s considered to be a vitamin B3 or niacin deficiency, but it’s not. You know what it’s a deficiency of?

Ari: Niacinamide?

Dr. Mercola: No.

Ari: NAD+?

Dr. Mercola: NAD+, yeah. Because when you give them NAD or niacin or niacinamide, usually either would work, then your body has the precursor to reconstruct the NAD. That’s what it normally does. When you consume it, you break it down into niacinamide. Your body reconstitutes it naturally. You don’t have to take these precursors, but if you’re not getting enough niacin because you have like about 100-milligram deficit per day, or somewhere in that range, maybe 50 milligrams — it depends on your height, weight, and some other variables.

So normally you need about 25 to 50 milligrams of niacin a day or vitamin B3 to compensate for that. Now there’s a lot of people in time, even Hoffer, who’s an MD psychiatrist who’s no longer with us, was a popular user of high doses niacin therapy. He primarily used it for schizophrenia, but he used it for other therapies, and interestingly, the first published paper on NAD+, not niacin, but NAD+, you know what year it was published in the United States?

Ari: No idea.

Dr. Mercola: 1961. That is 40, 50, almost 60 years.

Ari: It took a long time to gain popularity. It was only in 2018 we talked about it.

Dr. Mercola: Yeah, I know. We didn’t really get it until Sinclair figured it out really because you’re right. Everyone studied this for the last century or so. And if you’ve ever taken biochemistry, we all go out and do it, NAD, but no understood the importance of it. But then Sinclair was at MIT at the time with Leonard Guarente’s lab. He was doing research and was barely shown and studying this sirtuin with longevity proteins and found that the sirtuins would not work, specifically sirtuin 1, unless it had NAD. And he said, whoa, this is really important. So that’s when it started gaining — that was late 20th century, 1999, 2000, and then it gained prominence at that time. And then he’s done a lot of other work since then.

So anyway, the number of people — and actually, Sinclair himself is now popularizing NMN, which he uses personally. And then there’s others, NR, nicotinamide riboside. So that will convert to NAD+. The problem with those, though, is that most of these precursors — let’s talk the precursors first, and I’ll go back to niacin. 

The precursors are oral. They’re almost all given orally. And the problem with an oral precursor is that you have to absorb it from your gut into your blood, and the process of doing that goes through your liver, and the liver perceives it as a foreign molecule, so it tries to detoxify it. In the process, it methylates it, and essentially it changes it to a different molecule, which doesn’t work. So you get high — your liver gets high levels of NAD, but not the rest of the tissues in your body.

Ari: Got it. I’ve actually also read some reports, for example, Neurohacker Collective. They’ve published some research saying that a large percentage of the NR and NMN that get taken in orally actually get converted in the gut to niacinamide before they even get absorbed into the blood.

Dr. Mercola: Yeah. There’s that component too, but I think the bigger issue is getting converted in the liver. So you want it to be floating in the blood systemically and be absorbed through all of your cells throughout your body, into the cells and being converted to NAD+, which doesn’t happen very effectively. So you can do it. There is some benefit, but you have to understand too these studies. First of all, it’s really difficult, actually beyond difficult. There’s only a few labs in the world that can measure NAD+. There’s only a few, a handful. So most of these people, unless they’re a research lab, they’re not — I don’t know where they come up with these numbers to show it works because it’s almost impossible to measure this stuff. I mean, it’s a very difficult sophisticated niacin.

So that’s part of the reason why it’s so hard to get data on this. So anyway, that’s why I’m not a big fan of the precursors. You can use it and just be able to get benefits. But the point I was going with a tangent, assuming they’re measuring it. As I mentioned, your levels of NAD can decrease by 99%-plus as you get over 67 years old. So if it even doubles your NAD, which sounds impressive, or even triples, quadruples, say you’re a 0.5, and you’re supposed to be at 50, you’re not getting into therapeutic levels. It’s almost irrelevant. It looks good on paper, but I mean, it’s essentially worthless. And that’s why I think there’s a lot of confusion on this because they’re just aren’t telling the whole story.

So anyway, getting back to niacin and niacinamide. I think it’s a good strategy. I’m against high doses of those for a number of reasons. High dose niacin is actually a methyl consumer. So if you have a problem with methylation, you’re going to be an issue. You somehow compensate for that by taking methyl donors like trimethylglycine. And I take a lot of that. I like trimethylglycine. It’s pretty inexpensive, safe supplements, sweet. It’s a good sweetener, but that’s a concern. The more significant concern — this is what actually Sinclair figured out in his work with sirtuins — is that the niacinamide is actually a negative inhibitor of sirtuin 1 at higher levels. So if you get high levels of niacinamide, you’re taking a gram, two grams, three grams of niacinamide because it’s non-flushing niacin thinking you’re doing your body a good thing, you’re actually inhibiting your sirtuins — not a good strategy in any way, shape, or form.

Now, if you’re taking 25, 50 milligrams, I don’t think it’s going to do much, but it probably doesn’t matter. But when you start getting into grand quantities, I would be very concerned about that. So I think 25 to 50 milligrams niacin in most people’s not going to cause a flush. It would be fine if you want to do niacinamide. That would be fine too. But I think the key is to do these other strategies, like the exercise, the blood flow restriction therapy blows it through the roof.

Ari: You’re not crazy about the precursors. So what are the best ways to —

Dr. Mercola: Yeah, metabolically flexible, not insulin resistant, and doing things like blood flow restriction therapy, or even hyperbaric oxygen, and the way those work, they work on limiting enzyme for endogenous NAD+ production, which is any NAMPT. So they upregulate that enzyme. They increase it. It just goes bang. So if you’re going to take a supplement or a precursor, it’s important to know that you don’t want to take it around the time you’re exercising because you’re not going to get the bang that you want out of the exercise. So I do take an NAD supplement, and I take the actual molecule, NAD+, the real deal molecule.

Ari: The rainbow or liposomal or something like that?

Dr. Mercola: I do a transrectal. Yeah, so I put it into a suppository. It’s a very fragile molecule. I mean, you keep it at room temperature, it’s gone in a week or two. So it’s got to be kept in the fridge. It’s really fragile. So I put up my butt, especially before I do my hyperbaric, and I get a pretty good dose of it. And it’s relatively inexpensive that way. It’s not commercially available. There’s no company that sells it in that rock. Maybe company pharmacies might, but you can’t buy it over the counter or anything.

Ari: In suppository form?

Dr. Mercola: Yeah. Now, the other way that would work, and this clearly would work, but it’s hard to find because the thing is so fragile is if you put it into a nano liposome and that would get into the cell. It would bypass everything, and you’d be golden. That is the optimal way to do it. The problem is that making a liposome is usually heat intensive. And if you heat this thing much above room temperature, you’re killing it. You’re destroying it. So that’s a real process. I think I found someone to do it, but he’s gone dark on me, and I haven’t been able to connect with him for a few months.

Ari: You’re going to try and bring that supplement out under your supplement brand?

Dr. Mercola: No, because liposomal formulations violate so many FDA rules, and I’m already under a microscope with the FDA, so they would want to put me in jail, but for personal use, it would be an interesting thing. And we may spin it off to a different company and have them do it or something, but that is probably the ultimate way to do it. And it wouldn’t be much more expensive than NR or NMN, but in nano liposome, and you wouldn’t need as much. It’s probably a fraction of what you would need with NR and NMN because you’re getting the real thing right off the bat. There’s no conversion required. That is the molecule you’re trying to get.

So optimizing NAD+ levels, apart from maybe the suppositories you’re referring to, revolves mostly around sufficient intake of vitamin B3, niacin, niacinamide precursors, as well as mainly things like exercise, blood flow restriction, fasting, time-restricted eating, I think circadian rhythm and sleep also ties into this.

Dr. Mercola: Oh, absolutely, yeah. Sunshine.

Ari: And EMFs, you mentioned before and overall metabolic flexibility. Is that accurate? Is there any —

Dr. Mercola: Well, that is a really good summary. That’s what I love about you. See, because you are healthy, and you’re committed. You don’t do a lot of things that mess you up in any way. So your brain works the way it was designed to, and you can hear these complex topics, and you can summarize it concisely and succinctly in a very elegant manner. So thank you for doing that.

Ari: Yeah. Thank you for the kind words. I appreciate it. So we’ve covered numerous things. I just mentioned a bunch there: the blood flow restriction training, the EMFs, metabolic flexibility, insulin resistance, ketones. What else did we mention here? Hyperbaric and oxygen, time-restricted eating. I think that covers it. Are there any other — and I think, by the way, for everybody listening, I think this list of these six or so things that Dr. Mercola has already covered if you apply them, these things can absolutely transform your health and your energy level. These are powerful things.

Dr. Mercola: Foundational issues that contribute to your health, your energy, your mitochondria health, mitochondrial function.

Ari: Yeah. So having said that, I know there’s many more topics that you could talk about: circadian rhythm or light exposure, sunlight, UV, vitamin D, saunas. There’s lots of things you could cover. If there’s one more thing beyond what you’ve already covered, one more thing that you would say is a major key to boosting energy levels, what would it be?

Dr. Mercola: How about my favorite supplement of all time?

Ari: What’s that?

Dr. Mercola: Molecular hydrogen. That is a bumpy end. In fact, Tyler Baron is one of my good friends, and he is the head of the Molecular Foundation Institute, which is a non-profit. He doesn’t make any money selling this stuff or anything. He’s just a committed scientist, and he’s a bio-hacker, and he’s incredibly in good shape. This guy can run a marathon and sub-2:30 marathon. He can deadlift like 450 pounds. He’s an impressive physical specimen. And he’s smart as a whip. Anyway, he just did — I just ran this interview on my site. If you go to my site, mercola.com and you go type in Tyler, the Baron molecular hydrogen, you should come up with a few, but this lecture that he gave. It was like 30 minutes. He goes through the whole molecular biology of how it works in COVID-19, which is how it works for oxidative stress.

And essentially, it supplies your body. It’s a selective antioxidant, unlike vitamin E or vitamin C, which have their uses. And I use them both, but this is like the ultimate because it only works when your body needs it. So like this is the one you would take before the — if you had ischemic episodes, or you’re going for your CAT scan, or you’re flying. You definitely want to do the ketone esters and the molecular hydrogen so a one-two combo because they work on similar, but synergistic pathways.

So basically, there’s this protein — I think it’s a protein. I’m pretty sure it’s called NRF2. And it’s combined with HIF, and it floats around your cell cytoplasm. And when you have oxidative stress, HIF keeps kicks off, and the NRF2 goes into the nucleus, and it hits these AREs, the antioxidant response elements, which transcribes your endogenous antioxidants, things like glutathione, superoxide dismutase catalysts, and about 400 other antioxidants. But it only does that if there’s oxidative stress, which is the ultimate. Which means it’s almost impossible to overdose on this, which you can do with regular anti-toxins. You take a lot of lipoic acid. You don’t know what the consequences are because you could be suppressing beneficial free radicals. There are beneficial ones like nitric oxide.

Ari: If you don’t mind me interjecting, it’s worth mentioning there’s the work of Dr. Michael Ristow around hormesis and around how supplemental antioxidants can actually negate the beneficial adaptations from exercise.

Dr. Mercola: Oh, absolutely. There’s no question, but molecular hydrogen wouldn’t. It would only augment the benefit of exercise because it does it selectively. It’s working with your body, its own intuition. So it’s a synergy. I use it before I go for hyperbaric or when applying, and it’s just my favorite one. I think it’s just magnificent. It’s not terribly expensive, either. And the best way to get it is with the tablets. And there’s a lot of different modes of administration. That’s the best because it comes with — it’s metallic magnesium, and it’s constructed in a way that once the magnesium hits the water, it dissociates into these nanobubbles.

So you can get like 500% higher concentrations of the hydrogen gas in the water, and these nanobubbles that you wouldn’t normally plus it dissociates into ionic magnesium, which is almost everyone watching this needs extra amounts of because it’s such an important mineral that almost everyone’s deficient in. And it’s actually interesting. Magnesium is one of the key ones that help mitigate against oxidative stress from EMF, too. So it just is a winwin for everything. So it’s a great magnesium supplement, and it’s a great source of molecular hydrogen to improve your resistance to oxidative stress and just overall resilience. I just love it.

Ari: Beautiful. Dr. Mercola, this has been awesome. Thank you so much for the conversation. Thank you so much for sharing your wisdom. Always a pleasure to talk to you.

Dr. Mercola: All right, well, I’m glad to be with you, and hopefully, it’s helping someone.

Ari: Yeah. And for everybody listening, you now have a really powerful set of tools just from this one interview, let alone the other 40 interviews in this summit, but just this one, you’ve got one of the leaders in the natural health movement for over two decades sharing wisdom accumulated, and you’ve got hyperbaric treatment and oxygen, blood flow restriction training, timerestricted eating, EMFs, metabolic flexibility, and insulin resistance, ketones, hydrogen, molecular hydrogen. I mean, this is just powerful stuff. Thank you so much, Dr. Mercola, really a pleasure. And for anybody listening, who wants to follow your work, where’s the best place for them to do that?

Dr. Mercola: Well, I’ll tell you where you don’t want to go. Don’t go to Google. I suspect they censored you, but they censored us a long time ago. And so, we’re not there. We’re not on YouTube. I mean, we exist theoretically, but you can’t find us. So you go to my website, which is really hard, mercola.com, ME-R-C-O-L-A.com. 

And if you’re interested in that BFR, it’s bfr.mercola.com. And we’ve got a really interesting blog there too that comes out. We have like five, six posts a day. It’s just called breaking news, and you can subscribe to that and get the latest on the COVID-19. And I posted the interview. Yeah, the presentation that was given for the Louisiana physicians in the hyperbaric chamber. So that’s on the blog today.

Ari: Beautiful. And there’s lots of bestselling books on Amazon as well for people. I’d recommend it including —

Dr. Mercola: No, yeah, the books if you want to go deep, but just if you want to stay current on the latest, especially with this pandemic, plan-demic — Actually, one of our subscribers said it was COVID-1984. I said, oh —

Ari: Awesome. Well, thank you so much, my friend. I really appreciate your time and the extra time for going extra on this interview, always a pleasure. And I look forward to the next conversation.

Dr. Mercola: All right, it sounds great.

Show Notes

The big picture paradigm of human health (01:35)
The role of vitamin D levels in disease prevention (08:08)
How to optimize mitochondrial health and oxygen levels (14:45)
The biggest needle movers for improving health (24:06)
How EMF’s may affect health (32:08)
Ketones and how they affect health (38:37)
NAD+ (58:19)

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