Joe Rogan Experience #1474 - Dr. Rhonda Patrick

1. 0:00 – 1:16

   Why “immune system strengthening” isn’t discussed enough during COVID

   1. JRJoe Rogan0:00

      (inhales) What were you saying? (laughs)

   2. RPDr. Rhonda Patrick0:04

      (laughs) Damn you. You suck.

   3. JRJoe Rogan0:06

      No, it's not that embarrassing. You just-

   4. RPDr. Rhonda Patrick0:09

      Some-

   5. JRJoe Rogan0:09

      You get... Go ahead.

   6. RPDr. Rhonda Patrick0:09

      Like, sometimes when I get nervous, my eye will start watering, like...

   7. JRJoe Rogan0:14

      I don't think that's odd. I think that's probably pretty normal. I mean, your system's fired up and, y- you know, your eyes are probably trying to clear themselves.

   8. RPDr. Rhonda Patrick0:22

      (laughs)

   9. JRJoe Rogan0:22

      Right? Maybe, you know... I mean, I'm just speculating, but maybe-

   10. RPDr. Rhonda Patrick0:25

       Maybe pe- maybe people will message me after this, this podcast and be like, "That happens to me too," and I'll feel better, like... (laughs)

   11. JRJoe Rogan0:30

       I'm sure. It doesn't sound that odd. It's not... Certainly not embarrassing, so I don't know why you're embarrassed by eyes watering if you're nervous.

   12. RPDr. Rhonda Patrick0:37

       Okay. (laughs)

   13. JRJoe Rogan0:38

       Um, thanks for being here. I really appreciate it.

   14. RPDr. Rhonda Patrick0:40

       I am super... Uh, always happy to come.

   15. JRJoe Rogan0:42

       Well, we've been talking and we've been talking about, uh, immune systems, and this is one of the main things that I wanted to talk to you about, like what are the str- 'Cause this... All we're hearing is, "Shelter in place, wear a mask, don't touch anybody, don't go outside." But we're not hearing, what can you do to strengthen your immune system? And I think that as a public health, a public service, you know, uh, health thing, this is, uh, one of the most important things that I think you can really focus and concentrate on, and an actual thing that you can be proactive about during this weird time.

2. 1:16 – 6:59

   Immune variability: genetics vs. environment and the impact of past viral exposure (CMV)

   1. RPDr. Rhonda Patrick1:16

      Yeah. Well, definitely, I think focusing on, on, you know, lifestyle factors that you can, you know, possibly modulate your immune system and strengthen it is, is important. What's interesting is that the immune system is... You know, after doing just so much... Of course, the past, like, couple of months, I've been nothing but, like, reading about the immune system-

   2. JRJoe Rogan1:37

      (laughs)

   3. RPDr. Rhonda Patrick1:38

      ... and trying to understand, of course, this new virus, SARS-CoV-2. Um, but I've just learned so much, uh, you know, over la- the past couple of months. I'm not an immunologist, I'm not an infectious disease expert, so, um, you know, while I've had some training in, in immunology, I definitely, you know, didn't know... don't know everything there is to know. But what just... You know, doing some, some reading about, like, why are people's immune systems so different? Like, that's, that's the big thing, like when you take, like, a young population. As you get older, your immune system does decline. I mean, there's lots of changes that occur. But like, in general, like, people have different immune systems, and what's interesting is that there's been tons of, like, genetic studies done on, like, you know, identical twins and they're followed over time, and what's found is that genetics is not the major regulator of immune function. Um, it's something in the environment, and what... This is what surprised me, and, and it's not totally gonna answer your question, but w- we can totally get to that, but the main... One of the main things besides age that regulates the immune system is, like, previous exposure to viruses.

   4. JRJoe Rogan2:40

      Hmm.

   5. RPDr. Rhonda Patrick2:41

      Like, so I th- I thought that was really interesting, and in particular, one, one virus, the cytome- megalo virus, CMV. Did you know, like, between 50 to 80% of the US population has it? Like, at least by the time they're, like, an adult?

   6. JRJoe Rogan2:54

      Has it permanently or has caught it?

   7. RPDr. Rhonda Patrick2:56

      Yeah, it's a, it's a, it's a herpes virus, so it's-

   8. JRJoe Rogan2:58

      Oh.

   9. RPDr. Rhonda Patrick2:58

      ... it's a lifelong thing. And this is why it basically... So, it, it, it changes your immune system.

   10. JRJoe Rogan3:03

       What are the symptoms of it?

   11. RPDr. Rhonda Patrick3:05

       Most people that are healthy don't ever know they have it 'cause there's no symptoms.

   12. JRJoe Rogan3:07

       Whoa.

   13. RPDr. Rhonda Patrick3:08

       Yeah, unless you're immunocompromised. But most people that are healthy, they don't know, you know, that they're infected with it.

   14. JRJoe Rogan3:14

       Sa- wha- Say it again. What is it called?

   15. RPDr. Rhonda Patrick3:15

       The cytomegalovirus. It's CMV.

   16. JRJoe Rogan3:18

       Sounds like something Godzilla fights.

   17. RPDr. Rhonda Patrick3:20

       There it is. So, what's so interest-

   18. JRJoe Rogan3:23

       Hmm.

   19. RPDr. Rhonda Patrick3:23

       But here's the interesting thing about this virus, is that it... So, this is one of the major things. Multiple studies have be- have been looking at, like, you know, just immune variability, and it's like CMV's been identified in multiple studies. And the thing that... The reason it got me interested is 'cause I was like, "80... Almost 80%. I mean, I could have it, right?"

   20. JRJoe Rogan3:41

       Right.

   21. RPDr. Rhonda Patrick3:41

       "I could totally have it." Um, and, uh, it changes the immune function. It's totally different between young and old. So, so when you're younger and if you have it, uh, it actually enhances immune function. So there... They've done studies where, like, they, they, they have, um, given people influenza vaccine, and oftentimes these vaccine studies are used to kinda test the immune response and, like, how you're... how robust your immune response is, because you're, you're given a vaccine and there's all different types of vaccines, you know, pieces of an antigen or all different types of, you know, ways that you can, you can expose someone to a, um, bacteria or virus. But, uh, you have a response to it, and the response is, uh, you know, involves your adaptive immunity. You're making what's called neutralizing antibodies that, you know, basically eventually bind to the virus and neutralize it, prevent it f- prevent it from entering the cell. So, people with, uh, have CMV that are young have a really robust response th- to the vaccine, much better. Um, but older people have the complete opposite, where it's like, you know, deleterious. And the reason for that, scientists think, is because basically y- this virus, it's, it's stuck with you lifelong and, and it kinda reactivates every few years, and like, every time it reactivates, it kind of trains your T cells, you know, which are part of your immune system, to, to become focused on that CMV. And so as you get older, your, your T cell population becomes more focused on fighting that virus and less so on other viruses that you're exposed to. So-

   22. JRJoe Rogan5:11

       But this virus doesn't have any symptoms?

   23. RPDr. Rhonda Patrick5:14

       Most healthy people don't have any symptoms with it.

   24. JRJoe Rogan5:16

       Hmm.

   25. RPDr. Rhonda Patrick5:16

       I know. It's really like... It's really weird. So what I'm wondering... And the reason I'm even, like, going here, and it has nothing to do with, you know, taking vitamin C or zinc, and we can talk about all that stuff, and vitamin D, but I just thought it was so damn interesting because we, we hear all these stories in the news where, you know, some people are asymptomatic.

   26. JRJoe Rogan5:35

       Hmm.

   27. RPDr. Rhonda Patrick5:36

       Some people are, you know... Then some people are just really getting, you know, hard hit. And, and these people, let's say they're more age-matched, right? We know that elderly people are more, um, prone to a severe form. But it just made me think, what if this, you know, previous, previous viral exposure to something like CMV is, is kind of like also kinda shaping people's immune responses in some way? Surely people are gonna be looking, looking at that, but I just thought that was a really interesting thing to come across, you know? And then-... the other sort of on the same, on the same li- along the same lines as previous, you know, previous virus exposure is, like, something that really seems to be something that is a main regulator of how people... Like, what, how your immune, you know, what your immune response is, you know? And so-

   28. JRJoe Rogan6:22

       So you mean by how many times you've caught the flu, how many times you've had... Whether you've had chickenpox, measles-

   29. RPDr. Rhonda Patrick6:26

       How you respond to it, how you respond to it-

   30. JRJoe Rogan6:28

       Mm-hmm.
3. 6:59 – 9:16

   Cross-immunity hypotheses: common cold coronaviruses and SARS-CoV-2

   1. RPDr. Rhonda Patrick6:59

      Right. You're not always getting sick. And so, um, you know, like, another really interesting kind of thing is, like, you know, there's... So the SARS-CoV-2 virus, um, is part of a family of, of coronaviruses called the beta coronaviruses. So SARS-CoV-1, th- the vir- virus that was responsible for the original SARS outbreak in 2002 or something, the MERS one in the Middle East, and then there's two different ones that are re- uh, uh, responsible for the common cold. Now, coronaviruses are only responsible between, like, 15 to 30% of common cold cases. So it's not like... The common cold is, i- is the illness you get, but there's lots of different viruses that can cause it. Uh, but what's interesting is that there's been studies showing that these two beta coronaviruses that are responsible for some of the common cold cross-react with... Um, so there's one that cross-reacts with the SARS-CoV-1, um, which has a, a very... It's very, um... The sequence is very homologous to, uh, SARS-CoV-2 virus. And, um, and it's also been shown that the SARS-CoV-1, the antibodies against the SARS-CoV-1 can neutralize the, the common cold one. So there's, like, cross-immunity happening between these other viruses, right?

   2. JRJoe Rogan8:10

      Mm-hmm.

   3. RPDr. Rhonda Patrick8:11

      And so, um, there's been some studies by the CDC, uh, on the, on SARS-CoV-2 where they found basically, uh, that people that are infected with SAR- SARS-CoV-2 also boost their antibodies against the, the common cold one. So, you know, there's, there's certainly, I think, a good hypothesis to be made that po- potentially, you know, one or two of these common cold viruses could... The antibodies you make against them could also somehow maybe c- maybe, you know, interact with the SARS-CoV-2 virus, potentially neutralize it.

   4. JRJoe Rogan8:43

      Mm-hmm.

   5. RPDr. Rhonda Patrick8:43

      I mean, that's a big open question that seems possible. Um, without... We don't have any answer to that. I think we will. Like, there's large, there's large-scale, uh, sero surveys being done. I know at least three that, um... I think his name is Dr. Michael Busch, he's at UCSF. He's like... He's, he's doing, like, really large, um, surveys where they're, they're, they're gonna be analyzing sero from people from, like, you know, blood donors and stuff, and, like, following them over the course of several years to see, um, you know... To just basically understand more. So...

4. 9:16 – 13:29

   Why are some outbreaks mostly asymptomatic? Prisons, plants, and pre-symptomatic confusion

   1. JRJoe Rogan9:16

      Now, what is the speculation, if there's any sort of uniform speculation, as to why when you hear about prisons, where a lot of these prisoners... I don't know if you've seen that there's a v- video going around where one prisoner had, uh, SAR- SARS-CoV-2, COVID-19-

   2. RPDr. Rhonda Patrick9:31

      Right.

   3. JRJoe Rogan9:32

      ... whatever, and spitting into a cup and then passing it around to all these other inmates so they could all get it so that they could get released. So these... 'Cause they're releasing people, especially California, which is so wacky. They're releasing sex offenders, and there's been some really high-profile releases of these horrible people that should be in jail probably forever, and they're releasing them. It's like... It, it's really disturbing. But what would cause, other than something like that, what would cause all of these prisoners to not just be positive, that makes sense, but to all be asymptomatic? Is there any speculation as to why l- these large groups... There was another one that was a meatpacking plant where most of the people were asymptomatic as well?

   4. RPDr. Rhonda Patrick10:15

      I wasn't, I wasn't aware of the meatpacking one, being asymptomatic. Um, but the... I did read about the one in prison, and it was, like, blowing my mind. Like, what's-

   5. JRJoe Rogan10:23

      98%.

   6. RPDr. Rhonda Patrick10:23

      Like, what's going on?

   7. JRJoe Rogan10:24

      Yeah.

   8. RPDr. Rhonda Patrick10:24

      Like, that's insane. It's kind of like you read these stories... So, so this is, like, there's one thing that, uh... It's important to keep in mind when, when we say asymptomatic. Like, you know, there's asymptomatic in, like, a person that never actually gets symptoms, right? And then there's asymptomatic. So there was a study done at the CDC, I don't know, a month ago, maybe a little more, where they, they measured, like, uh... They did a, they did this nasal pharyngeal swab test in, in a nursing home, 70-something people, and, uh, 13 of them, uh, tested asymptomatic. Like, they had no symptoms, but they tested positive. But then they went back a week later, and 10 of those people had symptoms, and three were asymptomatic. So unless, like, there's another... Like, if you test someone and they're asymptomatic at that time of testing, they could be pre-symptomatic, right? In other words, like, you have to go back a week later-

   9. JRJoe Rogan11:13

      Mm-hmm.

   10. RPDr. Rhonda Patrick11:13

       ... and see if they have symptoms-

   11. JRJoe Rogan11:14

       Right.

   12. RPDr. Rhonda Patrick11:15

       ... because that, that's really important. So, so let's say even, you know, f- you know, 60% were asymptomatic. Like, I don't know if they went back and tested a week later or if it was just, like, a single time-

   13. JRJoe Rogan11:24

       Right.

   14. RPDr. Rhonda Patrick11:25

       ... but that's what, that's what... This is what got me thinking about this whole thing, was, you know, in, in the prisons and jails, I mean, they're in close quarters, and they're... You got one virus that someone's exposed to, and they all get it, right? So, like, what if there's... I don't know the CMV, you know, percentage there, but what if the coronaviruses are going around there? What if, what if, you know, some, some common cold coronavirus has gone around and that... You know, those antibodies that they've made to neutralize that coronavirus, beta coronavirus are somehow helping with the SARS-CoV-2? Like, I would love to see that tested, you know?

   15. JRJoe Rogan11:58

       Do you know if they immunize, uh, people, th- vaccinate people when they go into jail?

   16. RPDr. Rhonda Patrick12:03

       I was trying to figure that out as well, because, like, the tuberculocus, uh, tuberculosis, um, one of the ty- types of vaccines they do for TB-I think they do it in, like, Japan and some other countries where they've got a really low, um, death rate, and so they're kind of... That's a test, that's a clinical trial that's now going on where they're trying to test. But I was trying to figure out, is there a vaccination? Is there something, like-

   17. JRJoe Rogan12:24

       Yeah. 'Cause I would imagine it would be simple for them to do that. You're entering into prison, they just vaccinate you just to...

   18. RPDr. Rhonda Patrick12:29

       I couldn't come to an answer. I was, I was searching for that the other day.

   19. JRJoe Rogan12:32

       Hmm.

   20. RPDr. Rhonda Patrick12:32

       I was trying to figure that out. But I think that's also a really good... I mean, there's a ton of theories, right?

   21. JRJoe Rogan12:37

       Right.

   22. RPDr. Rhonda Patrick12:37

       I mean, it's just, you could go on and on and on. But the whole... The thing that, that... I, I just think that I would like to see more research, and I'm just hoping, you know, that, that CDC and other people are, are investigating these, these other... the cross-immunity, right? Like, if there's oth- if there's antibodies that you're making against another coronavirus, beta coronavirus, it's in the same family as this SARS 1. No one's had SARS 1 in the United States, you know? So, like, that one doesn't... that, that's not as relevant as... But the common cold, you know, that's, that's very common, right?

   23. JRJoe Rogan13:08

       Mm-hmm.

   24. RPDr. Rhonda Patrick13:08

       So, you know, if, if 15 to 30% of the common cold is composed of coronaviruses, we know at least two of those coronavirus are, are in the same family that have been identified to make... at least in one case, there's been neutralizing antibodies, so there has been cross-immunity-

   25. JRJoe Rogan13:24

       Hmm.

   26. RPDr. Rhonda Patrick13:24

       ... then you'd think, "Why, why not test that?" Like, let's get some animal studies started on that, you know?

5. 13:29 – 20:27

   Therapeutics pipeline: llama antibodies, monoclonals, remdesivir, and vaccine risks (ADE)

   1. JRJoe Rogan13:29

      Speaking of animal studies, there was an article that I was reading yesterday that was saying that they're, they're hoping that they've found some antibodies in llamas that they're hoping w- they're going to be able to... Because of... See if you can find this. Um, because of these antibodies in llamas, they, they, they're hoping they can either transfer them to people or learn something about how these antibodies are created. But llamas seem to be i-... Here it is. Llamas could be the key to fighting new coronaviruses, research says. We'll make that larger. It says, uh, it may sound bizarre to most, but llamas could be the key to fighting new coronavirus. Researchers from Belgium... Oh, remem- remember that's the big lady that I was showing you earlier? She's the health lady. And the United States (laughs) published an article this week in the journal cell that highlights the potential use of llama antibodies to prevent COVID-19 infections. Antibodies from a four-year-old Belgian llama named Winter show promise in blocking coronavirus from infecting cells, according to research from the University of Texas, Austin, the National Institutes of Health, and the Ghent... How do you say that? Ghent? G-H-E-N-T University. Studying early forms of the coronaviruses, researchers have found an antibody in Winter that effectively attached itself and neutralized spiked protein in SARS-CoV-1 and MERS-CoV. Uh, researchers believe the particular antibody, which has been found in other llamas as well, can be injected into an uninfected individual to protect them from getting infected with the new coronavirus. That's very interesting.

   2. RPDr. Rhonda Patrick15:02

      Yeah. So there... I think, you know, there's, there's lots of avenues for, you know, therapeutics and, you know, in addition to, like, repurposing drugs, um, monoclonal antibodies, you know, being able to basically identify antibodies that do neutralize SARS-CoV-2 virus, whether they come from llamas or humans, you know, and basically identify the specific antibody that can bind to that spike protein that you just mentioned, which is, um, that region. It's known that the antibodies bind there and neutralize it. It's also the region that, that is used to get inside of the cell. So, um, monoclonal antibodies, I think, are a really big, um, you know, possibility for a promising therapeutic because you can then... I mean, the problem is growing, like, large-scale manufacturing them, right? So, like, if you can identify these antibodies and then manufacture them, you can inject them in people and then potentially get some protection. The problem is, is that that's not gon-... Like, it's just gonna be a short-lived protection. Like, it's gonna be... It's not like you can... It's not like a vaccine where your body's making its own antibodies and they're, and they're more longer lived, you know?

   3. JRJoe Rogan16:08

      Oh, I see.

   4. RPDr. Rhonda Patrick16:08

      But I-

   5. JRJoe Rogan16:09

      So, in areas where people are getting exposed, perhaps you could give it to them and it would stop them from getting... But how long when you say short-lived?

   6. RPDr. Rhonda Patrick16:16

      We... Well, we... I don't know. I mean, how... So it's, you know, it, it's probably enough to pre-... Like, if you're a healthcare worker, your first line, you know, health, you know, first, uh, responder, people that are definitely, like, being exposed to large doses of the virus, um, that, that could be a promising area. But also, I think even just treating patients, like, that have already been infected, you know? So that's, that's also another...

   7. JRJoe Rogan16:41

      Hmm.

   8. RPDr. Rhonda Patrick16:41

      So, like, in combination with some of this other stuff, like remdesivir, uh, which is, you know, it's not like a, a silver bullet, but it seems like it's also promining- promising probably with combination of other, other factors as well. Um, but yeah, the mono- monoclonal antibodies is a really... I know there's, like... Regeneron's a big company. They're, um, they're, they're growing some large-scale ones. I think theirs, uh, they, uh, they isolated from humanized mice or something, but there's other companies that have isolated them from humans that have been infected. Uh, so, you know, that's, that's definitely, um, a promising area for sure. And the... A good thing about that is that, um... Have you heard of antibody-dependent enhancement? Do you know?

   9. JRJoe Rogan17:20

      No.

   10. RPDr. Rhonda Patrick17:21

       So that's a big concern. Um... All right. So, so basically, when you... when your body is exposed to a pathogen, like a virus, your, your innate immune system, you know, the first line of defense, like neutrophils, things like that, are making hydrogen peroxide, trying to kill the virus. But then in the background, your adaptive immune system, and I'm just totally generalizing, is tr-... you know, is, is also working in the background and, you know, part of that, uh, an adaptive immune response is, you know, to produce antibodies. So you have memory B cells that are making antibodies that are specific to bind to different regions, ep- epitopes on the virus and neutralize them, prevent them from getting inside of the cell. Um, and so, uh, that adaptive immune system usually takes about seven days after you're exposed to the virus, right? Um, the problem is, uh, antibody-dependent enhancement. So sometimes... A neutralizing antibody is an antibody that can bind to the virus and neutralize it, stop it from entering your cell, right? So your... it's doing its job. But you sometimes make antibodies that are non-neutralizing or don't...... do as good of a job, they don't bind as tight or something. And, um, then you can have what's called antibody dependent enhancement, and this was, like, a big problem for R- the RSV vaccine. Um, back in the, you know, like, most kids get RSV. It's a respiratory tract infection that most kids get it by the time they're two. Uh, like, and there's no vaccine that, that are, that's given. Uh, back in the '60s there was, um, this antibody dependent enhancement happened in some clinical studies with toddlers, and some toddlers got really, really sick and a couple died. But what happens is, basically, the antibody binds to the... There's a couple things. The antibody binds to the virus and can basically sh- change its conformation and allow the virus to get into the cell better, so then you become, like, you know, you get, like, a higher viral load and then you don't have antibodies to neutralize it and it just, you know, it could be more, it could be, it could lead to death. Um, the other thing that happens is the antibody binds to the virus, doesn't neutralize it, but it, like, makes this crazy immune complex that, like, activates your immune system to just go haywire and it causes all sorts of pathology in... That's what happened with the RSV toddlers. So, there's a few viruses that this happens with, and unfortunately coronavirus is one. Like, this has been identified with the SARS-CoV-1, um, virus, and I think MERS as well, where, um, uh, it... So this is also a problem with vaccines. So, like, people, like, giving, giving the vaccine, people's immune response, um, some people can have that antibody dependent enhancement, and that's what was shown to happen with these, with the SARS-CoV-1. There was some non-human primate studies that, that did that, um, and also, uh, animal studies as well. So, you know, mon- the thing with monoclonal antibodies is they're a little more specific 'cause you know they neutralize and you're, like, growing them up, like, you've done all that test as opposed to just letting your immune system do its thing and then p- potentially, you know, you may have this, like, non-neutralizing antibody that, um, could cause problems. But that's kind of the concern. I kn- I know that the vaccine, people that are working on vaccines are working on them. It's like they're concerned, I mean, about that and completely trying to, like, figure that all out. So-

6. 20:27 – 29:31

   Variants, spike mutations, and possible links to severity (plus blood type correlations)

   1. JRJoe Rogan20:27

      It's such a strange virus. It d- it d- it almost seems like there's multiple viruses.

   2. RPDr. Rhonda Patrick20:32

      There are. Yeah, so I mean, there's... And it's funny that 'cause it's kind of connected to this antibody dependent enhancement, there's, there's been quite a few different, like, forms, like mutations, that have been identified, um, but two particular in that spike protein region. That's like an important region because antibodies bind there and because that's the region, like, that, you know, the virus uses to get into the cell. Um, and so, uh, there's been, there's been two, uh, major, like, um, strains that have been identified, and one of 'em... So it's in a, in the spike region and it's an aspartate to gly- glycine mutation, and basically, uh, in, in Asia and China, um, it, the, the predominate form is the, the aspartate, the, like, original, quote-unquote, form. Um, and then in Europe and also in North America, this other f- this other form, the glycine mutant, I- is predominant. And there's been studies that have shown, um, looking at, like, okay, looking in parts of Europe, different countries in Europe that have this predominant form, um, that they're basically, there's a higher mortality rate. But they didn't actually measure th- infected patients, so, you know, it's kinda like correlation. But, um, what's interesting is that there's, there's actually been a genetic link to this mu- this mutant. So, um, there's studies, there's been some large-scale degentics- genetic studies that have found that Asians, about 20% of Asians have a, a, a basically a l- a se- um, a nucleotide change in a ge- in a gene that encodes for a protease that's involved in this, you know, basically in allowing this virus to get into the cell, but that basically prevents them from having this mut- mutant that's predominant in Europe and also in New York, um, and in North America in general. Uh-

   3. JRJoe Rogan22:12

      That's interesting because my friend, Michael, who got it, his mom who got it, who's in her 70s, is Asian, and she-

   4. RPDr. Rhonda Patrick22:19

      That is-

   5. JRJoe Rogan22:20

      She kicked it in a day.

   6. RPDr. Rhonda Patrick22:21

      That is interesting. So there's something... So there, there... I wonder if she has that SNP. So we, w- we, we're, uh, our genetic report that we have, like, we- we've got one that's, like, a new viral report, it's a free one, where we're kind of, like, putting some of these interesting SNPs, which don't mean anything. I mean, like, you know, it's just information that, you know, is interesting. There's a lot of researchers out there trying to, like, figure out if genetics is involved in this. But the thing that's so interesting about that mutation is that, um, the, it's in that spike region and it's where the antibody binds and peop- and there's a, there's like a theory going around because that specific region, it's been shown in SARS-CoV-1 to cause antibody dependent enhancement. So there's a theory that potentially that mutation is causing peoples' immune system to hyper-activate and basically become more active and it can be, lead to a more severe COVID-19 illness. That's not been shown. Like, it's not been shown at all. So, um, but it's interesting, right? It's interesting how in Asia and China particularly, I mean, about 1% of the population, it's like less than 1% has the other mutation. The m- the glycine mutation, that's in New York, it's in, um, you know, in, in most of the United States, but, um, that, that in- less than 1% of the population in China has that form.

   7. JRJoe Rogan23:33

      It's so weird. A- and Japan has a very low mortality rate, correct?

   8. RPDr. Rhonda Patrick23:37

      Yeah. They do. Um, I know that that, the, I was mentioning that TB vaccine, that's one thing that they're investigating. I mean, there's all sorts of differences in handling the whole, you know, from the beginning, just how you, how you handle-

   9. JRJoe Rogan23:51

      Mm-hmm.

   10. RPDr. Rhonda Patrick23:51

       ... the virus. I mean, I, like, there's, there's too many factors to, like, say one thing, but, you know, there's, there's lots of, there's lots of possibilities and I think that, that, I think that eventually there's gonna be therapeutics that are, um, identified, you know, that m- multiple ones maybe, and I, I think vitamin D is gonna potentially play a role there. Um, but I mean, just like, things like remdesivir and, you know, monoclonal antibodies and then you eventually, like, uh, you know, a vaccine will, you know, eventually, you know, be, be available. But I think until that ti- uh, until that point, I do think that things will be identified that just k- kind of help us, like...... deal with this, like, better, you know?

   11. JRJoe Rogan24:33

       (laughs) What is th- going on with blood types? W- One of the things we talked about earlier, y- you asked my blood type, and I, I said, "O positive."

   12. RPDr. Rhonda Patrick24:39

       Yeah.

   13. JRJoe Rogan24:39

       Now, why, why is O positive better?

   14. RPDr. Rhonda Patrick24:41

       Well... There's, um, there's been some data... And this was also with- s- identified with SARS-CoV-1, um, that people with type O blood, they, um, they make antibodies. They make type A antibodies, whereas people with type A blood, um, they make, um, antibodies against... like, they make an- a- against the B antigen. And so, um, the type A antibodies were identified. So, there's been studies looking at people with type O blood or type, um, type A blood, and also type B. In type O blood, there's, like, less, less frequency of getting COVID-19. So, um, as, as opposed to having a severe form, it's just, like, you're less likely to contract it, even.

   15. JRJoe Rogan25:26

       Mm-hmm.

   16. RPDr. Rhonda Patrick25:27

       Um, and it's thought because the type A antibodies that people with type O blood make, uh, neutralize the... They basically bind to that region, that spike region, and neutralize the antibody and prevent it from, the virus from entering the cell. So, that's... At least, that was the mechanism that was shown with SARS-CoV-1. So, it's thought, "Oh, well, the same... We're seeing the same, um, you know, pattern, where people with type O are protected from SARS-CoV-2, possibly that's, that's also why." But another really interesting thing is that people with type O blood, you've... We were also talking about these, like, blood clots. And like, I mean, there's all kinds of crazy things you read. I mean, I'm reading all these publications. It's just... And then the other thing is all these publications are being uploaded on, you know, before they're peer-reviewed, and I mean, some of them are just a mess.

   17. JRJoe Rogan26:14

       Yeah.

   18. RPDr. Rhonda Patrick26:14

       And it's just... Anyways, but you know, you kinda just take it with a grain of salt. Um, where these clots are like, you know, there's clots in people that are healthy and young, certainly people that have severe cases, people like older people, people that are, um, preexisting conditions and stuff. And, um, the type O blood, people have lower levels of this von Willebrand factor, which basically is involved in clotting. And it's been shown that that von Willebrand factor also, um, is inv- like, is higher, it's higher in people with SARS-CoV-2. It was shown also to be that with SARS-CoV-1. And it's involved with clotting, so having lower levels may somehow even help protect against. That's a theory. It hasn't been shown. But, uh, what is known is that people with type O blood are, are less susceptible to contracting, um, COVID-19. That's, that's definitely known. Um, but I mean, I think there's so many things. There's just... There's so many factors that-

   19. JRJoe Rogan27:15

       A lot of data that needs to be parsed out, right?

   20. RPDr. Rhonda Patrick27:17

       For sure. I mean, a lot of data that needs to be parsed out, a lot of data that needs to be generated. (laughs)

   21. JRJoe Rogan27:22

       (laughs)

   22. RPDr. Rhonda Patrick27:22

       And, and, you know, we need higher quality data. We need, you know, you know, people to repeat stuff. I mean, like, look what's happened with this hydroxychloroquine stuff, right? I mean, I mean, it's just kind of a mess, where it, initially it seemed like it could be helpful, and, and then just more and more studies came out where it was not, not only not helpful, it was, you know, toxic. It was causing people to have dangerous arrhythmias and stuff.

   23. JRJoe Rogan27:49

       Yeah.

   24. RPDr. Rhonda Patrick27:49

       Um, you know, so that's, that's kind of the, the reason to kind of be cautious when, when you have something new and a small, one small study, you know?

   25. JRJoe Rogan27:57

       Th- It just seems like, in the beginning at least, they're trying to figure out what the correct treatment was for these people, as they were just showing up en masse in the emergency rooms, and they didn't really know. And doctors, uh, they varied in how they approached it. My friend, Michael, his doctor didn't put him on a ventilator. And he said, "If I put him on a ventilator, he's probably going to die."

   26. RPDr. Rhonda Patrick28:16

       Right.

   27. JRJoe Rogan28:17

       Because he said, "His body's gonna stop working, 'cause it's, it's gonna let the ventilator do the breathing for him, and it's gonna give up." And what he was talking about, uh, after the fact, what Michael was talking about was how that is proven to be correct in New York, and that some monstrous number, like 80% of the people-

   28. RPDr. Rhonda Patrick28:36

       Yeah.

   29. JRJoe Rogan28:36

       ... that put on m- ventilators wind up dying.

   30. RPDr. Rhonda Patrick28:37

       Not just New York. I, like, uh, I've had friends, uh, that are physicians that have, like, you know, in, uh, New Orleans, I mean, the same thing, where it's like e-... You know, uh, I... There was, uh, someone on my team. We were loo- we were doing some research on this, and I, and I didn't sort of dive into the whole thing, but he was, he was telling me that, um, ventilators do actually, like, cause more damage to the lungs. And like, like, he'd been reading some studies to, like, confirm that, and he was pretty certain that, that ventilators actually cause damage and actually could, uh, like, induce damage, where it's like-
7. 29:31 – 55:48

   Vitamin D and COVID severity: deficiency rates, disparities, and potential mechanisms (ACE2/ARDS)

   1. RPDr. Rhonda Patrick29:31

      Right. Well, here, like, the, the, there's been some really interesting data looking at, like, in the f- There's one in the Philippines, um, and Indonesia. Where else? In New Or- I think New Orleans as well. Um, they've looked at patients that have died and their vitamin D levels. And in b- And basically, like, in the Philippines, you know, people that, for like, every standard deviation increase in vitamin D levels, serum vitamin D levels, you know, the people had like an 8%, or were eight-fold, eight times less likely to have a severe form of COVID-19. And if they had... And they were 20 times less likely to have critical, like, criti- critical, um, form of COVID-19.

   2. JRJoe Rogan30:13

      Whoa.

   3. RPDr. Rhonda Patrick30:14

      Um, in the f- in the... So, that was the Philippines. In the, Indonesia was a really interesting study where, like, they measured vitamin D, and this was measured in the patients. There's been some vitamin D studies also where they're, like, looking at, you know, countries that have been affected the worst, and they all, like, have low vitamin D, and it's like, okay. Well, anyways, that's correlation, but... Well, so is this, but, um, a little, it's a little stronger data. The, in the, in Indonesia, um-... patients that died, 90, ab- almost 100%, it was like 98 point something percent of patients that died with COVID-19 were vitamin D deficient. 4% of patients that died from COVID-19 were vitamin D suffici- or s- 4%, only 4%, uh, were fi- vitamin D sufficient. So basically, they were all vitamin D deficient, all the ones that are dying.

   4. JRJoe Rogan31:03

      Whoa.

   5. RPDr. Rhonda Patrick31:04

      Crazy, right? And like New Orleans had some craz- crazy number.

   6. JRJoe Rogan31:06

      And what would be the mechanism that would cause that?

   7. RPDr. Rhonda Patrick31:08

      So, I think there's... All right. Can we t- can we get into vitamin D? (laughs)

   8. JRJoe Rogan31:11

      Please do.

   9. RPDr. Rhonda Patrick31:12

      It's a big... I really think-

   10. JRJoe Rogan31:13

       Well, because of you, I take, uh, 5,000 IUs a day.

   11. RPDr. Rhonda Patrick31:18

       Awesome. Um, right now I'm taking 5,000 IUs a day.

   12. JRJoe Rogan31:20

       Mm.

   13. RPDr. Rhonda Patrick31:21

       Um, you know, 70% of the US population has insufficient vitamin D levels, which is considered less than, um, blood levels less than 30 milligrams, nanograms per milliliter. Um-

   14. JRJoe Rogan31:32

       And this is something that you c- your body can generate naturally if you're exposed to the sun on a daily basis.

   15. RPDr. Rhonda Patrick31:36

       Yes.

   16. JRJoe Rogan31:37

       That's the best way to get it.

   17. RPDr. Rhonda Patrick31:38

       It is. But the problem is, is that we don't go outside anymore. And, you know-

   18. JRJoe Rogan31:44

       Especially now-

   19. RPDr. Rhonda Patrick31:44

       Yeah. Especially now.

   20. JRJoe Rogan31:45

       ... with this lockdown.

   21. RPDr. Rhonda Patrick31:46

       Exactly.

   22. JRJoe Rogan31:46

       Yeah.

   23. RPDr. Rhonda Patrick31:47

       Uh, now more than ever. But even-

   24. JRJoe Rogan31:48

       And what a terrible recipe, right? Y- y- vitamin D deficiency is what makes it worse. And then you're staying inside, so you're not getting any vitamin D.

   25. RPDr. Rhonda Patrick31:55

       Yeah. You're becoming even more deficient. You know?

   26. JRJoe Rogan31:58

       Yeah.

   27. RPDr. Rhonda Patrick31:58

       Like thir- like someone, like 28% of the US population is actually deficient, like less than 20 nanograms per mil. You know, like that's defined deficiency. So, there's a lot of people in the United States. Um, as you mentioned, you make it from the sun, so particularly UVB radiation. There's a reason why I wanna talk about this. Uh, you make it from UVB radiation exposure. You know, basically your s- it's made in the skin. And, um, but, you know, there's certain times of the year, depending on where you live, in a more northern latitude where that UVB isn't even hitting the atmosphere-

   28. JRJoe Rogan32:27

       Right.

   29. RPDr. Rhonda Patrick32:27

       ... so you're not making vitamin D. Also, if you have darker skin, melanin protects you, like the whole... You know, people with darker skin, people, um, from maybe Africa or India or South Asia, they're more equatorial regions. They're closer, you know, closer to, to, to, to the equator, and there's more UVB radiation throughout the year. And so, as a protective mechanism to not get burned, you have melanin, which protects you, right? The problem is, is that melanin also blocks your, your ability to produce vitamin D. But if you're out in the sun all the time, you know, in a place where you're getting UVB radiation, it's not a problem.

   30. JRJoe Rogan33:05

       Well, this is the very reason why people in places like Scotland and England have such pale skin-
8. 55:48 – 1:11:32

   Vitamin C: oral vs. IV pharmacokinetics, dose-response, and clinical trial context

   1. RPDr. Rhonda Patrick55:48

      So, so I think that's the... certainly, m- you know, the issue. Um, yeah. I, I mentioned I'm drinking my vitamin C water. Um, it's funny because I've probably got, like, a thousand questions about vitamin C (laughs) in the past month to... month and a half, or whatever. Um, and I... S- we kind of, like, my team and I just dove in and put together an article, released a podcast on it, uh, a video where it would just... kind of covered everything. I mean, I can't believe how many studies are right on vitamin... 190 references in our article, the 28-page article on, on our website. Um, but vitamin C is interesting, too. I mean, I don't... I certainly... Th- the interesting thing about vitamin C is, you know, there, there, there's oral and then there's intravenous vitamin C. And the intravenous vitamin C is what's, what's... seems to be really relevant right now. Um, but, uh, I think the most interesting thing that I learned really had to do with the, the pharmacokinetics, which is basically, like, how much vitamin C raises your plasma levels and, like, is, you know, is there a, a saturation point where you can eat, you know, 20 grams of vitamin C but still only get to this certain point, you know? And then, versus what you do if you, like... in your... you know, inject it into your veins, right? Intravenously. So, um, what's interesting is that most people that are just, like, eating... Let's say that people are just eating, like, five... somewhere between five to nine servings of vegetables or fruits a day. Those people have anywhere between, like, 70 to 80 micromole, micromoles of vitamin C, like, per liter. So, it's micromoles per liter, um, in their blood. If you take, like, a 200 milligram supplement, you only raise your levels to, like, 90. So, it's not much over that, like, baseline. Most, most people that aren't eating that many, that cert- many servings probably have around 50, which is... can... still considered normal. Uh, 50 micromoles, or micromolar. Um, and then what's interesting is that, like... But those levels you take, if you take 200, 200 milligrams, it's... that doesn't do much. If you take a gram, it can raise you up to, like, 130 or something. If you take three grams, it can raise you to 220, and that's, like, the maximum level you can get from oral supplementation. 220 micromoles. That's big... That's a big difference, 220 versus, like, 50. (laughs)

   2. JRJoe Rogan58:12

      So, three grams?

   3. RPDr. Rhonda Patrick58:14

      Three grams. But here's the other interesting thing is that if you don't take it multiple times throughout the day, if you only take it once, you'll peak at around five hours after. I think I... There's, like, a really nice graph on, on my website, on the topic page, that shows this. Like, you'll peak, like, five, five hours after, but then you go down steadily and over 24 hours, you're back to normal. Your baseline. But if you take it, like, you know, four times a day, you can stay at 220, th- like...

   4. JRJoe Rogan58:42

      Mm.

   5. RPDr. Rhonda Patrick58:42

      ... all... the whole time. And, and the reason that's important is because a lot of studies looking at oral vitamin C consumption and, like, for ex- for instance, the common cold, incidence of the common cold, really depend... Like, there's huge variations in the results, and it all really seems to come down to dose. Like, it really does. And when you know the dose and how that's changing your blood levels, like if you're only taking 200 milligrams, which some studies are doing, it's barely doing anything over your baseline, you know? So, um, I found that really interesting. And then the intravenous vitamin C, you can, you can m- you can ma-... I mean, so far, like, the maximum I've seen measured is, like, 70 times that. Your blood can get 70 times 200. So yeah, so it's like-

   6. JRJoe Rogan59:23

      Wow.

   7. RPDr. Rhonda Patrick59:23

      ... 18,000 or 17,000 or something like that.

   8. JRJoe Rogan59:26

      So, IV is far more effective?

   9. RPDr. Rhonda Patrick59:28

      Oh, it, it totally overcomes all those, like, saturatable mechanisms. It's... And it's not only more effective, it's a completely different game-

   10. JRJoe Rogan59:37

       So when-

   11. RPDr. Rhonda Patrick59:38

       ... because-

   12. JRJoe Rogan59:38

       What... Can I pause you there?

   13. RPDr. Rhonda Patrick59:39

       Yeah.

   14. JRJoe Rogan59:39

       What, what dose do you recommend for, uh, intravenous vitamin C?

   15. RPDr. Rhonda Patrick59:44

       Hmm. Yeah, for inter-... Jamie, um, can you pull up foundmyfitness.com? And there's a vitamin C topic page, so that way I can answer that question better. 'Cause there's a... just pull... there's a graph. If you just, like, scroll to the graph, there's, like, a graph.

   16. JRJoe Rogan59:55

       And all this is on your website, we should tell everybody. Foundmyfitness.com. Um, vitamin C, oral...

   17. RPDr. Rhonda Patrick1:00:01

       Oh, that's the episode page.

   18. JRJoe Rogan1:00:02

       ... intravenous-

   19. RPDr. Rhonda Patrick1:00:02

       That's the podcast, but scroll back up to the, to the main home... Yeah. So, Topics. Click on Topics. There we go. Vitamin C is somewhere at the bottom. There we go.

   20. JRJoe Rogan1:00:13

       All right.

   21. RPDr. Rhonda Patrick1:00:14

       Okay. Sc- there's a... just, just look for the figure. Scroll, you'll see it. Okay, great, there it goes. Is there any way you can make that... Yeah. The bottom one is the one I wanna see. That's the intravenous. Okay, so there we go. So, this is intravenous dose. So, you can... I... T- you wanna get at least 10 grams. So, you can see 10 grams is like...

   22. JRJoe Rogan1:00:34

       And 10 grams is 10,000 milligrams?

   23. RPDr. Rhonda Patrick1:00:36

       Yeah. 10 grams is 10,000 milligrams. So that's, that's about 10 grams. That's what I've done in the past. Um, but what's interesting is when you get above... Most-

   24. JRJoe Rogan1:00:45

       Oh, you... Got us with the pop-up.

   25. RPDr. Rhonda Patrick1:00:47

       (laughs)

   26. JRJoe Rogan1:00:48

       (laughs)

   27. RPDr. Rhonda Patrick1:00:48

       Newsletter... My newsletter is great. I mean, I, I-

   28. JRJoe Rogan1:00:50

       I'm sure it's amazing.

   29. RPDr. Rhonda Patrick1:00:50

       I do lots of announcements there as the... Like...

   30. JRJoe Rogan1:00:52

       (laughs)
9. 1:11:32 – 1:16:12

   Zinc, quercetin, and other immune-supporting nutrients (plus red light skepticism)

   1. RPDr. Rhonda Patrick1:11:32

      Zinc's another one that's really, you know, important for immune function as well. Um, and elderly people are more ... Zinc deficiency's not really common in the US. Most, you know, zinc is found in, in, it's really high in oysters, but not a lot of people eat oysters. It ... Red meat, poultry, you know, if you, if you eat enough of that you should be getting enough zinc.

   2. JRJoe Rogan1:11:50

      What about vegetarians?

   3. RPDr. Rhonda Patrick1:11:51

      Vegetarians do, um, they, they are more prone to a zinc deficiency, and in fact, um, because the zinc is bound to phytate, it's less bioavailable and they need to, like, eat, like, up to three times more ... The RDA needs to be, like, almost three times as high for them. Or they can just supplement, which I know a lot of vegetarians do. But yeah, but zinc, zinc's really important for immune function. Like, there's been s- studies where they've, like, depleted healthy people of their zinc, just transiently, and, um, like, T-cell function, like, is all messed up, so it, like, totally messes the immune system up. Uh, randomized control trials showing that zinc, zinc acetate or zinc gluconate, like lozenges, um, they can, um, dramatically lower the duration of common cold. So ...

   4. JRJoe Rogan1:12:37

      Is acetate or g- w- gluconate, which one's superior?

   5. RPDr. Rhonda Patrick1:12:39

      So, there was, (sighs) it's, like, it was trending that acetate was better. Trending meaning it was non-significant. Um, although it was, like, 40% versus 28%. I don't, like, I, to me, lowering, lowering the duration of the common cold by 40% versus lowering it by 28%, I guess it was non-significant for whatever reason. So, they're say- it's, the study concluded that they're both the same, but it seems as though acetate may be slightly better.

   6. JRJoe Rogan1:13:03

      Hmm.

   7. RPDr. Rhonda Patrick1:13:04

      May be slightly better. Um-Uh, but you know. The, I am taking zinc. Zinc is also a positive ion, so you need a zinc ionophore to help it get into cells. Um, so like quars- flavonoids like quercetin. Quercetin's found in like apples, onions, buckwheat tea, which is what I drink. But you can supplement with it, which I also supplement with it.

   8. JRJoe Rogan1:13:24

      Yeah. I supplement with it as well.

   9. RPDr. Rhonda Patrick1:13:25

      It's um ... Quercetin's interesting because it's a zinc ionophore. It's also been identified to have, um, activity against SARS-CoV 1, um, antiviral activity against SARS-CoV 1.

   10. JRJoe Rogan1:13:36

       Doesn't it have nootropic properties as well?

   11. RPDr. Rhonda Patrick1:13:39

       I don't know. That-

   12. JRJoe Rogan1:13:40

       Am, am I wrong about that?

   13. RPDr. Rhonda Patrick1:13:41

       It, it has ... I don't know. Um, it-

   14. JRJoe Rogan1:13:43

       It might be confusing with something else.

   15. RPDr. Rhonda Patrick1:13:44

       It's, it's got senolytic properties, which means it can ... It's been shown, it's been identified as a possible, uh, compound that can clear out sen- um, uh, senescent cells, which are those cells that are, you know, ha- they accumulate with age and they're basically like ... They're not dead, but they're just like not really functioning and they're secreting, they're secreting cytokines and things that age nearby cells. I always like to think of like ... I was mentioning to Jamie that, um, I'm gonna be 42 next month and so, yeah, I have some gray hairs (laughs) . Hey, gray hairs. And it's funny how like you'll get one gray hair and the other gray hairs like cluster around that one.

Episode duration: 3:04:24