Joe Rogan Experience #1701 - Rhonda Patrick

1. 0:00 – 2:12

   Rhonda starts keto: chasing the “fasted-state” mental edge

   1. JRJoe Rogan0:00

      (drum music plays) Joe Rogan podcast. Check it out.

   2. NANarrator0:04

      The Joe Rogan Experience.

   3. JRJoe Rogan0:06

      Train by day, Joe Rogan podcast by night. All day. (rock music plays) All right, we're up. What's happening, Rhonda?

   4. RPRhonda Patrick0:15

      Hey.

   5. JRJoe Rogan0:16

      Very good to see you.

   6. RPRhonda Patrick0:16

      Good to see you. It's been a year.

   7. JRJoe Rogan0:18

      It has been. It's been quite a while.

   8. RPRhonda Patrick0:20

      Really. Yeah.

   9. JRJoe Rogan0:20

      And, uh, you were just telling me that you're 13 days into keto.

   10. RPRhonda Patrick0:24

       I am. (laughs)

   11. JRJoe Rogan0:25

       How you feeling?

   12. RPRhonda Patrick0:26

       Well, let's start off with like why do I even wanna do keto? Why now?

   13. JRJoe Rogan0:30

       Right.

   14. RPRhonda Patrick0:30

       I mean, like this has been how many years that it's been trendy, it's been like there's lots of benefits, and it's like why did I start trying it out now? (laughs) Well, um, I've noticed that when I am in a fasted state, so when I'm in ketosis, when I'm, you know, burning fatty acids and making ketone bodies and using them as energy, I'm like on top of my mental game. So, I've been doing ... Like when I have any sort of like podcast interviews I'm doing, or whatever, you know, I'm always trying to do them fast. Like I'm fasted right now. Um, and so I thought to myself like is this something that could be mimicked by a ketogenic diet? Like it's very noticeable for me, where I can stay focused. Um, I have more endurance. So like I don't like, you know, crap out like, like a couple hours-

   15. JRJoe Rogan1:21

       More mental- mental endurance.

   16. RPRhonda Patrick1:22

       Mental endurance, sorry.

   17. JRJoe Rogan1:23

       Yeah.

   18. RPRhonda Patrick1:23

       Yeah. More- more ment- mental endurance. So um, so I decided to try it out and I- I recently had a, uh, neuroscientist on the podcast, Dr. Mark Matsen. Have you heard of him?

   19. JRJoe Rogan1:33

       No.

   20. RPRhonda Patrick1:34

       He's like legendary. I mean, he's probably one of the most cited neuroscientists, but he's most well known for his intermittent fasting studies, like the 5:2 intermin- intermittent fasting stuff came out of his lab. Um, he's also sort of the father of hormesis and like, like why, you know, humans sort of adapted to be in a stressful environment and how, you know, all these stress response pathways that happen, you know, as a response that are beneficial. But anyways, so he was, um, talking about like when you're in a fasted state, when you haven't eaten, how your nervous system has sort of evolved to become like more focused, more alert.

   21. JRJoe Rogan2:12

       Mm.

2. 2:12 – 5:32

   How the metabolic switch works: glucose vs ketones in the mitochondria

   1. RPRhonda Patrick2:12

      And that's adaptive because if you can't find food, you have to be like alert in order to like eat or else you'll die. So um, so he's talking about like one of the main things that happens is this metabolic switch, wh- is what he calls but ... Um, so you- you do switch from burning glucose, you know, as a source of energy to basically f- you know, fatty acids are mobilized from your adipose tissue and go to your liver and you start to like oxidize them, use them for energy, and then you make something called ketone bodies as- as a byproduct, beta-hydroxybutyrate, acetoacetate. And um, most people think about these, well, this is an alternative source of energy, across the blood-brain barrier. It, you know, is easily used by, um, you know, neurons and- and other cells as well, but it's- it's actually an energetically favorable source of energy. So it actually requires energy to use glucose as energy. (laughs) To make energy from glucose requires energy. But beta-hydroxybutyrate, that doesn't happen. Like it goes into the mitochondrion and it's used without that energy requirement. So you can imagine-

   2. JRJoe Rogan3:21

      Can you explain how that works? Like, uh, the ... You use energy to use glucose?

   3. RPRhonda Patrick3:25

      Yeah, so glucose gets broken down into something called pyruvate. And pyruvate ... So it takes energy to do that and then pyruvate has to be transported into the mitochondria through a like active transport mechanism. And that requires energy to do that. Once it gets into the mit- ... Pyruvate gets into the mitochondria, it's then used through what's called the TCA cycle to make energy. Um, ac- acetyl ... So beta-hydroxybutyrate gets converted into acetyl-CoA and beta-hydroxybutyrate can just go in without like this active transport mechanism, so you're not requiring that energy to transport it in. Does that make sense?

   4. JRJoe Rogan4:00

      Mm-hmm.

   5. RPRhonda Patrick4:00

      So you're making energy but you're not using as much energy to make that energy. So um, that's kind of like what, you know, most people are thinking about is this. This sort of metabolic switch that happens. And you can imagine most people never do that. Like I- I typically ... I was, you know, doing ... I do a lot of time-restricted eating where I'll eat my food anywhere between eight to 10 hours and then I'm fasting anywhere between like 14 to 16 hours a day. And in order to actually go into this metabolic switch you have to deplete all of your glycogen levels in your liver and muscle. Um, and that usually takes anywhere between 13 to 36 hours depending on the person's carbohydrate intake, on their physical activity. And so um, you know, most people never get that metabolic switch. Most people are just constantly burning, using glucose and then when you're doing that, any fat that you're taking in gets stored as triglycerides in adipose tissue. So they're always in this like fat storage state instead of a fat burning state, right? And so um, 'cause most people are eating three meals a day and plus snacks, uh, you just ... You never get there. So um, with the- with the, you know, my s- ... You know, anywhere between 14 to 16 hours is what I typically was- was doing, I'd notice that like I was really mentally sharp. And so as I extended that out a little bit, it was like really clear to me that like not eating was like good for my brain in terms of like, like I felt smarter, I felt like focused more.

   6. JRJoe Rogan5:32

      Mm.

3. 5:32 – 8:28

   Ketones as signaling molecules: BHB, BDNF, and GABA

   1. RPRhonda Patrick5:32

      Like it was- it was noticeable, like- like a nootropic effect, right? And so um, one of the other things that's probably less well known about beta-hydroxybutyrate, which is one of the major circulating ketones you do make when you're in ketosis, is that it is actually a signaling molecule and this was shown by Dr. Eric Verdin. He's uh, he runs the Buck- Buck Institute for Aging in Novato, California. Um, he showed, back when he was at UCSF, that beta-hydroxybutyrate activates-... like many different genes, one of them including brain-derived neurotrophic factor, BDNF, which I know we've talked about before on the podcast. But that's something that is critical for, you know, forming new synapses and for learning and memory. I mean, there's... it's... there's all sorts of things that it does. But beta-hydroxybutyrate's activating that. Like, it's not just something that's being used as energy. Like, it's ch- like changing gene expression. Um, so, so that got me really interested. It's like, wow, this is something that, like, could be possibly also activating BDNF, maybe that's partly why. I mean, it's a hypothesis, but, you know, it seems, it seems like something that people could test, and it seems kind of, you know... it makes sense, right?

   2. JRJoe Rogan6:46

      Mm-hmm.

   3. RPRhonda Patrick6:47

      Um, and so, uh, so that was something that I was like, "Wow, what if I could do..." So, I a- so I asked Dr. Mattson, I was like, "What are..." You know, there's lots of, you know, differences between being in a fast-induced ketosis and a ketogenic diet, but there's also a lot of similarities, and the similarities are, one, you're making lots of beta-hydroxybutyrate if you do the ketogenic d- diet, right? We can talk about that (laughs) . But, um, and so, I was like, "Wow, well maybe..." And then the other thing that's o- that overlaps between the two is that you produce a lot of GABA. GABA's the, the neurotransmitter that's typically more of an inhibitory type of neurotransmitter. Um, I'm, I'm sure, uh, Doc- Dr. Dom D'Agostino's talked about this. I think I even re- remember him talking-

   4. JRJoe Rogan7:27

      Mm-hmm.

   5. RPRhonda Patrick7:27

      ... about it before, um, that the GABA is increased on both, you know, ketogenic diet and when you're in, like, a fasting-induced ketosis. And GABA is, um, you know, it kind of has an anxiolytic effect, so like helps calm you a little bit, but also seems to affect, uh, and this is what, uh, you know, some researchers think the reason why a ketogenic diet is so beneficial for, like, drug-resistant epilepsy, is through GABA, because it quiets down the neurons that have been excited through glutamate. So like, right now, we're like having an intelle- intellectual discussion, and we're like engaged, intellectually engaged, and so glutamate's being fired, right? And, um, it can do a lot of damage, like glutamate having this, like, constant electrical activity, like very stimulating, you need something... Like, if you didn't have GABA, you'd fry your brain, like without it, like with too much glutamate. So, it can cause something called excitotoxicity. And so GABA kind of counters that, and, um... So anyways, some of the things that I'm noticing

4. 8:28 – 13:02

   Why “keto” is harder than people think: measuring ketones and getting kicked out

   1. RPRhonda Patrick8:28

      now that I've been on day 12 or 13, um, for one, it's been incredibly hard. So I've been measuring my ketone, my beta-hydroxybuty- butyrate levels, um, daily, sometimes more than, you know, once a day, of course. And to be in, like, mild ketosis, you know, like, l- legitimately mild ketosis, like, I think, you know, you wanna be somewhere between like .9, 0.9, and, um, like 1.2. I mean, that's like m- mild or moder- mild to moderate. And I can't tell you how difficult it's been for me to first get to that point. Uh, it took several days, and it's, like, I think people, (laughs) probably like 90% to 98% of people that are, think they're doing a ketogenic diet, they're not (laughs) because-

   2. JRJoe Rogan9:17

      Really?

   3. RPRhonda Patrick9:18

      I think so, yes. Because I... it's not just enough to do carb restriction, and, like, you need a lot of fat. Like, you need, especially in the beginning, like, if your body... Like me, so I've always, you know, for the most part, my diet has been what you would call Paleo-ish, you know? I would, you know, like, I would have my protein and vegetables, and I rev- I've, I've generally speaking avoin- avoid, like, the refined stuff, refined carbohydrates, refined sugars, right? Um, but I do eat vegetables, which are carbohydrates, and I also eat some fruits. Um, and so, my body's used to, like, metabolizing the glucose and doing that whole pathway, you know, we were talking about, like, from carbohydrates. And the fat that I'm getting mostly probably is being, being stored, honestly, as triglycerides, but, um, it takes a while for your body to switch to that. And, um, I was surprised how long, because I thought, "Well, I don't eat all of that refined stuff, so it should be easy. It's just a little..." Like, it has been a huge challenge. And you read about all these foods that are like, okay, vegetables that are keto-friendly, you know, like cauliflower or, uh, Brussels sprouts or a little bit of spinach or... Like, I will eat, like, just a little bit of sauteed spinach, and it'll take me f- I will be at like 1.2 millimolar, and it'll take me down to, like, point, .7, um, you know? So it'll kick me out, just a little bit of something. And, and if I'm not eating enough fat, like, I can't even, like, get... So I finally was able to... Now I'm, like, doing, like, butter in my coffee, and I'm just, like, trying to get, like, olive oil in everything, and MCT oil in my coffee, and just, like, lots and lots of fat. When I started doing that, I was able to get up to, like, 2.2 millimolar, which is, like, good ketosis. And, um, and then, like, I would, you know, like I came here, traveling is really hard. I ordered, you know, I ordered some, like, I had a steak, and then it was some kind of cauliflower mash with, like, cheese and bacon, and that kicked me down to, like, 0.4, like, I was so upset. Checked my mil-

   4. JRJoe Rogan11:20

      So it's just the cauliflower, or is it-

   5. RPRhonda Patrick11:22

      Just the carbohydrate and the lack of not having as much oil, I think. Like-

   6. JRJoe Rogan11:25

      Mm-hmm.

   7. RPRhonda Patrick11:25

      So, like, I have the protein, so you can convert... So the thing, like, there are what's called glucogenic amino acids, and, um, those can be converted into glucose. Your body has a way... You, you need, you need glucose. Like, you can't, like, your red blood cells don't have mitochondria. The only source of energy they can use is from glucose. Your brain, you know, your astrocytes, and they're supporting cells in your brain, are mostly glycolytic, they mostly use glucose. You need, you need glucose. So your body has mechanisms to make it, you know, your, you can make it from these glucongeni- neogenic amino acids, which are in protein, or you can make it from glycerol, which is like the background of a tri- triglyceride, but, you know, I think...... once you become adapted, and this is something that I know, like, Dr. D'Agostino has talked about a lot, where he's got more of, like, a modified ketogenic diet, but he's been in it for, like, years. (laughs) You know? He's, like-

   8. JRJoe Rogan12:18

      Yeah.

   9. RPRhonda Patrick12:18

      ... done a ketogenic diet for, like, years. And, like, h- he can eat something that it's, like, a lot more, like, you can have the protein and, and the, and the, like, keto-friendly carbohydrates, like the leafy greens, you know, that are not, like, super carb.

   10. JRJoe Rogan12:31

       And it won't kick him out.

   11. RPRhonda Patrick12:33

       Yeah. He seems... Because he's, like, adapted. But in... You know, you read all these recipes. Like, "I'm going online. I'm trying to do keto recipes and all this," and it's, like, none of them work. None of them work. All the stuff that you, like, find in the store that says keto on it, totally not. Totally not. Like-

   12. JRJoe Rogan12:48

       Really?

   13. RPRhonda Patrick12:48

       Oh, yeah, because they have too much carbohydrates and not enough fat. It's like... And then they do this thing with this net carb, the net carb, you know, fiber. I'm telling you, like, if people were to measure their blood levels of beta-hydroxybutyrate, they would, they would know. Like, this, it's not-

5. 13:02 – 13:46

   Tracking ketosis: blood vs strips vs breath, and fat-adaptation questions

   1. JRJoe Rogan13:02

      And what is the best way to do that? Is the best way to do it through ketone strips? Is the best way to do it through, like, a breathalyzer-type deal? Blood?

   2. RPRhonda Patrick13:09

      I personally always think blood is the best. I'm not an expert. I mean, like, I haven't actually done a deep dive on all the different methods. Personally, I, you know, I like, like if you're measuring glucose, for example, like, blood is more accurate than, like, interstitial fluid area, like... So, I like to use this, you know, precisi- precision extra that you can get, and you can get these ketone, ketone strips. Um, and they're, they're actually a lot cheaper than they were, like, a few years ago. They used to be really expensive. And I just, I do that. Um, and I think that's the way I prefer. I mean, maybe there's some accuracy in some of the other ones, but I don't really know, honestly.

6. 13:46 – 17:25

   Exogenous ketones: esters vs salts, glucose drops, and use-cases

   1. JRJoe Rogan13:46

      Is there any, um, benefit to using exogenous ketones?

   2. RPRhonda Patrick13:50

      So, um, (laughs) I'll tell you what I think the benefit is (laughs) . It's probably not w- not something you're gonna expect. So, I've tried exogenous ketones many times, beta-hydroxybutyrate ester. The salts are like, the salts, like, I'm sure, like, Dr. D'Agostino has talked about that as well, like, they don't really ... they don't work as well, like, in terms of, like, actually raising you up to a millimolar level in terms of-

   3. JRJoe Rogan14:12

      So, what i- what is the difference in the actual name of the c- like, the supplements, like the salts would be-

   4. RPRhonda Patrick14:17

      Salts would be, like, a salty powder thing-

   5. JRJoe Rogan14:19

      Mm-hmm.

   6. RPRhonda Patrick14:19

      ... that you, like, add, and the ketone ester will be a liquid.

   7. JRJoe Rogan14:21

      Okay.

   8. RPRhonda Patrick14:22

      It'll be a liquid. And there's-

   9. JRJoe Rogan14:23

      So the liquid is more effective than the salts?

   10. RPRhonda Patrick14:25

       Oh, yeah.

   11. JRJoe Rogan14:25

       The salts are not very effective at all?

   12. RPRhonda Patrick14:26

       Not very much at all. And plus, they, like, can give you GI distress and stuff, and a lot of them have a lot of either sodium or calcium depending on what it's-

   13. JRJoe Rogan14:33

       Mmm.

   14. RPRhonda Patrick14:33

       ... complex to. But, so, um, one of the things that's interesting about the beta-hydroxybutyrate exogenous ketone esters, and I've tried a different... a few different brands, they all pretty s- work pretty well. Um, they'll raise you up, like if you d- if you, for example, if you drink, like, the whole serving, most of them are, like, 30 ml, they can take you from zero to, like, 3.3 millimolar like (snaps fingers) that.

   15. JRJoe Rogan14:56

       Oh.

   16. RPRhonda Patrick14:56

       I mean, like, ketosis that I haven't been able to achieve yet from 12 or 13 days of a ketogenic diet. And so, um, you can experience some of the, like, effects, but it also has the effect of lowering your blood glucose at the same time. And it's like, this is something that researchers are actually looking into, like, "Oh, this could potentially help people that can't regulate their blood sugar levels," you know?

   17. JRJoe Rogan15:19

       And this is only through exogenous-

   18. RPRhonda Patrick15:21

       This is... Yeah.

   19. JRJoe Rogan15:22

       ... ketones?

   20. RPRhonda Patrick15:23

       The k- like-

   21. JRJoe Rogan15:23

       The esters?

   22. RPRhonda Patrick15:24

       The exogenous ketone esters, yes. I have not-

   23. JRJoe Rogan15:26

       So it lowers your blood glucose and-

   24. RPRhonda Patrick15:27

       Dramatically.

   25. JRJoe Rogan15:28

       Wow.

   26. RPRhonda Patrick15:29

       But the, the problem with that is they're very short-lived. They're very transient. So, like, every time I've done it, l- like, they wear off, like, two hours max. Two hours max.

   27. JRJoe Rogan15:41

       Hmmm.

   28. RPRhonda Patrick15:41

       The problem is your blood glucose is also dramatically lower, and if you don't eat, if you don't, like, replenish that, like, you can crash hard. Like-

   29. JRJoe Rogan15:49

       Hmmm.

   30. RPRhonda Patrick15:49

       ... you can crash hard 'cause you have no beta-hydroxybutyrate around as the energy source. Now, whereas you're in ketosis, actual ketosis, your blood sugar levels are lower, but you're making beta-hydroxybutyrate, right?
7. 17:25 – 21:55

   Using ketones therapeutically: Rhonda’s mom, tremors, migraines, and diet adherence

   1. RPRhonda Patrick17:25

      Um, anyways, so like, convincing someone to do it is diff- diff- difficult, like very difficult. And so if you give them the exogenous ketone ester, they can experience, "Oh, I would feel this way. I would feel this way more often if I could," you know, first of all, initially do the ket- ketogenic diet. So I did this with my mom. So my mom has two types of motor dysfunction tremors. She has essential tremor, which is the kind of tremor where like, you know, you kinda just shake, like when you're doing something or grabbing like a s- you know, some spoon or whatever. Um, and then she has orthostatic tremor, which is like tremoring... tremors like where she st- if she stands still, like her legs shake really fast. So she can walk fine, but if she's standing, it's really hard. So she has to, like, not stand, she has to sit-

   2. JRJoe Rogan18:11

      Hmmm.

   3. RPRhonda Patrick18:11

      ... or walk or move.And with all the research on, on the effects of ketogenic diets on epilepsy, and then there's so- also some data, and, um, Dr. Matz- Matzon talked about this with me because he actually worked with the late Richard Veech on this, who was, like, the guy who invented the ket- ketone ester. Um, they're showing that it helps with, like, Parkinson's disease in animal models, Alzheimer's disease, like, and that's, you know, something that's a little different than motor dysfunction. But, um, so I wa- I ga- I, you know, I wanted to give her this, this ketone ester to say, "Look, the ketogenic diet may be beneficial for you, let's see." And it absolutely helped mostly with her essential tremor, uh, but she noticed a little bit of an effect with orthostatic. Now, of course, there's always the p- placebo. You can't placebo this. It tastes like shit. Like, you can't, like... I mean, maybe you could, but it's hard to come up with a placebo. I mean, people drinking this are like, "Okay, I'm (laughs) getting ketone ester."

   4. JRJoe Rogan19:05

      Yeah, I've tasted it.

   5. RPRhonda Patrick19:06

      Yeah. (laughs)

   6. JRJoe Rogan19:06

      It's rough.

   7. RPRhonda Patrick19:07

      Yeah. So, you know, it's kind of like-

   8. JRJoe Rogan19:09

      Gasoline.

   9. RPRhonda Patrick19:10

      There's always that, right? Yeah. So, um, so she's done this enough times, it also helped with her migraines.

   10. JRJoe Rogan19:17

       Hmm.

   11. RPRhonda Patrick19:17

       Like, so, uh, and there's, there's, like, literature, a body of literature out there where it helps. Ketogenic diet's been shown to help with migraines, both prevention and treatment. And then there's, like, one study showing ketone ester can help, uh, with migraines as well. I mean, they're, like, not, like, the best done, you know. I mean, there's, again, there's no placebo and all that, so you have to, like, take it with a grain of salt. But she's now been on the ketogenic, ketogenic diet with me, and, um, she's having the darnedest time g- getting into ketosis too. Like, and she's not doing the butter and the coffee and, like, the, all the, like, fat. Like, I'm t- I'm just really trying to get as much fat as I can.

   12. JRJoe Rogan19:52

       W- how is she doing it?

   13. RPRhonda Patrick19:53

       Well, she's eating... She's been eating the same meals. So, like... And she's a, a person that was like, "Refined carbs, woo-hoo!" You know?

   14. JRJoe Rogan20:02

       Mm-hmm.

   15. RPRhonda Patrick20:03

       Like, I mean, she's, like, someone that I've had to work hard on to, um, get her to stop drinking s- sugar-sweetened beverages, you know? Like, she thinks it fixes her migraine and-

   16. JRJoe Rogan20:15

       Coca-Cola?

   17. RPRhonda Patrick20:16

       Yeah.

   18. JRJoe Rogan20:17

       She would say it fixes her migraines?

   19. RPRhonda Patrick20:18

       Yeah, it does. Like-

   20. JRJoe Rogan20:19

       Does it?

   21. RPRhonda Patrick20:21

       According to her. I mean... (laughs)

   22. JRJoe Rogan20:23

       (laughs) Is there any reason why it would do that?

   23. RPRhonda Patrick20:24

       Maybe some caffeine, the caffeine's been shown to help.

   24. JRJoe Rogan20:27

       Hmm.

   25. RPRhonda Patrick20:27

       Um, also potentially, like, if she's having, like... If sh- if sh- if glucose is having a hard time getting into her brain and being used by her neurons, like maybe that sh- sh- you know, huge sugar rush from the Coke is gonna help. All the more reason, like, there's been, you know, there's been evidence, both animal and some early clinical evidence, that basically you can take someone with, like, early dementia. And, and the sign, some... One of the earliest signs actually of both Alzheimer's disease and, and, um... I'm not so sure if it's also dementia, but definitely Alzheimer's disease, is impaired glucose, like brain use of glucose. Like people, like their neurons and stuff are not using glucose well. And so, like, naturally, of course, beta-hydroxybutyrate would be an alternative to that, you know? So, so, um, anyways, uh, what was I getting at? Oh, yeah, basically there, th- there could be some effect with the glucose rush for her ca- well, for her headache thing. Um, but again, the exogenous ketones worked, they did.

   26. JRJoe Rogan21:31

       Hmm.

   27. RPRhonda Patrick21:31

       And so, like, I've been... Sh- I've given it to her and she's been wanting to do k- this is, this is... We've known this for like a ye- over a year, and she's been wanting to do the ketogenic diet, and I think it just finally took me doing it to, like, get her to start it, 'cause like-

   28. JRJoe Rogan21:43

       Does she live in the ne- same neighborhood as you?

   29. RPRhonda Patrick21:45

       No. No, she's close. I mean, she's in the same city.

   30. JRJoe Rogan21:47

       Okay.
8. 21:55 – 38:02

   Keto foods, micronutrients, and a surprise pivot: sardines, omega-3s, and heavy metals

   1. JRJoe Rogan21:55

      ... and what are you trying to get her to eat, like, specifically?

   2. RPRhonda Patrick21:57

      Well, right now we've been... I've been so busy and so I've been, like, doing the lowest hanging fruit in terms of (laughs) what's, like, the least amount of work.

   3. JRJoe Rogan22:06

      Bacon.

   4. RPRhonda Patrick22:07

      Bacon. I've got a bunch of bacon in my purse right now. I s-

   5. JRJoe Rogan22:10

      (laughs)

   6. RPRhonda Patrick22:10

      ... just because I gotta catch a flight after this and I'm fasted, I'm like, "I gotta eat something before I get on the plane." Anyways.

   7. JRJoe Rogan22:15

      What about beef tallow? Do you ever just-

   8. RPRhonda Patrick22:17

      I haven't... I'm going-

   9. JRJoe Rogan22:17

      ... scoop out beef tallow?

   10. RPRhonda Patrick22:19

       Not yet. Not yet. But, like, so, so what I've been doing just these past, like, you know, 12 or 13 days is what I thought was gonna, like, really get me in ketosis and be a ketogenic diet, which was like protein, avocado, olive oil drip- drizzled all over it, like some of the high-fat, low-carb nuts, like pecans and macadamia nuts. Um, and, and then I thought, "Oh, well..." You know, you know me, like, micronutrients, I need the magnesium, I need... So avocados are great, they're giving you a lot of stuff like potassium, but the magnesium, which I'm now supplementing with, is something that's been hard to get without my leafy greens. And my leafy greens have been, like, kicking me out (laughs) of ketosis. So I have to rest-

   11. JRJoe Rogan23:02

       Even if you, like, drench them in butter and...

   12. RPRhonda Patrick23:05

       I drenched it in butter and olive oil and I, you know, I cooked down... The spinach, when you cook it down, like so it's a lot more carb actually when it's cooked and-

   13. JRJoe Rogan23:15

       Really?

   14. RPRhonda Patrick23:15

       ... uh, I should have thought. Yeah, because haven't you ever sauteed spinach? I mean, you're like-

   15. JRJoe Rogan23:18

       Right, but I never thought it would be more carb-

   16. RPRhonda Patrick23:21

       Because you're eating more of it.

   17. JRJoe Rogan23:21

       ... because, because it's more s-

   18. RPRhonda Patrick23:22

       You're eating more.

   19. JRJoe Rogan23:23

       I get it. Right.

   20. RPRhonda Patrick23:23

       If you're eating spinach salad-

   21. JRJoe Rogan23:25

       You don't think you're eating more.

   22. RPRhonda Patrick23:25

       ... you would stop. You're like, "Oh, this is a big old bowl," like too much.

   23. JRJoe Rogan23:28

       Right.

   24. RPRhonda Patrick23:28

       But you eat that sauteed spinach and it's like little piece-

   25. JRJoe Rogan23:31

       Yeah.

   26. RPRhonda Patrick23:31

       It was like a little portion.

   27. JRJoe Rogan23:32

       It is kind of crazy.

   28. RPRhonda Patrick23:32

       Like how much spinach was in there? I don't know. Yeah.

   29. JRJoe Rogan23:35

       Right. Okay.

   30. RPRhonda Patrick23:35

       So, so, so of course everything that I was like, "Yes, I can't... This... I can do my leafy greens on..." I think I w- I will be able to eventually, but not initially. Not initially, for sure.
9. 38:02 – 42:44

   From nutrition to agriculture: factory-farm antibiotics and antibiotic resistance

   1. JRJoe Rogan38:02

      Yes.

   2. RPRhonda Patrick38:02

      ... the conventional is fat- uh, fattier as well. And before 2017, like, that's ... For a long time, I was ... Like, the main reason I was avoiding conventional meat was because, you know, these ... I don't know what you call them. These farmers, the ones that are growing, like, having the, the cows all packed in in there, you know-

   3. JRJoe Rogan38:19

      Yeah.

   4. RPRhonda Patrick38:19

      ... farming them.

   5. JRJoe Rogan38:19

      Factory farm.

   6. RPRhonda Patrick38:20

      Factory farm.

   7. JRJoe Rogan38:20

      Yeah.

   8. RPRhonda Patrick38:21

      They're ... They were feeding them antibiotics, not because they were, had an infection, but because it made them bigger, right? Like-

   9. JRJoe Rogan38:27

      That's why they fed them antibiotics?

   10. RPRhonda Patrick38:29

       Oh, yeah. So the FDA in 2017 ... You didn't know about this? So they-

   11. JRJoe Rogan38:32

       I thought it was as a risk-

   12. RPRhonda Patrick38:34

       They banned-

   13. JRJoe Rogan38:34

       ... as a reaction to the issues that they were having by eating corn.

   14. RPRhonda Patrick38:38

       Well, some, some, I'm sure some factory farmers were doing it for that. But, but by and large, like, there's like, there was a huge effect if you gave, like, an, a cattle or, or, you know, one of these animals antibiotics, it like, made them grow bigger.

   15. JRJoe Rogan38:53

       I wonder why.

   16. RPRhonda Patrick38:54

       I don't know. I honestly don't know.

   17. JRJoe Rogan38:56

       Hm.

   18. RPRhonda Patrick38:56

       But it was like, causing antibiotic resistance, like, was going through the roof-

   19. JRJoe Rogan39:01

       Oh, my God.

   20. RPRhonda Patrick39:01

       ... because it was, like, leaking into, like, all the water supplies.

   21. JRJoe Rogan39:05

       That is-

   22. RPRhonda Patrick39:05

       And not to mention-

   23. JRJoe Rogan39:05

       ... so scary to me.

   24. RPRhonda Patrick39:06

       We-

   25. JRJoe Rogan39:06

       Antibiotic resistance is so scary to me, because I know several friends that have had MRSA infections, and they are absolutely terrifying, because when you do get MRSA, like friends that have had, uh, staph infections and it got really bad, the doctors tell you, like, "This is touch and go." Like, you have to be in the hospital on an IV drip of antibiotics for we- I had a friend who was in there for weeks. And he is a young, healthy, black belt in jujitsu. He got a MRSA infection on his knee. Th- they had to cut his knee open like a fish, like pull it to the side to drain it and, like, to constantly clean it. It was horrific. He almost died. And he was in his 20s. And he ... Really healthy.

   26. RPRhonda Patrick39:48

       Yeah.

   27. JRJoe Rogan39:48

       Really active elite athlete.

   28. RPRhonda Patrick39:51

       Yeah. MRSA will take anyone down.

   29. JRJoe Rogan39:52

       Yeah.

   30. RPRhonda Patrick39:53

       That- That's ... I agree. Uh, that, that, that, that's scary.
10. 42:44 – 54:20

    Fighting skin infections: garlic/tea tree anecdotes, folliculitis, and hormone concerns

    1. JRJoe Rogan42:44

       But you talked about it, that the issue that you had with staph that you actually fixed-

    2. RPRhonda Patrick42:49

       I-

    3. JRJoe Rogan42:49

       ... with using garlic-

    4. RPRhonda Patrick42:51

       Yes.

    5. JRJoe Rogan42:51

       ... on-

    6. RPRhonda Patrick42:51

       So-

    7. JRJoe Rogan42:51

       ... on the actual-

    8. RPRhonda Patrick42:52

       I did.

    9. JRJoe Rogan42:52

       ... infection.

    10. RPRhonda Patrick42:52

        This is a total anecdote, and I had never tested the actual abscess to know if it was actually MRSA. But my anecdote goes as this. I came down with an abscess, and the first time I had it-

    11. JRJoe Rogan43:06

        Where was it?

    12. RPRhonda Patrick43:07

        ... the first one was, like, on my butt, and that had to be, like, they, like, removed it, and there was, like, like, a couple of inch hole. Like, it was, like, necrotic. Like, it was bad. And, um, and so that healed. But it has alre- it's already been on my skin, you know, it travels around, and so then I got it, like, in my pelvic region.

    13. JRJoe Rogan43:26

        Is that what happens?

    14. RPRhonda Patrick43:27

        And this-

    15. JRJoe Rogan43:27

        It just, once it's in your skin-

    16. RPRhonda Patrick43:28

        Well, we've-

    17. JRJoe Rogan43:29

        ... it just-

    18. RPRhonda Patrick43:29

        ... taught all this stuff, yeah. Once you get one, like even if it's not MRSA, whatever, whatever the st- you know, the staph-

    19. JRJoe Rogan43:35

        Mm-hmm.

    20. RPRhonda Patrick43:35

        ... you know, Staphylococcus aureus or whatever it's called, um, yeah, it's all over in your skin, and, um, I think it also depends a lot on, like, your immune system fighting it off. And this was- I got this in grad school. I was under a tremendous amount of stress. Like, I was so stressed out. I wasn't sleeping 'cause I had, you know, I was just working my, I was just working, working, working, and- and, like, stress, big time. Like, it was like a, I- I was getting sick a- a lot more often than, you know, I mean, it was just a bad, and I had IBS, bad part. Anyways, so then I got the- another abscess in a, in different region. It was closer to my pelvic region, and they gave me some antibiotics orally and then also some of this stuff called, like, Mupirocin, a topical antibiotic. And, uh, you know, it would go away and then come back. And it did this, like, on antibiotics again, it did this, like, twice. And at that point, I was like, "What the hell? Like, this isn't working." And I started looking into the literature on, okay, is there, like, a combination of things I can do to potentially help impact this, right? And, um, so, you know, you can find all sorts of those ... There's all sorts of compounds in various herbs and essential oils and things like that. And so after doing a lot of reading, I'd come up with, uh, some of the major ones were garlic, um, uh, this garlic was both topical and oral. I was also taking, like, oral vitamin C, like, once an hour to kind of help m- boost my immune system. I don't know, you know, whether or not that did anything, but, um, that was part of my, my, you know, protocol. And then, uh, topical, I was, I put garlic, so I would open up one of those garlic pills, and then I did tea tree oil. That was a big one that was shown to have, like, an effect, particularly on MRSA. And, um, so I was putting tea tree oil, and then I was also taking grapefruit seed extract orally 'cause that was shown to have an effect. And, um, I was taking EGCG, which is, like, from green tea. It also has- shown to have, like, uh ... These are all, you know, studies in vitro showing it has an effect on staph, uh, MRSA. You know, grain of salt, it's like, okay, in vitro, you put it on it, it's like, it kills it with a dose of X.

    21. JRJoe Rogan45:39

        Can you explain in vitro to people, that it's just cell culture?

    22. RPRhonda Patrick45:41

        Yeah. So you basically put something in cells that are in a Petri dish, you know, so it's- it's hard to extrapolate something like that to a human. But I was desperate and, you know, it was like, "Okay, well, I'm just gonna..." And I was taking this stuff, like the oral stuff, like the garlic and the grapefruit seed extract, and I was taking it, like, every one to two hours.

    23. JRJoe Rogan46:01

        Is there any benefit to taking fresh garlic versus taking it in a pill form or even, like, using it as, like, you were saying you took the capsules. Would be- there be benefit in taking the actual real garlic?

    24. RPRhonda Patrick46:13

        Well, the garlic, real garlic is great too, Then once this- once it, like, this thing went away for good, I was like, "Oh, garlic is the bomb." You know? So I would eat garlic any time I would feel any k- sort of sick or anything like that. But the oil's highly concentrated, you know what I mean? You're like smashing down all the oils from the garlic. So-

    25. JRJoe Rogan46:29

        So the- the- there are k- uh, capsule?

    26. RPRhonda Patrick46:30

        There's- it was a capsule with oil, garlic oil.

    27. JRJoe Rogan46:33

        Oh, okay.

    28. RPRhonda Patrick46:33

        Yeah.

    29. JRJoe Rogan46:34

        It's not powder.

    30. RPRhonda Patrick46:34

        Garlic- garlic oil. No, it's not powder.
11. 54:20 – 1:37:57

    Sauna deep dive: immune effects, depression trials, and hot-to-cold dangers

    1. JRJoe Rogan54:20

       I'm a... I have become absolutely obsessed with sauna use over the last like... I guess it started because of you. And then over the last, like, through the pandemic, the last year and a half or so, I'm in every day, every single day. Like, it's very rare that I take a day off. I mean, I have to be wrecked to take a day off of sauna use which-

    2. RPRhonda Patrick54:41

       Damn, you're getting all the benefits.

    3. JRJoe Rogan54:43

       Yeah.

    4. RPRhonda Patrick54:43

       You're-

    5. JRJoe Rogan54:43

       Even when I come home at night, like last night I had a show and I'm out with all these fucking weirdos with no masks on. So I'm like, as soon as I got home, I cook myself.

    6. RPRhonda Patrick54:52

       (laughs)

    7. JRJoe Rogan54:52

       I cook myself for like 15, 20 minutes at 185 degrees and just deep breaths. And you know, there's that paper that I sent you about, uh, COVID-19 and, um, you know, the, uh, therapeutic, uh, intervention of using sauna and this idea that...... when your body heats up like that, like you're trying to kill off a vi- a virus when you're- when you're sick. If you're sick with a viral infection and your body gets a fever, your body's trying to kill that. And this idea, this paper is, you know, exploring the use of sauna to intervene, to stop it from ever getting infecting, eh, ev- ev- from ever infecting your body, both through your nasal passages, through your- through your airway, and also just through the actual heating of the body.

    8. RPRhonda Patrick55:38

       Right. Yeah. There's a- there's a fever response that is induced, like, when you have an infection. And- and- and part of that is to help fight off, you know, the pathogen as well.

    9. JRJoe Rogan55:49

       'Cause the pathogen can only exist in a certain temperature range, right?

    10. RPRhonda Patrick55:52

        Part- partly, yeah. I mean, there's p- there's multiple mechanisms. It also activates heat shock proteins. Um, and heat shock proteins have an- a- a role in- in your immune system response and how your immune system responds. So it, like, you know, it- it plays a role particularly in- in- in innate immunity, um, which is the kind of immunity that is, uh, important when you first see a pathogen that you've never seen before. This isn't like an antibody type of response. It's like killing of it, you know-

    11. JRJoe Rogan56:18

        Mm-hmm.

    12. RPRhonda Patrick56:18

        ... before that. Um, but there's interesting evidence, I'm sure I've talked- we've talked about this coming out of Dr. Jari Laukkanen's lab in, uh, Finland. Uh, this was a few years ago where he- he looked at sauna use and, like, incidents of pneumonia. And people that, like ... So in Finland, saunas are ubiquitous. You know, most people have one at their house, and most people use it at least once, you know- at least once a week. Um, but then you have people that are using it, like, two to three or four to seven, and so he always kind of stratifies the- the data based on, like, frequency of use. And he found that people that used the sauna four to seven times a week were 40% less likely to get pneumonia. And this was after, like, correcting for all sorts of, like, other lung diseases and other health factors and exercise and all that stuff, you know. At the end of the day, it's a correlative study, right? I mean-

    13. JRJoe Rogan57:08

        Mm-hmm.

    14. RPRhonda Patrick57:08

        ... so ... But, um, I thought that was interesting because there's also, like, all these other studies that have been done in, like, the '80s looking at the effects of the sauna on the lung function and, like, helping with, you know, like, a variety of fa- factors of lung function. So, it's- it's interesting. There's probably, like, lots of things going on, um, as well. And as I just gave you my paper today, uh, was- was published with my co-author, Teresa Johnson, um, in the- the journal Experimental Gerontology. We argue that if ... The title is Sauna Use as a Lifestyle to Increase Healthspan, which basically refers to the disease-free part of your life. So, in other words, you know, like, you- as you age, you become more susceptible to things like, you know, cancer, Alzheimer's disease, heart disease, respiratory problems, all that stuff. And so, we argue that- that sauna use should be up there with things like exercise and-

    15. JRJoe Rogan58:08

        Mm-hmm.

    16. RPRhonda Patrick58:09

        ... good sleep and good diet, you know, things that are known to- to improve your quality of life. And there's tons of evidence, things that we've talked about before, but, um, you know, talking about the cardiovascular disease improvements, how sauna ... But one of the things I'm most excited about, like, I've been getting my mom in the sauna, and she's been sedentary, you know, like her whole life basically. She's overweight and, like, there's no- there's no getting her on a Peloton, there's no getting her to go for a jog. Like, it's just not gonna happen. Maybe once, but, like, it's just not gonna happen. And so, um, I've been trying to get her in the sauna because I'm trying to improve her health some way, right? And, you know, it's- it's a lot easier for people, at least I've noticed with my mom, you know, who's- if- views it as, like, a spa treatment, you know. She goes in there and puts some hot water- I mean, s- puts some cold water on the hot rocks, and it's kind of like a steam room. Like, she feels like it's a- it's a spa, but she's also getting, you know, the sauna-mimicking cardiovascular- mo- moderate cardiovascular exercise. Like-

    17. JRJoe Rogan59:09

        Yeah.

    18. RPRhonda Patrick59:09

        ... that's what it does. And we talk all about that in the paper. Um, but, you know, so- so people that are, like, sedentary and have been sedentary their whole life and also people that are disabled. Like, there are some people that can't go for a run. There are people that can't even get on a Peloton. Like, they're disabled, and they can't do aerobic exercise. Like, this, to me, is, like, a no-brainer.

    19. JRJoe Rogan59:33

        Yeah.

    20. RPRhonda Patrick59:33

        A no-brainer. I mean, granted, there are some contraindications, like certain- if you have certain, um, particularly certain, like, heart- certain heart disease risks. Um, that could be a contraindication, meaning you shouldn't do it. But by and large, it's- you know, improves a lot of cardiovascular things, and so-

    21. JRJoe Rogan59:50

        Can you mitigate those risks by having a- a slightly lower temperature? Like, instead of, like, going to 185, maybe going to 160 or something like that where it's a more mild form of heat?

    22. RPRhonda Patrick1:00:01

        Right. I don't know. I know that, like, it- to me, that would make sense, and this was- you have to, like, discuss this with your physician. But like, for example, s- people that have, like, arrhythmias, there could be a very mild contraindication with arrhythmias. And so the question is, you know, would a lower temperature, like 165, which is what I've been doing for my mom, like, mostly because she's not adapted to h- the heat at all, and so, like, you have to adapt before you can, like, do 20 minutes at 185. You know, like, it takes- takes a while for people that aren't used to even raising their core body temperature when they're exercising, you know.

    23. JRJoe Rogan1:00:36

        Mm-hmm.

    24. RPRhonda Patrick1:00:36

        So again, that's mimical- it's mimicking a lot of the physiological aspects, including that core body tem- core body temperature going up, you know, the- the- the blood flow changes going to your skin and sweating, heart rate. You know, your heart rate gets elevated while you're in the sauna, and then it- and then blood pressure goes down after. Like, these things have been compared head to head. So, it does mimic moderate aerobic activity, and it's, like, the only way that I'm able to get my mom in there.

    25. JRJoe Rogan1:01:00

        Mm-hmm.

    26. RPRhonda Patrick1:01:01

        And then there's, like, the brain benefits, you know, and this is something, um, people- people that are- are, um, depressed, like my mom actually has- she's been diagnosed with major depressive disorder. And, um, you know, you look at a ... She's got a variety of SNPs, like prop- like, there are certain SNPs that she has that are, you know, consistent, like in the serotonin transporter and things like that. You can look and see, like, there, you know, there's evidence that she has things that have been linked to, like, you know-... major depressive disorder. And also, she's had a lifetime of being inactive, and there's a lot of environmental factors at play, you know, like drinking Cokes, like refined sugar, you know? I mean, that's inflammation. But, um, there's been some evidence from Dr. Charles Raison. He was the first to show that like a single, what they called whole body hyperthermia, which is basically, they were using this really expensive device to elevate people's core body temperature to like 101 degrees Fahrenheit. I mean, they were doing a fever. I mean, they were getting hot. And they had a sham control, people that were th- ... They were elevating their core body temperature a little bit, so they thought they were getting the treatment, but they weren't. So it was- it was-

    27. JRJoe Rogan1:02:09

        How were they elevating the core body temperature?

    28. RPRhonda Patrick1:02:11

        There was ... It's- it's kinda like some ... It's- it's called the Heckel device. It's like this crazy thing that has kind of infrared-ish, like, where it's doing it, like, through like that, like what an infrared sauna would do basically.

    29. JRJoe Rogan1:02:22

        Okay. Mm-hmm.

    30. RPRhonda Patrick1:02:22

        Um, and- and so they did this in the- in the people that were, uh, in the sham c- control group, which is kinda like the placebo in a way. And so 70% of those people in that group actually thought they were getting the treatment, so it was a wonderful placebo because with anything depression, like placebo effect is a very real thing. And people know they're getting a treatment, they're gonna feel better. Like, yeah, this works, you know?

Episode duration: 3:03:23