Debunking The Internet’s Biggest Health Myths - Dr Karan Rajan

1. 0:00 – 4:10

   Never Hold in a Fart

   1. CWChris Williamson0:00

      Why should you never hold in a fart?

   2. KRDr Karan Rajan0:03

      (laughs) You know what? Uh, a patient did once ask me this, and this was an inspiration for me to make a statement or an explanation about this. And, you know, a fart is a gas, you know, it's a chemical, it's a bunch of chemicals, and when you hold in a fart, there's a percentage of that fart vapor which will diffuse through the walls of the colon, through the walls of the intestine, and eventually it will go to your bloodstream, and all the blood circulates and eventually goes to the lungs where the waste products are then exhaled out. So there's a tiny percentage of your fart which, if you hold it in, will go to your bloodstream, go to the lungs, and then be exhaled out, so you will have fart effects.

   3. CWChris Williamson0:48

      You're gonna breathe it- you're gonna breathe it instead of farting it if you don't fart it.

   4. KRDr Karan Rajan0:53

      You will exhale farts, so you will literally-

   5. CWChris Williamson0:55

      (laughs)

   6. KRDr Karan Rajan0:55

      ... breathe out fart fumes if you hold it in.

   7. CWChris Williamson0:59

      (laughs)

   8. KRDr Karan Rajan1:00

      It's physiology. It's science. (laughs)

   9. CWChris Williamson1:02

      Science, baby! This is what we're here for. Uh, I've always thought this: where does the gas from burps come from, and why does it never go away? You know, like, you keep needing to burp over and over again, so what, i- if I'm not adding any gas in there, is that gas that you breathe in that somehow ... ?

   10. KRDr Karan Rajan1:21

       Uh, a lot of the burps are a byproduct ... well, there's a couple of ways. Uh, a byproduct of air swallowing, so if you chew a lot of gum, you are swallowing a lot of air. You drink a lot of sodas and fizzy drinks, you are again swallowing a lot of air and the sort of carbonated gas that you're in- eh- sort of ingesting. And lastly, there will be a percentage of gas that your bacteria or the various microbes in your gut microbiome will produce, and they can may their- make their way upstream, as it were. And they'll c- also be a result of acid reflux as well, so if you have acid reflux, there's basically a floppy sphincter between where your stomach attaches to the first bit of your small intestine, and you get reflux of some of the gases and juices, and you get sort of excessive burping.

   11. CWChris Williamson2:07

       Yeah, it does seem, you know, if you've eaten a little bit too much or a little bit too quickly and you're a little bit full, it's like, it just is just not stopping. I just keep on burping over and over again. It's just gonna happen until I guess I've- my stomach levels finally settle down.

   12. KRDr Karan Rajan2:20

       Yeah, and there's actually a couple of hormones, uh, one hormone in particular called cholecystokinin, and we can call it CCK for short. And CCK actually delays gastric emptying and slows down how much your stomach empties into your small intestine, so that hormone is increased if you eat foods that are high in fat or spicy foods. So if you eat spicy foods, the chemical capsaicin in spicy foods or chilis actually increases the production of CCK, cholecystokinin, so there's more stomach content and there's more likelihood that you can burp or have reflux. Same with fatty foods. That stimulates CCK production, more burping, more reflux.

   13. CWChris Williamson3:01

       Presumably, with the spicy food, that is because your body doesn't want to transport too much of a very spicy thing through your digestive system too quickly, and with fat, something similar?

   14. KRDr Karan Rajan3:14

       Yeah, so it's just the nature of the fat molecules which slow down digestion so it has more time for your body to digest it, but the case with chili is different. Capsaicin, our body reacts so weirdly to capsaicin in so many different ways. So capsaicin is processed by our bodies essentially as sometimes a toxin, because it irritates the cells, and your body doesn't realize it's just spicy food. It doesn't have a spicy receptor. You only have receptors for, you know, sweet, sour, umami, and savory. Spice is not a receptor, so it actually interprets that as heat, because capsaicin triggers and stimulates the heat receptors, so it thinks something is burning inside, so it wants to say, like, "Oh, hang on, I'm not gonna let you digest," and it stays up there, and so our body is a bit of a flawed machine, you know?

   15. CWChris Williamson4:08

       Yeah. That's interesting.

2. 4:10 – 10:34

   What People Need to Know About Digestion

   1. CWChris Williamson4:10

      What do you think, or what do you wish that more people knew about how digestion works?

   2. KRDr Karan Rajan4:17

      So if you think about digestion, most people just think about the stomach. People would assume that the stomach digests everything like a big blender or a washing machine, and then that's it, it's done, right? And the esophagus, the food pipe, is just like a- a big waste pipe everything goes down. But actually, the stomach doesn't really have much to say in digestion. The digestion mostly occurs in the small intestine, and you've got a number of organs inside your abdomen, from the gallbladder to the pancreas to the liver, and all of these various organs actually interplay and interconnect with each other, and each step in that factory line of digestion is as crucial as the last one. So it's not just the stomach. In fact, the stomach is essentially a mixing bowl where things are mixed together, and it's later on the enzymes and the bacteria and everything kick in to really have a role to play in your digestion. So actually, digestive health, or gut health, as people love to talk about gut health these days, is more than just one part. You know, the sum of the parts is the real thing there.

   3. CWChris Williamson5:25

      What's ... I- I keep reading about IBS being on the rise, gluten intolerance being on the rise, f- food- food intolerance is increasing. What do you think is going on from your perspective?

   4. KRDr Karan Rajan5:37

      So IBS, irritable bowel syndrome, it's surprisingly quite common, and a lot of people think IBS is one thing. It's an umbrella term. IBS has lots of different subtypes. People can have things called IBS-C, IBS-D, where actually they're triggered by different foods, and one person's IBS trigger, for example, s- a type of fermented food, can be non-triggering for someone else, and we don't really 100% understand the causes of IBS because we don't really understand the human body to its fullest potential, and certainly there is an interplay between the microbiome and what are the symptoms and manifestations of IBS. And-With that in mind, the rise for IBS, why is that happening? Certainly there is a huge role to play in the microbiome. We know that the microbiome is influenced by the diets we ingest, so certainly we are having increased number of ultra-processed foods which can influence the microbiome negatively. Maybe a more sedentary lifestyle, we know that lower exercise, more stress, less sleep. Again, these factors can have a role to play in negatively influencing the microbiome and all of these things can trigger a number of digestive issues and IBS, irritable bowel syndrome, is one of them.

   5. CWChris Williamson6:55

      What's your thoughts on probiotics and collostrum supplements, prebiotics, all of that stuff?

   6. KRDr Karan Rajan7:02

      So, I think there's a lot of these buzzwords thrown out these days, prebiotics, postbiotics, probiotics. And as a surgeon who deals with bowel cancers and a lot of intestinal issues, I have perhaps prescribed probiotics, medical grade probiotics two or three times in my entire career. Probiotics, the ones you can go to the supermarket, pick up off the shelf, you know, Yakult, Dannon, whatever it is. For the average person, it's not gonna make a huge difference because the strains contained within these mostly unregulated, off-the-counter, or off-the-refrigerator-section supplements, they're not gonna be present in high enough concentrations or bacterial units to actually have a significant role to play. It's just like pissing in the wind, and they're not gonna be effective enough in colonizing your gut, which is what you want them to do. They will be wiped out by your digestive processes, the stomach acids, and they won't be able to compete or integrate with the existing bacteria that are in your gut. Actually, you can get more of a benefit from probiotic-rich foods, foods that have natural live microorganisms. Kefir, kombucha, Greek yogurt, live yogurt which has strains, um, things like that, you know, or- or sauerkraut, pickled vegetables. These are more effective than supplements. Supplements do work for a narrow range of conditions, rare types of pediatric, um, gastrointestinal issues, someone's had antibiotic-associated diarrhea, post, uh, bowel surgery sometimes. So, it does work for a very limited scope of things.

   7. CWChris Williamson8:42

      Yeah, it's interesting, I, um, I went to a place called Fountain Life in Dallas, here in Texas, about four months ago, and they're a preventative medicine clinic, and it is...

   8. KRDr Karan Rajan8:53

      Mm.

   9. CWChris Williamson8:53

      Full body MRI, heart angiogram, brain CT scan. I had a- an hour and 20 minute MRI of everything.

   10. KRDr Karan Rajan9:01

       Wow.

   11. CWChris Williamson9:01

       A balance scan, gut microbiome analysis, full body DEXA scan. Everything, everything, everything, everything. Then they run all of that through a- a ton of AI to try and work out predictive factors when all of this data is put together, and that is a training set that trains everybody else's, etc., etc. And, um, I found it really instructive. Thankfully there was nothing s- s- d- dangerous or whatever in there, um, but they did find, for me, a little bit of leaky gut syndrome.

   12. KRDr Karan Rajan9:26

       Mm.

   13. CWChris Williamson9:27

       And, um, that was something that I, again, like another, uh, like, that didn't exist 10 years ago.

   14. KRDr Karan Rajan9:31

       Mm.

   15. CWChris Williamson9:31

       I'd never even heard anyone say that 10 years ago. Uh, so since then I think I've been using a- a collostrum product, uh, Armour, which is, I actually really like, uh, and just trying to change up the diet. But dude, kefir is like just upgraded yogurt drink. It's, for the people-

   16. KRDr Karan Rajan9:49

       Yeah.

   17. CWChris Williamson9:49

       ... that don't know, it's kind of like a milksh- like a- a thick milkshake, I guess? But it...

   18. KRDr Karan Rajan9:53

       Yeah, like a fermented shake.

   19. CWChris Williamson9:54

       But it doesn't taste fermented. Like fermented-

   20. KRDr Karan Rajan9:56

       No.

   21. CWChris Williamson9:56

       ... makes you think, "Oh, it's gonna be kind of sour, like gone off milk."

   22. KRDr Karan Rajan9:59

       Yeah.

   23. CWChris Williamson9:59

       But it's not. You can get some really, really nice ones and I'm a m- massive fan so I'm team kefir as well for the-

   24. KRDr Karan Rajan10:05

       Oh, yeah.

   25. CWChris Williamson10:05

       ... digestive system.

   26. KRDr Karan Rajan10:06

       And you can make it at home. It's relatively easy to make at home. If you've got some kefir that you've bought over the counter or you've bought from the supermarket, if you save some of the kefir you can use some of the old kefir to make a new batch from home where you get a bit of milk or something like that and you add the old kefir to that and leave it to ferment overnight and you've got a new batch of kefir.

   27. CWChris Williamson10:28

       Mm, how funny. Yeah, that's like a- a pineapple, like chop the head off it, turn it upside down, you grow yourself another pineapple.

   28. KRDr Karan Rajan10:33

       Exactly, yeah.

3. 10:34 – 15:46

   A Day in the Life of a Surgeon

   1. KRDr Karan Rajan10:34

   2. CWChris Williamson10:34

      You mentioned there the fact that you're a- a surgeon. I think, uh, m- most people's understandings of what a surgeon does will be from some combination of Doctor Strange and, uh, like, uh, I- I don't know, uh, 24 hours in A&E. What is the reality of a typical day as a surgeon like?

   3. KRDr Karan Rajan10:56

      Reality of a typical day, so I would wake up around 5:30, uh, and I'm in work by around, you know, 7:00, 7:15, because the work starts probably 45 minutes to an hour before the actual surgery happens. I need to go and see the patients, review their scans, consent the patient, so take them through what the operation will entail, tell them about the risks of the operation. And then, you know, that's not counting the night before or the day before me reviewing all of their information, their medical charts, their records, to make sure I know the exact steps of what I'm gonna do for that patient specifically. They may have some complicating factors. And it's also essentially running simulations about the surgery the next day before surgery, just like an athlete would plan whatever route they're gonna take or how they're gonna combat an opponent, it's sort of running through, "How am I gonna combat that strange anatomy for this patient?" And on the day of the surgery as well, it's again, sort of briefly before knife to skin, thinking exactly what I'm gonna do and I see it as a sort of, uh, algorithm in my head, a tree of different consequences. "If this happens, I do this. If that happens, I do this." And, you know, have you seen The Queen's Gambit?

   4. CWChris Williamson12:09

      No, I haven't, but I know that I should watch it.

   5. KRDr Karan Rajan12:12

      So, there's this weird scene in The Queen's Gambit where she essentially, this prod- prodigious chess player, sees all the outcomes, she hallucinates the outcomes on the wall of all the chess pieces moving in different ways. In a somewhat slightly less genius way than that, I'm envisioning, "What's gonna happen if I do that? If I cut that there and it goes wrong, what can happen? How do I avoid that?" So I'm running all these stimulations and algorithms at a very basic level in my head, and, you know, you just keep doing that, rinse and repeat, again and again and again. And the surgery doesn't really end once you close up the skin. The surgery only ends once the patient goes home and is well for a few days, because complications can happen, you know, anywhere from during the surgery to 10 days post-op. So there's never really respite where you're like, "Okay, everything's gone well."

   6. CWChris Williamson13:06

      Wow, yeah. What are the most intense and long surgeries that you do? What's the thing where it's on the docket, you go, "Right, okay, I need a couple of extra caffeine pills before I get started with this"?

   7. KRDr Karan Rajan13:19

      Uh, probably, um, when you have to do bowel surgery when someone's got bowel blockage or bowel obstruction, and they've had multiple previous surgeries. When I read someone's surgical history and they've had lots of previous abdominal surgery, that basically means it's gonna be several hours of operating, because they're very likely to have lots of scar tissue, what we call adhesions. And these adhesions are cobwebs of scar tissue that line the abdomen, and it's a forest in there, and you have to slowly unpick all the scar tissue, and that is quite fraught with danger, because you can accidentally nick a bit of intestine, and then you need to fix that, and- and it can take literally 10, 12 hours sometimes. And that is, "Okay, this is a big deal."

   8. CWChris Williamson14:05

      Wow, is that the longest that you've done, 12 hours?

   9. KRDr Karan Rajan14:09

      Uh, the longest surgery I've ever done was probably closer to 15 hours, and it was probably one of the worst days of my life as well. I missed my birthday, missed my birthday dinner with my parents, from esse- around 9:00 AM till midnight is when I operated, and it was when I was assisting my boss years ago. Uh, we essentially removed everything inside the person's pelvis. We removed their bladder, their ovaries, their rectum, their uterus, uh, e- there's some tissue in their pelvic lining, and it just took forever, 15 hours. It was brutal.

   10. CWChris Williamson14:42

       What a fantastic way to spend your birthday.

   11. KRDr Karan Rajan14:43

       (laughs) I know, right? And I couldn't even unscrub to tell my parents, "I'm not gonna be there." Um, so...

   12. CWChris Williamson14:49

       Oh, of course. Yeah, you don't even le- what ha- I mean, there's got to be, "I need a- a bathroom break." Do you just, you've got to hold it in for 15 hours? "I need..." You've got to be hydrated. Does someone come over with a little squirty water bottle like you're a rugby player?

   13. KRDr Karan Rajan15:01

       Yeah, they do. They, uh, they'll come over under your surgical mask, and they'll put a straw under there, and you drink it, and occasionally they will lift your mask down and maybe pop a Haribo or something in there just to keep your energy levels up, but-

   14. CWChris Williamson15:15

       Elite, elite nutrition for the-

   15. KRDr Karan Rajan15:16

       (laughs)

   16. CWChris Williamson15:16

       ... surgeon too.

   17. KRDr Karan Rajan15:16

       Yeah, right, exactly.

   18. CWChris Williamson15:18

       Yeah, yeah, how funny, man. Yeah, we had, uh, when we were flying from Dubai to Vancouver, uh, when I was on tour with James, the videographer that James brought with us, ET, his birthday began when we departed Dubai. So he had a 36-hour birthday-

   19. KRDr Karan Rajan15:35

       (laughs)

   20. CWChris Williamson15:36

       ... which was the opposite of you. But he also-

   21. KRDr Karan Rajan15:38

       Yeah.

   22. CWChris Williamson15:38

       ... spent 17 of those 36 hours flying on a plane, so, you know, it's swings and-

   23. KRDr Karan Rajan15:43

       Yeah, swings and roundabouts, yeah.

   24. CWChris Williamson15:44

       Exactly. What's the truth about

4. 15:46 – 22:59

   Does Your Gut Control Your Mood?

   1. CWChris Williamson15:46

      your gut having more serotonin in it, more feelgood chemicals, being more determinant of your mood than your brain is? Uh, w- what's sort of real and what's BS there?

   2. KRDr Karan Rajan15:56

      Uh, it, th- there's a lot of nuance behind the gut-brain axis, or the gut-microbiota-brain axis. Your gut has, you know, produces a lots of serotonin. Uh, you know, 80% or more serotonin is produced in your gut. But that serotonin doesn't cross the blood-brain barrier, so that serotonin produced in the gut doesn't directly influence your mood. So there aren't certain foods that you eat which will produce serotonin which will then improve your mood. However, that serotonin which is produced in the gut has a role to play in how well you digest food, its peristalsis and contractility, so it sort of coordinates the contraction of the intestines. But the food you eat can influence, either positively or negatively, your microbiome and those gut microbes, and those gut microbes can, as a byproduct of whatever you do to them, can then release certain neurotransmitters which can then induce neurochemical signals via the vagus nerve, the information highway between your gut and brain, which can then influence your mood. So in the future, my prediction is that we will come up with specific medications called psychobiotics which will, you can eat or you can supplement, which will directly influence your mood because of their impact on the microbiome. I think-

   3. CWChris Williamson17:19

      It's called MDMA, Karan.

   4. KRDr Karan Rajan17:23

      (laughs)

   5. CWChris Williamson17:24

      (laughs)

   6. KRDr Karan Rajan17:26

      Well, uh, if the NHS is listening or watching-

   7. CWChris Williamson17:30

      (laughs)

   8. KRDr Karan Rajan17:30

      ... I cannot condone that, but yes, you know, uh, there will be, I think, for consumer grade, for the average person, uh, I think we're probably around 10, 15 years away from that.

   9. CWChris Williamson17:41

      I remember a very traumatic New Year's Eve when I was working at one of our events in Manchester. So I was at The Birdcage. We'd sold this thing out, and it's about two and a half hours to drive back home. And I noticed about an hour into the event, maybe half nine, I was being really short with everyone, super snappy, very agitated. And I took myself to one side and had a word with myself. I was like, "What's wrong with you?" Like, "What, what's- what's going on?" As I was doing that, I got a text from my business partner saying, "Mate, I'm trapped in the toilet," in our other event, which was in Riverside in Newcastle, and he says, "I, like, it's not good. Uh, things aren't pretty for me right now." And, uh, it turned out that there was norovirus going round at his son's first birthday party that we'd both attended the day before, and I thought, "Oh, no."This isn't good. So, I'm two and a half hours from home, only one hour into a six-hour event that I'm event managing and my business partner's away. He's in Newcastle, strapped to a toilet, so he, he definitely can't h- he can't even help the people in Newcastle, let alone the guy that's in Manchester. So I'm like, "Right, okay, I'm gonna be in for the long haul here." And then all this stuff happened too. When I think back to some of the things that I had to try and fix in my nightlife career. We booked this guy f- for New Year's Eve to come and play. It's very, uh, f- amongst DJs it's very highly, uh, uh, high-demand period. Obviously they-

   10. KRDr Karan Rajan19:00

       Mm-hmm.

   11. CWChris Williamson19:00

       ... charge a lot, the blah, blah, blah. And before he came through, we'd asked, "Do you have a microphone?" Because we needed to make sure he's got his own PA.

   12. KRDr Karan Rajan19:08

       Yeah.

   13. CWChris Williamson19:09

       And he arrived and I said, "All right, mate, did you bring your own microphone?" He said, "Yep, yep, got it here." And I started talking to him a- wh- through my gritted teeth of not wanting to throw up or shit myself.

   14. KRDr Karan Rajan19:18

       Yeah.

   15. CWChris Williamson19:18

       I started talking to him about an hour before and I was like, "All right, mate, can we start to spin up some of the, the, what we would call drops?" So I hear him like, "One hour until New Year's Eve, it's 30 minutes..." And he's like, "Oh, I don't use the mic." I go, "Hang on, I asked d- could you bring your own microphone." "Yes, I can bring my own microphone, but I'm not a DJ that uses the mic." Like, well, (sighs) all right. So, and it, that happened, and then, dude, we, we, the power thing that set off all of the pyrotechnics, that wasn't working, so I had to connect two nine-volt batteries together like that, like sort of (grunts) one into the other to get e- sufficient volts to like... And I'm shortcutting, like trying to like, ff- ff-

   16. KRDr Karan Rajan19:56

       Oh Jesus, fog something, yeah.

   17. CWChris Williamson19:57

       ... doing this thing, yeah, tr- try and set off all of this stuff at countdown, and I- I'm doing the countdown and then anyway, I drove home, uh, and did two and a half hours, like, pinned into my seat, desperately trying to not throw up, and, uh, then got home. It was the worst way to start a new year. But my point, uh, to that disgusting story, my point is, my mood knew that there was something up way before I did. And I w- I tuck myself to one side to say, "Why are you being so short? Like, what's up with you?" And if I ever have a little bit of sort of indigestion or some sort of digestive discomfort, the first thing that goes and the last thing that comes back is my mood.

   18. KRDr Karan Rajan20:34

       Oh, absolutely. You know, you know interestingly, you'll find this interesting, uh, at the University of Cork, they did these, uh, fecal microbiota transplant studies, where basically, shit transplants, where they took the microbiome from someone who is clinically depressed and transplanted that into a normal mouse. And that mouse, after a period of time, was observed to display signs and symptoms of depression. They repeated the same thing with a human who had autism, confirmed autism, transferred the fecal microbiome to another normal mouse that didn't have any conditions. And then that mouse, that rodent study started to display signs and symptoms of autism, uh, which is fantastic.

   19. CWChris Williamson21:19

       Wow.

   20. KRDr Karan Rajan21:19

       So, that shows you how well connected the gut is to our mood and the brain.

   21. CWChris Williamson21:25

       That's incredible. That's absolutely wild. I, I have a friend here in Austin who is a, uh, like, poo donor.

   22. KRDr Karan Rajan21:35

       Oh, yeah.

   23. CWChris Williamson21:35

       A very highly paid poo donor. So, he's had to go through, I think, four stages of screening, uh, genetic testing, uh, lifestyle, diet, scrutiny, all this stuff. But they, he sends off, he literally shits money.

   24. KRDr Karan Rajan21:51

       Oh, yeah.

   25. CWChris Williamson21:52

       And he sends this off and they recapsule it and people use it to help with their, uh, digestion and, and I'm not, I don't know what... Is it a suppository that they do? Where they literally be eating poo capsules? What are they gonna give him?

   26. KRDr Karan Rajan22:03

       Either way. So you can actually get, um, powdered poo capsules that you would just swallow, like a vitamin D capsule. Or it can be inserted as an enema or during a colonoscopy they can actually put that microbiome in the colon for you, which we do medically, uh, for inflammatory bowel disease treatment. We use poo transplants in the NHS-

   27. CWChris Williamson22:25

       You might have used one of my friends. He might have imported it from-

   28. KRDr Karan Rajan22:28

       Yeah.

   29. CWChris Williamson22:28

       ... Austin, Texas and it could have been inserted by you.

   30. KRDr Karan Rajan22:31

       Your friend is a unicorn because, you know, that's the point naught 1% of people are the-
5. 22:59 – 31:50

   Debunking Sleep Myths

   1. CWChris Williamson22:59

      sleep. A lot of conversations on the show about sleep. Docume- Dr. Matthew Walker's book, I'm a massive fan of that. And that kind of really red pilled me on the importance of, of focusing on sleep. But what are some of the other things, what are some of the lesser known things that you wish more people were focused on or, or, or understood about sleep and its impacts?

   2. KRDr Karan Rajan23:18

      Yeah, and, and similar to you, I mean, I, I took a greater interest in sleep because of the negative consequences of my own sleep early on in my career as a doctor. So definitely that s- you know, sparked an interest in looking into the research and evidence. And, you know, there's a sort of fallacy that everyone needs to sleep eight hours. The eight-hour sleep myth. Everyone thinks, "Okay, you've gotta sleep this amount of hours." And that drives a certain degree of sleep and health anxiety when you don't hit eight hours. And we have within every cell in our body clock genes and clock proteins which determine how much individual sleep you need as directed by your individual DNA. So your required sleep may be seven, seven hours or seven and a half hours. Mine may be six and a half or eight and a half. I think there is a spectrum in which most of the population lies, somewhere probably between six, six and a half and eight, eight and a half. The mass concentration will be in there. There'll be some outliers who may get by physiologically on five hours and some may need nine hours. Uh, but certainly, the eight-hour, one-size-fits-all sleep dogma is incorrect actually. And that's been proven by science.

   3. CWChris Williamson24:32

      ... the likelihood that you have that actual gene mutation-

   4. KRDr Karan Rajan24:37

      Mm-hmm.

   5. CWChris Williamson24:37

      ... where you can survive on, I think it's, like, closer to four-

   6. KRDr Karan Rajan24:41

      Oh, yeah.

   7. CWChris Williamson24:41

      ... or three, three and a half hours sleep, I- I remember reading this a while ago, the likelihood that you ha- 'cause a lot of people go, "Oh, no, I'm sure, I haven't had my testing done, but you know, I- I'm fine. Four hours sleep, I'm sweet, man." Um, the likelihood that you have that mutation is the same likelihood as you being hit by lightning twice.

   8. KRDr Karan Rajan24:59

      There you go.

   9. CWChris Williamson24:59

      That's the same, that's the same number of people that have got that particular gene mutation.

   10. KRDr Karan Rajan25:03

       The DEC2 gene mutation, very unlikely.

   11. CWChris Williamson25:05

       Is that what it is?

   12. KRDr Karan Rajan25:06

       Yeah, DEC2 gene mutation. Supposedly, Margaret Thatcher had it, uh, Nikola Tesla had it, Einstein.

   13. CWChris Williamson25:13

       She slept, uh, what's it called? Poly- poly- uh, polyphasally, I think, or biphasally, she slept.

   14. KRDr Karan Rajan25:20

       Oh yeah? So sort of in two chunks of sleep?

   15. CWChris Williamson25:23

       Yeah.

   16. KRDr Karan Rajan25:23

       That's how, uh, well, h- Victorians, uh, slept as well. They would have a normal sleep during the night and then they would briefly wake up in the early hours of the night to do work, and then they would sleep again. Uh, but the biphasic sleep pattern is not unusual, and the modern version of the biphasic sleep pattern is probably what happens in a lot of Mediterranean countries where they have siestas because if you look at our 24-hour cycle, there is a natural dip in energy and fatigue that arises postprandially. So after some lunch or some food around 12:00, 1:00, there is a dip in energy level, there's also a slight dip in our temperature levels because our sleep is very closely linked to temperature. So actually, if you do have a nap around 12:00, 1:00, 2:00 PM, that is fine and that's in keeping with our normal physiology. So naps are science.

   17. CWChris Williamson26:16

       Have you got any idea about why my mood is so dysregulated when I wake up from a nap and James is-

   18. KRDr Karan Rajan26:23

       How long do you nap for?

   19. CWChris Williamson26:24

       Uh, I would guess, with these ones I'm talking like more than 15 minutes, so I'm actually getting into a, into a proper sleep cycle. Um, there's been a couple of times, we did it on tour, you know, when we're trying to just grab 60 minutes here or there because we know we've got to get straight off to this thing. But there was a few times where me and (laughs) James would wake up and we didn't want to speak to anyone and we're thinking, "God, I gotta get up on stage and actually be likable and whatever." And you do, after a little bit of time, people bring you out of yourself. But I- I certainly notice in myself that if I nap, I wake up and my mood can be very discombobulated.

   20. KRDr Karan Rajan26:58

       So is that the kind of like, uh, groggy, slightly hungover feeling you're describing?

   21. CWChris Williamson27:03

       Yeah, and then it- it tends to actually impact kind of my- my positivity and my energy as well. And there's a, I would say, kind of an electric feeling to my body that- that's sort of, uh, anxious, uh, in some regards maybe.

   22. KRDr Karan Rajan27:16

       Yeah. I think, you know, whenever I've experienced that if I've over egged a nap or under egged a nap, it's that sleep inertia feeling where perhaps you've gone into too deep a sleep cycle or a sleep phase, and when you wake up, you're dredging yourself from the depths of a deeper sleep cycle. So there's not that gradual gentle awakening that you'd have if you naturally woke up, and that sleep inertia where there's still some sleep hormones percolating, slightly stressy, anxiety-riddled e- kind of emotion.

   23. CWChris Williamson27:50

       What's your protocol for naps? The- all that I know is once you push it past, or supposedly once you push it past about 20 to 25 minutes, you're really getting into this is actually sleep and not a nap. And if you're going to do that, if you can, try and hit 90 so that you can get yourself into and back out of a phase. Have I missed anything there?

   24. KRDr Karan Rajan28:10

       No, that's absolutely spot on. I mean, I- I'm- if I nap on a weekend, for example, that's the main time I have to nap, um, 90 minutes would be my go-to because I want something that's substantial enough that would help me consolidate my memory, make me feel refreshed at the end of it. And I find it's easier to stick to 90 minutes than go in and out of 20 minutes. Because for me, my sleep induction time is longer. If I told- if I told myself I was gonna nap for 20 minutes, it would take me too long to actually get into the nap first of all. So 90 minutes is preferable for me.

   25. CWChris Williamson28:44

       Yeah. My s- my sleep latency has been all over the place this year. Uh, I- I don't know what it is. I- I think a lot of people feel this as well, you know, if you're busy during the day and even if you try and do the digital detox thing, that three, two, one rule I think is really nice actually, if you're familiar with that.

   26. KRDr Karan Rajan28:59

       Three, two, one, uh, is that the three hours before bed, two hours before bed-

   27. CWChris Williamson29:03

       Yeah. Yeah, so three hours before bed stop eating, two hours before bed stop drinking, one hour before bed stop using screens. Which is funny that screens have been placed in with food and hydration as like, you know, like, the- the mandatory bottom of Maslow's hierarchy of needs that people have. Um, I think that's been really great. And i- it's so funny, like, I know that memeing healthcare stuff is kind of a bit cheesy and it- it- it's, you know, almost a little bit juvenile and s- simplifying things down, but that's what helps people retain principles.

   28. KRDr Karan Rajan29:34

       Yeah. It's true.

   29. CWChris Williamson29:36

       So yeah three, two, one rule, um-

   30. KRDr Karan Rajan29:37

       I would, I would maybe sometimes if you're really struggling with sleep, add a 10 before the three, two, one for the coffee because the half-life of coffee is upwards of eight hours. So if you were a habitual coffee drinker, you know, and you were having cups of coffee at 2:00, 3:00 PM and your bedtime is 11:00 PM, there's still likely to be a decent percentage and concentration of coffee in your bloodstream when you're going to bed, which is gonna dysregulate your sleep.
6. 31:50 – 34:40

   How to Preserve & Improve Hearing

   1. CWChris Williamson31:50

      One other thing. I was having a conversation with a friend, uh, this weekend, who's a DJ, and we were talking about hearing-

   2. KRDr Karan Rajan31:55

      Hmm.

   3. CWChris Williamson31:55

      ... and improving and protecting your hearing. Is there anything that people should be aware of when it comes to that?

   4. KRDr Karan Rajan32:02

      You know, the- the hair cells which help us transduce sound and then in... basically translate the sound waves into electrical signals which our brain then interprets as sound, those are directed by the hair cells in our ears, and we've got around 16,000 hair cells. You are born with all the hair cells you'll ever have. Once you destroy them, that is it. Uh, and they detect various frequencies. So you know that feeling where you go to, I don't know, a cricket match, or a tennis match, or a concert, or a very busy place where there's this constant hum, and then you go somewhere quiet and there's that ringing feeling in your ears? That is your hair cells being bent by the sounds, and they are kind of unbending. That is that sound, and that's the process you're experiencing. And if you party hard for long enough, you know, nightclubs and loud music all the time, you've- you're in a band, you're singing, you're going to concerts, you can long term damage those hair cells. Or those old rockers of the '60s, '70s, and '80s, they've got a lot of hearing impairments. Like Ozzy Osbourne is essentially deaf because he never wore those earplugs that would protect his hearing, and that is the risk with these hair cells, where, you know, unexpected sources can damage those. And once they're gone, there is no, you know, re- reprieve at all.

   5. CWChris Williamson33:26

      That's wild. Yeah, my old business partner, my former business partner, Dave, had a hearing assessment done, and I think he'd lost 15 DB off the bottom end and 10 DB off the top end, so he- he'd really damaged his hearing from... You know, he stood inside or outside nightclubs for a decade and a half, and he's still going, and none of us-

   6. KRDr Karan Rajan33:48

      Wow.

   7. CWChris Williamson33:48

      ... had nicely molded earplugs that would not be a- a fuck on to take out when we went outside and whatever. And now you can get custom molded ones with a tiny little filter. It's like a weeny little straw that filters through so that it means that if you do go outside to go and speak to people, you can still quite easily hear what they're saying without it sounding like you're underwater.

   8. KRDr Karan Rajan34:09

      Yeah. (laughs)

   9. CWChris Williamson34:09

      Um, but yeah, yeah, I do... I mean, thinking back to my nightlife career and some of the sound booths that we used to be in, and DJs would just want more monitors. They want to hear with full richness what's happening out in the club, and also they're partying, they're with their boys or they've got-

   10. KRDr Karan Rajan34:25

       Yeah.

   11. CWChris Williamson34:25

       ... like chicks in the booth with them, and they don't want it to be, uh, well, why can't we hear the music out there? Why is it only coming through your headphones? "Oh, don't worry about that. I'm actually protecting your hearing." Like, that's not a big-

   12. KRDr Karan Rajan34:35

       (laughs)

   13. CWChris Williamson34:35

       ... rockstar thing to say. Um-

   14. KRDr Karan Rajan34:38

       Exactly.

   15. CWChris Williamson34:38

       But yeah, what was that thing

7. 34:40 – 37:21

   Should You Pluck Your Nose Hairs?

   1. CWChris Williamson34:40

      about, uh, plucking your nose hairs? Speaking of hairs inside your head.

   2. KRDr Karan Rajan34:46

      Yeah, so when you... You- you've got different types of nose hairs. Uh, you've got the deeper, longer vibracy, um, and you've got other types of nose hairs, and they do a lot of jobs. And the main jobs of the nose hairs, uh, apart from looking out of place, is that they actually filter microbes, dust particles, and potentially infectious causing agents getting into your delicate moist inner linings of your airways. And when you pluck those, you obviously increase the risk of things getting in and you're removing that filter system that's there, but actually, you can increase the risk of microabrasions every time you pluck something. Just like when you pluck a hair on your hand or somewhere else, you create a small opening, a microabrasion or a microcut through which things can creep in, bacteria from your skin, you know, Staphylococcus species from your skin can creep inside the bloodstream, and that region of your face, the triangle on your face from the bridge of your nose to the tip of your top lip and a triangle which forms there, that's actually known as the danger triangle, where there's a very close association between the drainage, the venous, the vein drainage to your brain and the nose as well, and there's something known as the cavernous sinus. And if you get a bloodstream infection in the cavernous sinus, that can lead to all sorts of very horrible things, like meningitis, clots, um, and in rare cases, death, although that is quite rare. I mean, the average person plucking their nose is not gonna die, but it's not a 0% chance of that happening.

   3. CWChris Williamson36:22

      I was in Dubai to do that live show a couple of weeks ago and I needed a haircut-So I spoke to one of my friends, George, uh, who lives out there. And I said, "Who, who usually does your hair?" So he sends this girl over and she was like, you know, perfectly, like, nice and, and cutesy or whatever, but also was a boxer. So she was, like, kinda hardcore, and she's from Lithuania. Interesting chick, interesting chick.

   4. KRDr Karan Rajan36:43

      (laughs)

   5. CWChris Williamson36:43

      But she had gone full habibi mode with-

   6. KRDr Karan Rajan36:47

      Oh, wow.

   7. CWChris Williamson36:47

      ... the, the... So she's getting the little, like, the wax, putting the wax on the in-, on the inside of the, the eyebrows. She's got wax in the ears, like, doing the wax in the ears.

   8. KRDr Karan Rajan36:58

      Wow.

   9. CWChris Williamson36:58

      And the wax, wax in the nose, and she's, like pulling it out. And, uh, yeah, that was, that was a real, a real experience, so maybe not to be done again. And if I do have my hair cut from her, I can actually say, "My doctor..." Uh, doc-, not my doctor. A doctor told me I'm not allowed to have this done-

   10. KRDr Karan Rajan37:13

       That's true.

   11. CWChris Williamson37:13

       ... because of my, my fibrilles or whatever it was called.

   12. KRDr Karan Rajan37:16

       Vibrissae. Yeah, you gotta, you gotta protect the vibrissae.

   13. CWChris Williamson37:19

       I'm, I'm trying my best. What about

8. 37:21 – 42:45

   How to Deal With Pain Better

   1. CWChris Williamson37:21

      people who can deal, uh, need to deal with pain more effectively? Have you got any tips for how people can, can deal with it?

   2. KRDr Karan Rajan37:29

      You know, a lot of the time in the clinic, I see people with chronic abdominal pain or other sorts of chronic pain. And I've found anecdotally... And actually, I looked it up and it's evidence-based as well, when you explain something to someone, explain how something works, for example, in the case of pain, if you explain to a person why they're getting pain, the scientific, physiological reason why they're getting it, that simple act of them understanding their pain actually increases their pain threshold and lowers their pain perception as well, which is almost like a Jedi mind trick. You know, you just, you almost dampen down their pain. And the interesting thing about pain is that there isn't a direct correlate just between tissue trauma and the amounts of pain that you will perceive because a lot of the pain, it's modulated by what you think. So if someone is getting an injection or, uh, you know, a vaccine or whatever they're getting, if you ask them to look away from the injection, that will elicit less pain than you watching the injection go into your skin. So again, that is... Visually, you're not getting the signals and that's dampening down your pain perception because you're not getting the visual input. So there are lots of things that you can do mentally to dampen down the pain. There was an interesting case report from many years ago of some... A person who was admitted to the emergency room. Like, a doctor wrote this case report up. He sees a man in the emergency room and he's... He works in a construction site and he's got a big nail that's going through his boot and presumably skewering his foot. So he's screaming in agony, like, "I've got this nail in my... Going through my foot. I'm, I'm bleeding. I'm gonna die." And what they do is they remove the boot, first of all, to see, you know, the damage and see what's happened, and it turns out the nail is not going anywhere near his foot. It's stopped by the boot itself. So actually, his foot is completely fine. Just that perception of it was going through was enough to cause that pain. And it's almost like a placebo and nocebo effect that you create in your head about pain. So, you know, similar to cold water exposure, initially it may be painful because you're expecting it, expecting it to be horrible. But if you expect it to be nice and you're gonna enjoy it, you can actually improve that experience.

   3. CWChris Williamson39:57

      There's something interesting about cold exposure I learned from Huberman that is, you can be relaxed when you get into the tub and that will make your experience much more enjoyable than being stressed about it. But what you actually want to try and elicit is that stress. So his advice is to go in with a sense of aggression as opposed to a sense of relaxation. So for me, my favorite way to do it is to just slowly sort of lower myself in, get up to my neck, put my hands in, and then just very gently breathe through my nose and count down from 180.

   4. KRDr Karan Rajan40:31

      Mm.

   5. CWChris Williamson40:31

      If anyone wants to know how to actually stay in a ba-, a, a cold tub for three minutes, just count down from 180. It'll be difficult between sort of 150-

   6. KRDr Karan Rajan40:39

      (laughs)

   7. CWChris Williamson40:40

      ... and 60. And then after, the first bit's fine, and then after that you're fine as well. But what he's saying is that part of the cascade of responses that he wants to have happen or that would be optimal to have happen, is something that's a little bit more fear-based and, and, uh, uh, sort of activating, I suppose. And, um, we did NAD. We did an NAD drip this week. So me, James, and my housemate, Zach. Have you done one? Do you know what that feels like?

   8. KRDr Karan Rajan41:09

      I've not done one. I've given, um, NAD to someone, but not... Uh, I've not had it myself.

   9. CWChris Williamson41:15

      Okay, so it's not very comfortable. Um, anyone that's had it will say it's not... It's not an enjoyable experience at the time. It's a very unique category of pain. So, um, they give you... Is it zo- Zofran? Zolpidem? Anti-anx- anti-nausea, uh, drug?

   10. KRDr Karan Rajan41:30

       Okay, yeah.

   11. CWChris Williamson41:31

       Um, so they give you that because you can sometimes get nausea with it. Um, it's a unique category of pain because it's one that you think or know is making you better, and it's one that is not associated with damage and is time-bounded. So you know that as soon as that bag's finished, it's done. You know that you're doing it in service of you being better, and it's not because something's snapping or breaking or going to, going to be, be ruptured or whatever. So your relationship and the story that you tell yourself about the pain is very unique. There's not many categories of discomfort that can be like that. You know, you got a pain in your stomach. "Oh my God." Like, "It's, it's my appendix. It's gonna blow," or whatever.

   12. KRDr Karan Rajan42:09

       Yes. Yeah, yeah.

   13. CWChris Williamson42:09

       Um, but yeah, I just... I really enjoy... From a mindfulness perspective, I really enjoyed playing with that sensation. What does this mean to me? What's the story I'm telling myself about this pain? Like how can I find more intrigue in this sensation? It's a very unique opportunity for me to be able to see this and not layer it with fear and concern and worry and stuff like that. It was very, very interesting.

   14. KRDr Karan Rajan42:30

       Yeah, that, that will... Certainly fear will amplify your pain perception. So you yourself... It's hard to do, but... And especially people dealing with chronic pain. But you can up-regulate or down-regulate your perception of pain depending on how you put your spin on it.

9. 42:45 – 48:23

   Optimising for Eye Health

   1. CWChris Williamson42:45

      That's interesting. What about eye health? How can people keep their eye healths optimized?

   2. KRDr Karan Rajan42:50

      (laughs) Well, eye health now more than ever, there's... You could say there's a myopia epidemic, a shortsightedness epidemic because people are just on screens constantly all the time and when you're on screens all the time, laptops, mobile phones, TVs, whatever you've got, watches, you know, smartwatches, our eyes, the muscles which help our eyes focus on nearby objects are constantly activated and that actually over time changes the shape of the eyeball. Uh, i- you know, becomes less round and more rugby shaped and this can affect long term eye health causing eye strain, eye fatigue. Um, so I- I genuinely think people do need to look up from screens a lot more. I know it's pretty ironic us saying this and us having a conversation about eye health whilst, uh, you know being virtually h- having a chat, but yeah, I- I think we are, we are addicted to smartphones and constantly craning down and, you know, wearing our eyes out.

   3. CWChris Williamson43:46

      What is a good protocol for people to try and offset that?

   4. KRDr Karan Rajan43:52

      You know, me personally, I- I've spent a lot of hours reading, revising for surgical exams over the years and put- poring over, you know, textbooks and various things and I've found that just breaking it up and doing something called the 20-20-20. So every 20 minutes, you have a break from whatever you're doing, uh, and you, you know, just 20 minutes and you get up and you look somewhere 20 feet away and then you go back into it after another 20 minutes and just giving yourself a bit of a break or, you know, just o- every 20 minutes you should have some sort of eye break, uh, where you are defocusing your eyes, you're not so intently focused on one thing and you look into the distance, into a horizon, into a broader vista or a broader view, allow your eyes to s- almost, you know, defocus and defocusing your eyes and looking at a broader picture helps to activate the parasympathetic nervous system where you sort of, you know, downregulating your stress response because when you are focused on something, whether it's closely looking at a page on a piece of paper or closely looking at a moving object that's close to you, that is some sort of stress response. Your adrenaline is spiked at that point and defocusing offsets that somewhat.

   5. CWChris Williamson45:07

      One of my favorite triggers is to remember that you have all of this on the outside of your vision and that if you're looking at something or anything and a really easy parasympathetic activation is to just allow your focus to kind of ease out onto the sides, even if you're remaining focused on what's in front of you being short but allowing the width of your vision to kind of come into view, uh, and- and to be a- a part of your, uh, like salience network I guess you'd say. And that's just so nice. It's such a lovely trigger. That and a nice slow breath out is about as quick of a way to just (sighs) I'm downregulated a little bit.

   6. KRDr Karan Rajan45:48

      Yeah and- and what... Exactly what you're describing there is known as optic flow, so you know, when you're cycling, uh, around and you're constantly seeing both what's in front of you but also all these things passing you or if you're taking a hike through nature, you've got this broad vista, so you've got both the combination of a broader view and it's a moving broader view as well.

   7. CWChris Williamson46:12

      Mm.

   8. KRDr Karan Rajan46:12

      Uh, which further stimulates the parasympathetic nervous system.

   9. CWChris Williamson46:15

      There's something about lateral eye movement downregulating amygdala response, isn't there?

   10. KRDr Karan Rajan46:22

       I- I- I think... I mean, I'm no expert specifically on the eye, but you know, the eye and the retina is part of the brain, so there are a lot of things to do with the eye that directly impacts the brain and, you know, I have no... I wouldn't be surprised if there were certain triggers or certain types of movements that did influence your perception of fear or anything like that as well.

   11. CWChris Williamson46:49

       I think optic flow is probably one of the big movers for what I'm talking about, but I seem to remember learning from Huberman again that there's something specific that occurs as you're moving through an environment, things are coming past you and you're looking from left to right. And I remember... It- it's so cool, man, when you test stuff in your own life and then science comes along. Well, I guess science was probably already there, you just didn't know about it. Someone comes along and informs you about the science and, uh, for years and years I was doing this morning walk thing and in... Sometimes I'd wake up and I'd feel a little bit kind of anxious in my body or in my mind or I'd have thoughts that I... Just percolating in a way that I didn't want and I'd find that after 15 minutes of a... The same loop I used to do in Newcastle, I'd get back and I'd just feel, uh, a lot better. Like the world was kind of... The world was-

   12. KRDr Karan Rajan47:38

       Yeah.

   13. CWChris Williamson47:38

       ... a bit rosier. And, uh, I remember just really enjoying that experience to the point where I think a morning walk is the most consistent thing I've- I've done from a habitual perspective over the last maybe 10 years and, uh, then yeah, I hear of optic flow and this sort of downregulation of the amygdala and I go, "Oh wow, that was maybe part of what I was feeling."

   14. KRDr Karan Rajan47:57

       Back to science. Yeah, absolutely and- and I think the routine is key as well. I mean, it sounds like when you went on your morning walk in Newcastle, there was a moment where you were by yourself, uh, just with your own thoughts and I think sometimes the act of just doing nothing helps to spark creativity and just... It's a f- it's a form of mindfulness whether you acknowledge it or not, just being with your own thoughts, uh, you know, is quite calming.

   15. CWChris Williamson48:22

       What

10. 48:23 – 54:48

    The Best Tactics for Slowing Neurodegenerative Diseases

    1. CWChris Williamson48:23

       about slowing cognitive decline? I know that Alzheimer's, Parkinson's, dementia, general cognitive decline is kind of a- another hot topic at the moment. What's the 80/20 from that?

    2. KRDr Karan Rajan48:35

       Yeah, I- I mean that... As a doctor that is genuinely one of the diseases that scares me the most. I used to think it was cancer and as someone who deals with cancer and removes bowel cancers and other types of cancers, I think the human race has gained some sort of...... foothold in the fight against cancer with various trials and medications that we've got coming out. But Alzheimer's still seems to be the outpost that we haven't quite got to yet in figuring it out, although there are some interesting trials about monoclonal antibodies which can reverse potentially Alzheimer's. Revert- you know, our brains are all slowly turning to mush whether we like that fact or not. How can we slow down the decay? Uh, and for me, it's very basic things that we need to start setting into our habits now because the clinical signs of Alzheimer's, they don't start until maybe you're in your 60s, 70s and 80s but the first seeds are planted in your late teens, 20s and 30s. So our sleep habits notoriously bad when people are in their teenage years or 20s and sometimes even 30s, especially nowadays with Netflix and various streaming services and, you know, endless TikTok, uh, you know, scroll holes. So poor sleep and chronic poor sleep can prevent the amount of brainwash that happens during those sleep cycles. You know, we have this cerebral spinal fluid which watches the- washes the brain of, uh, all the toxic protein buildup. That doesn't happen in such an efficient way if you don't sleep well. And those toxic proteins, the amyloid beta plaques and the tau proteins can accumulate and actually cause neurodegeneration over time. Same thing with if you don't exercise enough, you don't get enough regular blood flow to the brain. Um, again, diet has a role to play as we know, the microbiome, its interaction with the brain and the gut, that has a role to play but also social contacts as well. If you look at these blue zone areas where people live to 100, centenarians, and sometimes even longer, they have great social networks and social contacts, and, you know, we are humans, are social creatures so we crave on a physiological level some degree of, uh, network loyalty and community as well.

    3. CWChris Williamson50:56

       One of my friends, Johnny, talks about, uh, the keystone decisions, he called them. Getting a dog is a keystone decision for him.

    4. KRDr Karan Rajan51:04

       Oh, yeah. Love it.

    5. CWChris Williamson51:04

       It's a, an individual decision downstream from that, there are a ton of other things that end up coming along for the ride, so you're gonna get more steps in and your wake, sleep and wake cycle is going to be up and you're going to have to have an externalized sense of ego because something else is dependent on you, so on and so forth. And, um, I think that, you know, pushing to spend as much time on an evening trying not to eat on your own, trying not to eat with a screen, you know, really relatively simple rules, three, two, one rule, you know?

    6. KRDr Karan Rajan51:32

       Yeah.

    7. CWChris Williamson51:33

       Th- this is something easy for me to follow. Sean Stephenson told me about this this year. He has a rule where every meal that he has on an evening time has to be with someone. It has to be with somebody even if he's going to like call on the phone, uh, with his AirPods in or whatever s- because he's in the house on his own or he's traveling or whatever. And, um, yeah, you know, it's such a keystone decision to think downstream from the relationships that you have. What have you got? Well, you're out of your own head, you're talking a little bit more, you're probably eating more slowly-

    8. KRDr Karan Rajan52:04

       Yeah.

    9. CWChris Williamson52:04

       ... even from a digestive perspective. Maybe the person that you're with says, "Hey, why don't we go for a walk?" And you go, "Oh yeah, why don't we go for a walk?"

    10. KRDr Karan Rajan52:10

        Yep.

    11. CWChris Williamson52:10

        And going for a walk after you've eaten, fantastic for digestion, insulin response-

    12. KRDr Karan Rajan52:15

        Yeah.

    13. CWChris Williamson52:15

        ... et cetera, et cetera, blood, blood, uh, sugar. Uh, yeah, that's, that's a, that's a big one, finding, finding people that you can eat. There's a meme going around the internet at the moment that guys can't eat lunch without YouTube on. So this dude's phones run out of battery and he's absolutely starving but he has to wait for the phone to boot back up before he can start the lunch which is already in front of him, but it's true. It's, it's a meme because it's true, because of how many people can't choose to eat in front of screens and, um, you know, in my less disciplined days, I do it too.

    14. KRDr Karan Rajan52:50

        Yeah, and if you, if you look at a lot of these Mediterranean cultures and even, uh, you know, the sort of Asian cultures, African cultures, they're all about big shared meals, right? Whether it's lunch, breakfast or dinner, you've got the elders of the family, the grandparents, you've got the mother and father, you've got the grandchildren, you've got uncles and aunts, and it's like a big occasion where everyone is there with each other. And even in, um, Japan, in Okinawa, the island of Okinawa, you know, you've got people, you know, who are friends with each other for decades, you know, they're friends for over 50 years and they have these little tribes called the Moai, and, you know, they help each other when they're in financial struggles, emotional struggles, stress in their lives. So that, that support network, even something as simple as just a meal with someone has a, you know, significantly huge impact on your health and this is, you know, not just wishy-washy bro science. If you actually look into the evidence of companionship and heartbreak when someone loses someone they loved, they can actually die of a broken heart, and this is called Takotsubo cardiomyopathy. Your heart changes in a way where it causes such a significant... That, that huge negative event in your life, so your, I don't know, wife of 50 years passing away, the flood of stress response chemicals, adrenaline, cortisol and various other things has such a huge impact on your physiology of your heart that it causes a type of heart attack and you die of literally a broken heart.

    15. CWChris Williamson54:29

        That's wild. My mum's-

    16. KRDr Karan Rajan54:31

        Yeah.

    17. CWChris Williamson54:31

        My mum and dad's dog two years ago, two years or three years ago, I can't remember, um, passed away. Uh, it was super ill and, and there was two dogs. One that was ill, another one that was old. Within five

11. 54:48 – 1:02:47

    Recognising Chronic Stress in Yourself

    1. CWChris Williamson54:48

       days I think or 10 days of the first one dying, the second one had died as well.

    2. KRDr Karan Rajan54:52

       Well, there you go. Yeah. Um-

    3. CWChris Williamson54:53

       Companionship a- and increase in stress and all of that. What about stress? You know, it's kind of, uh, again, another buzzword that people throw around. What ... Well, when I think about it, it's the, I understand that chronic stress is the thing that we need to be concerned about, that stress in small doses is that. But how do people know if they are stressed on a daily basis? You know, after a while that's just life to you, you know?

    4. KRDr Karan Rajan55:19

       Yeah. I- I think, you know, it's interesting. So a lot of people do think that maybe stress is just a psychological state, that it's something to do with your mind and you, you'll obviously be stressed if you feel bad or whatever. But actually stress invokes a physiological response as well and stress affects so many different organ systems. Uh, for example, stress can cause breakouts of various skin conditions. It can exacerbate a lot of skin conditions like eczema, dermatitis, rosacea. You can get a- uh, acne breakouts. With stress it can dysregulate your gut as well. We know the brain and the gut are i- intricately connected and they intertwine, so if someone's got certain types of inflammatory bowel disease like ulcerative colitis or Crohn's or even irritable bowel syndrome, states of stress can cause diarrhea or in some cases the other way and cause constipation or abdominal pain. A lot of autoimmune conditions like rheumatoid arthritis, stress worsens the symptoms of that. So actually, every organ system you look at from your immune system when you're stressed, the number of natural killer cells, the type of white cells which help you fight off cancer and viruses, actually plummets if you're stressed because stress itself is an immunosuppressive response.

    5. CWChris Williamson56:41

       What's that? I- I remember reading about this, that during periods of high stress it's often ... Uh, people sometimes don't get ill, but that as soon as the stress finishes, as soon as they hand in the dissertation, as soon as they complete the project for work, they rebound and find that they get incredibly ill. Have you got any idea about what the mechanism is that's working there?

    6. KRDr Karan Rajan57:05

       If I had to have an educated guess, it would probably be some sort of compensatory response by your body that just needs to survive. You, it's on survival mode where y- you know, um, you hear these reports of people being in accidents and somehow they've managed to lift a car so someone's leg can be pulled off from the car. They display superhuman strength for that particular scenario and that can be explained by increased amounts of stress response chemicals. I suspect it would be something similar in the case of, you know, you're facing a deadline or chasing a deadline and that stress response keeps you afloat but actually you're about to break, and as soon as that event is over you are broken and those cracks, they start to appear. Uh, that's what I would hypothesis.

    7. CWChris Williamson57:54

       Yeah. I- I think it's not ... I seem to remember that it wasn't far off. You know, it's kind of like a protracted hormesis response thing that you've got going on. Um, with regards to the lifting cars off of children and legs and, and stuff like that, another interesting thing, now it sounds like science fiction, but we have a, um, like a rate limiter on what-

    8. KRDr Karan Rajan58:17

       Yeah.

    9. CWChris Williamson58:17

       ... our brain will allow our muscles to do because if our brain just allowed our muscles to do whatever they wanted, you would snap your shit significantly more frequently-

    10. KRDr Karan Rajan58:25

        Yeah. (laughs)

    11. CWChris Williamson58:25

        ... than we ... And I ruptured an Achilles three years ago so I know how, how frequently we snap our shit.

    12. KRDr Karan Rajan58:30

        Ouch.

    13. CWChris Williamson58:30

        Um, but yeah, and if you thi- Eddie Hall tells this really cool story. Have you heard him tell the story about when he first lis- lifted 500 kilos?

    14. KRDr Karan Rajan58:38

        Oh, no.

    15. CWChris Williamson58:38

        So he's going for the deadlift world record and he talks about the fact that he, for, uh, in however long before in his warmup routine envisioned a car on his daughter and he walks out and, you know, does this thing, but he gets by (laughs) he does this one lift, it takes 10 seconds I guess to do this thing and he's immediately put on a, a ventilator, his blood pressure is off the chart, his-

    16. KRDr Karan Rajan59:03

        Jesus.

    17. CWChris Williamson59:03

        ... heart rate's through the roof. His eyes turn blue. People can go and look at the video of him. He's got, he hasn't got blue eyes but if you go and watch the video of him, his eyes turn blue. It's crazy. So yeah-

    18. KRDr Karan Rajan59:12

        Wow.

    19. CWChris Williamson59:12

        ... th- those single formative extreme sort of stress-driven adrenaline-controlled instances of people doing stuff, wild shit comes out of them.

    20. KRDr Karan Rajan59:25

        Yeah. I- I think, you know, you're right. I mean, there is a certain degree of stress that we need and that hormesis that you mentioned, it's the same as when you're eating vegetables, right? Um, a lot of people talk about there are various bizarre people online who talk about how vegetables are bad for you and you should cut them out because they contain anti-nutrients or defense chemicals in the plants. And yes, they do, and technically at a very microscopic level they are poisonous for us because those defense chemicals do poison us, but actually it's such a small amount that it's actually beneficial for us because it is that process of hormesis. Just like cold exposure, that small amount of stress is beneficial for us and allows the body to respond to that and eventually grow over time and improve.

    21. CWChris Williamson1:00:15

        Talk to me about the role of awe in wellbeing.

    22. KRDr Karan Rajan1:00:19

        Uh, awe. Yeah. So I mean, this is another thing which can help to offset or delay neurodegeneration and brain atrophy and it's just that profound sense of potentially doing something new, seeing something new and just experiencing new things, and that is awe. It doesn't have to be always you need to go and see a wonder of the world. It can literally be you going out into nature and being exposed to awe and being inspired by something, by someone, something, an act, uh, either yourself or seeing something else and, you know, tho- these are all positive emotions which ultimately are good for you.

    23. CWChris Williamson1:01:00

        It's so strange to think about awe as an emotion, and no one talks about it.

    24. KRDr Karan Rajan1:01:04

        Yeah.

    25. CWChris Williamson1:01:04

        People talk about all manner of emotions, but awe, dread, even dread, which is kind of the, I guess, uh, in some ways the opposite of awe, um, ah, p-people talk about that. I think it's kinda been repurposed as anxiety or fear-

    26. KRDr Karan Rajan1:01:17

        Hm.

    27. CWChris Williamson1:01:17

        ... or, or whatever. Um, but yeah, awe just, it needs a, like, we need to make awe great again. It's, it needs a-

    28. KRDr Karan Rajan1:01:23

        (laughs)

    29. CWChris Williamson1:01:23

        ... it needs a rebrand.

    30. KRDr Karan Rajan1:01:24

        Need it.
12. 1:02:47 – 1:03:19

    Where to Find Dr Rajan

    1. CWChris Williamson1:02:47

       one home. Where should people go if they wanna keep up to date with you and check out all of the stuff that you've got?

    2. KRDr Karan Rajan1:02:51

       Uh, you could check me out... I am like a virus. I'm everywhere. I'm on YouTube, Instagram, TikTok, Facebook, wherever you wanna find me.

    3. CWChris Williamson1:02:59

       New book as well.

    4. KRDr Karan Rajan1:03:00

       Yeah, this book may save your life. We, you know, we cover a lot of the things we talk about here and hopefully more to hopefully save your life.

    5. CWChris Williamson1:03:07

       Amazing. Karan, I appreciate you. Thank you, man.

    6. KRDr Karan Rajan1:03:10

       Thank you, Chris.

    7. CWChris Williamson1:03:11

       If you enjoyed that episode, then press here for a selection of the best clips from the podcast over the last few weeks, and don't forget to subscribe.

Episode duration: 1:03:19