 Welcome to Resiliency Radio with Dr. Jill, your go-to podcast for the most cutting edge insights in functional and integrative medicine. I'm Dr. Jill, and on each episode, we have thought leaders, innovators who are at the forefront of medical research and practice, our mission to empower you with knowledge and inspiration aiding you on your journey to optimal health. Today, I am absolutely delighted to introduce a neighbor and friend and colleague, Dr. Scott Scherer is a board certified internal medicine physician, certified to practice health optimization medicine and a specialist in hyperbaric oxygen therapy. He is also COO of Transcriptions, a smarter not harder company. His clinical telepractice includes HOME, which is the health optimization medicine and its foundations alongside integrative approach to hyperbaric oxygen includes cutting edge and dynamic protocols, comprehensive testing and targeted supplementation, personal practices, synergistic technologies, and so much more. And we're gonna dive into that. Welcome, Dr. Scott today to the show. Thanks for having me, Jill. Yes, neighbor five minutes away. Yes, it's so crazy, because we didn't know this. I knew about your company, I knew about your products. And then you're like, I'm just down the street. Do you want me to stop out of the office? I'm like, yes. So we... Yeah, that's amazing. Yeah, because I'm relatively new to Colorado. So it was great to have a veteran in Colorado and as they say, give me a little bit more about the low down. If I can reveal, you were an ex surfer, right? You're kind of like your California boy? I was in California for a while. I wasn't much of a surfer, let's be honest. Okay, that's right. But I wasn't California. No, it's cool because I kind of give off that surfer vibe sometimes to people, but I'm not a surfer. I always liked the beach. Like even when I was in medical school, I used to wear sandals all the time in Baltimore. So I mean, I got, I give out the vibe. I went to UCLA for undergrad. So that California does run deeper than I'd like to in some times. I give off that Midwestern vibe somehow, like... We all give off the vibes. I grew up in New York, so I don't know how much New York Violet give off anymore. We're all just like this Mishmash. Well, I'm glad to talk to you today and speaking of backgrounds in California and New York, tell us a little bit about, I love a story. I love what drives us to get into what we do. So obviously you're doing, we're gonna talk about your specifically what you're doing now, but how did you get into medicine? Tell us a little bit about your journey. Did you always know you wanted to be a physician? So my father's a chiropractor. He's been a chiropractor for over 40 years in New York. And so I grew up inside of his practice seeing what he was doing. And as you likely know, Jill, before there was functional medicine or integrative medicine, they were chiropractors. And chiropractors did everything and he still kind of does everything. He's been changing his diet, doing different types of exercises, bringing in new technologies, like doing everything from the ground up from a dietary perspective since I was, you know, before I was born, really. And that starts even before that when, you know, from his upbringing, et cetera, et cetera. But in general, I grew up in that ecosystem. And so it was an interesting conversation. I always love science and I really gravitated towards it being in his practice and had a conversation with him, probably before I went to college, definitely before I decided to go to medical school. The idea being, you know, what should I do dad? I really like what you do. Should I be a chiropractor? Should I be a regular doctor? What should I do? And I kind of decided on conventional medicine because I had this really high-minded idea. It was very high-minded. It still is, where you could bridge this chasm between alternative medicine as it was called then and conventional allopathic medicine. And could I find a way to do this that really felt like it could do something to move the needle on health, move the needle overall and how I could help people? So I ended up to go into medical school in Baltimore at the University of Maryland. I graduated and did my internal medicine residency. It's kind of my fastest way out. That was kind of how I thought about it. Like I can get a good, broad education from there. I could really figure out what I wanted to do. And in medical school, I learned about hyperbaric oxygen therapy. And it was interesting because it was a very novel technology in some ways, but it had been around for such a long time. And I knew that there wasn't that many people that knew a whole lot about it. So I was like, wow, I really like this technology. I could really learn it very quickly and know more than most people. That's a cool thing as a young doctor. And so I got involved in creating like an integrative approach to hyperbaric therapy. As I finished my internal medicine residency, I started becoming medical director of various hyperbaric practices. I created my own telemedicine practice where I was consulting with hyperbaric patients across the world and hyperbaric clinics across the world where I would help with protocols, I help with development, integration of various technologies inside of hyperbaric therapy. But there was something missing from it really. There was a missing sort of foundational piece because I found out very early on that if I put people in a chamber too early, that they wouldn't do well if they had a lot of chronic medical issues and you can resonate with this, I'm sure. Chill in your practice and how it works. If you start things too quickly, you might be doing the cart before the horse kind of deal. And so I gravitated towards another practice that was being run by or started by a friend and colleague his name is Dr. Ted Otracoso. And Dr. Ted created this thing called health optimization medicine. And it's a foundational approach to health. It's similar to functional medicine, but a little bit of a different perspective, more perspective on health and focusing on optimizing health and kind of leaving disease to the side for the moment. And that became like the foundation of my practice and still is. And so now I have a telemedicine practice where I do health optimization medicine as that foundation. I've been medicine as sort of my specialty upon specialties. And then we have a for-profit company called Transcriptions that make products that help me along the way with everything that I do in my patients and my practice. Wow. First of all, I knew I liked you, Scott. And there's something so similar. I had no idea. This is why I love getting to know my guests on the podcast. So I grew up with my primary doctor, chiropractor, Dr. Vernon Mann. And he had had polio and he was like bent over. So he was like the funniest version of a chiropractor. But his heart was the most hugest healer. And I literally grew up with basically, I go for preventative visits to him. He was my mentor. He was my like epitome of healer. And I wanted to go and be a chiropractor. And I remember it was so similar to the conversation you had with your dad and in your journey. I was like, you know, Dr. Mena and I really want to be a chiropractor. And it was funny because he had been in the, you know, 40s and 50s. And he was older when I met him. Sure. There was a lot of persecution with the AMA and the chiropractor because you well know, right? Yes, absolutely. And my mentor, Dr. Mena, went through a lot of, you know, difficulties because of our dichotomy of healthcare, which is sad because you and I know this like all one thing in a way of how we heal. Oh, let's just say like he literally was like, Jill, you're too smart to be a chiropractor, which again, no offense. I have some of the most amazing friends and smart chiropractors that is not a, but he had been through the persecution. And it's so interesting. You said your goal was kind of like, what if I could do something different? I went in, I finally was like, well, maybe I should go to medical school. Like it was an afterthought, right? And then when I started getting acceptance, I'm like, maybe I could be a doctor. You know, like that was so in that, like my thought process of holistic medicine and keeping ourselves well. I literally remember probably at 10, the chiropractor gave me this like nutrition book and same thing. Chiropractors were the original holistic, like take care of ourselves, eat good food. Yo, geez. And I was fascinated like really food could change our lives and our minds and our bodies. Yes, yes, yes. I love that about your dad because that was so much my journey. And then when I went to medical school, I was like, well, what if I could go in and actually like this big goal? What if I could transform medicine, right? Yeah, small goals, the small ones. But I love that because it sounds like both, I mean, your dad clearly was a mentor. Oh yeah, totally. Yeah, I mean, it's funny. He used to say back in the 80s that food was the most powerful drug that you could take. And that was just unheard of at the time. It was not even in the realm of possibility. And so he was definitely, I think, in the same boat to some degree as your mentor in the sense that if you wanna have licensure to do, you know, quote unquote, whatever you wanna do. Then become a medical doctor and then figure it out from there. But as you said, I have tons of very, very, very smart parapartic colleagues. And I love what they do. Part of it than me, right? Like that's what I respect so much because to me, I literally like adore and admire because they went through so much more difficulty, especially back in that generation than we ever will. And that's part of I think why you and I probably chose, for me, it was the same thing if I wanna do medical missions international or any sort of things, sadly, our standard system reimburses the best for an MD or DO. So I clearly, same path as you, but so fascinating because it's quite similar. That's so cool. We wouldn't have known that probably unless we had a podcast together. So I'm so happy to hear that's awesome. And then this type of medicine, again, I always learned this health optimization medicine. I love it because it's so aligned. It sounds like where I'm at the complex chronic healthy for reverse disease. You're over here like, how do we actually perform and how do we live well and how do we like really, really thrive in that health and not just like get up every morning grown another day, but really, really feel our very best. And I'm so excited to talk about that because I think not only myself but my patients, a lot of people listening wanna really know that. So let's start with hyperbaric because I've got so many questions for you. First of all, let's just talk about what would be like some of your, I'm sure anyone could use it, but what are some of the biggest indications, the biggest game changers, what kinds of people would benefit the most from hyperbaric therapies? Yeah, so when it comes to hyperbaric therapy, I often say it's not, if you need hyperbaric therapy, it's when. Most of us can potentially benefit from it. It just depends on when that time is going to be best. I mean, really what we're doing in hyperbaric chamber is we're immediately doing a bunch of things. We're decreasing inflammation. We're reversing low oxygen states. We're releasing stem cells, which are the baby cells in our body that can make new cells wherever they need to go. We're fighting infection. We're increasing the immune system function overall. We're increasing blood flow overall too. And then over the long term, you're creating new blood vessels and tissue. You're decreasing inflammation over the long term as well in tissues and various types of pathways that are involved in inflammation as well. And those stem cells can mature and those infections can get better and the flow can get better. So it's a matter of understanding what the reasons are honestly, Jill, because I think when, so when it comes to like an acute trauma, acute inflammation, acute stress, hyperbaric therapy is fantastic at mitigating all of those things very, very fast. And it does it in a very much synergistic way with the body and just kind of doing it more efficiently honestly, depending on where in the body we're talking about. So if it's the brain, for example, the brain only has a certain amount of capacity to heal because it has to prevent itself from swelling. If the brain swells, we're in a bad situation. So hyperbaric therapy with more oxygen at play can help reverse those low oxygen states. So if you had an acute heart attack, acute stroke, acute traumatic brain injury, acute spinal cord injury, there is data that hyperbaric therapy can help in those cases. Now, please go to the hospital first. Of course, there's been crazy doctors in the hyperbaric community that just put themselves in chambers with strokes and things like that, of course. In general, most of them from the Midwest, I have to say, but anyway, or Texas, but you're not surprised there. But in essence, really what it comes to down to for me is that if the physiology aligns with somebody that could potentially use hyperbaric therapy, that's what I'm going to consider it. But, and this is the big but, if they have a chronic issue, if there is something long-term that's going on, a long-term goal or a long-term inflammation, chronic inflammation, chronic infection, chronic fill in the blank, it's often not a good idea to go into a hyperbaric chamber right away because if you don't have the machinery available in your cells to make energy well, so what hyperbaric therapy is doing really is getting more oxygen in the system, okay? If the body has a lot more oxygen in it, what's going to happen? You're going to make more energy, but you're also going to make more energy byproducts or reactive oxygen species or inflammatory molecules or free radicals or whatever you want to call them. What the body has to do is it has to neutralize those free radicals by creating an antioxidant response. And if it can't do that because you're already chronically inflamed, you're already antioxidant deficient, you already have a leaky gut, you know, fill in the blanks, et cetera, et cetera, you're not going to do as well in the chamber and it might not be a beneficial for you over the long-term. So that's where the health optimization medicine piece came in for me is that, well, what am I doing to truly optimize the cellular foundation of my patients? Can they make energy well? Are we getting energy or are we getting oxygen to where we want it to go? Are we detoxing from the energy that we're making? Is our neurotransmitter ecosystem optimized in a way that you're going to optimize the function of neurotransmission when you're inside of a hyperbaric chamber? So all these kinds of things kind of hit, it was all very obvious to me when I was in clinical practice and realizing if somebody went in with Lyme disease, for example, and they had a significant, you know, heart-simer reaction, significant detox symptoms, they couldn't move for three days after getting out of a chamber, that wasn't really conducive to their healing. I even found that toughing it out in these kinds of situations because that's what a lot of hyperbaric clinicians told me that I needed to do initially, like have them tough it out and they'll get better over time. Some did actually get better over time, but the problem was that three, four months, six months later, they were back to the way they were before because it was just not a conducive process to put them in a chamber so early on in their process of getting better from Lyme. And so those are some examples of kind of what brought me to more of a foundational approach before just doing hyperbaric therapy and more of these chronic related indications. Hey everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience Through Functional Medicine, Science and Faith, is now available for order wherever you purchase books. In this book, I share my own journey of overcoming life-threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other autoimmune conditions, infections like Lyme or Epstein Bar and mold and biotoxin-related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you wanna get your own copy, stop by readunexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through Functional Medicine in Finding Resilience. Okay, that makes so much sense. And I'm so fascinated. I have a few follow-up questions. My own experience was probably just a shortly after my really bad mold exposure. I was so toxic. I have had underlying Lyme and co-infections. They weren't maybe active, but I completely crashed the one time I tried hyperbaric. And I'm sure my thought was two things, that reactive oxygen, like you mentioned, these free radicals are created with oxygen, right? And oxygen is a great thing. But if you have all this cytokine inflammation, you're gonna drive it into the inflammatory pathway. So that makes so much sense. But you're just really clarifying, and I'm sure I'm repeating this for our listeners because I'm sure some people as well. So you really don't wanna be in a chronic state of Lyme or mold or inflammation and go in there and do it intensely because that was probably. Now, my other thought is I've read some research on nitric oxide production, which is so crucial to blood flow to every area of the body. And as we age, we diminish. Is it true that hyperbaric chamber? I think I saw a study that definitely increases nitric oxide as well. So just to quickly kind of just put a little bit of an emphasis on the Lyme and the co-infections and the chronic illness. It doesn't mean you can't go into a hyperbaric chamber. It just means that you have to be supported through it. And having a good idea of what your foundational cellular machinery is going to be able to handle. So in previous cases, I used to give people antioxidants before they went in, if they needed. And that's kind of paradoxical on some level because the way hyperbaric therapy actually works is by creating this oxidative stress in the system. And that stress causes these changes in your DNA and how it's expressed. So that's called your epigenetics. So you want that, but you don't always want it that much because what's also happening other than that free radical piece that we're talking about is that you're also getting die-off of bugs. So if you have bugs that do not like high-oxygen environments and you go into a chamber, you're gonna get that die-off. So do you have the ability to bind those bugs and get rid of those bugs? Yeah, with the garbage, right? With the garbage, exactly. So you have to be able to do all those things. So I almost always refuse to actually put a person in the chamber if they don't have like a limelight or a doctor or a chronic complex medical illness doctor that's helping support them along the way. Otherwise, I've just gotten burned too many times and it's not fair to the patient, obviously. So I don't want to mention that. That's because I do think, like you said, I feel like anyone could benefit. It's really, is there any contraindications? Let's talk about that. What would be like absolute or temporary contraindication besides what we talked about? There's only one absolute contraindication and that's if you have a dropped lung or attention pneumothorax, which is when one of your lung cavities is filled up with air and you can't breathe, but you'll most likely be in a hospital for those kinds of things. So relative contraindications or if you're pregnant, you're not supposed to go into hyperbaric chamber, but the chambers are indicated for carbon monoxide poisoning and pregnant women have gone into chambers for decades without any problems, the babies are fine, et cetera. So if you are a COPD patient, so if you require oxygen before going to the chamber, if you have severe asthma, if you have severe cardiac disease that's not controlled, if you have an ejection fraction less than 35%, if you have how well your heart is pumping basically, if you have uncontrolled seizures you don't want to go into chamber because the oxidative load or the extra oxygen does cause more potential brain excitability, but in essence what you're really doing here if you're doing it well is you're looking at dynamic hyperbaric protocols, like you might have to start somebody at a milder pressure and then drop them deeper into pressure as you're trying to get more effect systemically because more neurologic pressures are milder pressures, so less oxygen, less pressure, and more systemic pressures or deeper pressures overall. Oh, fascinating. I could talk to you for hours on this. So, yeah, a lot of things to talk about. And so that then- You asked me about nitric oxide too. I forgot about that. Yes, oh yeah, yeah, let's talk about that. Yeah, so what's interesting about nitric oxide is that what hyperbaric therapy does, the deeper you go, the more vasoconstriction you have. And this is actually because you are mildly depleting nitric oxide initially. And this is because what those free radicals are doing is actually they're making nitric oxide less active and making it more inert. So you get mild vasoconstriction actually. And this is not actually a bad thing. So if you've had a traumatic brain injury, for example, you have a lot of swelling in your brain, unfortunately. So what they do is they open up your skulls that let the swelling out, but they also notice that if you put somebody in a hyperbaric chamber, you decrease their risk of death by half by just three hyperbaric sessions. And the reason why that it's doing that is causing a vasoconstriction, but at the same time, you're getting more oxygen into that tissue because you've diffused so much more oxygen in circulation. So despite that vasoconstriction, there is more oxygen flowing is what it comes down to. So now over the long term, there is an enhancement of nitric oxide, okay? And this is because of some of those epigenetic things that are happening and new blood vessels that are forming in these tissues. But in the short term, you're actually having a mild depletion of it, but in my cool sort of integrative way that I always look at ways to mitigate that. And you can think about using nitric oxide boosters and things like alargenine or niacin, other things to help vasodilation, low-level light therapy helps as well. There's tons of things you can do to help mitigate some of that depending on what you're going into the chamber for. Okay, but I'm having a big ah-ha because post-COVID and even before, I'm treating a lot of people with this thing called the triad. And it's this combination that often occurs together, mass selectivation, dysautonomia pots and hypermobility or Euler's Danlos symptoms. And this all relates to the mast cells, the inflammation, all that. And what happens vascularly, again, you're gonna know this because your internal medicine background is there's a kind of a collapse of the circulatory system at least on all of the extremities, right? So there's like the lack of- This is inducible nitric oxide, yes. Right? So they're not getting blood foot to the brain when they stand up, they feel weak and dizzy. And I actually had this last year after COVID for a couple of months where I was really low blood pressures. And what you're saying is something like hyperbaric could probably help that as well, right? Because you're gonna actually constrict and get that, because that INOS pathway can be reactive to reactive oxygen and infections and inflammation, which actually makes us vascularly collapse, right? Exactly, yeah. So the inducible nitric oxide is the key there. So we have different types of nitric oxide. We have the endovascular nitric oxide or INOS and that's in our vascular system, that's the normal. And then you have the inducible nitric oxide. And that's the one that gets released with inflammation, with stress, with infection. And that's the one that mostly gets impacted by hyperbaric oxygen therapy. And it's the same one that gets impacted by methylene blue, which is really kind of a cool combination there. Well, that's a perfect transition. Okay, this is starting to make sense except that I never thought, because literally one of the reasons I brought you on the show and I wanted to really talk about methylene blue, your company and all that good stuff is because for me, this POTS decided to know me stuff that I had since COVID was dramatically shifted by the small little doses of methylene blue. And it's because of this, but I did not know that hyperbaric could do the same thing. So let's talk about methylene blue. There's so much to talk about. First of all, do you wanna give us a little bit of the history? Cause this has been around a long time. And I think one of the things that's so puzzling to people is this is an industrial dye, right? But it has some really profound benefits and lots of research. Do you wanna lay the framework a little bit about why it's potentially a really positive thing? Yeah, so the brief framework on the history for me personally in the background is that the nonprofit organization that we have called Health Optimization Medicine and Practice. This is a educational company. It's training practitioners on how to optimize health as I was alluding to earlier and I'm trained in this. As we were learning, as we were creating this whole process and this program, we knew that we needed to create a for-profit company to help people right now on that health optimization path. Some people have a long way to go and it can take a long time to get there. And Jill, you work with the most challenging of the challenging and how long it can take people to truly see the benefits of the work that they're doing. So we created transcriptions, the company, to help people right now along that path. And the first compound that we really started to dive into was methylene blue. And as you were mentioning, methylene blue has been around a long time. So a little bit of a history. It used to be the dye that we used to dye blue jeans, blue, and then somehow in the late 1890s, they figured out that high doses of methylene blue treated malaria. And it was the first drug that was registered with the FDA back in 1897. And it's a- Like the original antibiotic, right? Yes, the OG because it was the only antibiotic, only antimicrobial available, excuse me, really until the 1950s. And there's great stories about World War II pilots going to the Pacific theater and having to take methylene blue tablets with them as a preventative for fungal infections. And they had songs about urinating blue because back then, and that's one of the things that we still know now that methylene blue, when we take it, it concentrates in our urine. And so we urinate blue as a result of taking it. Now, really high doses will make other secretions also blue, but we're not really talking about those kinds of doses for the most part, but it came out of favor in the 1950s because of antimicrobials coming around. But it was a primary treatment for urinary tract infections, for fungal infections, for viral infections. My colleague, Dr. Ted talks about how in the Philippines, they used to have methylene blue lollipops that they would give kids when they had viral infections coming on to prevent the viral infection from propagating, et cetera. So it has that history. And then in the 1950s, the first antipsychotic drug was derived from methylene blue called chloropromazine. And that's because methylene blue also has something called monoamine oxidase inhibition. This means that it helps or prevents the release or prevents, sorry, the breakdown of neurotransmitters, dopamine, norepinephrine, and serotonin. And so as a result of that, it gives people a mood boost when they take it. And initially it was used in a way where it was actually compounded with antipsychotics so that they knew the psychiatric patients were taking it, the antipsychotic because their urine would turn blue. But yeah, now we know that it has fantastic properties on its own. And it's been studied now in depression, in bipolar, in other mental health disorders to help as potentially as a standalone treatment or as something that could be used in combination with other therapies. And then the final part of the history is that in the last couple of decades, we now know that methylene blue is a fantastic mitochondrial enhancer. And most of us know methylene blue from if you were like you and me in medical school, we would look at stains in biochemistry and methylene blue is used as the stain. And where does it stains? It stains your mitochondria. And so we know that it concentrates in mitochondria. And where do we have our most mitochondria? In our brain, our heart, our liver, our muscle tissues and our sexual organs, our ovaries and our testes. So why are we having such huge amounts of infertility out now? Or brain fog or brain problems, heart issues or exercise-induced fatigue? It's because our mitochondria aren't working well because 95% of us have poorly functioning or non-optimal functioning mitochondria. Makes so much sense and that's how we get to know one another. Because like Scott, what's this thing you're making? It's really cool. I want to know more about it. Now again, granted, you can get it from company pharmacies and that. The one caveat I would say, which we've talked about and we actually have the data to share if people want, the purity of this matters, right? Because if it's just the industrial form, it could be containing heavy metals or toxins. And your company in particular is very clear about the... Tell me just a little bit about that so people listen. Yeah, sure. Yeah, so this is a really good point. So Methylene Blue is still found in fish tank cleaner as well. And so you can, and a lot of people that are, people that like aquariums, there's a word for this, I'm forgetting, aqua people, whatever it is. They love aquariums, like they'll use Methylene Blue to actually treat the fish and treat the water as an antifungal and as an antimicrobial. The problem with that is that's industrial grade, Methylene Blue. And industrial grade has up to about 11% impurities and that could be mercury, cadmium, arsenic and other heavy metals. And so you wanna make sure that you're getting the cleanest stuff possible. So the first thing you wanna make sure is that you're getting a USP version. A USP is pharmaceutical grade, but unfortunately that's not even good enough because USP can even be contaminated. So it took us another eight months to launch our company back in 2019, 2020, is that's how long it took us to find a clean source of Methylene Blue. So we publish everything that we get. We publish all of our testing. And I mean, as you know, I'm a clinician. And so we wanted to make sure there's three other docs on the team, including me, that we were giving our patients the cleanest stuff available. So we go through the end of the earth. We test every batch that we get. We have given away batches. We've thrown away batches in the past. I mean, we've, you know, thousands of dollars in things because we just wanna make sure we have the cleanest stuff possible. And it's a really big deal because you can buy stuff on Amazon, but they don't come with a C of A, which is a certificate of analysis. You have to ask for it. Make sure that you're asking for it if you are looking for it from other sources. Yeah, I'm so glad we're talking about this because I think it is so common. And we know even during the pandemic, if you were going for substances, we won't name any names or things, but they weren't pure and they weren't made for human consumption and to be a really big deal on this, especially because it is a powerful substance. I have seen it in my own life and lives just yesterday. I have a patient who's on oxygen, chronic bceosis. She's in her late 20s. She's a young woman and she's been disabled and in bed. And I've had her on methylene blue for the last six months and she came to the clinic. She's getting ready to go to Europe with her mother. Like it is a game changer for her. And it's been doing a lot of other things for a lot of years. And this is the thing that really took her to the next level. My thought is as we're talking, I bet she'd benefit from hyperbaric as well. Possibly, but now that she's much better, right? Now she's a bit more supported. So the way I think about methylene blue here is that there's a spectrum of dosing. And I think that's what you were alluding to. Let's talk about that. Go ahead and dive in. Because there is a lot of literature out there that the dose quote unquote should be of methylene blue somewhere around one milligram per kilogram, which would be about 50 to 70 milligrams for most people. But I find that's usually a very high dose for most people. And I often find that very, very low doses can go a long way. And there was some interesting studies that had been done in Alzheimer's patients actually. They did a study where they actually compared eight milligrams twice a day to 50 milligrams twice a day to 150 milligrams twice a day. And the people in the eight milligrams twice a day did much better. That was the placebo group. And the reason why they used the eight milligrams was that they wanted everybody's urine to turn blue. And this is actually, there's a lot of parallels to this on hyperbarics, but we can talk about that another time. But it's very difficult to do studies when things turn colors or you have pressures and things like that. So, but interestingly, right? This lower dose did the trick. And I think the reason for this Jill is that what methylene blue really can do is support in enhanced mitochondrial function. It's got this really cool capacity that's called electron cycling. And what that means is that it can actually help donate electrons, which in this case in the mitochondria helps you make more energy. Even if some of the parts of your mitochondria aren't working very well, you have all these protein complexes, it can actually bypass those. It can support them. And it help you make energy where you need it to make. And at the same time, when you make energy, we were talking about this on the hyperbaric side. You're making free radicals. And you have to have the ability to neutralize those to help keep the system be efficient. And if you don't, the system is going to be inefficient and it's going to break down. But what methylene blue does is it directly can act like an antioxidant. It can actually pick up these electrons. And then at the same time, it actually induces in the system, your pathways that increase antioxidant production, specifically glutathione through something called the NRF2 pathway. And so, but what you need here is something that could be supportive most of the time. And then it's not the only thing that you're doing as a clinician. You're using methylene blue, at least the way I think about this is that as a supportive, while you're also doing other work to enhance and to regenerate mitochondrial function. So you're giving and you're optimizing vitamins, minerals, and nutrients. You're optimizing gut health. You're working on neurotransmitters and hormones. And if you're doing all that, at the same time as you're giving some methylene blue, you can start off with really low doses and see these profound benefits, which is what I think you've seen in your practice. Yeah, no, this makes so much sense. And so years ago, I've been using it. It is indicated a lot of the doctors who treat chronic Lyme and tick-borne infections have used it. It's especially good for bartonella, which is a tough treat. We often add that in, but we would start at 50 and go up from there. And I'll just tell you, there's a side effect, you know this, well, methyl hemo-globinuria and all these different things so that we'd have some real issues with dosing people up inside effects. And since I've just really reframed that and started with the lower doses. And I'll just tell you personally, for me with a POTS dyscedenomia, this was the biggest thing that transformed my symptoms. And I was doing like eight milligrams every other day or every third day, like that small, just tiny little bit, wouldn't even need a daily. And it transformed. So I mean, I could probably do eight milligrams twice a week and be okay. It's just phenomenal. And to me, that was such a game changer and eye opener. And again, that's came from your product because it comes in a milligram but quartered. So you can do like a quarter or a half or whatever. What made you think about, was it the studies with the low dose? Cause I felt like that's a real game changer. And it's also more safe for the average person to try versus like a 50 hundred. I think the research shows above 50 was when you're really gonna have side effects and interactions with SSRI drugs and things like that, right? Right. So we started off at the low dosing because of the work that was being done on Alzheimer's and the cognitive literature, somewhere around the 16 milligram dose, seemed to be the sweet spot for neurologic optimization. And so if that was the case, we said, well, why don't we start at this dose? Because it's extremely safe. The side effect profile is next to none overall. And you're right. As you get to above about 50 milligrams, and so our company has a professional line and we have something called Tro Plus Blue and that's our prescription strength or our professional only methylene blue trochee for that reason or for those reasons. Now, as far as SSRIs go, so we talked a little bit about MAOI inhibition earlier and how methylene blue was the drug that the antipsychotics or some of them first came from. The risk of having an SSRI alongside of being on methylene blue at the same time is something called serotonin syndrome. And this is extremely rare. It's actually never been described with oral methylene blue before, only IV at very high doses. So honestly, Jill, I don't worry about it very much, but I do worry about some of the oxidative load that happens at the higher doses of methylene blue because what happens actually, as you get to a higher dose, you're gonna get more hydrogen peroxide production. And hydrogen peroxide is something that our body makes. It's a way that our body fights infection. It's a way that our body helps stimulate antioxidant pathways to make something like glutathione, like I said earlier. That's not a bad thing, but you do have to think about, does your patient have the capacity to neutralize the hydrogen peroxide that they are making? And that in somebody that has chronic infections may not be the case. So we'll often do, at least in my clinical practice, and I've worked with a number of Lyman literate docs and that are doing Bartonella work and et cetera, they start off at eight milligrams. And I'll titrate their dose every five to seven days until I get to a dose that we're having a positive effect. And then depending on how they're doing, keep them on seven days a week for month, two months, but we're always trying to see what we can do about coming down to that dosing over time. But I think the key is titration and the key is understanding that the risk, really with the higher dose, is going to be more of the oxidative load. SSRIs are important. You have to be thinking about that, but only in the context that people might feel a little more uncomfortable with the extra serotonin around. And you also have to think that if you have a little bit more of norepinephrine around, so that's something that also can be interactive if people have high blood pressure, for example. I do find, and this is kind of with the pots, it's kind of be helpful, right? But in some people that already have high blood pressure, you have to be a little bit careful with your dosing to go slowly to make sure they don't have any elevations in their blood pressure when they start taking methylene blue as well. Wow, this is just so great and such good information for even the general public, because again, I feel like it's really safe at these low doses. And I've had actually, I've been doing this and doing methylene blue for probably a decade, but I've had much better results with the low dose. Like to me, it's a danger and safer in that sense. So you'd recommend starting at like the four or eight, which again, you can quarter, make sure you tolerate it. And then my thought, a couple of thoughts, first of all, I think there's some research on combining methylene blue with red light therapy for the brain. Talk about that a little bit. Yeah, so there is a really great researcher out of the University of Texas, Austin. His name is Francisco Gonzales Lima. He's done a couple of podcasts over the years as well. He's done notices research and his main thing is methylene blue for Alzheimer's and Alzheimer's like disorders. So he studied it in Alzheimer's in animals. He studied in traumatic brain injury in animals. The challenge with methylene blue gel, as you know, is that it's off patent. So it's not something that has a blockbuster drug at the end of the rainbow, but he published a really cool paper looking at low doses of methylene blue. So less than a milligram, less than 0.5 milligrams per kilogram. So around that dose of like about 25 milligrams or so. And he did this in combination with red light. So, and the red light dose was around 660 nanometers. The cool thing about methylene blue and red light is that under optimized or relatively normal conditions, they're both going to donate electrons to what's called complex four or cytochrome oxidase in your mitochondria. So as a result of that, they're synergistic and they're both going to be enhancing the capacity of your mitochondria in your cells to make energy. So if anybody's done this, and I certainly have it, I'm guessing you have too, you can take the methylene blue and then go out in the sunlight about 30 minutes later or maybe an hour later if you swallowed your methylene blue and you'll feel this sort of rise in energy. Your cognitive capacity is gonna go up. Your endurance is gonna go up too. And so I have a bunch of elite athletes that I work with that are using methylene blue along with obviously their other training program to help with their endurance while they're in the sun. And of course, red light panels do this too. Amazing. So I'm gonna share a little secret here in public that I haven't ever talked about before. But one of my favorite things is taking the lotus methylene blue. I have a device that goes in the head and does red light to this brain and nose cytochrome plate. And sometimes I'll even add a mitochondrial peptide to that mix. And it's amazing. And it's funny because we talk about this, there's not a high. It's just like a wonderful, good, healthy energy. It's just like, mm, I feel good. You know those days where if you're out there listening, hopefully most of you have had these days but you just wake up and it's gonna be a great day. You just feel amazing. And that's because they're natural neurotransmitters. Maybe you had good deep sleep or you know, whatever happened or you just got home from vacation. But that's the kind of thing we're talking about. It's just this really good, sustainable energy where you're not crashing, you're not. Exactly. I like this because granted, there's all kinds of natural highs too, but this isn't really a natural high. It's just a really healthy state of being, right? Yeah, I like to call it an elevation. You just kind of feel like this rise. And then some people, if you're pretty well optimized, what you may actually realize is you take it and then the day is over. And you're like, well, how was my day? Oh, I didn't get as tired in the middle of the day. I was able to have more conversations. I ran further at the gym. And I have some of my patients that will refuse to not work out with Bethlehem Blue because they can keep their heart rate up longer. One of the things that it can do is actually can be just like oxygen at yourselves. So even if you have less oxygen around, it can actually take the place of oxygen or it can compensate for low oxygen levels. So if you're coming to visit us, Joe and I in Colorado, and you're gonna be at altitude for the first time in a while, Bethlehem Blue can potentially help you. If you're on an airplane, for example, you're pressurized to about 8,000 feet. So for Joe and I, that's like nothing because we're already at five or six here. But for somebody at sea level, that's 8,000 feet is a lot. And so you're gonna get low oxygen up there. You're gonna get radiation exposure and you're gonna get sluggishness from the circadian rhythm disruptions and the lights and everything else. And so what is Bethlehem Blue gonna do there? It's going to compensate for that. It's going to give you more energy capacity. It's going to give you more detoxification potential as well. So it's a great, great thing to have a supportive, especially with travel. So it's a big jet lag hack. We have a full blog on it on our website to talk about the protocol that we've developed. And it works, actually works flawlessly. I mean, you can add in certain other things, of course. I mean, this is not the only thing you wanna do, but it can certainly help significantly along those processes. I love that. I'm a traveler and I really, really love travel. I know you are. We're a lot of the same conferences. I know, but that's an aha for me. I'm like, oh yeah, I remember going to Australia, I had a whole protocol that did holy hack jet lag. And I did and I really was very impressed with, you know, the ability to do that, but this is gonna add to that and super exciting for those of you listening. You can give that a try too. So in our last few minutes, what do you see as, I mean, you're in this really health optimization world. I love it. Our world's very much overlap. For sure. Methylene blue has been really a game changer. And first of all, just thank you for helping to be on that team to develop and to get it out in an easy way and a safe way and a way that's tested for the public and general population. If you're listening and no matter where you're listening, you'll be able to find a link to get your own. And I'll mention this now, I'll mention it at the end, but the code Dr. Jill will give you 10% offs you that you guys have graciously given us a code to share. Of course, of course. So you guys can get a discount on your order. But let's go back to the final thing though. What do you see as up and coming, either new technology, new ideas in health optimization, maybe things just to be keeping on our radar? Well, Jill, this is like, this has been awesome. It's always good to hang out with you. I think what I've been more focused on recently is actually the GABA neurotransmitter system. And this is because GABA is our most powerful inhibitory or relaxing neurotransmitter. And most of us, I think we discussed this when I had you on my podcast, was most of us are in fight or flight most of the time. And the challenge with that is that depletes our GABA system. And GABA is really important for relaxing the brain and relaxing us. People that are GABA deficient have higher levels of anxiety, higher levels of stress, depression. They have sleep problems. They have multiple issues. It's associated with mental health disorders like schizophrenia and OCD and even systemic symptoms like tremors and blood pressure and like so many different things. And so what I've been really interested in recently and this goes along with I think just society in general is that, and then transcriptions my company is also very involved in this is like how can we modulate the GABA system and take people off that threshold? This is actually a file that my father's description of people that were always so many, so many of us are just over the cliff and we can bring them back off that threshold. That's where we can start healing. And so this goes back to my work in hyperbaric therapy. Like if I want people to be in the chamber, I need to have them relax so they can actually heal in there and not like watching John Wick number three or something like that, right? Because you're gonna be like so stressed in there like your body's gonna be like all clenched up. It's the same deal. Like when we're trying to heal, I think that the real key for all of us is to get more parasympathetic or more rest and digest. So I've been really looking into the world of how we can modulate the GABA system. And the hard thing about the GABA system is you can't give GABA itself most of the time because GABA itself is not something that can get across the blood brain barrier very easily. It's kind of cordoned off. It's a big molecule. So what can you do? You can use herbals like Kava, for example, or Valerian root, or you can look at something called agarin, which is this ingredient from the psychedelic mushroom amniota muscaria that gets across the blood brain barrier. It doesn't cause psychedelic experiences, but it helps you as a long-acting GABA agonist, something that increases GABA. But on the health optimization side too, what are your glutamine levels like? What are your glutamate levels like? Do you have vitamin B6 and magnesium? Because these are all really important to enhance and to support the GABA system. If anybody's had MSG at the Chinese restaurant or Asian restaurant in general, you'll have this experience of headaches. Like I'll get them. My father gets them for three days. And this is because you get this overabundance of glutamate from the monocytic and glutamate. So you're having a hard time converting it because glutamate in the brain gets converted into GABA. So that's a long, that's like its own thing. But in general, like I'm really excited about modulation of the GABA system and increasing the ways that we can modulate and be more parasympathetic and more relaxed more of the time. Awesome. So this is super exciting. And I know obviously we talked about Methylene Blue, yours website, Trosscriptions.com, right? And if you're listening and want to get that discount on your first order, you can use the code you guys have graciously given me to share. And that's just Dr. Jill. But this also lends itself to mention the other products because you guys have some of these other things available. Why don't you tell us real quickly what else that is on that site? Sure, yes. So on our Methylene Blue side, we have a combination with nicotine caffeine and CBD. This is our blue canotine. This is for focus. This is for productivity. This is for three to five hours of really trying to get it done kind of deal. It's great for targeted focus. And then we have Trocom, which is our anxiousness and stress relief. It's something you can use during the day. It has Cava, CBD, CBG, both non-secoactive. And something called nicotinolgaba, vitamin B3, attached to agaba, it lets it get across that blood brain barrier. Fantastic for stress relief. And then we have Trozi, which is our sleep formula. This has eight different ingredients in it for comprehensive sleep modulation, helping you fall asleep, stay asleep and wake up feeling rested. Number of things that are working on the GABA system. Also working on a slow wave sleep with something called Corticepin, which is a fantastic mushroom derivative and then five-HTP and melatonin. But Jill, but this is the big but with all of this. I'm a clinician and you are too. What I truly care about is that all of these products that we make could be hopefully just temporary solutions for you while you're doing the hard work. And we know it's hard of trying to optimize over the long-term. And so that's always the framework for me is that, I guess I have a product company, we make supplements. I think they're fantastic. But in the end, my hope is that you can only use these things when you need them and not hopefully you don't need them all the time. And then if you're doing the work of optimizing mitochondrial function and your gut health, your toxic load, as you say, et cetera, then after all of that is said and done, hopefully you don't have to, you need our stuff all the time. And only when you're traveling or when you're not sleeping well for a couple of nights or your immune system is messed up because you're not sleeping because you have a baby at night that's crying or whatever it might be. But we're there for you. But I think hopefully in the long-term, you don't need us as much. And that's completely fine with me. Thank you for bringing this great information to the world. Thank you for just the clinician that you are. It is an honor to talk to you and also call you neighbor because you're just down the road from me in what a treat. Thank you again. Likewise.