 Good morning everybody. You can find the cord for this sound and light out of this machine. We'll just do a quick sound check. Let's see my stuff come up on your screen. Good, it works. Apologising for breaking the space that Glenn just created. So the title of my presentation was, whole body photobiomodulation for fibromyalgia and other pain syndromes. Who here has heard of photobiomodulation? I can't see any of you. I have no idea. Are there any hands up? Okay, is that like half of you or 10%? I couldn't hear that. And who here has been treated with it? I have no idea what you're doing. I can see a bit if I do that. Okay, and what else did I say? Anybody here treated somebody else with it? You have to wave your hands a bit. Yes, I can see the movement that helps. Who here has never heard of it? It's hard to tell. It might be half of you. I'm not sure. Okay, right. So my plan for you is to say, what is photobiomodulation? How does it work? Something about its medical uses, specifically fibromyalgia and other health applications. When you do medical presentations, you have to do disclosure. So I am founder, CEO of Thor. I'm a co-founder and an investor in another photobiomodulation company called Luma Thera. So that means I'm extremely biased and you can't believe anything I'm about to tell you. I started life as an engineer designing radio stations. I'm not a scientist or a doctor, so you can't trust me that I don't know what I'm talking about. But I have been doing this a long time. Since 1987, 35 years in this field, I've co-authored 27 academic papers on this subject, six of them with Harvard Medical School, co-authored four academic books, my expertise on dos and bin parameters. I'm an expert reviewer for the journals that publish most of the work in this field. I'm a co-chair of the Biomedical Optics Society Conference of Photobiomodulation Mechanisms, and I've joined a couple of other interesting clubs. A lot of our collaborators are here on the screen here. Many of them from Harvard Medical School, Harvard School of Public Health, working on noise-induced hearing loss, Brigham Women's Hospital, treating children who are going through bone marrow transplants for cancer. They get nasty side effects. I'll say more about that later on. Traumatic brain injury at MGH Massachusetts General Hospital, doing experiments on mice and rats, looking on the mechanism of action, the dose response, the VA, we are already treating patients, and so I've got a small amount of time so I can't go through all of these, lots going on in our national health service in the UK, which by the way explains my speech impediment. It's called English. Anyway, so we're collaborating with 60 different academic institutions around the world, most recently lots of NHS, Stanford University School of Medicine, working on age-related hearing loss at the moment, among many. Fibromyalgia, what is it? You probably know. Fibromyalgia is the pits, isn't it? If you know anybody's got it, they've got pain, inflammation, tenderness. They're having sleep problems as well, so pain in joints, inflammation leading to fatigue, systemic inflammation, tenderness in muscles, sleep problems. They get brain fog as well. My wife, who's an osteopath, says it's very similar to long COVID, she says. Okay, that's fibromyalgia. What is photobiomodulation? It's something that your grandparents used to watch on TV in a TV show called Star Trek. On Star Trek, when somebody was injured, they'd get taken to the sick bay and the doctor would get out a laser beam and would aim the laser at the injury and the injury would heal instantly. So we make those. Any questions? Okay, it's not as fast as it's on TV, but get the idea. We shine light on people and they heal more quickly. Live long and prosper. And if you're old enough, you know that voice. It's Mr. Spock. And if you use photobiomodulation, you will live longer and prosper. There you go. Anyway, unfortunately, these therapies have a lot of different names over the years. Too many to mention, but over 100 different names in this therapy used to be called mostly low-level laser therapy on the internet. If you know what pub med is, the government database for medicine, low-level laser therapy was the leading term. It is now photobiomodulation. Photom means light, biom means life. Modulation means we can stimulate and we can inhibit. We can slow some things down and already it's been reduced to PBM or PBM therapy or sometimes PBMT. So we're going to call it PBM from now on. Oh, it's stuck there. Right. What is it? It's the application of monochromatic light, which means light of one color. And if we have light at the right color, whereas we prefer to say the right wavelength, if we have light at the right wavelength, if we have light at the right intensity, and if we have it in the right place for the right amount of time, we increase the speed and quality of tissue repair. We can reduce inflammation and edema, and we can induce an analgesic effect. Most of the published clinical evidence is of musculoskeletal pain, so sprains and strains and creaky joints. But there's also good evidence for its effects on neuropathic pain like shingles and post-apathic neuralgia, hard to heal wounds like venous ulcers and diabetic foot ulcers, breast cancer-related lymphedema, fibromyalgia on the list, chronic regional pain syndrome. And also it has some effects and useful benefits for healthy people as well. It's used like this. It's applied to the body in this manner with handheld devices in and around the oral cavity if you're a dentist. Non-healing wounds being treated here. Cancer patients being treated for that. Very common to have oral complications, one of which is called oral mucositis. You can hear a bit more in a minute about that. And veterinarians are using it as well. And of course we now have this whole body treatment system where you can treat the whole body. And that kind of looks like that when you're using it. This is not a heat therapy. People assume lasers and red and near-imperial light must mean something to do with heat. No, the effectiveness treatment is more like photosynthesis and plants because humans and animals will photosynthesize. This is something you know already. You know when you go out in the sun you change colour. It's a form of photosynthesis. And you know that we use sunlight to help synthesize vitamin D. And you might know they use blue light therapies on prematurely born babies to reduce neonatal jaundice. Another form of photosynthesis. Doctors or dermatologists specifically will use ultraviolet light to treat psoriasis and vitroligo. So nobody should be surprised if light has other effects on the body. Now, normally people think of lasers and medicine as being used for cutting and ablating and quarterizing tissue. Well, not all lasers are dangerous. If you're old enough, you may have seen this movie, Goldfinger with James Bond. So not all lasers are dangerous. That's because there's different classes of lasers. The lasers used in supermarkets or my lecture point to hear, nobody gets hurt with this thing. Lasers are not necessarily dangerous. The dangerous ones you're thinking about in medicine are the class 4 lasers. These are the ones that have a thermal effect. We use class 3B lasers. They have no harmful effects on skin or clothing, but they are potentially hazardous to the eye. So you, your patients and the observers would wear laser safety glasses. We also use light emitting diodes, LEDs. They've got some similar qualities to lasers. We don't have time to discuss today. But we use those, and you don't need all the safety glasses, but they have the same effect. Very briefly touched on the history. It starts with Albert Einstein. Seems to end up with me. Great slide. My mum would have been proud. Einstein came up with a theory about amplification by the stimulated emission of radiation, LA-SER laser. This guy wanted to, actually made the first working laser in 1960. This guy wants to find out, does it cause cancer? He does an experiment on mice. He takes a group of mice. He shaves the hair from their bodies. He divides them into two groups, puts a low intensity laser beam on one group and not the other to see if the treatment group has cancer. They didn't enter his surprise. The hair grew back more quickly on the treatment group compared with the untreated group. That's how he discovered photo by modulation. Over here in the United States, things really didn't lift off until NASA got involved over here. That's my best joke of the day. Things didn't lift off until NASA got involved. You have to be old enough to know these things. We've got SpaceX and Blue Origin and the galactic thing that Richard Brownson does and NASA, I mean, there's a rocket going up every day now. It's stuck. Anyway, yes, NASA wanted to find that we're planning man missions to mask the problem for astronauts in the long space flight as they lose bone density, they have muscle wasting, they cut themselves shaving, they don't heal, they wanted to find out if there was something, you know, if this magical light, photo by modulation would help with the life and longevity of astronauts. Now, on a trip to Mars, they haven't been to Mars yet, so we don't know, but they did some interesting research on the field. But subsequently, I suppose the field really took off when I suppose around 2006, the Journal of Nature published an editorial on the mechanism of action, the Journal of Pain from the International Association for the Study of Pain on the treatment of photo by modulation for neck pain down the World Health Organization. They started recommending it for neck pain. The Lancet, the world's leading journal for breakthrough medicine, started recommending it for neck pain. American Physical Therapy Association, Achilles Tendinopathy's International Association for the Study of Pain, strong evidence in their systematic reviews for myofascial pain syndrome, frozen shoulders, tennis elbow, lymphedema, low back pain. American College of Physicians guidelines now say, recommended as a non-invasive treatment for chronic low back pain, a strong recommendation, Blue Cross Blue Shield and they're all saying it's medically necessary. In the UK, National Institute for Health and Care Excellence, the guidelines now recommend photo by modulation for cancer patients at risk of developing oral mucusitis and so on. Eventually, we end up down here. JAMA, the Journal of the American Medical Association says it's an option. It's not a strong statement, but it's a start. I mean, it's a hugely influential journal for low back pain lasting more than 12 weeks. So now, for the field, there's over 1,000 randomized placebo-controlled clinical trials on humans published in peer-reviewed medical journals, more than 4,000 lab studies, 660 academic papers published last year on the subject, 8,500 academic papers in total for our own products, 34 million treatments have been performed to date. Yet nobody's heard of it, or most of you haven't heard of it. Anyway, state-of-the-art is the strong evidence of muscle and joint pain, all of the mucusitis I mentioned, the cancer therapy side effect, dry aid-related macular degeneration, the leading cause of blindness in this country, improving strength and endurance and recovery in athletes, and other things I've kind of mentioned some of those already, but we're going to move on due to time. So moderate levels of evidence just means small clinical trials and not many of them. Experimental means mostly just case series papers, anecdotal means not even that, just anecdotal. How can one medicine treat so many different conditions? You know, you should never leave anything that appears to do everything, and when it doesn't do everything, it does one thing, it has a profound effect on mitochondria. You may know that mitochondria are often, if you learned about a bit of biology at school, they were often called the powerhouse of the cell. They take up glucose and oxygen and make cellular energies probably what you were taught. Okay, so mitochondria is a cartoon picture of one, you have hundreds and thousands of these in every single cell of your body, and when we're sick and when we're injured and when we're stressed and just gradually as we get older, our cells tend to be low on energy, ATP. They tend to be high in oxidative stress, which is a bad state for your cells to be in. They're making too many reactive oxygen species, free radicals if you like, that lead to oxidative stress and the over stimulator gene transcription that's called NF-Kappa B. This is as nerdy as it gets, and it's going to get easier from here. The master switch for inflammation in every cell of the body is all those inflammatory cytokines we've heard about with COVID, for example, the inflammation cell death, necrosis, degenerative diseases, and generally accelerating the aging process, which is why you want antioxidants in your diet, for example. But when we put light in the patients, we can put it exactly where the injury is. We put light in to get absorbed in mitochondria, and the state of the cells changes to one where it makes more energy and less oxidative stress. And I'm going to call it the master switch for tissue repair. We get these regenerative effects. If you've done any biology or a doctor, or anybody out there, these are anti-inflammatory mechanisms you might be familiar with, get turned on, regenerative mechanisms if you've done enough biology, but leading to tissue repair and tissue survival. I love what Glenn was saying earlier. It reminded me that photobiomodulation basically leads to health cell home estasis, or a state of peace, as he was saying, if you want me to put it in the terms of this conference. That has some interesting downstream effects which I'm not going to talk about. But this is basically what happens next after you put light in. That leads to faster tissue repair, less edema, less inflammation and less pain. There is a dose response. If you don't have enough intensity, there's more light. If you put a bit more light in, you get positive effects on inflammation and repair too much. You tend to lose it and you can actually slow things down if you want to. So we try to keep people inside this therapeutic window. So medical use of it. Its regenerative is one of its features. Oral mucositis. There's over 60 randomized placebo control clinical trials with this horrible side effect of chemotherapy and radiotherapy. In this study here, the five grades of oral mucositis in these cancer patients who are going through chemotherapy here. This is grade four oral mucositis in the placebo group. You can see that the placebo group get most of the grade four. These patients cannot drink or eat or swallow solid food. Grade three patients can drink liquids but they can't eat solid food there. And you'll notice at the dial up bars which are the active photobiomodulation group, only one patient get is in grade four with where they can't eat or drink. Everybody else has got mouth soreness, just erythema in the mouth or nothing at all. So PBM has moved these patients from the severe end of being able to eat or drink down to this end of the scale which is low grades of pain, inflammation or just visual erythema or nothing at all. It's highly anti-inflammatory and it's regenerative. This is a neuro sensory recovery after injury to the inferior alveolar nerve. That's the nerve that runs down the inside of your jaw, your mandible. It then just pulls your third molar out through the wisdom extraction there. Sometimes the roots of the tooth get caught up in the nerve. They pull the tooth, the nerve snaps and it doesn't heal by itself within a year. You're left with a numb feeling around the border of your tongue, around your neck and chin, around here for the rest of your life. You know what it's like after injection, you can't drink or anything, you dribble or anything, you're stuck there for the rest of your life. These patients have had it for more than a year, they've got this is my point of that. Now at the bottom there, they're getting a low score on the brush stroke directional discrimination test, the dentist closes their eyes, the patient closes their eyes, the dentist does the test, they can't feel anything. They've got a very low score, a course of treatment, photo by modulation three times a week for seven weeks, 20 treatments in all, you get recovery of the nerve. In medicine, does this apart from photo by modulation? If you can see four kids in my kitchen, you do not have dry age-related macular degeneration, the leading cause of blindness in this country. You may know people who have injections for it, they have the wet form that's 10% of AMD patients, 90% are untreatable and basically it goes like this, you lose central vision and you get distortion in your vision, you lose sensitivity, your world goes black and white, you develop these blind spots called geographic atrophy, which get worse until you can't read, you can't drive, you can't shop, you can't enjoy TV, you lose independent living. With the treatment in my co-founder in this business disclosure, there, an investor in the company, we just finished 18 randomized controlled clinical trials across the world, it's all in the hands of the FDA now and we expect that early next year the product will be released and for treatment I'll just show you one set of data patients here from their baseline have an improvement on the Snellen chart, you know, the chart where you get the ophthalmologist, where the letters get smaller you have this increase in visual acuity, five letters effectively means you can read one line further down the chart and for most people that means the difference between losing your driving license or not, for example, and that they get a course of treatment in month one and then we measure them three months later and the improvement seems to be continuing even though we stopped treatment, you stop for too long, the treatment, the benefits disappear but you give them another course of treatment, they come back again, we stop the treatment again, it goes away again and so on. So degenerative diseases are not curable but we can get rid of the symptoms of dry AMD and this is true for all degenerative diseases with this technology, you treat it, if it's degenerative like your knees, your osteoarthritis, your brain with your Alzheimer's or your eyes with the disease, it always comes back so you need more treatment. If you have an acute traumatic injury, you know like a sports injury or something or surgery and you treat it and you heal it, it's healed for life. So get that bit handled, it's anti-inflammatory, here's an experiment done on athletes, they've got Achilles tendinopathies, they do something called a micro dialysis measurement for PGE2 concentrations, that's an inflammatory marker, so you stick it in the Achilles tendon there and then they get a treat, I've missed the graph off, but you know the answer, we do active treatment group to a placebo group and you treat their Achilles tendon, the inflammation goes down in the treatment group and not in their placebo group. Sorry, I missed the graph off of that. It's analgesic. Potipatic neuralgia is one of the worst kinds of pain that anybody can get. People can't lie down, they can't wear shirts, they can't bear to be touched, it drives people to suicide, it's that kind of pain, typically around the thorax here. So in this study here, just a small study, 20 patients have had PHN for a mean duration of two and a half years, that's six to eight years. Only one treatment a week, I thought this wasn't going to work. The treatment group, the pain comes down on the pain score, doesn't happen in the placebo group. It's a crossover trial, that means this group B, get the active treatment, this group go on to placebo and that pain doesn't come back and it stays away. 95% of patients discontinued all medication for a month. 5% had a reduced dosage and at six months follow up 80% of patients have maintained their pain reduction. And nothing else does this. This is the use of opioids by cancer patients having all of these there is a 68, you can't see my dot really, but 68% reduction in the use of opioids and this has been repeated multiple times. Like I said, there's over a thousand randomized controlled clinical trials. Post-operative pain, I know of three off the top of my head which show approximately the same 68, 70% reduction in the use of opioids if they have this treatment after surgery. Myofascial pain, these are the tender points you get on your body, you know somebody massages your neck and says you've got knots in your shoulders, press on that or something like that. Systematic review published in the Lancet the world's leading journal for breakthrough medicine say that those myofascial trigger points in your neck that basically stop people from being able to turn their heads. If anybody who has a problem like this and can't fully rotate and turn their head, we should treat you later on. PBM works well for reducing those points. It improves sleep. Chinese People Liberation Army study here lying under a red LED lamp, not fully closed they would normally be in their underwear, get a treatment every night. What happens? They have an improvement in serum melatonin so the melatonin levels in their blood, it doesn't happen in the placebo group. They have a reduction in the Pittsburgh quality sleep index that measures the negative aspects of sleep like insomnia for example goes down in the photo by modulation group, it doesn't go down in the placebo group and they also do some exercise tests. They have to see how far they can run in 12 minutes and they run further than the control group does. They rather have an improvement in that too. Fatigue, we do experiments on people where we put them on a biodex machine, how much exercise they can do, repetitions on this machine which measures the amount of exercise they do, then they either get cryotherapy or they get photo by modulation or they're ice followed by PBM or PBM followed by ice or placebo. So there's four goots and a placebo and they do blood tests before and afterwards one hour, one day, two days and three days afterwards and they also do strength tests and they do pain tests and photo by modulation after that exercise, blood test for creatinine kinase, a marker for muscle damage here shows that it's down here and the red line at the bottom here compared with all the other groups, photo by modulation reduces delayed onset muscle so there's less pain means all the groups that have photo by modulation have got less pain compared with cryotherapy or placebo treatments down there. Maximum voluntary capacity strength in newton meters these people are back to full strength the next day and the day after that it doesn't happen with ice therapy or cryotherapy or placebo. We were first introduced to Novathor at the 2016 Olympic trials. Alberto Salazar had a unit at his house. He offered Justin the ability to use the Novathor bed that he personally had to help him get through the rounds. And it was crunch time and I'm running with an ace bandage on and then this comes to me and he says look you know we're going to go over here we're going to try this Novathor out and I literally did it maybe the day before because sometimes athletes are really skeptical about doing things the day of their meet and they don't want to break routine and I remember getting off the bed and I felt so rejuvenated I just felt like my cells were just popping like popcorn and I told Dennis we got to go over there before the finals of the 200 so we went to the day of the race so the next day we went there again I got a Novathor treatment and I felt great I went out there the odds were against me I was running in lane 8 so I was running blind and I was still up in air about this this nagging injury I had and I went out there and ran one of the fastest times in the world at that point in time to make the Olympic team. The difference between him one day to the next day using the Novathor bed was like night and day and we knew he had a really big race and his competitor which was a Nike athlete too was also using the bed so we kind of had a little hey you can't get it better than I can kind of thing and Justin ended up squeezing him out by a couple of hundredth of a second to make the Olympic team and win the Olympic trials so at that point we were sold on Novathor stop that there and let's jump to the fibromyalgia so basically I'm building up to the story with fibromyalgia being the pits pain, inflammation, tenderness and sleep issues fibromyalgia we did a randomized controlled clinical trial on 42 patients no benefit in the first two weeks of any significance but by about week four they're using it three times a week for four weeks you begin to see the pain levels coming down on the scale and then you stop treatment and it continues to get better and this is a consistent thing we find with this once you've started people healing, treatment doesn't just take away pain it actually helps you heal and once you stop using it you still got momentum to that and so the scores continue to get better over time quality of life goes up here over the same period of time if you're a statistician out there you'll know what a co-insidious and a p-value is .05 is good .01 is better .001 is extraordinary co-insidious anything better than .8 is good 2.5 nearly is enormous very strong very effective treatment leisure activity not much after two weeks and then four weeks you can see it jumps up people have more confidence to go out and use their bodies I'm aware that I'm up against my time limit then I'm just going to say there is one more thing I'm just going to show you how it actually reduces inflammation and what it does for the longevity of the brain and the health span but the one more thing we actually do is to make something that actually treats your head as well I've now run out of time so I'm going to thank you all for coming and you may now clap your hands wow there's another crowd there