d]

Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin Marchegiani. We got Dr. Andrew Hill on the show today. Dr. Andrew is a grad over the UMass Amherst School. I went to school as well so we’re fellow alums, also a PhD grad over at UCLA. Dr. Hill, it’s been a while, but glad to have you back on the show.

Dr. Andrew Hill: Yeah, thanks for having me, Justin. I’m guessing a lot has happened for Beyond Wellness, as well as on my end of things, the past couple of—few months.

Dr. Justin Marchegiani:  Very cool! I’m excited. What's new on your neck of the woods?

Dr. Andrew Hill:  We are—and we, I mean, a new company I’ve been working on called Peak Brain, we’ve been opening up brain training centers, neurofeedback centers. We’re also doing a lot of free mindfulness instruction, you know, I’m sure we talked about this last time.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Just to review a lot of different aspects on you know, call it biohacking, call it therapy, call it exercise. There’s lots of different avenues into this space and for many people, different choices might make more sense towards you know, free things–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Like mindfulness and meditation where you’re always carry around the equipment. Once you know how to do it, you can always practice. So I have this focus, at this point of bringing tools to accessible, or bringing the accessibility to people. So the idea is to provide a lot of you know, open mindfulness instruction and these training centers as well as the higher tech tool that people can sort of you know, buy services and getting a lot of hands on training and qEEG and neurofeedback. So I’m taking it more to the—to the fitness and out of the clinical level as much as possible these days.

Dr. Justin Marchegiani:  And you’re doing more qEEG or neurofeedback work?

Dr. Andrew Hill:  Yeah, the—most of the neurofeedback we do is EEG-based–

Dr. Justin Marchegiani:  Okay, got it.

Dr. Andrew Hill:  Neurofeedback or biofeedback. We also do HEG, which is another form of neurofeedback. We do a little bit of HRV, which is biofeedback referral. Let me—let me break–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This down for one second. There—there’s some overlap in terms. All neurofeedback is a form of biofeedback but not all biofeedback is neurofeedback. The difference really—the central nervous system as—as you know is a pretty savvy guy, but the body is—some of the systems is everything encased in bone essentially. So—all the nerves are inside the spinal column, the brain and so–

Dr. Justin Marchegiani:  Exactly.

Dr. Andrew Hill:  And everything outside is—is peripheral nervous system, and so broadly you can define neurofeedback as central neurofeedback or sorry, central neurofeedback or peripheral biofeedback.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And that’s for the line that—that is getting drawn, but it’s a little blurry because you can do things centrally, like HEG where your training blood flow voluntarily and EEG is a form of central biofeedback where it’s involuntary thing—so the lines blue quickly because the body is not divided into, you know, discrete compartments that are purely isolated from each other in—in a system, so it’s a little bit of complicated but that’s probably more information than you need—on—on the differences. So–

Dr. Justin Marchegiani:  Very cool. So if someone is out here, maybe they have excessive sympathetic nervous system overdrive or an adrenal dysfunction–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Right? Neurofeedback and/or EEG tend to be a really good way to dampen that's—over sympathetic, over fight or flight response that’s happening. So if someone's having that, they’re making the diet and the lifestyle changes, maybe they’re on an adrenal program using some adaptogens and nutrients and they’re stabilizing their blood sugar, making themselves be a more—a fat burner, would the next step be, if they’re doing all these things correct, how would they incorporate–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  The EEG neurofeedback into their life?

Dr. Andrew Hill:  The next few steps in terms of you know, adding tools and technology to support, you know, health as well as transformation would be probably to add in either peripheral biofeedback tools like HRV, like all that skin response, like mindfulness, like meditation practice and then I would say the next level is adding in the sort of higher tech tools like the EEG neurofeedback. And—and to enter that stage, you sim—and if there’s a problem, I mean, for the average person who’s working on stress management or just trying to optimize the performance, you know, you will wanna build things to have a good foundation. If you're trying to remediate a specific issue, you have seizures, you have ADHD, you got some, you know, problems that’s really getting in your way then you can go right to neurofeedback, I think as a, you know, first line intervention. And for something like that, you start with what is called a brain map, a quantitative EEG ideally and those are usually baseline assessments of brain activity that or then compared to a normative database, and out that you get maps that tell, you know, practitioner like myself how unusual you are compared to a population. And then we examine the most unusual aspects of your brain, how it’s functioning and some of those tend to cohere with certain functional limits or patterns or bottlenecks. You may notice I’m using a lot of very tentative language and that’s because the qEEG is not neuroimaging. It’s statistical analysis. You know, it’s you compared to some distribute—there’s some distribution of—of continuum of function, you know? So it’s really you compared to a bunch of different average people and—and your brain can be special and unique and wonderful, and—and really unusual and still be fine.

Dr. Justin Marchegiani:  Uh-hmm. Uh-hmm.

Dr. Andrew Hill:  So qEEG is—is much of an art as is a science. There are a few things in the EEG and the quantitative EEG that are well validated, some diagnostic markers, or other you know, some discriminants, pretty reliably if you have clean EEG, you can spot traumatic brain injuries in people if they are at all significant. You can often or almost always actually spot ADHD. The FDA has a pretty good at this point support of a few discriminants in the EEG that suggests ADHD, including you know, going so far as to support a hardware diagnostic headset a couple years ago as actually diagnosing ADHD passively without any clinical involvement and essentially it’s doing I—I believe it’s—it’s doing a ratios of frequencies in the brain. So you start with these assessment tools to get a peek under the covers, and so the quantified self implication as well as a, you know, remediation benefit and you get a sense of how your brain works and then the next step is to start exercising and training it using you know, biofeedback feedback essentially and we shape brain activity and figure out how that affects function and over time you make changes to the brain. I know we talked about this before, but it’s essentially offering conditioning, not if you could think Skinner not Pavlov–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  So we aren’t—we aren’t making you know, a voluntary response happen by providing a—a random thing like—like the bell and pairing it with the stimulants.

Dr. Justin Marchegiani:  Yes, exactly.

Dr. Andrew Hill:  What we’re doing is instead only rewarding certain stimuli you do. So Skinner, you know, Skinner’s left alone noted Pavlov but it—I think it bears expanding. Skinner trained essentially pigeons to peck along bars or do certain behaviors to get rewards, you know, to turn a light on or you know, hit a switch or something. And a Skinner box is a behavior-shaping device. You don’t just examine how pigeons behave. You examine how they learn so you’re shaping or changing their and the way you do that and operate conditioning is you reward behavior that is near what you want to accomplish, so–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  You find what the brain is doing moment to moment, and then you—you know, when—when a certain brain wave moves a little bit or trends in the right direction or stays in the direction that’s when you provide—provide the reward. So over time your—you're shaping.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  You're just rewarding—

Dr. Justin Marchegiani:  Shaping, right.

Dr. Andrew Hill:  A different trend, yeah.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And then you move the goalpost and you reward further, you know, development of the trend, the physiological trend and not direction. The—the weird thing about—about the analogy of Skinner vs Pavlov is this is operate conditioning. However, the pigeon knew what it was doing. It was—you know, it was trying different things. Pigeons actually can get very superstitious.

Dr. Justin Marchegiani:  Hmm.

Dr. Andrew Hill:  If you—you know, if they spin around once, and then get rewarded, they will then spin around once and they approach that food bowl and switch again because they’ve learned. Pigeons are like baseball players. They’re so superstitious–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  A little ridiculous.

Dr. Justin Marchegiani:  That is funny.

Dr. Andrew Hill:  But in the case of EEG—the—the analogy breaks down because what you’re rewarding, the—the behavior if you will of the brain, a fluctuating EEG that’s happening in a time course that is faster than you can perceive or control. So it's really measuring sort of the real-time, you know, under 100 milliseconds or time window of what fluctuating in your brain. And you don't really control things in that time course. You are only perceiving in the like 92 to a couple hundred milliseconds timeframe for most of us. We don't proceed rapidly and we perceive most of what’s going on, you know, neurologically. And so as it’s fluctuating, reward it and shape it, and over time it changes which was kind of magical and lovely. But it—it’s not the magic of neurofeedback that’s doing that, it’s the magic of the brain.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  It’s the brain's ability to interpret a signal, a shaping signal. It’s the brain’s ability to enhance its plasticity in response to a signal. There’s really good evidence now that neurofeedback rams up plasticity fairly profoundly, something called a—an evoked motor potential can be used to measure plasticity of cortex. Essentially, you—you trans—carry all magnetic stimulations and zap a little bit of the brain and see—like over the hand area of the motor cortex and see how much bulk it takes to make the hand jump.

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It—it sounds brutal but it’s actually a fairly innocuous little thing they do with TMS, just to see if they’re over the right area. The—there was an experiment a couple years ago that showed that before-and-after neurofeedback. After neurofeedback, the motor cortex respond to a much lower voltage, a much lower, you know, signal before it perturbs or it jumps in responds and changes. And—and so this is a sign of motor plasticity or learning–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You know, broadly, that seems to be upre—upregulated regulated fairly rapidly with neurofeedback.

Dr. Justin Marchegiani:  And when you’re saying–

Dr. Andrew Hill:  With the other evidence of this. Yeah.

Dr. Justin Marchegiani:  And when you’re saying neuroplasticity, basically your brain is almost starting to rewire itself essentially.

Dr. Andrew Hill:  Yeah, it’s rewiring itself. You know, I—I think of it sort of like it's getting younger because–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  For many of us we—we’ve have the experience of being, you know, over plastic. I mean, that’s being a teenager is to some extent. Things just change a little, you know, too rapidly, swing. But there’s this—there’s this proliferation of synapses, of connections between neurons in early seniors,  10 through 14 or 9 through 14, or around 9 or 10 or 11, the brain sort of finishes all this lateralization. It’s often that’s where a lot of final development happens. Post that age is when language acquisition without an accent becomes very difficult, but right after there’s this—there’s this proliferation for a few years or synapses. Massive like overbuilding in some ways. Think of like a forest that is becoming so thick and so overgrown that it just doesn't have a lot of light getting through it. You know, it’s almost like too much in terms of synaptic density, and then there’s a big period of learning where those synapses change widlly in mid-teen years and many get pruned away, you know, this—this neuropile as it’s called.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It’s pruned away into more discrete circuits. And that’s the time of profound learning and skill development and self-regulation, and other things in those mid-teen years. And so I really do think about you know, the plasticity enhancement features of neurofeedback as sort of rolling back some of the—some of the kid, not the—the decline of synaptic flexibility that was so prevalent when most of us were in our mid-teen years when things were just changing and responding and changing and responding and—and learning was like trivial because it’s just learn, learn, learn, and change and grow and develop. And it all seems effortless, you know? Relative how things feel, you know, 20 years later or 30 or 40 or 50 years later. So—so that’s my goal from all this stuff. Be it nootropics or mediation or neurofeedback. And—and be it for whatever goal, peak performance, substance abuse, you know, remediation if you will, changing your relationships and your—and you’re in control over substance behavior which is hard when you think about it. Getting control of executive function, getting control of aging, getting control of mental illness. These are equivalent in my mind. They’re all about getting some control over this 3-lb blob that uses most of our, you know, glucose and oxygen resources on our body.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  And—and learning to take you know, a little more active role if you will in how it develops, how it changes, how—how it has a trajectory of improvement and aging, and learning and growth. So a lot of my focus is—has really swung far towards encouraging and supporting people’s access to these tools.

Dr. Justin Marchegiani:  Interesting and you mentioned a couple of things especially with ADHD, and it's interesting when you–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Because when you compare and contrast, you know, the—the functional, more natural alternatives, EEG, nutrition, functional medicine for like, let’s say ADHD, you also have the conventional options which are pretty mainstream, but they typically involve stimulants–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Methamphetamines, Adderall, Prozac, you know, those type of medications where you’re trying to–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Overstimulate the brain into focus, into the ability to pay attention, how is that different? I mean, obviously, one I see is whipping a horse, whipping a tired horse. The other one is—is much more different and is trying to align the brain in a more functional, more sustainable way.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Can you compare that?

Dr. Andrew Hill:  Interesting analogy. An interesting analogy. Let me—let me just talk about medications for a second.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Now I’m not a psychiatrist. I’m a neuroscientist, but I—you know, I know a thing or two about pharmacokinetics–

Dr. Justin Marchegiani:  Of course, yeah.

Dr. Andrew Hill:  And dynamics and how—how they work. The—in theory, they should not be working. Psychostimulants should not be working by whipping the tired horse. In theory, the CEO of the company is asleep under the desk, and the psychostimulant is like a cup of coffee to get something productive again so they control all the random nonsense going on in all the different departments of the company.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  So it—it’s waking up some—an executive that is not controlling thing versus driving an already tired system. I just want—you know, I wanna shift the metaphor a little bit.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Because there’s a couple of other classes of drugs that are now used. You mentioned SSRI’s I think.

Dr. Justin Marchegiani:  Yeah, Prozac.

Dr. Andrew Hill:  Yeah, Prozac. Not as used sometimes—on no longer very much in kids and teens because the—the suicide fatality–

Dr. Justin Marchegiani:  Side effects, yeah.

Dr. Andrew Hill:  Increased risk is pretty high.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  They’ve discovered.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  That’s often not a great course, but the other two classes that are used, some of them promising with—with some promise are mood stabilizers and beta blockers, blood pressure meds that are being used really seem to work for some of the most acute behavioral symptoms.

Dr. Justin Marchegiani:  Are they beta-blockers? That they’re helping to decrease that action potential in the heart and the sympathetics. Is that how it’s working?

Dr. Andrew Hill:  Not sure how they’re working. Things like—like Intuniv which is a—what’s that? Atenolol or something. I forget–

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  What the—what the generic is.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Yeah, it’s basically beta blockers which work great for other things, too. And as well as comorbidity. So I wonder how much is it does ADHD cause anxiety being dealt with better, and you know, but all day long I look at brains that have been labeled ADHD or anxious or other things, and I often find there’s some agreement with labels on the physiology and how it functions, but not complete, you know. And they’re often very coarse and very poor agreement. So I—I will say that—that functional patterns that support the interpretation of ADHD, anxiety, and sleep issues tend to show up together more than they show up separately. So you almost always, if you see two of those three things, you almost always see all three—ADHD, sleep issues, and anxiety.

Dr. Justin Marchegiani:  And I know there are potential adverse–

Dr. Andrew Hill:  In terms of—Uh-hmm?

Dr. Justin Marchegiani:  I know there are potential adverse effects of the methamphetamines long-term on the brain, so I get in the short-term, hey, you got an exam–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  You’re gonna do it to kinda get really get those centers revved but long-term, what’s your take on that?

Dr. Andrew Hill:  Yeah, well, it depends on the class of psychostimulant. I mean, some things like Adderall–

Dr. Justin Marchegiani:  Adderall.

Dr. Andrew Hill:  Since you have a structure similar to—to methamphetamines–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Those things we—we don't know too much about and—and it’s probably not great long-term. The drugs like methylphenidate, Ritalin–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  That seems to actually be a little neuroprotective but don't necessarily work for everyone or you know, have—have all the benefits. You know, when I was just post college or in college, I—I need to add Ritalin and it made me really sedated. I was profoundly ADHD, classic ADHD, in you know, even in my 20s, not so much anymore but—but back then I was, and methylphenidate just made me feel numb, you know, Ritalin. And—and it just did not work to control my attention and at that time as a “young” man, I did take Adderall. It worked relatively well and I tried it again about a decade or two later and it my—I have my liver gotten too old. I couldn't tolerate the side effects. And I—and I think I'm not so concerned about the—the short-term side effect.

Dr. Justin Marchegiani:  Right. It’s definitely the long-term.

Dr. Andrew Hill:  As you say–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  But—but even the short-term side effects can be fairly profound to a developing person. If you’re appetite suppressed, if your sleep’s disrupted, if you have underlying cardiac issues, I—I think that stimulants in general can really provoke a pretty, you know, negative set of consequences in the short-term. I don't know that we know a huge amount about long-term, but I think that the sort of atypical stimulants like Ritalin, we know are fairly safe long-ish term because of how long people have been on them. And we know that the biggest risk for a lot of the other drugs is more about either sensitivities, like I said, cardiac or other issues or there’s—there’s risk of abuse in—in stimulants, right? There’s often very significant risk of abuse, and I think the problem—that the scope of the problem is actually, even I’m—I’m downplaying it a little bit is actually much more dramatic that I might—that we might suggest because I think ADHD and, therefore, stimulant prescription is so phenomenally rampant and fat outstretched the actual clinical sort of narrow scope focus of pathology that must be addressed. I mean, ADHD is a bucket that has become you know, huge, to swell and catch all kinds of things especially in school systems.

Dr. Justin Marchegiani:  Oh yeah.

Dr. Andrew Hill:  There are like something like half or three quarters of you know, in some school systems have kids that are on psychostimulants, and have these diagnoses. And I don’t think the diagnoses match. First of all, I think ADHD is only diagnostically relevant when it’s getting in the way and—and it’s so profoundly overdiagnosed that you know, it’s a fraction people who have some attention problems under some circumstances that I would call ADHD—you know, capital A, capital H, whatever.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  The—and prescribed for. Because the consequences are high and this is the medical doctor’s you know, job of course to know this that there are—are side effects you must balance against the desired effects–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And the side effects and stimulants are not significant, they’re better than other things. I'm not sure why the beta blockers work. I have a hunch we’re gonna discovered it’s more about reticular activating system issues.

Dr. Justin Marchegiani:  Uh-hmm. Yeah.

Dr. Andrew Hill:  And thalamic—and thalamic activation of downstate–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than it’s really gonna be about you know, cortical activation and—and relaxation if you will. But all those things regardless of how they’re working are doing short-term intervention. They’re not teaching their brain how to not be ADHD, but how to sustain your executive function, and sustaining sort of you know, sustain a—a perspective on attention that is resilient and not reactive. That takes some work and you can get there, but it’s not—you know, it’s not rocket surgery. You can get there through mindfulness or meditation, and you can absolutely work on ADHD and other another cluster type phenomena with a short simple mindfulness practice. In weeks, it will start changing your brain. The research is mounting. You can do a lot of mindfulness to—to reign back in executive function challenges that aren’t necessarily, you know, there.

Dr. Justin Marchegiani:  And I think you can learn a lot by the mechanism of how these drugs work. I mean, if you—if you know about the methamphetamines–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just the average listener here, they really are gonna stimulate serotonin and dopamine and a lot of your catecholamines, norepinephrine, epinephrine. So if that's helping, while the question becomes how can we utilize construct of vehicles to increase those neurotransmitters? Also they block the reuptake to so they allow more of these nutrients or more of these brain chemicals to sit in between the pre-and postsynaptic neuron. The problem is long-term, we start to have more degrading or recycling enzymes that break them down faster. So if short-term, it works okay. But in the long-term, you start gearing up more enzymes to break them down.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  So the question I guess comes down to what can we do, I mean, on the neurofeedback side to improve these neurochemicals and maybe you want to take it to the diet side and maybe even supplements side, too.

Dr. Andrew Hill:  Yeah, you can do a fair amount. I mean another benefit of neurofeedback is it really makes your brain more sensitive and sort of reset some this—this acquired tolerance. And we see that in psychostimulants dramatically. You know, a couple weeks into neurofeedback you have to reduce your dose usually because you’re suddenly getting hit with a sledgehammer by—by your psychostimulants if you’re taking the.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  We also see it from things like cannabis oddly enough. You suddenly have to ramp your—your consumption down if you’re a cannabis user because your brain is super flexible.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  But some of the—some of the best of research is still coming in. I mean, we don’t really understand nutrition fully in terms of ADHD. And it’s also not a homogenous issue when it’s actually truly present. I mean, there are several variants, some more types of you know, dopamine receptor coding repeats that show up that gets classified as ADHD, and some of them make you more hyperactive but also more resistant to distraction and some of them make you, you know, more distractible but less able to focus—but also able to, you know, almost more able to focus rather when you get checked in. So it—it’s a little bit of confusing space and, therefore, what works for one person is not necessarily what works for other people. But those blog classes like mindfulness and neurofeedback works for pretty much every so that’s why I start there. There’s other things that may work for you. Things like L-tyrosine, which of course is the precursor to dopamine, does work for–

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  A certain percentage of people as a—as a support to attention pretty profoundly and I—I have a hunch that it’s working best for those people who’ve either been on stimulants, on who’ve got you know, one very sort of narrow subtype of ADHD where it's really about a dopa—a dopamine receptor you know, proliferation. And for those people I think L-tyrosine is actually helping in need. There’s no real evidence that supplementing L-tyrosine increases levels of dopamine, but I have a sort of perspective on it where I’m gonna let the dopamine system regulate itself, because you know, anything goes directly to synapse or increases release of dopamine, things like stimulants. Those are always gonna be adapted to by the system because there are supraphysiological. They’re dangerous. They’re—they’re alarming to the brain and the brain has to adapt and, therefore, meaning tolerance, addiction especially in dopamine. So my perspective on this stuff is always to back up a level in the regulatory space if you will and feed the neurons, feed the dopamine neurons what they need to use their enzymatic chain to make dopamine. And there you’ll only get more dopamine if you actually need more dopamine in the moment. I mean I’m really somebody who—who believes that there's no such thing as a chemical imbalance in the brain. It can’t really exist and there’s you know, massive sweeps of regulatory tuning in terms of receptor density and receptor sensitivity and all kinds of other things like that but my—my perspective on monkeying with the systems is they know how to regulate themselves and any ideas we have about what we’re are gonna be really imperfect at best, and you know, therefore, we’re gonna be trying things that don’t make sense. I think we got lucky with you know, SSRIs as mentioned earlier, Prozac. We now know that Prozac, yeah, if does work on serotonin, but not necessarily to increase it, you know, all sorts of neurons have autoreceptors that measure the amount of serotonin in the synapse that they are releasing into the synapse.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And if SSRIs decrease breakdown and, therefore, increase synaptic levels of serotonin, the autoreceptor shuts down release. So actually you have to adapt to it, you get sort of lower tonic release of serotonin in your—in your brain than you—than you did before you started taking whatever it was. You know, the SSRI. That’s—that sounds like that can’t possibly be true because serotonin’s the happy chemical and it—it’s antidepressive. It’s just not. I mean, if you—there’s something about the anxiety, it’s a little more closely linked to serotonin. But the antidepressive—antidepression effects of the SSRIs as well as anything else that lists depression, be it learning new things, be it exercise, be it whatever you’re dealing. The final common pathway if you will of depression release seems to be increase of BDNF. Brain derived–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Neurotropic factor.

Dr. Justin Marchegiani:  Neurotropic factor, right.

Dr. Andrew Hill:  In the hippocampus, which is all about learning and integrating information. That—that’s kinda what that job is and that’s really the key, yeah, I think. The key plasticity if you will, neuroregulatory factors. So it’s all about, I think the name of the game is BDNF. And depression is elicited by raising it through indirectly, you know, many steps back by—by tweaking serotonin and the brain responds to that loud signal by—wait, what’s going on? And getting a little more plastic if not integrate the slightly bizarre signal it’s getting from the SSRI is my—is my take on it. It cannot be, you know, perfect.

Dr. Justin Marchegiani:  How about B vitamins? How about B vi—I find B6 or P5P–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Pyridoxal-5-phosphate–

Dr. Andrew Hill:  Sure. Yeah.

Dr. Justin Marchegiani:  Is deemed really important to help convert some of these amino acids in the brain.

Dr. Andrew Hill:  Oh, yeah, all—all kinds of reasons. I mean, just look at the Krebs cycle,

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Just think back to our physical biology, there’s all kinds of amazing things that B vitamins do to the Krebs cycle, specifically some of the, you know, nicotinamide riboside, NA—NADH in terms of electronic streams. There was some related research—sorry—there’s related compounds in the Krebs cycle called alpha-ketoglutarate.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Which recently some research came out of UCLA, about a year ago, that showed that the anti-aging benefits in model organisms, C. elegans in this case. The anti-aging benefits of alpha-ketoglutarate are like 10 times higher than resveratrol in the same organisms and through a differnet mechanism—we know the resveratrol activates sort of the stress response gene, CERT, and that seems to be how they cause, you know, the sort of French paradox and other you know, animal model documented life-extension things. But the—the alpha-ketoglutarate is operating in a different place. It seems to be tweaking the Krebs somehow and, therefore, optimizing energy production. So all the other thing that tweak CERT, like caloric restriction, like cold stress–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  They do extend lifespan in model organisms but they do it at the cost of either mobility or reproduction, right? The animal become less metabolically active and that’s what happens if you restrict calories in humans, too, you know? Eventually we downregulate metabolism, not—not immediately.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  But eventually and—and so caloric restriction is the only biohacking modality that’s been proven to actually affect aging, but in model organisms, it does do it at the cost of metabolic output and it probably–

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Does the same thing in humans. So I'm excited about not only B vitamins, but things like alpha-ketoglutarate and this is the idea of going after the energy, you know, production machinery a little bit more directly. You know, lubricating ATP production. So B5, B12, and of course, we need versions that can cross-convert a methyl state, so ideally hydroxos and things. So yeah, I—I think a really good compliment B vitamin is kinda necessary. I think that you can also get really specific in a way that we don't really understand yet, in terms of what you might need for B vitamins. I mean, there’s a lot of that genetic research done looking at methylation analyses–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And that’s essentially a study of how B vitamins are used in metabolism of energy and neurotransmitters. You know, that’s sort of how—how that—those analyses are used least. And–

Dr. Justin Marchegiani:  And when you’re talking about B vitamins and B12 though, you have like methyl B12–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  And you mentioned the hydroxyl and the adenosyl, when would you recommend one over the other?

Dr. Andrew Hill:  I don't know is the short answer.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And I—I don't—I don't think enough is known. I mean, the—the methylation stuff, you know, it’s not well-established. There's—from my perspective and—and I come from sort of the optimism space being clinically many years ago, there’s a lot of focus on methylation in childhood diseases or development including these you know, things like autism and Fragile X and a lot—there was a lot of focus for many years on energy production and methylation. And some of it seems to do something in some of these people and some of it is just bad science, and we don't know the line between it unfortunately because it's grown out of a population of people who’ve been trying every—I mean, when you have an autistic kid, you try everything until you find something that works, and almost nothing works. This is how—this is why autistic spectrum population is a pretty good segment of the neurofeedback market because they discovered that it actually affect the brain, very little effects, you know, profoundly affects the brain people of autistic people. Neurofeedback can, doesn’t always, but it can. And that got a lot of attention in that community, so therefore, you know, word of mouth is very high, and—and that’s why there’s a big push there. And the same thing is true with methylation. Sometimes the right B vitamin cocktail, you know, dial it in in an authoritative manner.

Dr. Justin Marchegiani:  Are you familiar with—with pyroluria condition where you need excessive B6 and zinc levels?

Dr. Andrew Hill:  Yeah, I’ve heard of that. It seems to be related to phenylketonuria as well where there’s some aspartame sensitivities, right? It’s a similar genetic, but it’s more about elimination of—of some core vitamins.

Dr. Justin Marchegiani:  Yeah, so they—they need just accelerated levels of B6 and zinc and—and will see some of it–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  On the organic acids test, but we give them higher levels of B6 or zinc and helps their mood or helps their sleep or helps whatever else in their energy systems to function better.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Do you have any clinical experience with that?

Dr. Andrew Hill:  I—I don't, but really this is outside my area of expertise. I—I sort of do a little bit of personal biohacking in this space but my understanding of supplements is not as broad probably as my understanding of nootropics, so you know, B vitamins when I think about them are all about, “Mmm, how can I t weak the brain?” So I think, you know, B vitamins, I think like saw beauty in the, you know, which is a thiamine, a B1 dimer essentially gets into the brain and then cleaves. Then you have a massive hit of thiamine to the brain and if somebody came in as an alcoholic, I would—I would think, “Ooh, thiamine.” Because they have impaired B1 metabolism from drinking alcohol for many years and they probably have memory issues and—and failing the basal brain like mammal antibodies because of thiamine deficiencies. So I have a very specific you know brain focus on this stuff and not a good understanding of either the—you know, the phlebotomy driven if you will understanding of—of the biochemistry. It’s just not—I work at a very high-level of brain waves, so for me it's all about tweaking that—that dance versus reading out the—the low-level output if that makes any sense.

Dr. Justin Marchegiani:  Yeah, so let’s shift gears with some of the smart drugs that you’ve–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  You’ve done. I know we kinda have our pallet here, whether it's modafinil or piracetam or aniracetam or oxiracetam. What’s—what are your favorites? I know in the past you’d mentioned you’re not–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  A big fan of the modafinil, so I’ll let you have it.

Dr. Andrew Hill:  Yeah, you know, of course, I have designed TruBrain.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  And so I’m a big fan of mix of classic you know, a—a racetam plus a good choline, plus a few other things to support it and that’s sort of what went into the TruBrain formulations. Personally I—I’m still, you know, I still—piracetam and either CDP-choline or Alpha-GPC, still the best one to you know, combination I’ve ever found. And—and there hasn’t seem to be any downside or tolerance in these things when used for years and years and years, so that’s the, you know, the more serious biohacker’s you know, stack or the beginning biohacker stack potentially, but a little bit less racy, less risky, less you know, fully understood would be things like L-theanine. I—I mean I’m a big fan. I—I keep a couple things around my house, my office, and my campsite when I’m hanging out with my hippie buddies.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And those include L-theanine and ibuprofen.

Dr. Justin Marchegiani:  Ahh.

Dr. Andrew Hill:  Because L-theanine can pull back over caffeination pretty quicky.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And over arousal, anxiety, and a few other things.

Dr. Justin Marchegiani:  It’s doing that with GABA, right?

Dr. Andrew Hill:  For some people. Yeah, it’s very GABAergically–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  It appears to be very GABAergic in alpha wave productions. If you really, you know, can break some—break some stage that aren’t comfortable, and then ibuprofen for—for those folks that have like, you know, smoked one too many joints or eaten one too many pot cookies and their, you know–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Freaking out because of that. Ibuprofen can knock back THC intoxication a little bit and—and help people who are in crisis. So from my perspective, there’s a 2-mile like emergency kit if you will, nootropics. Even though ibuprofen is not really nootropics. In fact, pain killers in general probably should not be considered nootropics because evidences is—is—and I’m sorry, analgesic pain killers, ibuprofen, acetaminophen, those are just things—the research is mounting that they actually turn off either learning or empathy a little bit in some cases. Now ibuprofen seems to be the better case these days because the cannabis research anyways, there’s evidence that it eliminates the memory formation problems that happen when you're high as well as–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Reducing some of intoxic—the high level of intoxication that people gotten in trouble with it. So there’s a little bit of benefit there but a lot of things do actually tweak brain function fairly profoundly, and we don't yet know, you know, what that necessarily is for many of these things. Even things like Tylenol and you know, ibuprofen, these—the brand names—I guess Advil is a brand name of that one, but whatever. Even those are not necessarily you know, that are without side effects and there are organ system issues with all those drugs as well–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, kidney for ibuprofen–

Dr. Justin Marchegiani:  Elevated liver enzymes. Yeah.

Dr. Andrew Hill:  And liver for Tylenol.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And every year–

Dr. Justin Marchegiani:  Gut lining. Uh-hmm.

Dr. Andrew Hill:  You know, people make sui–yeah, gut lining for apirin—or ibuprofen. Every year people make—make suicide attempts with Tylenol and end up in liver transplant wards waiting for a liver because Tylenol’s so profoundly toxic to the liver. So yeah, not those but I—I also think, and get back to the ADHD question, there needs to be a big emphasis on not only systemic inflammation but supporting lipid metabolism through things like fatty supplementation, you know, Omega 3s, medium-chain triglyceride, even get good ketone production. For me, the—the focus on nutrition is shifting more towards getting crap out, you know, bad sugar, bad starch, actually all sugar bad starch and leaving in or enhancing the quality fats which include Omega 3s, Omega 9s–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Medium-chain triglyceride–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Usually food sources of those but I’ll toss them. I’m not a fan of refined oils. I—I don’t love them and most forms of refining I find either strip things out or leave things rancid, and so I try to get as much as possible from food, of course not always possible, and so I do supplement with DHA. That’s the only Omega that I—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Supplement and I get it form of—

Dr. Justin Marchegiani:  Algae or fish?

Dr. Andrew Hill:  In, yeah, exactly. Algae.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  TruBrain—the—the capsule form of TruBrain, still has a DHA capsule in the afternoon packet, and so we—that’s my sort of baseline—gotta get some Omega 3’s in because I know my body can cross convert as necessary. It’s not efficient but if necessary to make EPA from DHA and DHA seems to have more brain affinity so it’s a better, you know, Omega to go after if you’re gonna supplement and then I of course, keep my diet super low and grain-fed in anything including, you know, I don’t eat grains. I try not to eat anything that’s eaten grains.

Dr. Justin Marchegiani:  yes.

Dr. Andrew Hill:  And that keeps my Omega 6’s pretty low, too, which is, you know, something Westerners, specifically Americans are quite bad at.

Dr. Justin Marchegiani:  Yeah, and it sounds like you like really established to—to really have good fats, kind of a Paleo template-esque as well.

Dr. Andrew Hill:  I did, I guess. I mean—I didn’t know it was called that, you know, I was—I was sort of looking at initially of course, I don’t know, 20-25 years ago I—I read this book, and it was all about cycling ultra-low and ultra-high carbs and you know, there’s some flaws in the theories in the book but it had really good explanation how insulin works and it really stuck with me and there’s all kinds of you know, before that I thought insulin was just the thing that your body secretes in response to blood sugar spikes so then your cell can suck the blood sugar up and store it, either as fuel or lipids, whatever. But you know, I sort of realize at that time that it actually is tied to all these other hormones and other regulatory, modulatory things that cause you know, catabolic or some anabolic changes and releases of growth hormone and—and cortisol and it started it started to get me thinking a lot about how probably somewhat a time bomb the—the typical way of eating, which was like repetitively spiking our blood sugar. I mean, let me—let me—the—the blood sugar question is fairly well understood but it’s also not, not magical. We dropped back to a sub—a less well understood but also very similar feature of regulatory systems in the body or brain which is cortisol in the brain, high levels of cortisol, a person responds to stress and it goes up so you can focus and be alert and a bunch of other things happen in the brain and the body, but in the brain, it watches the range of cortisol and as it goes up, it responds and when it goes down, it responds differently. If the cortisol level goes up and stays up, response fails. The brain stops responding and eventually those high levels of cortisol start killing brain tissue and you know what, that's exactly what happened in things like diabetes. If insulin goes up and stays up with repetitively spiking your blood sugar until eventually your cells stop responding to the insulinogenic signal and that causes a cascade of failures at every level.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  In body metabolism and aging and repair and growth and learning and, I mean, the list goes on.  And so I figured that out about 20 years ago and, yes, I have a slight, you know, problem with ice cream occasionally I will admit it. But on the days that I’m being good, I’m perfect.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And I’m good about 80% or 85% or 90% of the time, and on those days I’m absolutely damn ironclad on keeping my total carbohydrates below 65g.

Dr. Justin Marchegiani:  Yup,

Dr. Andrew Hill:  Unless I worked out you know, hugely—

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Like a 90-minute ______ class when I can barely let myself off the ground, then I might have you know, like an extra 20g of carbohydrates right after that and coconut water or something to replenish my glycogen from my you know, quivering muscles.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  But that’s when I have profound physiologic signal of you know, glycogen depletion and good note for, you know, levels of carb intake, the human body is fully depleted can store about 50g of carbohydrates per hour.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Of glycogen.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So you know, you—it would never make sense to—to take more than you can store and spiking for me anyways, I sort of figured it out it used to be around 20g of raw carbohydrate seems to spike my blood sugar and I—so, so my—my general rule is never more than 20g at anyone sitting, never drink my carbohydrate—it seems to spike things faster if it’s you know, sugar in a drink or you know, even milk or something versus—

Dr. Justin Marchegiani:  How about the Glycemic Index though?

Dr. Andrew Hill:  Ah, Glycemic Index is a load of hooey. It’s—it’s about—it’s about as accurate as—as calories, you know? Which are also a load of hooey.

Dr. Justin Marchegiani:  How about—how about the—how about the glycemic load?

Dr. Andrew Hill:  Ahh, see that’s—that’s a valid concept.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  We just don’t know necessarily how foods produce it.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  The—the rating of food is, you know, arbitrary little bit but the—the effects of load on insulin and—and the carrying capacity if you will is occupying sensory—a sensing molecule is—is a real thing. I don't know what that is but I do know if you keep your in—if you keep your signal of sugar low, very low in the body, the way regulatory systems work is s they listen harder. What that means for insulin is increased insulin sensitivity.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So I don’t think it matters if you’re in ketogenesis or if you're Paleo or Primal.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I think if you—if you stop spiking your damn insulin, and you get a sense of what that feels like when you occasionally go over it, I mean, if you spike it every day you don’t notice it. But if you spike it once a week, you—you know exactly what it feels like to have your insulin go up a little—a little bit above, you know, where you need because you have this drunk feeling and you get a little bit sleepy afterwards, and—but you know, after you adapt to lowish carbs and high fat, energy is rock solid stable. So at some point I figured this out and about the same time we started figuring out as a you know, culture if you will—Westerners how problematic you know, many grains mass produced farm grains at least are—

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  In—in their correct format, you know?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And I started two’s together, I went, “Oh yeah, that's what my gut feels like, you know, pun intended, feels like crap all the time is because of all this, you know,  inflammation and sludge moving through my system all the time from eating pizza and whatever else I was eating in the 80s and 90’s.” So you know, yeah, it ends up being Paleo or Primal-esque and I—and I would say, I would say that you know, more—more primal blueprint if we have to tie it to an existing pran—plan in Paleo because I do think there’s a place for dairy in humans, or can be at least, not—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Not every human can handle it and we have to make space for inter-individual variability but dairy in a cultured or fermented form, I’m just not willing to give it up.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know? And there's, you know, we can make a rationale but historically, ancestral health although I don't generally make that connection because humans are ridiculously adaptable so we can point to any population in history and point out something that they've eaten that we couldn't handle now. You know? People are variable. So whatever works for you is really what’s important. The insulin as a general rule, you know, carb loads are rules, the general—general guidelines are not you know, ironclad what’s gonna work for you, but—but I do think that you know, cheese and cultured butter and—and other fermented, you know, dairy can be fairly beneficial to the body I think it—it can develop in the gut biome can break it down to—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  To useful things. I think it can be a really great source of nutrition and I’m, you know, I'm also of Scotch-Irish ancestry. I'm gonna eat me some cheese.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know, some really sharp, crumbly you know, grab me by the tongue and squeeze kinda cheese.

Dr. Justin Marchegiani:  Absolutely,

Dr. Andrew Hill:  I have to have that. It’s—it’s built into my—into my body.

Dr. Justin Marchegiani:  And if you can do raw cheese—

Dr. Andrew Hill:  So—

Dr. Justin Marchegiani:  You know, obviously if you get more of the enzymes intact so you can break down the casein and protein—

Dr. Andrew Hill:  Exactly.

Dr. Justin Marchegiani:  Which tends to be the more—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Problematic protein out of them all.

Dr. Andrew Hill:  Yeah and—more problematic and it’s also huge again, genetic variability in terms of—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Can you handle that or not? Right? And I am blessed to be able to handle dairy, no problem. I’m cursed so that at least current generation, you know, mass-produced chemical shit storm wheat—I can’t handle and I'm not like half the Americans who seem to have no problem with, you know, mass-produced wheat. I’m of the, you know, at least 40%, 50% that seem to have fairly significant issues with—with eating you know, bread so to speak from commercial grains. So, you know, I was a baker throughout high school and into college.

Dr. Justin Marchegiani:  Huh.

Dr. Andrew Hill:  And I’m a—I’m a nominal cook. I’m an amazing baker.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  I can bake you anything you want, name it. I’ll walk into a kitchen. If there’s ingredients, you'll—you’ll, you know, be happy but—

Dr. Justin Marchegiani:  Awesome.

Dr. Andrew Hill:  I can’t—I can’t bake. You know, I can’t bake with wheat, with gluten as an adult essentially, as a—as a grown man because of the lack of, you know, ability to handle it and I—and I—this is—this not a new thing. I didn’t know why I had poor digestion as a teen and you know, early 20’s person but I did and it was eventually because of you know, of—of grains. I—I have a hard time wrapping my head around us as a society and human creature, culture, developing this big, fat, greedy, hungry brains that needed high starch to really be fueled with the fact that half the planet seems to be struggling to metabolize starches and grains. These two things are really incongruous to me and I don’t—I can’t quite wrap my head around it. I don't quite believe the full you know, idea that we’ve distorted the plants you know, too profoundly because—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Humans are adaptable and—and they seem to be able to adjust long-term to re—and quickly to big changes in diet. I just don’t understand why we're having such a hard time. I—this strikes me as a blind man and elephant situation.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  What I discovered there’s some third factor that’s really you know, causative in destabilizing our ability to handle brains, and you know, 50 years ago that doctor was not present.

Dr. Justin Marchegiani:  I think it is—

Dr. Andrew Hill:  Nowadays it is.

Dr. Justin Marchegiani:  Yeah, I know, if you’ve read Dr. Davis’ book, he talks about the—

Dr. Andrew Hill:  Uh-huh.

Dr. Justin Marchegiani:  Genetic modification of wheat, not like the genetic modification when we’re talking about with like Monsanto, but just we’ve started off—

Dr. Andrew Hill:  With breeding.

Dr. Justin Marchegiani:  With breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Just kinda cross-breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  We have this einkorn wheat that was nine chromosomes and then we—we kinda cross, you know, cross-bred it so it can produce more gluten and you know, we’re res—basically be able to withstand various weathers and conditions. Now part of that from what I’ve seen with the genetic mod—genetic modificaion and the hybridization, the gluten content—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Has gone up significantly. I think 50%, 75%. So part of it could be just the extra gluten that is present that maybe wasn't there years back.

Dr. Andrew Hill:  Maybe. I think it’s really—it may be due to that or the gluten may have changed in some—in some form. And the reason I think of this is oats. You know, oats do not actually have true gluten. They have only gliadin, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You have other forms of—

Dr. Justin Marchegiani:  Zeen—

Dr. Andrew Hill:  Gluten, gluten-like proteins.

Dr. Justin Marchegiani:  Or avenin, avenin.

Dr. Andrew Hill:  Yeah, but—but exactly. It’s different.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And theoretically, if there’s no cross-contamination, you have gluten-free oats, theoretically people shouldn’t have an issue with them, and you know, I’m about as—as pale as they come as sickly, you know, 23andMe points me at Scotland and Ireland and is not unsure about it at all. You know, I’m like I’m one of people. I’m short. I’m wide. I can climb mountains. I hang out in cold climates and love it. You know, I’m—my people ate oats and I as an adult cannot handle gluten-free oats all that. You know, a little bit but not all that well and there’s not a lot of those proteins in something like oats compared to true wheat, so I’m not sure what it is. I think there’s something else. I think we’ll discover that there’s something unrelated to wheat completely, unrelated to food completely that has changed how we—how we do this and I don’t know if it’s—you know, something in a processing step or—

Dr. Justin Marchegiani:  How about Roundup? How much is the—the glyphosate contributing?

Dr. Andrew Hill:  You know, and maybe—and maybe 20 years of ex—of exposure to that you know, in my traditional western diet has sensitized me forever to you know, those type of proteins found in starchy you know, grains. I held feeds just fine but not—but not grains. So and again—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This is an N of 1 and I’m, you know, just an informed consumer here, but I—I think that those—those glyphosphate and other you know—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Chemically induced problems, we—we know those things cause problems. You know, when I was in grade school, you know, I wrote a paper on how DDT made you know, eggs fragile and it was—had to be removed for the environment in like 70s.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And this is not—this is you know, there’s always things like this. Every year, we go, “Oh, yeah, oh yeah, BPA. Ooh, oh yeah, that, hmm. Okay, let’s get that out of the environment, let’s get that—that out of our diet,” and one of those things is gonna be—is gonna interact the gut environment, the micro via the—the genetic expression of the microbiome, something will—is gonna be manning—there are many, many times the genetic, you know, material load of chromosomes in our gut that are not human DNA—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than—than there are. You know, the microbiome is incredibly more complex than our own genome, profoundly more, you know, many, many, many, many, many, many times bigger in terms of number of actual genes, and you know, I have a hunch that we’re—we’re gonna find something in there is—is you know, thrown off by something we’re doing—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  As a modern people.

Dr. Justin Marchegiani:  And I guess the next will be comes down to how long does it take for our DNA to adapt, because I know where human species have been around at some level at 1.8 million years, but perhaps and what grains have been here about 10,000. So I guess the question becomes are all of us adapting at that same rate to be able to handle grains?

Dr. Andrew Hill:  Yeah, I mean, it’s a bit of—what you mean by adaptation?

Dr. Justin Marchegiani:  Being able to digest. Yeah.

Dr. Andrew Hill:  We seem to very float—yeah, but that—that might happen quickly. It’s—I don’t think we fully understand what it—what is necessary in producing those, you know, old enzymes and ways to break down material. Like for instance, we can’t digest cellulose anymore, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  At one point in our development as—as creatures, we could eat wood pulp and survive off of it probably if we had to. That’s no longer the case. We no longer have those enzymes. You know, that swept through the population probably over many thousands or tens or hundreds of thousands of years, we weren’t quite yet human. But other things, you know, your—your grandparents had an experience that’s affecting your genes right now, Dr. Justin, you know?

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, if your—if your grandparents were at World War II, I’m assuming you’re about my age—

Dr. Justin Marchegiani:  Yeah. Uh-hmm.

Dr. Andrew Hill:  And they experienced trauma or you know, stress—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or anything else, the way your brain and body secrete and respond to cortisol is different than it would be—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Otherwise.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  You know, two generations of epigenetic, sort of cascade—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Have affected you. So the question about you know, how quickly does it take to adapt is unfortunately you know, becoming blurrier and blurrier the more we—we discover about the—the genetic expression or the organism learns and changes and patterns on the environment. You know, the—the gene for sort of modern big brain size that is in humans, I think it swept through the primate population at the time in something like 20,000 years which is absolutely fast. I mean, there’s no way that—that could—that could have happened by breeding pressure. You know, it happened through a combination of a bunch of factors probably including things like natural disasters and isolated certain population.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I mean, who knows what else, but you know, those are individual—actually two or three identified gene based on brain size, and those swept through the population in a—in a blink on an evolutionary timescale. But we talk about evolution as if it’s this massive glacier melting, no—no pun unintended.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Thing.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And it can be, you know, this is why I’m—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  The fact that I’m bald is—is gla—is a function of glacial evolution. It—it took a long time for that to show up, but the fact that I was hyperactive as a kid, the fact that I’m sensitive to gluten and other forms you know, grains. That might simply be a function of my genome going “Dude, that hurt,” or “I gotta respond to that,” or “That’s dangerous,” and I ‘m not sure what it responded to but it’s unfortunately left me unable to you know, enjoy baking or—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Consuming, you know, really good pizza which is—which tragic.

Dr. Justin Marchegiani:  And what’s the evolutionary role for baldness? I know you were kind of touching on that briefly there.

Dr. Andrew Hill:  Ah, you know, I don’t know, I—

Dr. Justin Marchegiani:  A theory?

Dr. Andrew Hill:  I see a few theories including things like it allows radiation of heat a lot better.

Dr. Justin Marchegiani:  hmm.

Dr. Andrew Hill:  Because the brain is ridic—I mean, 90% of body heat is sort of escaping through the head. If you’re bald, you lose more heat through the top of your head. It allows your brain to cool itself more. There’s also some testosterone you know, relationships where it might not an adaptation so much as a you know, epiphenomenon of some other adaptation. Slightly higher testosterone expression or—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or your levels in the—in the skin produce suppression of the follicle which is male pattern baldness, that set link characteristic of male pattern baldness, not all pair of patters in all baldness, but you know, the one that I have is—is probably a high level testosterone that reduced you know, the follicle. I’m not sure it—it produced, I mean who knows? The more I learn about the brain and the body, the more I’m surprised at how damn efficient every adaptation is. Nothing seems to happen by random and adapation is that you think serve one feature, serve multiple often. So I wouldn’t be surprised if at the same the organism was learning to become more efficient or a heat radiator. The same adaptation made it more you know, competitive sexually or something, and that meant the genes proliferating, you got both baldness and higher level of testosterone with some creatures, you know? But for me and I work in EEG which is a mysterious space. For me, understanding plausible is enough.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  If we can tweak a system and they can respond, then plausible is—is good enough as long as we are fighting is what is actual.

Dr. Justin Marchegiani:  Interesting.

Dr. Andrew Hill:  And we’re discovering what is actual in things like follicles. You know, there was a study out a few months ago that showed that—that they’ve figured out why hair goes gray and it looks like the same mechanism actually might be related to the—the key of the suppression of the follicle. There are some—some evidence that they tested but there’s some theory that was generated by this first finding. The first finding was, “Oh, look! Here’s what makes hair go gray.” And that actually explains why thigns like resveratrol may actually reverse—may actually plausibly reverse graying in some people who—who claim that it does, it’s not a wide—widespread phenomenon but it seems to happen. But the same mechanism seems to you know, suggest suppression of hair follicle and so we might be like right around the corner from you know, no more male pattern baldness through cosmetic you know, pharmacology if you will or genetic manipulation or who knows but it seems to be we’re right around the corner from—from solving that if you will. And then I’ll have a very firm opinion about how it works.

Dr. Justin Marchegiani:  Got it. So you’re thinking—

Dr. Andrew Hill:  But right now, you know—

Dr. Justin Marchegiani:  Yeah?

Dr. Andrew Hill:  It doesn’t matter.

Dr. Justin Marchegiani:  So you’re thinking the resveratrol could be helpful?

Dr. Andrew Hill:  I think it probably can be. You know, I don’t—I don’t mind being bald, you know? I—Ia m—I guess I’m blessed in that I have a sort of Patrick Stewart shaped head.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And so I can cool it off—

Dr. Justin Marchegiani:  Love it, yeah.

Dr. Andrew Hill:  it’s fairly, it’s fairly round. There’s not a lot going on up there.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Beyond curve.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I—I can pull that off and I, you know, I wear glasses so doesn’t mean to break in that expanse of flesh but—

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It doesn’t really bother me and I don’t really care too much about it. But yeah, resveratrol will probably or some related molecule probably, you know, unsupress the follicle, I mean, right now resveratrol has other uses, right?

Dr. Justin Marchegiani:  Mitochondria, yeah.

Dr. Andrew Hill:  You’re taking resveratrol for mitochondrial support.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It seems to suppress estrogenation or other Romanization—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Of some hormones, so take it to protect the heart valve. If you’re taking other compounds can be useful. You know, there’s a few other like—like serotonergic but you don’t wanna take 5HTP and—and other serotonin converting things and get peripheral nervous system serotonin, that will do damage. You know, you’ll get peripheral neuropathy and damage your heart valve. If you wanna take you know, resveratrol and things like to suppress Romanization of hormones, but I—I bet we’re gonna discover something else like that, and suddenly sprout big, thick full heads of hair. And—

Dr. Justin Marchegiani: Love it.

Dr. Andrew Hill:  And will I try it? Sure. You know, because I actually have a gorgeous—you wouldn’t know this—but I have a gorgeous you know, reddish blonde Scottish mane.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And you know, it’s been 25 years since I’ve seen it, and you know, I can grow a ground _____ Willy style moustache right now.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And I might, but it’d be kinda fun to go all full like you know, lion again, just playing in my age, so I say, yeah. I—as much as I am sort of laughing about who cares if we cure baldness, I would probably partake if there was a you know, natural-ish substance that I could tweak my—my follicles with.

Dr. Justin Marchegiani:  Absolutely, I love that. Well, kinda finishing up here. I wanna just go through just a—a rapid question round for you. Just kinda hit these next couple things off.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just really quick, sound good?

Dr. Andrew Hill:  Sure.

Dr. Justin Marchegiani:  Alright. ADHD, what are the top 3 things you do for that?

Dr. Andrew Hill:  Meditate, neurofeedback and drop sugar out of your diet.

Dr. Justin Marchegiani:  Addiction.

Dr. Andrew Hill:  Understand why you’re using.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it impulsivity?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it boredom? Is it discomfort with your emotions? Is it brain injury that lead you to behave where you weren’t inspecting. Figure out which it is and solve it.

Dr. Justin Marchegiani:  Got it. You’re studying for an exam. What are the best things to get your brain revved up for that?

Dr. Andrew Hill:  The best thing is to space your practice versus mass your practice first of all.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Short breaks ideally with rest and sleep in between them over many days to ensure consolidation. The other thing is to put yourself in the perspective of get to versus have to.

Dr. Justin Marchegiani:  Love it.

Dr. Andrew Hill:  So engaged with your—engage with your material because it's fun and find a way to make it so. And the third thing is don't binge on food when you're studying. Snack very lightly make.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  To make sure you don't end up in a—in a bonk, blood sugar-wise which will completely abolish the learning and studying interest you have for that session.

Dr. Justin Marchegiani:  Love it. Top three smart drugs.

Dr. Andrew Hill:  Clearly, piracetam, cito— citrocholine and let’s say DHA.

Dr. Justin Marchegiani:  DHA.

Dr. Andrew Hill:  These are the kinds of drug. Yeah.

Dr. Justin Marchegiani:  Yeah. Basically the 22 carbon fat and the fish oil. Awesome.

Dr. Andrew Hill:  Yeah, it seems to, you know, and maybe even Vitamin D might even fall in that category.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  These things are so profound in—in so many tissues and supporting so much metabolism. I think they upregulate stock even when it’s not noticeable.

Dr. Justin Marchegiani:  Love it. Recovering from brain trauma or a TBI.

Dr. Andrew Hill:  First thing, don’t do anything immediately.

Dr. Justin Marchegiani:  Fast, right?

Dr. Andrew Hill:  Don’t jostle your brain physically or mentally.

Dr. Justin Marchegiani:  mmm.

Dr. Andrew Hill:  For a few weeks then drop inflammation, which means rest, low sugar, and then you can start doing things like neurofeedback and concentration-focused mindfulness to start waking up all that bruised and delta-rich cortex.

Dr. Justin Marchegiani:  I’ve seen a low of stuff on low-calorie diets especially for a couple days after the injury.

Dr. Andrew Hill:  Yeah, it’s just that fasting produces a drop in inflammation, so you know. Yeah, basically you gotta rest and you can’t even think hard ideally. You know, you definitely, you know, the—the damage comes in concussions from the second impact that you get in certainly within 3-5 days but maybe even 3-5 weeks after a first significant insult to the brain. There’s all these inflammatory cytokines that cause inflammation after the first insult that protect the brain in the—in the short term but make it fragile, make the tissue very shatterable for days and if you receive a second impact in that time, the damage—the damage is much more profound. You know, the damage carries through the brain , you know, through a solid almost, the way it would like a block of ice instead of just kinda pushing on a—on a corner like a piece of Jell-O or something, so—

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You gotta let your brain rest for weeks, you know, 3 to 5 weeks if it’s a significant injury, and you can rebuild, you know, if you’re somebody who’s had a lot of wear and tear, brain fog, irritability, wearing out mid-day with cognitive fatigue, those are the—those are the 3 big signs. If you are somebody who’s post-concussive and you—you  realize that you still are, you know, months or years later, do something about it. Get some neurofeedback. You can completely—not completely maybe—but you can certainly affect it positively. And there are some long-term risk for many post-concussive. You know we know now that, you know, there’s a study out a few years ago, not even a few months ago I think or something last year, that showed that high school football players who never played a game but practiced with the team show early signs the chroma—of chronic, or sorry—CT, chronic, traumatic encephalopathy. From beginning brain scan, to the beginning to the end of the season, without ever playing a game—

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Simply doing practice. So the amount of damage the brain can actually shrug off is negligible. It’s not really supposed to be bounced.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Or st—or change direction suddenly at 60 miles an hour. It’s not designed to go 90 miles an hour highway and suddenly stop, you know, or anything else where—where you’re launched through the world and then suddenly stopped. The brain’s great at you know, not that extreme impact, but it fails very quickly over a certain amount of impact. Let’s say it’s not force and we hit that force all the time. A single—there’s a study out 2 weeks ago maybe—a single stocker heading drill, and in heading the ball 20-30 times in a few minutes, memory test before and after showed a three quarters drop in performance, severe hermit.

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Right afterwards. Now, the study didn’t—didn’t look at long-term, it looked at immediate and it found a—and it found massive GABA-ergic, well, they were hypothesizing GABA as an inflammatory response but they found inflammatory markers and they found massive impairments in memory right after drill, and those things we know are things the brain learns from and—and responds to. So there is no safe level of head impact, you know? If I ever have a kid in high school, they are not going to play football or soccer. You know, I—

Dr. Justin Marchegiani:  That was my next question.

Dr. Andrew Hill:  Yeah. Never.

Dr. Justin Marchegiani:  Would you like your kid to play football?

Dr. Andrew Hill:  No, I would not. No, I would not.

Dr. Justin Marchegiani:  And what do you think about what’s happening with the NFL? I mean, do you think this is just like smoking in the 1950s and it’s just, we’re just waiting for enough—

Dr. Andrew Hill:  Yes.

Dr. Justin Marchegiani:  Research to come to a head?

Dr. Andrew Hill:  Yes, absolutely. Yup, absolutely. The—the NFL will become and also ran a small network of people who were the bad boys who still continue to do this thing that leaves people damaged. The NFL will be seen as an organization like Monsanto that has secretly known for decades that they’ve been injuring and killing people and had been doing lots with millions of legal dollars to keep that suppressed.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  And we will discover that if there—it just isn't. It was never safe. That will be considered a barbaric time in—in 50 years.

Dr. Justin Marchegiani:  I think you’re right. Well, here, last question with you Dr. Hill before we find out more about where everyone can go see you. If you’re on a desert island, what’s the one supplement or nutrient you bring with you?

Dr. Andrew Hill:  Alright, well, does this—does this desert island have coconut trees or not?

Dr. Justin Marchegiani:  It does, so you’re gonna have the medium chain triglycerides there.

Dr. Andrew Hill:  Nice. So if I have coconut meat and—and fat and everything else—

Dr. Justin Marchegiani:  You could probably fish, too, so you’re Omega 3’s and DHA will be recovered.

Dr. Andrew Hill:  I can fish, I got my DHA, you know, okay.

Dr. Justin Marchegiani:  Sunlight, vitamin D, that’s covered.

Dr. Andrew Hill:  I think that—I think that something, maybe beta-carotene.

Dr. Justin Marchegiani:  Okay, so vitamin A.

Dr. Andrew Hill:  Or, no, I don’t know, I may go get astaxanthin from like—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Shellfish.

Dr. Justin Marchegiani:  You probably would.

Dr. Andrew Hill:  So, hmm, what—what can I—what couldn’t I get from a natural, from an island I really needed? Yeah, I would probably have to say something like piracetam.

Dr. Justin Marchegiani:  Okay.

Dr. Andrew Hill:  You know? but not, you know, let me—let me give you a non-standard answer. I—I wouldn’t bring any racetams with me. I’m on a desert island. I’m gonna relax.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I’m gonna fish. I’m gonna you know, I’m gonna get plenty of vitamin D and—and good food and you know, maybe—maybe grow some vegetables. Huh! But if I’m actually on a desert island, high-performance is not my survival. I’m gonna survive and once I’m surviving, I think—I think the environmental press of—of having to live and pry on a desert island would be sufficient nootropic to keep me functioning at my highest level.

Dr. Justin Marchegiani:  Love it. very cool, Dr. Hill. Now people who are listening, they wanna find out more about you and about TruBrain and about some of the services that—that you provide. Where is the best place to find more info on you?

Dr. Andrew Hill:  Yeah, so fols can check me out at @AndrewHillPHD on Twitter. I think I’m also at Instagram, but that’s a pretty anemic page. Peak Brain LA, Peak Brain Institute has a Twitter, @peakbrainLA. We have a website, peakbraininstitute and of course, trubrain.com—T-R-U-Brain dot com is the supplement—it’s the supplement that the nootropic stack that you mentioned that I helped design a few years ago, and you know, I’d love if people reach out and ask me a specific brain questions. We have very unique brains. You put 10 people in a room, there’s at least 11 different brains in that room from my perspective. You really gotta share what’s special about you and celebrate it or take control of it and tweak it and address it. So I’d love if folks have, you know, quirky brains they wanna share to look me up and—and find out what we’re doing and you know, there’s lots of ways to—to take control and change your brain, so give me shoutout if you want one.

Dr. Justin Marchegiani:  Thanks a lot, Dr. Hill. It was a great talk and we look forward to chat with you again soon.

Dr. Andrew Hill:  My pleasure, Dr. Justin.

Dr. Justin Marchegiani:  You take care. Have a good one.

Dr. Andrew Hill:  You, too. See ya.

Dr. Justin Marchegiani:  Bye now.

Dr. Andrew Hill:  Bye.