Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with red light therapy?

Transcript

What's the deal with red light therapy? · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:01
  Speaker 1: Perry.
• 0:01
  Speaker 2: I have been feeling like a liar as we've been
• 0:05
  Speaker 2: doing more of these podcast episodes, and so I want
• 0:08
  Speaker 2: to come clean to you and the listeners. I spend
• 0:13
  Speaker 2: a lot of time, and we're going to talk about
• 0:14
  Speaker 2: red light therapy today, and I'm going to tell you
• 0:17
  Speaker 2: that I think it's a bit of a scam. But
• 0:19
  Speaker 2: I do so many scammy wellness things and I feel
• 0:24
  Speaker 2: like I'm not being honest about them.
• 0:27
  Speaker 3: WHOA.
• 0:28
  Speaker 1: I feel like, first of all, I should put on
• 0:29
  Speaker 1: my like priestly frock and you know, prepare to hear
• 0:33
  Speaker 1: this confession. But all right, I'm in the headspace. This
• 0:36
  Speaker 1: surprises me, Emily. You're an evidence based person.
• 0:38
  Speaker 4: Yeah, I know.
• 0:39
  Speaker 2: And I want to tell you that one of the
• 0:41
  Speaker 2: things I think is so compelling about these wellness influencers
• 0:45
  Speaker 2: online is they're selling people the thing they want. So
• 0:47
  Speaker 2: they're telling you, like, you are worried about your wrinkles,
• 0:50
  Speaker 2: and so you should get this red light mask or
• 0:52
  Speaker 2: this cream or whatever. And the thing is, it's easy
• 0:55
  Speaker 2: for me to say, like, you shouldn't do that because
• 0:58
  Speaker 2: I don't care about.
• 0:59
  Speaker 4: All my wrinkles. That's not important to me.
• 1:01
  Speaker 2: But I really, really, really care, like an unbelievable amount
• 1:05
  Speaker 2: about running fast, and I will do any crazy thing
• 1:08
  Speaker 2: to try to run faster. The other day, I spent
• 1:12
  Speaker 2: twenty eight dollars on four tiny bottles of broccoli sprout
• 1:17
  Speaker 2: juice because the Norwegian ski team uses it. And I
• 1:23
  Speaker 2: don't know, if you watch that guy ski, he was
• 1:25
  Speaker 2: really good and my friend Shana said it improved her
• 1:28
  Speaker 2: long run, and I.
• 1:29
  Speaker 4: Was like, that's it, all right, no problem, I'm buying
• 1:31
  Speaker 4: it right now.
• 1:32
  Speaker 1: I twenty eight dollars is a small price to pay
• 1:34
  Speaker 1: to get whatever it is extra, So.
• 1:38
  Speaker 2: Who knows it could be could be as much as
• 1:40
  Speaker 2: two to three extra seconds.
• 1:42
  Speaker 4: I haven't tried it yet.
• 1:43
  Speaker 2: They haven't come and I haven't tried it, and I'm
• 1:45
  Speaker 2: actually injured. So I'm also going to go do another
• 1:49
  Speaker 2: thing this afternoon to fix my injury, which is called
• 1:52
  Speaker 2: shockwave therapy, which is also probably a scam. Anyway, this
• 1:57
  Speaker 2: is all to say, I just I I want to
• 2:00
  Speaker 2: be clear to the audience that I am very susceptible
• 2:04
  Speaker 2: to the Internet, just maybe not the particular topics that
• 2:08
  Speaker 2: we are talking about.
• 2:09
  Speaker 1: Like today, it is so important to recognize your own biases.
• 2:14
  Speaker 1: We all have them. We're all human, we all have limitations,
• 2:19
  Speaker 1: and fortunately, for when it comes to red light therapy,
• 2:22
  Speaker 1: even if you don't care about your wrinkles, there's enough
• 2:24
  Speaker 1: purported benefits across a wide variety of things that surely
• 2:29
  Speaker 1: you'll find something that you're motivated reasoning will compel you
• 2:32
  Speaker 1: to believe in and purchase these thousand dollars devices. Surely
• 2:36
  Speaker 1: I am.
• 2:36
  Speaker 2: Hoping for that, because you know, so if it's only
• 2:38
  Speaker 2: been twenty eight dollars this week, but.
• 2:39
  Speaker 4: It could be more. Let's get lit.
• 2:44
  Speaker 2: I'm Emily Aster, I'm an economist and a data expert.
• 2:47
  Speaker 1: And I'm Perry Wilson, I'm a medical doctor. It's Thursday,
• 2:51
  Speaker 1: March twelfth, twenty twenty six. And this is wellness actually,
• 2:55
  Speaker 1: because you're getting a staggering amount of health and wellness
• 2:58
  Speaker 1: information nowadays from every source imaginable, and some of it
• 3:02
  Speaker 1: is awesome and.
• 3:03
  Speaker 4: Some of it is well actually bulls.
• 3:07
  Speaker 2: Fortunately, we're both people who know how to read studies,
• 3:11
  Speaker 2: how to parse the data, and can tell you what's
• 3:13
  Speaker 2: worth thinking about and what you can safely ignore.
• 3:16
  Speaker 1: But before we dig in, a note that this podcast
• 3:19
  Speaker 1: is for educational purposes and should not be construed as
• 3:21
  Speaker 1: medical advice. We don't know your unique situation, so talk
• 3:24
  Speaker 1: to your doctor for personal health decisions. This week, we'll
• 3:28
  Speaker 1: answer the age old question, Roxanne, do you have to
• 3:32
  Speaker 1: put on the red light? As we ask what's the
• 3:35
  Speaker 1: deal with red light therapy? Emlyn. I will give the
• 3:38
  Speaker 1: official smash or pass and we'll get to your question
• 3:40
  Speaker 1: of the week, But first let's do the health news
• 3:43
  Speaker 1: roundup after the break. We're looking at the health news now.
• 4:00
  Speaker 1: The CDC has issued a new travel advisory for thirty
• 4:04
  Speaker 1: two countries over the spread of polio, a disease that
• 4:10
  Speaker 1: is a particular interest to me. My mom had polio.
• 4:14
  Speaker 1: She was actually in an iron lung for a period
• 4:18
  Speaker 1: of time when she was five or six years old,
• 4:19
  Speaker 1: so just to remind people how horrible this paralyzing condition
• 4:23
  Speaker 1: can be. She recovered to the point where she was
• 4:25
  Speaker 1: only paralyzed in the lower part of her left leg,
• 4:28
  Speaker 1: but my mom walked with that limp for her entire life.
• 4:32
  Speaker 1: She caught it just before the infamous SOK vaccine was
• 4:37
  Speaker 1: developed and released, which essentially eradicated polio, at least in
• 4:41
  Speaker 1: the West. I never liked to see polio spreading again. Emily,
• 4:45
  Speaker 1: what are your thoughts on the travel advisory.
• 4:48
  Speaker 2: So I also don't like to see polio spreading in
• 4:51
  Speaker 2: I mean, I think it's it's polio is spreading again
• 4:53
  Speaker 2: for the same reason the measles is spreading again, which
• 4:56
  Speaker 2: is some vaccine hesitancy.
• 4:58
  Speaker 4: We actually, maybe.
• 4:59
  Speaker 2: Last years saw the first community spread, non travel associated
• 5:04
  Speaker 2: polio case in the US in very very very long time,
• 5:07
  Speaker 2: an unvaccinated teenager, I think in Upstate New York. So
• 5:11
  Speaker 2: most people who are listening to this, most people in
• 5:13
  Speaker 2: the US are vaccinated for polio. The vaccine's extremely effective,
• 5:17
  Speaker 2: and so the travel advisory is probably not something that
• 5:22
  Speaker 2: is going to cause people to change their travel plans
• 5:26
  Speaker 2: unless they are not vaccinated for polio. But you really
• 5:29
  Speaker 2: should be vaccinated for polio.
• 5:30
  Speaker 1: Yeah, It's one of these things where some of these diseases,
• 5:33
  Speaker 1: I think people have kind of forgotten. They forgot, they
• 5:36
  Speaker 1: forgot how bad it was, so it's like, oh, no,
• 5:38
  Speaker 1: like what is polio even, right, But.
• 5:39
  Speaker 2: It's real, yeah, and it's not too long ago. I mean,
• 5:42
  Speaker 2: the rates of polio in the nineteen fifties. I think
• 5:45
  Speaker 2: it's hard for people our age, we don't remember that,
• 5:47
  Speaker 2: but for people our parents' age, they do.
• 5:49
  Speaker 4: And this was a really really.
• 5:51
  Speaker 2: Really scary thing where healthy kids were dying. We're spending
• 5:54
  Speaker 2: time in iron lungs because of being at the pool.
• 5:58
  Speaker 4: So polio bad, all right.
• 6:00
  Speaker 2: A new randomized trial has found that a daily multi
• 6:03
  Speaker 2: vitamin decreases something called epigenetic aging. Perry, have you upped
• 6:10
  Speaker 2: your multi vitamin intake as a result of this exciting
• 6:12
  Speaker 2: new finding?
• 6:13
  Speaker 5: Oh?
• 6:14
  Speaker 6: I have not.
• 6:17
  Speaker 1: As you know, I'm not a big vitamin and supplement guy,
• 6:21
  Speaker 1: and despite what you see on social media about a
• 6:24
  Speaker 1: multivitamin a day reducing genetic clocks, I'm not really buying it.
• 6:29
  Speaker 1: This is a sub analysis of a trial called Cosmos,
• 6:32
  Speaker 1: which did randomize people to get either a multi vitamin
• 6:35
  Speaker 1: a day. It was centrum silver or cocoa extract or
• 6:40
  Speaker 1: both or placebo. So four groups followed them for a
• 6:44
  Speaker 1: few years. And the original Cosmos trial was designed to
• 6:46
  Speaker 1: show that coco extract reduced the risk of cardiovascular disease.
• 6:50
  Speaker 1: It didn't. But they've done sub analyzes over and over
• 6:54
  Speaker 1: and over again. This one looked at what are called
• 6:57
  Speaker 1: epigenetic clock. So as you age your DNA, it gets
• 7:00
  Speaker 1: these little methyl groups attached to it. It's like dust
• 7:02
  Speaker 1: on the mantle of our lives, and it does correlate
• 7:06
  Speaker 1: with age. You can measure that and assign someone a
• 7:09
  Speaker 1: biological age that might differ from their calendar a So
• 7:12
  Speaker 1: like I'm forty six, but maybe my DNA age is
• 7:14
  Speaker 1: like fifty. And there are studies that show if your
• 7:18
  Speaker 1: biological age is older than your calendar age that that's bad,
• 7:21
  Speaker 1: like you have higher risk of cancer and cardiovascular disease
• 7:23
  Speaker 1: and death. Like there is something there. Here's the problem.
• 7:26
  Speaker 1: There are multiple different age and clocks, like there's one
• 7:29
  Speaker 1: clock on your wall. There's like any number of algorithms
• 7:32
  Speaker 1: that will spit out an age based on DNA information
• 7:36
  Speaker 1: that you feed it. And in fact, in this study
• 7:37
  Speaker 1: they used five different algorithms. They examined those five different
• 7:42
  Speaker 1: algorithms across two different time points. So now we've got
• 7:45
  Speaker 1: ten things and across two different interventions, a multi vitamin
• 7:51
  Speaker 1: and coco extract. Now we have twenty things. Okay, of
• 7:56
  Speaker 1: those twenty things, two and only two two showed any
• 8:01
  Speaker 1: statistically what we call statistically significant trend in benefit, and
• 8:06
  Speaker 1: that benefit was very small. What's the problem, Emily? You
• 8:10
  Speaker 1: know what the problem is.
• 8:12
  Speaker 4: The problem is that that is called pe hacking, Perry.
• 8:15
  Speaker 2: I mean This is something I think we should spend
• 8:17
  Speaker 2: more time on at some point because it it's actually
• 8:19
  Speaker 2: a really important statistical point. But put very simply, if
• 8:24
  Speaker 2: you have those twenty different effects, twenty different things you're
• 8:28
  Speaker 2: looking at, even if there is no effect on any
• 8:31
  Speaker 2: of them, you would expect probably one of them to
• 8:35
  Speaker 2: show up as very statistically significant, maybe two, because that's
• 8:40
  Speaker 2: what statistical significance means. And I don't want to like
• 8:43
  Speaker 2: ruin this whole episode by explaining statistical significance. We'll ruin
• 8:46
  Speaker 2: another episode on that. But fundamentally, this is not a
• 8:51
  Speaker 2: real result. This is just I tried a lot of
• 8:54
  Speaker 2: different things and I picked the one thing that worked,
• 8:56
  Speaker 2: and you can always do that with statistics, but it
• 8:59
  Speaker 2: is not consistent with it being true exactly.
• 9:01
  Speaker 1: I will just make one note, which is that whenever
• 9:04
  Speaker 1: I come down hard on vitamins and supplements, someone comes
• 9:07
  Speaker 1: after me and is like, you're you know, these are
• 9:09
  Speaker 1: natural things, and you're a pharma schill. And I just
• 9:11
  Speaker 1: want to point out that in this particular study, the
• 9:14
  Speaker 1: Centrum silver was donated and partially funded by the makers
• 9:18
  Speaker 1: of Centrum silver at the time, that was Pfizer and
• 9:20
  Speaker 1: Glaxosmith KLEINB and the cocoa extract was provided by the
• 9:25
  Speaker 1: Mars Corporation.
• 9:27
  Speaker 2: And I just want to disclose that I take vitamin
• 9:29
  Speaker 2: D and vitamin B every day because somebody told me
• 9:32
  Speaker 2: it was good for my performance.
• 9:33
  Speaker 4: See Cold Open. Okay.
• 9:35
  Speaker 2: Last thing I want to talk about is the baseball
• 9:38
  Speaker 2: pitch clock. Okay, the baseball pitch clock, Perry is a
• 9:41
  Speaker 2: thing that I think the goal of this is to
• 9:43
  Speaker 2: make baseball less boring because it was taking too long
• 9:46
  Speaker 2: and then now it's fast because you have to pitch
• 9:49
  Speaker 2: real fast. You can't just screw around spitting on the
• 9:51
  Speaker 2: ball and like stretching and pulling up your pants or
• 9:53
  Speaker 2: whatever is to do.
• 9:54
  Speaker 4: I'm not a fan of this sport, and I believe.
• 9:57
  Speaker 2: There was some concern that my making people pitch really
• 10:00
  Speaker 2: fast it was going to increase this very common injury
• 10:04
  Speaker 2: in pictures.
• 10:05
  Speaker 4: Someone's called the Tommy John injury.
• 10:07
  Speaker 2: I think it's a UCL tear, but it sounds like
• 10:09
  Speaker 2: that's not true.
• 10:10
  Speaker 4: No concern there.
• 10:11
  Speaker 1: The most recent study suggests probably not. The Tommy John
• 10:15
  Speaker 1: injury is clearly becoming more common, especially in younger pitchers
• 10:20
  Speaker 1: like high school kids are getting more and more surgeries
• 10:23
  Speaker 1: for the UCL is the owner collateral ligament tear, but
• 10:27
  Speaker 1: the Tommy John surgery is what it's called in part
• 10:30
  Speaker 1: because pitchers are throwing much faster, like training regimens are
• 10:33
  Speaker 1: getting them stronger, they're putting a ton of stress on
• 10:36
  Speaker 1: that elbow. I mean, I remember when I was a kid.
• 10:38
  Speaker 1: You don't like baseball, but like, if you saw someone
• 10:40
  Speaker 1: throwing a pitch at one hundred miles an hour, you
• 10:43
  Speaker 1: were like, holy cow, Like what a fastball? And now
• 10:45
  Speaker 1: it's like, routinely they're throwing these one hundred plus mile
• 10:48
  Speaker 1: an hour fastballs. It's ridiculous. This new study examined changes
• 10:52
  Speaker 1: in UCL injuries since the pitch clock, and the thought
• 10:55
  Speaker 1: was that you're just pitching faster, more like, you're doing
• 10:58
  Speaker 1: it more often, so maybe you're going to hurt overall,
• 11:00
  Speaker 1: no effect there was. Were skeptical of subgroup analyzes, but
• 11:03
  Speaker 1: I will say that starting pictures tended to get a
• 11:07
  Speaker 1: little more frequently injured than the rest of the pictures.
• 11:10
  Speaker 1: We probably don't want to overread that. If anything, the
• 11:13
  Speaker 1: rate of Tommy John injury is increasing because of sort
• 11:17
  Speaker 1: of the way we have optimized for this thing, which
• 11:21
  Speaker 1: is throwing balls as fast as possible. Which is not
• 11:23
  Speaker 1: really what our arms are designed for.
• 11:25
  Speaker 2: I also think there's a sort of interesting thing here
• 11:28
  Speaker 2: around youth sports that.
• 11:29
  Speaker 4: Kids used to do more variety of sports.
• 11:32
  Speaker 2: The increased youth sports specialization has pushed kids to do
• 11:35
  Speaker 2: more and more and more of one sport early on,
• 11:38
  Speaker 2: when your ligaments and so on are more susceptible to overuse.
• 11:44
  Speaker 2: So I think that is part of what we always
• 11:47
  Speaker 2: seen more of this in high school kids over time.
• 11:50
  Speaker 1: And that's it for the health news of the week.
• 11:52
  Speaker 1: After the break, what's the deal with red light therapy?
• 12:01
  Speaker 2: All right, so let's talk about red light therapy. So,
• 12:05
  Speaker 2: for people who are not on the internet, red light
• 12:09
  Speaker 2: therapy refers to the idea of putting red lights lights
• 12:13
  Speaker 2: of the particular wavelength we'll get into that on your face,
• 12:16
  Speaker 2: your wound, your body, your brain, and a helmet in
• 12:19
  Speaker 2: some way exposing some part of your body to this light.
• 12:22
  Speaker 2: And it's supposed to improve a wide variety of things.
• 12:26
  Speaker 2: So the way I would like to structure this is,
• 12:29
  Speaker 2: I want to talk about why we might think this
• 12:31
  Speaker 2: would work, but then really think about the relationship between
• 12:35
  Speaker 2: biological plausibility and is it likely this actually works for
• 12:39
  Speaker 2: the things that people say that it works for but
• 12:42
  Speaker 2: then also is buying that red light mask on Instagram
• 12:45
  Speaker 2: like the way that I should implement this even if
• 12:47
  Speaker 2: it works. And I think those are always really important
• 12:49
  Speaker 2: benchmarks in these discussions, like is it plausible? Are we
• 12:52
  Speaker 2: seeing it in studies? Is it actually something you could
• 12:55
  Speaker 2: implement on your own? So if that works for you,
• 12:58
  Speaker 2: I want you to tell me why we would think
• 13:01
  Speaker 2: putting lights on our face is good or anywhere?
• 13:04
  Speaker 4: And why what is this thing?
• 13:06
  Speaker 1: I thought we might get through an episode without talking
• 13:09
  Speaker 1: about mitochondria, but here we.
• 13:11
  Speaker 4: Are so far no, so far.
• 13:14
  Speaker 1: So far, No. This is so biologic plausibility. This is
• 13:17
  Speaker 1: like the central technique of wellness influencers to sell you
• 13:21
  Speaker 1: on something is to convince you that there is a
• 13:24
  Speaker 1: biologically plausible mechanism and then jump to the conclusion that
• 13:27
  Speaker 1: because there's plausibility, it must work. And I think we
• 13:30
  Speaker 1: can teach people anything, it's that that you have to
• 13:33
  Speaker 1: prove that biologic plausibility is table stakes for something that
• 13:37
  Speaker 1: you're going to invest in for your health. But let's
• 13:39
  Speaker 1: talk about the table stakes. Because at first you hear
• 13:41
  Speaker 1: it and you're like, I'm gonna shine red light on
• 13:43
  Speaker 1: my skin like, what of course that doesn't work. That
• 13:45
  Speaker 1: seems ridiculous. It's not actually ridiculous. So I'll try to
• 13:49
  Speaker 1: go through this very quickly. First, a bit of physics,
• 13:52
  Speaker 1: the wavelength of light.
• 13:54
  Speaker 2: I'm sorry, but when somebody starts with I'm going to
• 13:56
  Speaker 2: go through this quickly and then begins with just a
• 13:58
  Speaker 2: bit of physics, let's do it.
• 14:01
  Speaker 4: Do it quickly. Now, a little bit TDB.
• 14:05
  Speaker 1: Let's start the big bang. I'm gonna start the big bang. Okay,
• 14:08
  Speaker 1: the universe was hot and dense. Okay, no skip forward light.
• 14:12
  Speaker 1: Light has wavelengths. Longer wavelengths are redder, Shorter wavelengths are
• 14:17
  Speaker 1: bluer as wavelengths, yet longer you go in the visible
• 14:20
  Speaker 1: light spectrum, go from blue to red to infrared. And
• 14:24
  Speaker 1: the longer the wavelength is, the easier it passes through stuff.
• 14:29
  Speaker 1: The longest wavelength that you're typically exposed to are probably
• 14:32
  Speaker 1: radio waves, which are very long, much longer than infrared light,
• 14:35
  Speaker 1: and they go right through your walls and through your
• 14:37
  Speaker 1: body and all these kind of things, right, So wavelength
• 14:40
  Speaker 1: matters because of that, Some wavelengths of light can actually
• 14:44
  Speaker 1: get below the surface of your skin and even slightly
• 14:48
  Speaker 1: deeper we'll talk about that, Okay. In your cells, there
• 14:51
  Speaker 1: are mitochondria, the powerhouse of the cell. As you learned
• 14:54
  Speaker 1: about in high school. What's actually happening in mitochondria is
• 14:58
  Speaker 1: called aerobic respiration. Aerobic means having to do with air,
• 15:03
  Speaker 1: but in this context it means oxygen. So mitochondria are
• 15:06
  Speaker 1: the things in your cells that metabolize the oxygen you
• 15:10
  Speaker 1: breathe and help turn it into energy by combining it
• 15:14
  Speaker 1: with byproducts of glucose and other energy containing molecules. They
• 15:19
  Speaker 1: are burning the gas of your cells basically to make
• 15:21
  Speaker 1: the ATP that is the energy of your cell, and
• 15:24
  Speaker 1: this is a very complicated process. In the mitochondria is
• 15:29
  Speaker 1: a protein called cytochrome c oxidase, and cytochrome cy oxidase
• 15:35
  Speaker 1: is the final step that the mitochondria needs to transform
• 15:39
  Speaker 1: glucose and all the other sugars and other sources of
• 15:42
  Speaker 1: energy you need into ATP, which is the energy your
• 15:45
  Speaker 1: cells use. It's very critical. If you were to try
• 15:48
  Speaker 1: to kill someone with cyanide, the way you would kill
• 15:52
  Speaker 1: them is because cyanide binds irreversibly to cytochromesy oxidase, shutting
• 15:58
  Speaker 1: it down, which shuts down all your mita chondria and
• 16:00
  Speaker 1: all your cells start to die. Fascinating, Okay, very important, Okay.
• 16:05
  Speaker 1: Noting that in nineteen eighty one a paper comes out
• 16:10
  Speaker 1: entitled cytochrome c oxidase is a possible photoreceptor in mitochondria
• 16:16
  Speaker 1: and Emily in Layman's terms, what do you think that means?
• 16:19
  Speaker 4: Not going to kill you.
• 16:21
  Speaker 2: With cyanide, Barry, And that's what I'm taking from this conversation,
• 16:25
  Speaker 2: all right.
• 16:26
  Speaker 1: What that means is that this is a protein that
• 16:29
  Speaker 1: light interacts with, which is odd because most of the
• 16:33
  Speaker 1: proteins that light interact with in our bodies are in
• 16:35
  Speaker 1: our eyes and like some in our skin to help
• 16:39
  Speaker 1: make vitamin D and stuff like that, but a little
• 16:41
  Speaker 1: bit unusual to see in mitochondria, and I suspect it
• 16:44
  Speaker 1: probably comes from the bacterial that the mitochondria were in
• 16:47
  Speaker 1: our deep evolutionary history or something. So in a petri dish,
• 16:52
  Speaker 1: it has been shown that certain wavelengths of light interact
• 16:55
  Speaker 1: with cytochrome c oxidase, and this begins the entire like
• 16:59
  Speaker 1: redl light therapy movement. Essentially what happens when you shine
• 17:05
  Speaker 1: red light certain wavelengths, So we're talking wavelengths of somewhere
• 17:10
  Speaker 1: between six hundred and eight hundred nanimeters. There's different frequencies
• 17:13
  Speaker 1: that seem to work better and worse. Is that it
• 17:16
  Speaker 1: changes the electrical state of cytochrome cy oxidase and makes
• 17:21
  Speaker 1: it work a little bit more efficiently. You're going to
• 17:24
  Speaker 1: see influencers online tell you that it like kicks out
• 17:27
  Speaker 1: nitric oxide from cytochroncy oxidase. Actually don't think that's true,
• 17:30
  Speaker 1: but we don't have to go into that, but it
• 17:32
  Speaker 1: clearly does ramp up in a Petri dish. It ramps
• 17:36
  Speaker 1: up the production of ATP that's the fuel of yourself
• 17:39
  Speaker 1: by shining light on this thing. And that's interesting and
• 17:44
  Speaker 1: surprising that you could give a little light and you
• 17:47
  Speaker 1: would slightly increase ATP production, and then we're off to
• 17:50
  Speaker 1: the races, right.
• 17:51
  Speaker 2: And I think then because ATP just to sort of
• 17:54
  Speaker 2: step back, because ATP is such an important driver of
• 17:58
  Speaker 2: our cell and driver of book kinds of things, I
• 18:01
  Speaker 2: think that is why this has become a space where
• 18:04
  Speaker 2: we're evaluating the potential of this therapy for like almost anything,
• 18:08
  Speaker 2: because it's like ATP, we're using that all the time.
• 18:10
  Speaker 4: That's like how your cells.
• 18:11
  Speaker 1: Yeah, if you don't have it you literally die.
• 18:13
  Speaker 2: Right, So before we get into the details, I do
• 18:16
  Speaker 2: want to like double click on the you know, this
• 18:18
  Speaker 2: is a really cool paper from nineteen eighty one. But
• 18:21
  Speaker 2: the beginning of the summary of this paper says, the
• 18:25
  Speaker 2: effect of light on respiration of intact mouse liver mitochondria
• 18:29
  Speaker 2: was examined at various temperatures using various inference filters. And
• 18:32
  Speaker 2: what that means is in this study, you know, it's
• 18:35
  Speaker 2: not that they went to people and they did stuff
• 18:37
  Speaker 2: to them and they saw how it's they have some
• 18:39
  Speaker 2: mouse liver mitochondria in a petritis and they're putting light
• 18:43
  Speaker 2: on it and then they're seeing what happens. And it's
• 18:46
  Speaker 2: super super cool science and very interesting biological plausibility, but
• 18:50
  Speaker 2: not some direct like we shine light on people and
• 18:54
  Speaker 2: things happen, and that's what you then need to evaluate
• 18:57
  Speaker 2: in these studies.
• 18:58
  Speaker 3: Right.
• 18:58
  Speaker 1: So again, the that wellness space tends to work, Like
• 19:02
  Speaker 1: if I want it to be a very popular wellness influencer,
• 19:05
  Speaker 1: I would be like, look at this, it's amazing. It
• 19:06
  Speaker 1: increases ATP by twenty percent, and here by my thing,
• 19:10
  Speaker 1: and it'll increase your ATP by twenty percent, and that'll
• 19:12
  Speaker 1: make you younger and more virile and like everything will
• 19:15
  Speaker 1: get better.
• 19:16
  Speaker 4: There's a really big nack between you guys.
• 19:19
  Speaker 1: You got to tie those things together. Let's time together.
• 19:21
  Speaker 4: Let's time together. So they're actually because of this ATB
• 19:24
  Speaker 4: is so important.
• 19:25
  Speaker 2: There are many many, many, many many things which people
• 19:27
  Speaker 2: will claim, and so I think we should start with
• 19:28
  Speaker 2: actually something that is that is real.
• 19:31
  Speaker 4: There is you know, there are is at least.
• 19:34
  Speaker 2: Kind of one thing in this space, I think, which
• 19:37
  Speaker 2: is called photodynamic therapy. That is a real kind of
• 19:41
  Speaker 2: positive red light effect. So tell me positive effect.
• 19:45
  Speaker 1: Yeah, photo dynamic. I mean this is this is this
• 19:49
  Speaker 1: is definitely real, but it's definitely not the wellness space.
• 19:52
  Speaker 1: So what photodynamic therapy is is a combination of light
• 19:56
  Speaker 1: plus some chemical to affect a change in the cell.
• 19:59
  Speaker 1: So this is usually used for skin conditions like actinic keratosis,
• 20:04
  Speaker 1: which is a precancerous skin condition. You put a special
• 20:07
  Speaker 1: cream on the spot on the skin. The cells sort
• 20:12
  Speaker 1: of take up that cream, and then you shine light
• 20:15
  Speaker 1: of a certain frequency on that area and the cream
• 20:19
  Speaker 1: undergoes a chemical reaction that creates a toxic byproduct. And
• 20:23
  Speaker 1: the idea is that you know, like a chemotherapy, the
• 20:26
  Speaker 1: cells that took it up get killed because these are
• 20:28
  Speaker 1: precancerous cells that you're trying to kill. And because light,
• 20:31
  Speaker 1: as we pointed out, doesn't penetrate that far beneath the skin,
• 20:36
  Speaker 1: we should probably talk about how much it penetrates you
• 20:40
  Speaker 1: limit the toxicity of that therapy. So like, yes, these
• 20:43
  Speaker 1: things exist, Obviously, that's cool. It's like a combination of
• 20:47
  Speaker 1: light and medicine. I like it, But that's not really
• 20:49
  Speaker 1: what people are talking about online.
• 20:51
  Speaker 2: Yeah, and that's something that if you had this condition,
• 20:53
  Speaker 2: your doctor would potentially prescribe this, but it is not
• 20:55
  Speaker 2: something you would you do on your own because there's
• 20:57
  Speaker 2: a weird dry spot on your face exactly.
• 21:00
  Speaker 1: I mean, I think where the bulk of what I'm
• 21:03
  Speaker 1: seeing online is about skin, skin skin related stuff, sprinkles
• 21:09
  Speaker 1: and discolorations and acne and things like that. So, Emily,
• 21:12
  Speaker 1: I know you've thought about this a bit. What does
• 21:15
  Speaker 1: the evidence suggest in terms of red light affecting meaningful
• 21:19
  Speaker 1: changes in people's skin. I know you don't care about it.
• 21:22
  Speaker 1: You've told us you don't care about wrinkles, but I do.
• 21:25
  Speaker 2: So I think this is a very interesting space because
• 21:29
  Speaker 2: it's actually quite hard to study. So imagine that I
• 21:34
  Speaker 2: do something to you and I tell you, like, here, Perry,
• 21:36
  Speaker 2: here is this cream, this mask, this whatever, like, use
• 21:39
  Speaker 2: it on your face every day for you know, three weeks,
• 21:42
  Speaker 2: and then come back and tell me how you feel
• 21:44
  Speaker 2: like your face is.
• 21:45
  Speaker 4: Okay.
• 21:46
  Speaker 2: I could give you almost anything, a bottle of aqua
• 21:48
  Speaker 2: for some you know, see to fill face wash, a
• 21:51
  Speaker 2: cream glow recipe from my kid, whatever it is, and
• 21:55
  Speaker 2: you would come back and you'd be like, I think
• 21:57
  Speaker 2: my face looks amazing.
• 21:59
  Speaker 4: And that's called the place effect.
• 22:00
  Speaker 2: Basically, we are really susceptible to the suggestion that something
• 22:05
  Speaker 2: might work.
• 22:06
  Speaker 4: So one of the issues with many of.
• 22:08
  Speaker 2: The studies of these masks or these kind of red
• 22:11
  Speaker 2: light wrinkle treatments is that they are using as the
• 22:15
  Speaker 2: perceived outcome, either the sort of evaluation of the individual
• 22:19
  Speaker 2: or an evaluation of an investigator who kind of knows,
• 22:22
  Speaker 2: potentially knows whether somebody was in fact using the red
• 22:27
  Speaker 2: light mask. And so what the ideal approach to a
• 22:31
  Speaker 2: study like this is to have a blinded approach where
• 22:34
  Speaker 2: some people get red light therapy and some people get
• 22:36
  Speaker 2: a placebo. But the placebo needs to actually seem like
• 22:40
  Speaker 2: red light therapy. But since the therapy is just putting
• 22:44
  Speaker 2: light on your face. It's actually very hard to have
• 22:46
  Speaker 2: a placebo form of this. It's not that it's not
• 22:50
  Speaker 2: like a pill where you can give them a pill
• 22:51
  Speaker 2: and it looks the same and then you can have
• 22:54
  Speaker 2: a placebo. So I think a lot of the studies
• 22:57
  Speaker 2: of this, just like before we get into the results,
• 22:59
  Speaker 2: a lot of them are really pretty limited because it's
• 23:02
  Speaker 2: very very difficult to have it like what's called a
• 23:04
  Speaker 2: sham placebo.
• 23:05
  Speaker 1: But you could have a blinded evaluator, like so instead
• 23:08
  Speaker 1: of the person that did the therapy, just like have
• 23:10
  Speaker 1: their picture or something and have some third party decide
• 23:15
  Speaker 1: if their skin looks better or not right.
• 23:16
  Speaker 2: And so the better studies do that, but even there
• 23:20
  Speaker 2: you want a sham placebo because like, how do you
• 23:24
  Speaker 2: know the effect is red light rather than something else, right,
• 23:28
  Speaker 2: And so I mean maybe that doesn't really matter, But
• 23:31
  Speaker 2: if you actually care about the sort of biological plausibility
• 23:34
  Speaker 2: and linking that to these effects, we would like to
• 23:36
  Speaker 2: test this particular you know, this wavelength or this you know,
• 23:40
  Speaker 2: this particular treatment, and that's very hard to do without
• 23:44
  Speaker 2: having a true placebo, because maybe there's an effect, but
• 23:47
  Speaker 2: maybe it's not really about the red light. Maybe it's
• 23:49
  Speaker 2: about the laying down and having the warm stuff on
• 23:51
  Speaker 2: your face, like I don't know, right, or.
• 23:54
  Speaker 1: The patient or the participant in the trial kind of
• 23:56
  Speaker 1: knows they're getting the red light because, as you say,
• 23:58
  Speaker 1: it's hard to placebo and they like or something after moisturizer,
• 24:03
  Speaker 1: whatever it is.
• 24:03
  Speaker 2: So when we look at these studies, there are a
• 24:06
  Speaker 2: small number of mostly very small sample size RCTs, some
• 24:12
  Speaker 2: of which show maybe some small impacts of some red
• 24:17
  Speaker 2: light therapies and sort of different directions.
• 24:21
  Speaker 4: I would say my take on.
• 24:22
  Speaker 2: This is the effects are generally very small, and the
• 24:25
  Speaker 2: dosing is really inconsistent, and in many of the cases
• 24:30
  Speaker 2: it has the problem that you know, there's twelve different
• 24:34
  Speaker 2: things we can measure about your wrinkles, and you know,
• 24:37
  Speaker 2: two of them it kind of seems to work, and
• 24:39
  Speaker 2: most of them it doesn't. So this is not a
• 24:42
  Speaker 2: statistically very compelling literature. I'm not sure that I would
• 24:45
  Speaker 2: say we completely rule out any possible small effects on
• 24:48
  Speaker 2: wrinkles or other sort of skin elasticity, but you know,
• 24:52
  Speaker 2: it's not botox for getting rid of or I mean
• 24:54
  Speaker 2: just realistically, this is not very large impacts, and I
• 24:58
  Speaker 2: think it will be hard to study. I mean, I
• 24:59
  Speaker 2: think it's not. I'm not sure we're gonna get really
• 25:01
  Speaker 2: super to the bottom of that just because of this
• 25:04
  Speaker 2: sham because of the sham problem.
• 25:07
  Speaker 1: Let's move off of skin then a little bit to
• 25:09
  Speaker 1: some of the other claims that people talk about.
• 25:13
  Speaker 2: One I was extremely interested in is wound healing, which
• 25:16
  Speaker 2: feels like, again a more directly medical thing, but maybe
• 25:21
  Speaker 2: something where there's a little more positive evidence.
• 25:25
  Speaker 1: Maybe maybe, but not really. Yeah, So I dug into
• 25:31
  Speaker 1: this a little bit. Most of the literature here actually
• 25:35
  Speaker 1: comes from real medical device studies, not so much the
• 25:40
  Speaker 1: wellness space. So we're talking about lasers being used to
• 25:44
  Speaker 1: treat diabetic foot ulcers and things like that. There was
• 25:48
  Speaker 1: one decent randomized trial, I mean also small, thirty people,
• 25:52
  Speaker 1: but nicely blinded. In this case, these were patients with
• 25:55
  Speaker 1: diabetes who had diabetic foot ulcers, and they did demonstrate
• 25:59
  Speaker 1: some accelerated wound closure through the use of this very
• 26:03
  Speaker 1: specific nine hundred and four nanimeter laser that is not
• 26:07
  Speaker 1: available to be purchased anywhere. This is a medical device
• 26:10
  Speaker 1: that is used in certain doctors' offices. This is one
• 26:15
  Speaker 1: of the like meta problems of red light therapy. Is
• 26:19
  Speaker 1: that like red light, this isn't like a chemical like
• 26:23
  Speaker 1: an antibiotic or a chemotherapy drug that is difficult to
• 26:26
  Speaker 1: synthesize and you know, requires a giant lab like you
• 26:30
  Speaker 1: can buy a red led at you know. I was
• 26:33
  Speaker 1: going to say radio shack, but you can't because radio shacks.
• 26:35
  Speaker 2: Anymore am to you.
• 26:40
  Speaker 1: And you can buy these things for you know, sense,
• 26:43
  Speaker 1: does that sell this? Probably? I bet it does. It
• 26:45
  Speaker 1: definitely does. But you know what I'm saying. So you
• 26:48
  Speaker 1: do also have to be careful when influencers are like, oh,
• 26:51
  Speaker 1: look at this study and it does show this good
• 26:53
  Speaker 1: it's good for wounds, and they're using like this very
• 26:57
  Speaker 1: specific type of thing that is not necessarily what you're
• 27:00
  Speaker 1: buying online. Yeah, again, is there plausibility a little bit,
• 27:05
  Speaker 1: But I don't think this is something that you really
• 27:08
  Speaker 1: should be strapping to open wounds or shining at open
• 27:12
  Speaker 1: wounds necessarily. I think you should be using your triple antibiotic,
• 27:15
  Speaker 1: ointment and band aid and abandoned. Yeah, let's move off
• 27:19
  Speaker 1: of wound and go to like weirder, weirder stuff. Let's
• 27:24
  Speaker 1: go to the head. Because I saw some people arguing
• 27:27
  Speaker 1: that this red light therapy might improve cognition or thinking.
• 27:32
  Speaker 1: I am skeptical, Emily.
• 27:35
  Speaker 2: So this is a place where I think the biological
• 27:37
  Speaker 2: plausibility kind of falls down, right. So you talked about
• 27:40
  Speaker 2: sort of different wavelengths at the beginning, and the idea
• 27:44
  Speaker 2: that this sort of might work by wavelengths kind of
• 27:46
  Speaker 2: these longer wavelengths being able to penetrate your skin. It's
• 27:49
  Speaker 2: not really obvious that those wavelengths could penetrate far enough
• 27:52
  Speaker 2: to be into your skull. I think there's like disagreement
• 27:56
  Speaker 2: about surely some wavelengths like radio waves go long enough,
• 28:00
  Speaker 2: but it's not clear that even at the upper end
• 28:04
  Speaker 2: of the wavelength of red light that they can actually
• 28:06
  Speaker 2: get into your brain.
• 28:08
  Speaker 1: Yeah. I tried to look at this, and for red
• 28:12
  Speaker 1: light that you can see, so not infrared, but kind
• 28:15
  Speaker 1: of deep red light that you can see, the penetrance
• 28:18
  Speaker 1: into the skin is about a millimeter. So we're really tough.
• 28:22
  Speaker 1: I mean a millimeter is a tiny, tiny amount, maybe
• 28:25
  Speaker 1: enough to get at like some of the cells that
• 28:27
  Speaker 1: have to do with wrinkles and stuff, you know, but
• 28:30
  Speaker 1: definitely not deeper than that. The infrared light can maybe
• 28:33
  Speaker 1: get five millimeters beneath the skin. You sure aren't getting
• 28:37
  Speaker 1: through the skull with that kind of light, like your
• 28:40
  Speaker 1: brain is staying dark.
• 28:41
  Speaker 2: So there's one kind of double blind, placebo, randomized controlled
• 28:45
  Speaker 2: trial of evaluating people with traumatic brain injury, and you know, broadly.
• 28:51
  Speaker 4: It kind of shows nothing.
• 28:54
  Speaker 2: They don't have any symptom improvement on the sort of
• 28:57
  Speaker 2: standard measure of symptoms on this which is a questionnaire.
• 29:01
  Speaker 2: There's like some stuff in that paper saying that maybe
• 29:04
  Speaker 2: when you put people in MRIs, like on one of
• 29:07
  Speaker 2: the metrics that you measure in the MRI, maybe there's
• 29:09
  Speaker 2: something statistically different. But again, we're in a space where
• 29:12
  Speaker 2: we're looking an awful lot of different outcomes and one
• 29:15
  Speaker 2: of them is working, and that's kind of how statistics works,
• 29:19
  Speaker 2: even if the results are zero. So the combination of
• 29:22
  Speaker 2: lack of biological plausibility and lack of any real good
• 29:27
  Speaker 2: evidence here, I think there's this feels like a real
• 29:33
  Speaker 2: no go on.
• 29:34
  Speaker 1: It's a reach when you've got a lot of placebo
• 29:38
  Speaker 1: effects and issues with blinding and things like that. Sometimes
• 29:41
  Speaker 1: the animal literature can clue you in. You know, we
• 29:43
  Speaker 1: often see positive studies and animals that don't work in humans.
• 29:47
  Speaker 1: That's a typical pathway but this is one of those
• 29:49
  Speaker 1: cases where actually the study in mice is negative. So
• 29:53
  Speaker 1: there are mice that develop Alzheimer's disease or in Alzheimer's
• 29:56
  Speaker 1: disease like condition with the same sort of brain pathology
• 30:00
  Speaker 1: that humans have, and they can test them by their
• 30:03
  Speaker 1: ability to get through mazes and stuff like that. And
• 30:05
  Speaker 1: they tried near infra red eight hundred and ten nanimeter
• 30:08
  Speaker 1: transcranial therapy three times a week for five months, and
• 30:13
  Speaker 1: the mice got no better at working through mazes or
• 30:16
  Speaker 1: doing any of the problem solving tasks that mice are
• 30:19
  Speaker 1: good to do. So we're here, We're yeah, agree limited, No,
• 30:23
  Speaker 1: essentially no biologic plausibility.
• 30:24
  Speaker 4: Not for people and not for mice.
• 30:26
  Speaker 1: Probably not strapping it to your head for that reason.
• 30:29
  Speaker 4: Well what about Perry?
• 30:30
  Speaker 2: Okay, so obviously on the Internet, I think that women
• 30:35
  Speaker 2: get more of the wellness influencer push. But the one
• 30:38
  Speaker 2: thing that men are really really into is their hair.
• 30:43
  Speaker 2: Then really I don't like to lose their hair.
• 30:45
  Speaker 1: I can confirm that this is true.
• 30:47
  Speaker 2: And so this comes up as like red light for
• 30:49
  Speaker 2: hair loss? So should I put red light on my
• 30:52
  Speaker 2: head for hair loss? If I am a man or
• 30:53
  Speaker 2: a woman, I guess, but men specifically, I.
• 30:56
  Speaker 1: Think I have good news and bad news here.
• 30:57
  Speaker 4: Okay.
• 30:58
  Speaker 1: From my read of this research is that the good
• 31:03
  Speaker 1: news is that red light therapy seems to be maybe
• 31:08
  Speaker 1: as effective as monoxidal or finasteride, the two most common
• 31:12
  Speaker 1: medications that we use for hair loss in terms of
• 31:15
  Speaker 1: hairy growth. The bad news is it seems to be
• 31:18
  Speaker 1: as effective as monoxidal and finasteride for hairy growth, just
• 31:24
  Speaker 1: to say, not very We're not good at this. And
• 31:28
  Speaker 1: this is something like you don't care about wrinkles. You
• 31:30
  Speaker 1: care about your running times. I care mildly about wrinkles,
• 31:35
  Speaker 1: but boy, I would take like a thick, luscious head
• 31:38
  Speaker 1: of hair like I, yes, I am into it. And
• 31:41
  Speaker 1: so this is where this is where they twist the
• 31:43
  Speaker 1: knife on me. So yes, there have been some studies
• 31:46
  Speaker 1: which showed increased hair density with near infrared and deep
• 31:51
  Speaker 1: red therapy, about an increase in hair density of forty
• 31:55
  Speaker 1: one hairs per centimeter squared. And I had to look
• 31:59
  Speaker 1: into like how good that is? But again, that's similar
• 32:02
  Speaker 1: to what you see for finastride. There was actually a
• 32:07
  Speaker 1: believe it or not, a randomized head to head comparison
• 32:10
  Speaker 1: of monoxidil and red light therapy for hairy growth, and
• 32:14
  Speaker 1: there was no difference between them, which again could be
• 32:18
  Speaker 1: because neither of them work, but it could be because
• 32:21
  Speaker 1: both of them work. I mean will say that monoxidyl
• 32:25
  Speaker 1: and finastride both are medications that have side effects. Monoxidal
• 32:29
  Speaker 1: can lawrier your blood pressure, lead to a little bit
• 32:30
  Speaker 1: of dizziness when standing up, things like that. Finasteride can
• 32:33
  Speaker 1: have some sexual side effects reported and things like that,
• 32:37
  Speaker 1: Whereas the adverse event rate for red light therapy is
• 32:41
  Speaker 1: very low. So I'm not willing to write this one
• 32:44
  Speaker 1: off completely, but I'm even if I were really excited
• 32:48
  Speaker 1: about this, I come to the same problem and I
• 32:51
  Speaker 1: think we've got to address this at the end is
• 32:53
  Speaker 1: like okay, sure, let's even say like, yeah, this works
• 32:56
  Speaker 1: as well as fanastride and I might as well try it.
• 32:59
  Speaker 1: What do I do?
• 33:01
  Speaker 3: Right?
• 33:01
  Speaker 1: Like, what am I supposed to buy if finastriides a prescription?
• 33:04
  Speaker 4: Yeah?
• 33:05
  Speaker 2: This is the sort of core problem with this space
• 33:08
  Speaker 2: because in some ways this is a very simple idea,
• 33:11
  Speaker 2: like We're going to put some wavelength of red ish
• 33:14
  Speaker 2: or red more red less red light onto something your head,
• 33:17
  Speaker 2: your face, your wounds, something else, there is no like
• 33:22
  Speaker 2: specific wavelength, specific criteria, specific dosing. Every one of these
• 33:27
  Speaker 2: studies has a slightly different wavelength, a slightly different delivery mechans,
• 33:31
  Speaker 2: a slightly different dosing, a slightly different timeframe. It's all
• 33:35
  Speaker 2: like really wild West, and so relative to some kind
• 33:39
  Speaker 2: of medication where you'd say, Okay, we're evaluating a medication.
• 33:42
  Speaker 2: We have a dosing schedule, we have a dosing amount.
• 33:44
  Speaker 2: You take the medication. We know exactly what the activity
• 33:47
  Speaker 2: is you do to get the treatment effect. This is
• 33:50
  Speaker 2: a place where even if you said, okay, you want
• 33:53
  Speaker 2: to use it to grow your hair, we wouldn't really
• 33:55
  Speaker 2: be able to give super specific information about what to do,
• 33:59
  Speaker 2: or what to buy or how to achieve.
• 34:02
  Speaker 1: I tried to keep like a running list of the
• 34:05
  Speaker 1: parameters that these different things could have. And so there
• 34:09
  Speaker 1: are different wavelengths. You mentioned that there's different power density, right,
• 34:12
  Speaker 1: like how much wattage do you put into these bulbs?
• 34:15
  Speaker 1: Basically there's different what they call fluence, which is that
• 34:18
  Speaker 1: total energy delivered during a therapy session. Right, So if
• 34:21
  Speaker 1: you think like is more better, is less better? Some
• 34:24
  Speaker 1: of these pulse at different frequencies. I have no idea
• 34:27
  Speaker 1: if that makes a difference. And then there's the timing.
• 34:30
  Speaker 1: Are you doing this every day? Are you doing it
• 34:31
  Speaker 1: for thirty minutes, two hours, you know, just once a week,
• 34:34
  Speaker 1: et cetera. When you have a parameter space that big,
• 34:37
  Speaker 1: it's nearly impossible to read any study, And unless you're
• 34:42
  Speaker 1: using the exact same device that was used in that study,
• 34:45
  Speaker 1: it's really hard to know that you're getting anything similar
• 34:49
  Speaker 1: to what was actually studied. Yeah, all right, this is
• 34:52
  Speaker 1: stressing me out thinking of all the different possibilities for
• 34:54
  Speaker 1: red light therapy. It's affecting my mood. But fortunately I
• 34:58
  Speaker 1: have something for you, red light therapy there.
• 35:01
  Speaker 2: You don't for me, you don't, okay, So I actually
• 35:03
  Speaker 2: I want to talk about mood because I think that
• 35:05
  Speaker 2: the evidence on mood, the way that the impacts of
• 35:10
  Speaker 2: the sort of idea that red light therapy might improve
• 35:12
  Speaker 2: your mood. I think the way that literature has moved
• 35:14
  Speaker 2: is actually a really interesting thing about science and almost
• 35:17
  Speaker 2: a cautionary tale. So there's like one series of papers
• 35:23
  Speaker 2: in a set of trials called the Elated Trials, And
• 35:26
  Speaker 2: so what happened in these trials was there's like a
• 35:29
  Speaker 2: pilot trial where they did a actually quite good like
• 35:33
  Speaker 2: double blind sham controlled study in which they tried to
• 35:36
  Speaker 2: deliver red light therapy to people with major depressive disorder,
• 35:41
  Speaker 2: and they found in this like small initial pilot that
• 35:45
  Speaker 2: the effects on the subjects were much like the people
• 35:49
  Speaker 2: who were treated were much more likely to be doing
• 35:52
  Speaker 2: better than the people who were control So it looked
• 35:54
  Speaker 2: like it had a very big effect.
• 35:56
  Speaker 4: But when they like looked further.
• 35:58
  Speaker 2: Into that particular, they actually found that although they intended
• 36:03
  Speaker 2: for the treatment to be blinded to the evaluating clinician,
• 36:07
  Speaker 2: the evaluating clinicians like eighty percent of the time were
• 36:09
  Speaker 2: able to figure out what the treatment was, so like
• 36:12
  Speaker 2: effectively they were even though they had tried to blind,
• 36:14
  Speaker 2: they were not blind. And so then they sort of
• 36:17
  Speaker 2: took this as what it should be, which is like,
• 36:19
  Speaker 2: this is an interesting suggestive hypothesis but not conclusive with
• 36:23
  Speaker 2: twenty subjects and this problem. And then they went to
• 36:27
  Speaker 2: a much bigger study of like fifty people across multiple
• 36:31
  Speaker 2: places and they did the same thing, and they found nothing.
• 36:33
  Speaker 2: And so it just turned out like in the better data,
• 36:35
  Speaker 2: this does not seem to impact depression in this way,
• 36:38
  Speaker 2: but I think it is a sort of it's a
• 36:40
  Speaker 2: good illustration of the kind of follow up studies you'd
• 36:42
  Speaker 2: want for other things in this space. If you thought, hey,
• 36:45
  Speaker 2: this might work for this, let's do it in a
• 36:47
  Speaker 2: larger setting where we're testing something much more specific, where
• 36:51
  Speaker 2: we're doing much less pea hacking. That's kind of how
• 36:54
  Speaker 2: science should work. It doesn't often doesn't totally.
• 36:57
  Speaker 1: The power of replication is so huge.
• 37:00
  Speaker 2: I mean, we do know that light affects mood, which
• 37:02
  Speaker 2: is different from red light therapy affecting mood. I mean
• 37:04
  Speaker 2: I know because this winter is very depressing for many people.
• 37:08
  Speaker 1: Oh yeah, yeah, for seasonal effective disorder. Yes, light box
• 37:12
  Speaker 1: therapy has clearly been shown to improve mood.
• 37:15
  Speaker 4: But it is not red.
• 37:16
  Speaker 1: It's white, it is not red. It's multi spectrum like
• 37:19
  Speaker 1: the sun.
• 37:19
  Speaker 4: Like the sun.
• 37:21
  Speaker 2: So another thing that I see a lot is in
• 37:25
  Speaker 2: the sports people, is red light for a muscle recovery.
• 37:28
  Speaker 2: You know I'm going to sit under a red light
• 37:30
  Speaker 2: thing after by a workout.
• 37:33
  Speaker 4: Yes? No, should I buy that? Probably? Yes, right, I
• 37:35
  Speaker 4: should buy it. I'm going to buy it. I'm actually
• 37:37
  Speaker 4: ordering it right now.
• 37:38
  Speaker 1: I mean, if I told you it would make your
• 37:40
  Speaker 1: long run time faster, I know you're going to get
• 37:43
  Speaker 1: your credit card out right now. So again I think
• 37:45
  Speaker 1: the depth of the tissue is the key biological plausibility
• 37:49
  Speaker 1: indicator here. Again, even the infrared light therapy is only
• 37:54
  Speaker 1: getting about five millimeters below the skin. So if you're
• 37:56
  Speaker 1: talking about stuff that's deeper, and you know, five millimeters
• 38:01
  Speaker 1: is a quarter of an inch, right, Like, this is
• 38:04
  Speaker 1: really not getting very deep. So if you're talking about
• 38:07
  Speaker 1: any sort of deep tissue stuff, it's just not plausible
• 38:10
  Speaker 1: that the light gets there. There are muscles on the
• 38:13
  Speaker 1: surface and there are joints that are sort of in
• 38:15
  Speaker 1: the surface. Even that I think is probably too deep.
• 38:18
  Speaker 1: I will say that there. If you look, you'll see
• 38:20
  Speaker 1: some randomized trials in some athletes where they did see like,
• 38:25
  Speaker 1: for example, one trial and forty healthy subjects saw that
• 38:30
  Speaker 1: they could do more REPS after being given some of
• 38:33
  Speaker 1: this red light therapy as opposed to when they hadn't
• 38:36
  Speaker 1: been given the red light therapy. You've pointed this out
• 38:38
  Speaker 1: plenty of times. REPS is totally susceptible to placebo effect, right,
• 38:42
  Speaker 1: you just like believe in yourself and you can do more.
• 38:46
  Speaker 1: I'm not very compelled by that. There's a nice negative
• 38:50
  Speaker 1: trial which looked at people doing eccentric bicep curls to
• 38:56
  Speaker 1: exhaustion and compared a variety of different light sources, and
• 39:01
  Speaker 1: there's no difference across any of these groups. So it
• 39:04
  Speaker 1: doesn't really make sense to me for exercise. It just
• 39:09
  Speaker 1: doesn't get deep enough. That's basically the bottom line. There
• 39:13
  Speaker 1: are I think a couple other things that we can
• 39:16
  Speaker 1: just quickly knock out that I've seen online.
• 39:19
  Speaker 4: Things we can reject.
• 39:20
  Speaker 1: Yeah, I think we just have to cross them off
• 39:22
  Speaker 1: the list. So testosterone no, that fat loss no, although
• 39:30
  Speaker 1: although where are you shining the red light for the testosterone.
• 39:32
  Speaker 4: That actually it seems like a source of sunburn. I
• 39:35
  Speaker 4: don't know that things could go very poorly.
• 39:39
  Speaker 1: We'll talk about that when we talk about safety.
• 39:41
  Speaker 2: Fat loss is a no, this is not this is
• 39:43
  Speaker 2: not going to give you better fat loss.
• 39:45
  Speaker 1: Yeah, So taken altogether before we move on to sort
• 39:49
  Speaker 1: of the safety issues. Is like maybe for things that
• 39:52
  Speaker 1: are very superficial, basically we're left with maybe some skin,
• 39:55
  Speaker 1: maybe some hair.
• 39:57
  Speaker 4: Maybe, but very very small effects.
• 40:00
  Speaker 2: I think we always want to think about, you know,
• 40:02
  Speaker 2: is it likely that this is the like life changing
• 40:05
  Speaker 2: you know, is this the difference between a full, luscious
• 40:09
  Speaker 2: head of hair and baldness. Is that the difference between
• 40:11
  Speaker 2: looking like you're sixty and you know, is this going
• 40:13
  Speaker 2: to turn you into a thirty year old? No?
• 40:15
  Speaker 4: Could there be some very marginal effect where when your
• 40:18
  Speaker 4: partner squints at your face really really carefully, maybe it
• 40:23
  Speaker 4: looks a little bit different for them. Maybe also why
• 40:26
  Speaker 4: are they doing that? And so I think those are
• 40:29
  Speaker 4: the like that for me.
• 40:30
  Speaker 2: It's just like a eh, like, maybe it's something there,
• 40:34
  Speaker 2: but also it's definitely not something important.
• 40:37
  Speaker 1: Okay.
• 40:38
  Speaker 4: So then there are two.
• 40:39
  Speaker 2: Other like sort of downsides I think or we're talking
• 40:41
  Speaker 2: about here. So one is the question.
• 40:42
  Speaker 4: Of just like is this safe.
• 40:44
  Speaker 2: Like let's say I hear you're like, yeah, I hear you, Emily,
• 40:46
  Speaker 2: but my partner does squint in my face a lot,
• 40:48
  Speaker 2: and I really want to get these small improvements.
• 40:51
  Speaker 4: Should I be concerned about safety?
• 40:53
  Speaker 1: Yeah? Again, one of the problems is there's a million
• 40:56
  Speaker 1: of these devices online and it can be really hard
• 40:59
  Speaker 1: to know what to get. We can talk about that
• 41:02
  Speaker 1: in a second. But one aspect of safety is just like,
• 41:05
  Speaker 1: these are electronic devices that may be manufactured in less
• 41:08
  Speaker 1: than safe conditions, and things can spark and catch on
• 41:11
  Speaker 1: fire and stuff like that. That's sort of the generic
• 41:13
  Speaker 1: like don't buy these things from TIMU bit of warning.
• 41:16
  Speaker 1: But biologically there's some concern here too. Even in the
• 41:20
  Speaker 1: Petri dish studies, they found what's called a biphasic response
• 41:24
  Speaker 1: depending on how much red light they put on these cells.
• 41:28
  Speaker 1: It seems like at the lower level, at kind of
• 41:31
  Speaker 1: the right level, you increase ATP production and the cells
• 41:36
  Speaker 1: kind of do their thing a little bit better. If
• 41:38
  Speaker 1: you exceed that, you start to generate what are called
• 41:42
  Speaker 1: reactive oxygen species. You're essentially like goosing your mitochondria too much,
• 41:47
  Speaker 1: and it causes these inflammatory oxygen molecules to be created,
• 41:51
  Speaker 1: which can actually kill the cells. So this is a
• 41:54
  Speaker 1: mechanism that is, you know, one of the ways that
• 41:57
  Speaker 1: light can actually hurt you, inflammation and things like that.
• 42:02
  Speaker 1: And so there's this therapeutic window where like there's the
• 42:05
  Speaker 1: right amount and there's too much, and we don't really
• 42:08
  Speaker 1: know what that is. So I would say if you
• 42:10
  Speaker 1: were going to use this, you probably don't want to
• 42:12
  Speaker 1: like leave it on your face overnight or whatever you're doing.
• 42:15
  Speaker 1: The second thing is, as you alluded to, is heat.
• 42:20
  Speaker 1: So these things give off a lot of heat. In fact,
• 42:23
  Speaker 1: one of the complaints I saw in some of the
• 42:24
  Speaker 1: products online is that they're loud, which I really realize.
• 42:27
  Speaker 1: But they're loud because they have fans in them that are,
• 42:29
  Speaker 1: you know, blowing off the heat from all the LEDs
• 42:32
  Speaker 1: that are going through them. So they've got the fan
• 42:34
  Speaker 1: blowing that heat is potentially damaging, particularly if it's right
• 42:39
  Speaker 1: up against your skin. It's also one of the mechanisms
• 42:43
  Speaker 1: that these things might could work.
• 42:44
  Speaker 4: This could be how it works. Yeah, right, we.
• 42:46
  Speaker 1: Talked about muscle strain. It's like, oh, yeah, the light
• 42:48
  Speaker 1: doesn't get to your muscle, but it's warm.
• 42:50
  Speaker 4: It's like a nice heating pad. Yeah we have, I
• 42:53
  Speaker 4: have one.
• 42:53
  Speaker 1: Heat it's a heating pad. Might work, yeah, exactly, And
• 42:56
  Speaker 1: it's a lot cheaper to get a heating pad. But
• 42:58
  Speaker 1: too much heat can cause can cause problems, and so
• 43:01
  Speaker 1: generally these things are pretty safe, but there are some
• 43:04
  Speaker 1: theoretical concerns that people should be aware of.
• 43:06
  Speaker 2: I think the much bigger problem is these things are
• 43:08
  Speaker 2: incredibly expensive.
• 43:09
  Speaker 1: Oh my god.
• 43:10
  Speaker 2: Led lights are cheap, like so if you just go
• 43:12
  Speaker 2: to you know, the home depot when you get some LEDs,
• 43:14
  Speaker 2: like that's that's nothing. But these masks are like I mean,
• 43:20
  Speaker 2: this stuff is really expected.
• 43:22
  Speaker 1: About fifteen hundred dollars, and I tried to like, like,
• 43:25
  Speaker 1: how much could this possibly cost to make? And I
• 43:29
  Speaker 1: know it's not just LED's which costs like a cent
• 43:31
  Speaker 1: to maybe fifty cents each, but like, I know, there's
• 43:36
  Speaker 1: like some probably some circuit boards and stuff in there,
• 43:38
  Speaker 1: but there's no way these things cost one thousand dollars
• 43:41
  Speaker 1: to make. I think these are all drastically effli.
• 43:43
  Speaker 2: So cost plus pricing, it's the cost plus the marketing budget,
• 43:47
  Speaker 2: and that is most of it.
• 43:49
  Speaker 4: Most of it is the marketing budget.
• 43:51
  Speaker 2: So I mean, I think there are some of these
• 43:53
  Speaker 2: devices that are sort of FDA cleared, which I think
• 43:57
  Speaker 2: makes people feel like they are more legitimate.
• 44:03
  Speaker 4: That does not defend the pricing though now FDA clearance.
• 44:06
  Speaker 1: Has nothing to do with pricing, but if people are again,
• 44:08
  Speaker 1: if you are looking for something, this is one way
• 44:12
  Speaker 1: to distinguish one product from another. So an FDA cleared
• 44:17
  Speaker 1: device is one that has gone through pre marketing approval
• 44:22
  Speaker 1: from the FDA. It's not that high a bar. They
• 44:26
  Speaker 1: just have to prove that they're substantially similar to an
• 44:29
  Speaker 1: already approved device, so it's called a predicate device. They
• 44:34
  Speaker 1: have to show safety in some like manufacturing parameters, so
• 44:38
  Speaker 1: at least you kind of know that, like they went
• 44:40
  Speaker 1: through a process. It's not a total scam. They also
• 44:44
  Speaker 1: if they are FDA cleared, then get the ability to
• 44:46
  Speaker 1: make health claims, which are those you know you've seen
• 44:50
  Speaker 1: it on non FDA clear devices. Right, this is not
• 44:53
  Speaker 1: intended to diagnose, prevent, cure, or treat any disease. So
• 44:58
  Speaker 1: devices that haven't gone through the FDA care can't say that.
• 45:01
  Speaker 1: So you'll see the non FDA clear face mask that
• 45:04
  Speaker 1: say like promote you know, facial wellness, facial wellness, but
• 45:08
  Speaker 1: they can't say like will treat acne, or like will
• 45:11
  Speaker 1: treat rosetia. It doesn't mean they don't work per se,
• 45:16
  Speaker 1: but that FDA clearance is something you could potentially look for,
• 45:19
  Speaker 1: but it comes at a premium.
• 45:21
  Speaker 2: Yeah, all right, Perry, red light therapy smash or pass.
• 45:28
  Speaker 1: I am passing at the current price. I do think
• 45:33
  Speaker 1: someone invents something to put on my scalp that costs
• 45:37
  Speaker 1: like one hundred bucks and actually works. I might. I
• 45:42
  Speaker 1: might do it. How about you, Emily smash a pask.
• 45:45
  Speaker 4: I'm a pass on this.
• 45:46
  Speaker 2: I think that the effects are not big enough and
• 45:51
  Speaker 2: I think the likely actual effects, if you really got
• 45:55
  Speaker 2: good ones, would be even more minuscule than the ones
• 45:58
  Speaker 2: we estimate in the trials.
• 45:59
  Speaker 4: And so I'm a pass. Save your money, spend it
• 46:03
  Speaker 4: on botox if that's what you want. That's my feeling.
• 46:06
  Speaker 1: Rock Sand, you don't have to put on the red light.
• 46:11
  Speaker 4: You're really going to make that work.
• 46:12
  Speaker 2: You're going to make it work. So that is it
• 46:15
  Speaker 2: for red light therapy. Your mail back Question of the
• 46:17
  Speaker 2: Week after the Break.
• 46:24
  Speaker 6: Hi, Emily and Perry. This is Adrian from Minneapolis, and
• 46:27
  Speaker 6: I have a question always wanted to know the answer to,
• 46:31
  Speaker 6: and that is the illusion or the reality of periods sinking.
• 46:37
  Speaker 3: I'm wondering if it's the kind of thing where like
• 46:39
  Speaker 3: if I live with two female roommates and all of
• 46:42
  Speaker 3: our periods seem to line up. Is that a real
• 46:46
  Speaker 3: thing with some kind of scientific basis or is it
• 46:49
  Speaker 3: just like frequency illusion where we are all thinking about
• 46:53
  Speaker 3: blue volkswagons and so we see them all the time.
• 46:57
  Speaker 4: Thanks for your help, Ah, this is an interesting question,
• 46:59
  Speaker 4: people ask us.
• 47:00
  Speaker 1: So before you get into it, do you know what
• 47:02
  Speaker 1: the teenagers call this? Now?
• 47:04
  Speaker 4: Oh god, what do they call it?
• 47:05
  Speaker 1: They call it getting bluetoothed. Have you heard that?
• 47:09
  Speaker 4: Oh I did, someone did tell me that. That's so weird.
• 47:13
  Speaker 4: It's like I'm going to bluetooth you my peers.
• 47:15
  Speaker 1: Yeah, because it's like you're connecting you you're sinking up
• 47:18
  Speaker 1: right like anyway modern times, I don't know, how do
• 47:21
  Speaker 1: you even know that I have a sixteen year old daughter?
• 47:24
  Speaker 4: Sixteen year old daughter? Okay, fair enough. I think it's
• 47:27
  Speaker 4: nice that you know that.
• 47:29
  Speaker 2: So there was some early research that suggested that people
• 47:34
  Speaker 2: who live in a household together I think it was
• 47:36
  Speaker 2: based on dorms, would have periods at the same time.
• 47:40
  Speaker 2: But then basically, further more detailed research shows that in fact,
• 47:44
  Speaker 2: this is not true. People do not sink their cycles.
• 47:48
  Speaker 2: I mean, of course, if you have a dorm of
• 47:51
  Speaker 2: twenty girls, many of them will have their period at
• 47:55
  Speaker 2: the same time because your period is seven days typically
• 47:59
  Speaker 2: five to seven days of a twenty eight day cycle.
• 48:01
  Speaker 2: So you could easily feel SYNCD because everyone has their
• 48:05
  Speaker 2: period at the same time as some other person. But
• 48:07
  Speaker 2: it is not like a it's not a true sinking
• 48:10
  Speaker 2: in that way of period's not moving around to match
• 48:13
  Speaker 2: other people's. And I think it's not surprising because I
• 48:16
  Speaker 2: don't know what the evolutionary reason for that would be, Like,
• 48:19
  Speaker 2: why would it be beneficial for everybody to be fertile
• 48:21
  Speaker 2: at the same time.
• 48:22
  Speaker 4: That almost seems like the opposite of what you would want.
• 48:25
  Speaker 1: Right, Yeah, I don't know. I always hear like pheromones
• 48:27
  Speaker 1: and stuff like that. There's an interesting mathematical correlate here,
• 48:31
  Speaker 1: which is that in any system where there's periodicity, where
• 48:35
  Speaker 1: there's things that are happening at recurring time points but
• 48:38
  Speaker 1: the periods are slightly different, they will sink over time
• 48:43
  Speaker 1: and dcink over time. So you see this if you're
• 48:45
  Speaker 1: in traffic and you all have your left blinker turned
• 48:48
  Speaker 1: on right and everyone's kind of blinking at slightly different
• 48:51
  Speaker 1: rates because car manufacturers can't get it together. By the way,
• 48:54
  Speaker 1: side note, car manufacturers can we all blink at the
• 48:57
  Speaker 1: same rate. Okay, they all blink at different rates. If
• 49:00
  Speaker 1: you kind of follow it, you'll see that, like they
• 49:02
  Speaker 1: kind of are blinking, and then they'll sort of sync
• 49:04
  Speaker 1: up and you'll feel like, oh, we're all blinking, and
• 49:06
  Speaker 1: that kind of dcincs again. So that's just a phenomenon
• 49:08
  Speaker 1: of periodicity that could also be a play here.
• 49:10
  Speaker 2: Which would totally work here because of course, some people's
• 49:13
  Speaker 2: psycles it's a little bit different cycles. Normal cycles can
• 49:15
  Speaker 2: range from twenty one to thirty five days, so everybody's
• 49:17
  Speaker 2: got a different blinker. That's totally fascinating. You knew a
• 49:20
  Speaker 2: lot more about this than I thought that you would.
• 49:21
  Speaker 4: I will say, I.
• 49:22
  Speaker 1: Want to give you I'm a man for all your renaissance.
• 49:26
  Speaker 2: Your renaissance Maneah. That's that's all there is. All right,
• 49:32
  Speaker 2: that's it for us for today. Stick with us next
• 49:34
  Speaker 2: week and we'll ask what's the deal with microplastics. Wellness
• 49:40
  Speaker 2: Actually is produced in association with iHeartMedia. Our senior producer
• 49:44
  Speaker 2: is Tamar Avisheik. Our executive producer at iHeart is Jennifer Bassett.
• 49:49
  Speaker 2: Our theme music is by Eric Deutsch, and our content
• 49:52
  Speaker 2: is for educational purposes only.
• 49:54
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• 49:56
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• 49:59
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• 50:02
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• 50:05
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• 50:08
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• 50:11
  Speaker 1: leave us a question for our mailbag or suggest a
• 50:13
  Speaker 1: topic for a future show.
• 50:15
  Speaker 4: We'll let the influencers have the last word.
• 50:17
  Speaker 5: They make your eye gollows. Watch what happens to your
• 50:20
  Speaker 5: vision after a week to fourteen days of being in
• 50:22
  Speaker 5: a red light therapy that without eye protection, If you
• 50:24
  Speaker 5: don't have a marked improven in your vision, I'd be
• 50:27
  Speaker 5: very surprised.
• 50:28
  Speaker 4: So what is the negative aspect or why do they
• 50:30
  Speaker 4: tell you to cover your eyes?
• 50:31
  Speaker 3: Well?
• 50:31
  Speaker 5: Because you know, I guess the bright light. If you're
• 50:33
  Speaker 5: staring directly at one in one of those lights and
• 50:35
  Speaker 5: you have some kind of damage to your rods or
• 50:37
  Speaker 5: your cones, or your macula or your retina. I mean,
• 50:39
  Speaker 5: if you had iyepathology, which you would know about, then
• 50:43
  Speaker 5: there might be some some downside consequences